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0004 HALYARD WAY - Health
4 Halyard Way - _- A = 194-084 Centerville s M EAD® NUPC=4 smsad aom 9 Me&In USA U.S. Postal Service,. CERTIFIED MAILT. RECEIPT- (Domestic Mail Only;No Insurance Coverage Provided) ■ For delivery information visit our website at www.usps.como OFFICIAL USE-- ' ;. w PS Form 3800.August 2006 See Reverse for Instructions Certified Wil.Pro^Wdes: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USP%postmark on your Certified Mail receipt Is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. if a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7630-02-000-9047 i 9 °FtT Town of Barnstable q, Barnstable Board of Health snaxsTABLE i63qmass. g 200 Main Street, Hyannis MA 02601 . ♦0 2007 Office: 508-8624644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi March 30, 2010 Mr. & Mrs. Edward Miksis 8 Edmunds Way (BODPW Franklin, MA 02038 Re: 4 Halyard Way, Centerville and Assessors' Map 194, Parcel 084 NOTICE TO ABATE VIOLATION OF THE TOWN OF BARNSTABLE CODE §360-16 AND 20A AND E. The property owned by you located at 4 Halyard Way, Centerville, MA was inspected on March 29, 2010 by Donna Z. Miorandi RS, Health Inspector for the Town of Barnstable because of a complaint. The following violation of the Town of Barnstable On-Site Sewage Disposal Systems Ordinance, §360, was observed: §360-16; Town of Barnstable Code: The septic system is in hydraulic failure. Raw sewage was observed at ground level by the side of the leaching pit flowing toward the abutters' property. You are ordered to correct the above listed violation through the following directives: 1. You are directed to hire a licensed septage hauler to pump the overflowing septic system within twenty-four (24) hours of receipt of this letter. 2. You are also directed to keep the on-site sewage disposal system pumped as many times as necessary (daily if need be) to keep it overflowing onto the ground. 3. You are further directed to contact and hire a professional engineer to determine the cause of failure in respect to the aforementioned system within 14 days.. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in the issuance of non-criminal ticket citations of$100.00 each. Each day's failure to comply with an order of the Board of Health shall constitute a separate violation. Q:order letters/sewage violations/4 Halyard Way,Centerville.doc c� PER ORDER OF THE BOARD OF HEALTH t; Pomas A. McKean Director of Public Health Cc: Copy of Town of Barnstable E-Code Pictures CERTIFIED MAIL: 7008 3230 0002 5177 8384 Q: order letters/sewage violations/4 Halyard Way,Centerville.doc Page 4 of 12 consider if strict interpretation of this regulation would do manifest injustice to the applicant; however, the applicant must demonstrate that the same degree of environmental protection required by this regulation can be achieved by other means. ARTICLE VII Disease-Prevention Regulation [Adopted 5-1-1984, effective 5-3-1984 (Section 7.00 of Part VIII of the 1�991 Codification as updated through 6-1-1996)] § 360-15. Purpose. The purpose of this article is to protect ground-and surface waters from contamination and prevent the spread of disease. § 360-16. Spilling and discharge of sewage prohibited. No sanitary sewage, septage, treated or untreated sewage effluent shall be allowed to discharge or spill onto the surface of the ground or to flow into any gutter, street, roadway, right-of-way, public place or watercourse, nor shall such material discharge onto any private property. ARTICLE VIII Installation of On-Site Sewage Disposal Systems on Marginal Lots [Adopted .12-17-1985, effective 12-22- 1985 (Section 9.00 of Part VIII of the 1991 Codification as updated through 6-1-1996)] § 360-17. Findings. The filling of marginal lands in close proximity to groundwater in order to provide for sufficient area to make it suitable for the installation of a sewage disposal system is not considered an acceptable practice and such lands are considered as not suitable from a sanitary point of view for human habitation and for the protection of groundwater and watercourses. Watercourses are defined in Regulation 15.01, of 310 CMR 15.00, the State Environmental Code, Title 5, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. § 360-18. Restrictions. A. Subsurface sewage disposal systems shall be located in an area where there is at least a four-foot depth of naturally occurring pervious soil below the entire area of the leaching facility and the designated leaching reserve area. This four-foot depth of naturally occurring pervious soil must be above maximum groundwater elevation. B. The maximum groundwater elevation shall be determined by utilizing the formula contained in the United States Department of Interior Geological Survey publication, "Estimating Highest Groundwater Levels for Construction and Land Use Planning dated September 1983, or by observing the height of the groundwater table when it is at its maximum level or elevation. Maximumtgroundwater' determinations shall be made during the wettest season of the year, normally March or April. Allowances shall be made for high water level if the Board of Health permits the determination to be made outside the wettest season. ARTICLE IX Criteria for DeterminingSystem Re Y pair or Replacement [Adopted 6-11-1991, effective 6-11-1991 (Section file://C:\DOCUME-1\miorandd\LOCALS-1\Temp\5WAR2YR3.htm 12/27/2007 O Page 5 of 12 11.00 of Part VIII of the 1991 Codification as updated through 6-1-1996)] § 360-19. Purpose. To protect the public health against potential sources of contamination of the ground- and surface waters in the Town of Barnstable, the Board of Health adopts the following regulation. § 360-20. Criteria. The Board of Health may require the repair or replacement of an on-site sewage disposal system if any of the following apply: A. There is evidence of sewage flow to the surface of the ground. B. There is structural damage to the components of the system which prevent it from functioning as required. C. The bottom of the cesspool or leaching facility is less than four feet from the observed maximum groundwater elevation. D. The system was pumped more than two times in a ninety-day period (excluding maintenance pumping of grease traps). E. There is evidence of breakout. F. There was sewage backup into the house because of a nonfunctioning leaching area. G. The edge of a leaching area is less than 100 feet from a well or less than 50 feet from a watercourse, as defined in 310 CMR 15.00: The State Environmental Code, Title 5: Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. H. The standing liquid level in the leaching facility(ies) is at or above the invert pipe elevation. I. According to current local regulations, the system is not properly sized to accommodate a proposed change in use or expansion of a building or dwelling. J. Any other condition deemed by the Board of Health to require maintenance as defined under 310 CMR 15.02 the State Environmental Code Title V, Section (19). § 360-21. Variance procedures. Variances may be granted only as follows: A. The Board of Health may vary the application of any provisions of this regulation with respect to any particular case when, in its opinion the enforcement thereof would do manifest injustice and the applicant has proved that the same degree of environmental protection required under this article can be achieved without strict application of the particular provision. B. Every request for a variance shall be made in writing and shall state the specific variance requested and the reasons therefor. Any variance granted by the Board of Health shall be in writing. Any denial of a variance shall also be in writing and contain a brief statement of the reasons for the denial. A copy of any variance granted shall be available to the public at all reasonable hours in the office of the Town Clerk or the Board of Health while it is in effect. C. Any variance or other modification authorized to be made by these regulations may be subject to such qualification, revocation, suspension or file://C:\DOCUME-1\miorandd\LOCALS-1\Tem \5W,,, p AR2YR3.htm 12/27/2007 __. ' F"kjl .. ka '?t,^h „ r� gr ^�ta. � {'#�S'1e�ty:i°''d�/X` .*tR-'S'•�'-- '�` T � •3'-, }Ys � .ss`i 4 ,F ° � .., rzili"•r�•Y? .. . a. ar tfi ,e,- , y� ° 9 �._ a x •'Y "i'i , ..e�a6' yt` - yti''�"� h t Y<-,E's+,st `[� rat s"'�'�#ti,d. ^•Ji .fir # aw dy , .'s' �• § x s 1t' ' ft?kz'r•�e ' tS>_ c. asks{; �, 'S„a ;• . ig•a y'^ �„ �: �"�. "� :a; �1���,� `,v+v-.�' .�'�d..�,.:�a;��.�&�-�l l:i,,, �`4n��' ;a�1� �r,�,§4�.i .`'a' Ka:�.�✓"`�'."�y,,..�,'I�.�F"�c.',.'¢� {a #� �� tiF ..,y Y y„� ti,,, tL� _t 'F v� �s �s. 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I` �'� r �,-'- ,,ti``� el .e��R.�`�.'A'^J �7x �S'a'i'^ 1 - 1/ '\ T• �t \ t\ �' /{ I/ �,l €Y �r )�'wf•� �`�' t :�2Z 1 �� � ���} )\' �/J� t (�& �� ��t.8��� � t��� ff!' w►t ` ''- t''`raf'•tl .�. �" \1 '4. yrrr.�l. _`�.Y.y`_`t`w r✓�n¢,u" � `F e � }. = )\ !�, _ ¢,d y 'G,, �' � + `�,1 t`l' Tfi��+S;l� SGM1 1\/�:'. `�r F 5�1� �. .'•iy Y'�`i ) � �•��f i. �\ 6J , �4��d.. � � f tV T N. •,: tr-,` F.F`:ei.�i}-5 c,,`.,.T-_i' 1`,;'•. °/;/ .;4.,�a I 7- N s " TOWN OF BARNSTABLE 1 LOCATION 141 SEWAGE# VILLAGE ekVI E' ASSESSOR'S MAP&PARCEL q -O INSTALLER'S NAME&PHONE NO. f O 9 11 ® .SEPTIC TANK CAPACITY EX%6T0,)J /nD C,.,4-1 P P LEACHING FACILITY:(type),*'� ,5_6D N JPX X��IS (size) 33 05 X g,g 4 NO.OF BEDROOMS OWNER PERMIT DATE: 5" � 0 COMPLIANCE DATE: � � Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY I� �b ,L s . No. .�`''16 l Fee �® THE COMMONWEALTH 6F MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zpplitation for Bigpogar �§pgtem Con tructiou permit Application for a Permit to Construct( ) Repair( y� "Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. L_\ I,A LA, f,;f_Al ea041 0- Owner's Name,Address,and Tel.No. £D AA,'k5,S $ EtJMvAAS Wc,-A NIA Assessor'sMap/Parcel I�l, PelnC�� VI eI - L 1 G IN nn Installer's Name,Address,and Tel.No.-ylb v i1 Ray&n 6 ZJ J , Designer's Name,Address and Tel.No.C3,5s l`,U<A. fwyi A earan 11(43 C_a5�� D-Q-\n.`So A4A J �5� vhk•i75r � 4a,,vwJly, c1`jQ,- z3e�g78 0�- ^� 1-12(0 Type of Building: e Dwelling No.of Bedrooms Lot Size /5,?71 sq. ft. Garbage Grinder (00) Other Type of Building No.of Persons Showers(Z) Cafeteria( ) Other Fixtures Design Flow(min.required) 31P gpd Design flow provided '%L4:3 gpd Plan Date 5 l'7)10 Number of sheets Revision Date Title Size of.Septic Tank C)oC7 Type of S.A.S. L• P Description of Soil 16l4 .S C HO'C L O A M{rAl V✓✓1 SG,o1.. Nature of Repairs or Alterations(Answer when applicable) Ro � a�Q{ dA 11500Grm/.�8.� c�•�. l d.Z4cln c .4- ea H-2 t"Ve 10 4-b 1 Z 1 tS4, s,'-Q ZI t S lJ;'f h 04 , y 1/H.QA 1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by As Board of e h. Signed Date S I k a Application Approved by Date Application Disapproved by: U Date for the following reasons Permit No. �10 l -1 Date Issued S-1e'r 0 , Fee 1 E„w Entered in computer: - THt COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN 010BARNSTABLE, MASSACHUSETTS res application for Miopogal ;i2p terry Conotruction Permit- Application for a Permit to Construct O Repair(f), Upgrade O Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No.(_` ff h,�'k0.o� ��� 4 f✓17eQd�t� Owner's Name,Address,and Tel.No.1% M,'J'StS 'Q)MvAAS wu-{ t Assessor's Map/Parcel 4 p,n c1 y Installer's Name,Address,and Tel.No..)ctSu n,j R0,1y n5 1 04,Zk Designer's Name,Address and Tel.NoQSS a.�1'tk 64y1A Pw,�' �I(e3 Eu54 P-Q-*%A;S, /v►A w Type of Building: J Dwelling No. of Bedrooms Lot Size 1`-27► sq. ft. Garbage Grinder (gyp ) Other Type of Building No.of Persons Showers('Z ) Cafeteria( ) Other Fixtures Design Flow(min.required),required),ogin gpd Design flow provided 'Z L,)'j gpd Plan Date�'���` T Number of sheets Revision Date Title l TL= !1 yn n ` Size of.Septic Tank 1/)nr') Type of S.A.S. 1^ P Description of Soil JQ-it t_ P.a% 7 0,A rA.r'j n ) Sc-i-1 Nature of Repairs or Alterations(Answer when applicable)Q Q fZ!t_L u /r)(:/) C_COI/C✓1 IAI� tl ( � 1 S'(X� an1Jnn L.u4c4.d� Ck& t b AS N Zala,�lt V4LJ - UU 1jV Date last inspected: ` a Agreement: / The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in. accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of ' Compliance has been issued by this Board of Health. Signed ��j / Date /l Q �/D Application Approved by i( / }�j c� Date _� ^l d r Application Disapproved by:y Date for the following reasons Permit No. ,a0 1 G i s of Date Issued - k r y THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of,Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (�) , Upgraded ( ) Abandoned( )byl, at V\ �, � ,� has been constructed in accordance provisions s e P Y �o(0 / dated S�°7 ^(�with the of Title 5 and the for Dis osal System Construction Permit No. Installer _.� Designer e+2 (—.5 #bedrooms ? Approved design flow 3 i() gpd The issuance of • is pe'mit shall not be construed as a guarantee,that the system i' ll fianctibn s_designed. Date �,, �3 1 Inspector //j/AV )Z:::) No. ')C) 15,f"j, . Fee 16 a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS lwigogal �§pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at y d and as'described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this grmit—, R Date - 'J(/ Approved by /A ,`�-� ' i f Town of Barnstable Regulatory Services Q, Thomas F. Geiler,Director KAM = Public Health Division 659. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Sewage Permit# D 15 Assessor's Map/Parcel &ik, &{ 26 f I qL4 Installer&Designer Certification Form Designer: ' Installer: kcrr1%25 "BIS7.Qwq& 1 Address: �_(�.30� \\la`S Address: mcfl S+— rod N,t_s c. A& 02U41 0951 1(04W A ,��a,02Lati On h i e)Ou was issued a permit to install a (date) (i staller) septic system at � � �Iwar� based on a design drawn by (address) ec44 IN 4Q L,& dated 2 (desigt er) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if requi d!W inspected and the soils were found satisfactory. OF k,#4 o� 4 7THOMAS J. G _ McLELLAN m CIVIL (1 stall a ure) 5 9No.36471 o (Designer'sig�nature) (Affix Des tamp Here) PLEASE RETURN TO TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice formsWesignercertification form.doc Town of Barnstable P# 12 10 Department of Health,Safety,and Environmental Services �TIM Public Health Division Date qlxl 367 Main Street,Hyannis MA 02601 BARNFrABr$ tor it rf039. Date Scheduled /(0 Time i Fee Pd. UU Soil Suitability Assessment for Sewage Disposal{ d � �,q Apr ' � �f � Performed By: _T HOMAS M l lain/ I D Witnessed By: /��, �U, J S LOCATION & GENERAL INFORMATION Location Address y� Owner's Name E bv�n Mj K,S) Address ��// Assessor's Map/Parcel: �/1 )�y Engineer's Name THomS M C-L&ILA NEW CONSTRUCTION / REPAIR �- - - - Telephone* 50�" .3.���_3y2� Land Use J 'A `/� Slopes(%) Surface Stones Distances from: Open Water Body "6/IA ft Possible Wet Area VAft Drinking Water Well NA 'ft; Drainage Way R Property Line R Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) S PLAN i Parent material(geologic) y 50 (g g V(f�(l✓1��.� _ _._.Dept}i to Bedrock. Depth to Groundwater: Standing Water in Hole? 1}� _ Weeping from Pif rice-M - Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: !ndex Well lcvei Adj.factor Adj.Groundwater Level PERCOLATION TEST ..Date ']�o _Time_11 Observation Hole to Time at 9" . 3o Depth of Perc Time at 6" Start Pre-soak Time© Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back-j Copy: Applicants - T 1 DEEP OBSERVATION HOLE LOG Hole # ' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % I8-4 A 132 I , (0 . a DEEP OBSERVATION HOLE LOG Hole # 7 Depth from Soil Horizon Soil Texture Soil Color Soil t Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. o'' ; jA LS. . loIti 311 NA 30 (,S " r )o'1ns d IVA 13 Z" DEEP OBSERVATION HOLE LOG Hole # Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. °o Gravel) DEEP OBSERVATION HOLE LOG Hole # Depth from m Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes " Within 500 year boundary No Yes` Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? OM - If not, what is the depth of naturally occurring pervious material? Certification o I certify that on — I (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise an experience described in 310 CMR-15.017. Signature_ I v Dates 17-/y ' �� �iy%���y; F^/<ri�'-� �'+��'4y r tom! A��• 1 �°-lr �. �.'y'.(� �r �'�► Fj�j1;AX j \, C'r�r') �.-� l r '"`,. - A( '^`�` r-,•L�'�.j !J f ice"•r_� �, ��•*,..� 1 . i +�. _L*,''i�r� — �JJ94 till F �„� � as -. -� Ytf � s �-�9.�`'+w"� J� �Y�"Z�,.ftib �'• ' ��'t a.c .� - PS'`'.... .. .• A f�* . b ,r.y, T-'\ ,,,.,•. �• w, .y +`c s� *'fa +��..4//� ''� "" C.p. �.. ..,Tarr-"" �4 1 y "'Ta'f"-� /�./'Ci --7�."q,.��WT�• k°'1-- a S� � A g tp7 �� .' a FF w " i f I a " 1. � !>'- �• '♦ �'.�+ .5-: yrE;. r 14a:� ).` � ;,`v,_ r- Grp i vvtzP 'act er �,RE � �`` t��k+. �'�at r .,^'F�t� �'. •. �a ��l/ i',ai�k awe ���, �¢ L O CATION SEWAGE PERMIT NO. L o 1NSTA LLER'S NAME i ADDRESS B U I L D E R OR OWN ER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED ,�l`i®-� �., a � b` ,�,. �-. y-. ��_ ,�-_ f?o.r,T '� No. FimB THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH Application is hereby made for a Permit to Construct ( &_�®r Repair an Individual Sewage Disposal Seepage Pb Nu--_--.—_ Diameter-_----_ Depth below inlet.--_---__ Tota leaching area_—_-'__�� f� �� ) Dosing Yta � ~~ Percolation Tco Results Performed ' � Test Pit No l per inch Depth of Test ut6 to ground water......... .............. � Test fit No. per inch Depth of Test Depth mground water'__'__-- w ------------------------------ —..._----_.--------.—_ ................................................................................................................................................ � U Nature of Repairs or Alterations--Answer when applicable-__—_-_.---_--_---.--.—'—_.--.-____- � ____—_'-'--- ___--.__--__.---'--__--'—'-------'_____-_ Agreement:� The undersigned agrees to install the ufocedosoribe6 Individual Sewage Disposal System io accordance with the pr -is*ons of'L ',lE not to place the system in oper u er *ficate of Compliance has been issued by the board of �talth. �__ -------' -.r--'----' ----- 8DP «� � l Date Application Disapproved for th ollowing reasons:......................................................................................).......................... Date ------------------------------''''''''''-''—'''-- ..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r1'!i✓y✓..............OF.. /�.! Jas'C-!'..-� �1 Appliration for Diipn,ial Works C> onotrnrtinn ramit Application is hereby made for a Permit to Construct (--I�or Repair ( ) an Individual Sewage Disposal i� �sLocatA-Addre s..__._ ...........(Owner o Lomot No Address 1.4 Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms----.-*:� C................................Expansion Attic'49) Garbage Grinder/(��) aOther—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria Other fixtures ........ W Design Flow.......... ........................gallons per person per day. Total daily flow___: �. •-------__::-- ------gallons. W Septic Tank—Liquid' capacity_._..._...--gallons Length................ Width................ Diameters.............. Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total.leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing to W Percolation Test Results Performed by._.: - .....__V.... :�--� e,( � Test Pit No. 1................minutes per inch Depth of Test Pit_.... ........ Depth to ground water........._.............. f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -•-------•----=--------------- Description of Soil.... __ _--•--_ %''%tr' __. _._.! - � G-�-....... x ---------------------------------••-----•---------------•-••--.........----- UW .................................................................. ••---•-•-• .--••-••---••----•-----------••------------....--••-•----•••--•---••----•-•-•----•-••----------......-•--------.......... Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...--•------•-----••-•-------•-...---•--------••-•----•--------------•---------•-------•.....------------•-----•-•------•--••--------••=--------------------------------------•----•----•--........--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 'the provisions of TITLE] 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of Plealth. Signed__- � _< -� � . �'" 5� Date Application Approved By.......... .. . .._ 1 I') ? I �' i Date .w Application Disapproved for t following reasons:..................................................................................-•----••------• ------------ ---------------------------------------------------------------------------------•-••--- Date PermitNo....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH O F..,_.,. ''r-' / '` ................................. ............................. .......... Tatifiratr ,af Tnmtrfianrr THrIS IrS TO CERTIFY. That the Individual -. ewage Disposal Sy tem constructed ^(---)'or Repaired ( ) y.......... a ._2................................................................ Installer P ----------------------- has been installed in accord cc with the provisions of TIM, 5 of The State Sanitary Code as described in the a. A application-for Dispp5al Works Construction Permit No.... ....... dated..... _`__l $ ................. 4THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUED AS A GUARANTEE THAT THE SYSTkM WILL FUNCTION SATISFACTORY. DATE `' - - 9,I Inspector , ....._.......----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS-rp Sf P'T4, = -FtAIi f pi: l BOARD OF HEALTH '�� 0 3 0 TN .. P9T1 X,c ... O F.... ............... Disposal Work.5 %Tlantrnrtuan Vormit "2 Permission is hereby granted................. to Construct ) orp pair ( ) an Individual Sewa5,e Disposal System,0. at N a ' ----------- ---------at -cam - / Street as shown on the application or Disposal WorkConstruction Permit N ::$ D ed.._... _ ..�.�.� .......... 5 >*' ........................ .. i/�- . ..._..__.........» d o a th DATE $ . -- --.............................................. FORM 1255 A. M. SULKIN, INC., BOSTON .r S///GLE FA/y/G Y ^- 3 BEo�2oorVl 1 _ ►�3.3 A10 45A.2B445E OA/LY FLoW - //.ox 3 - 3.30 G.PO .�A7 ,tom/.S�2S,4L �/T•- SE /400.6,t!/- . ,. . /l3 ���_� f/�0 , ; . . 4r- s.c X B0TTotiIA.eF,,4 o s,� 'r lzz to , .f a T PE'.2GOL4T/a4/.24T�' '�i `D� .,, . r AsER 9c6� .� - -� z . Fi1CHARD . fVAN Att9�33 BAXTER ; i ' t I o4 4 Na 24048 I E a r , t , F /yam /� Y� d C Z EL.LO$ 6.a /.v✓. GAL. l �A-/r.0ir //6- SEPr�G i /c)6:S _ W-/ '.ivy A T.v!vrc jarTa/ice •• l .fTGNE otj '' 709.Z loQ•� G'E,2T/F/EO f'G OT ,oL:4�t/ - Y >of c-. , G: /oo,S� LoG.�T/orsi _ 'AJ TC �✓/ .$GALE /�/�(-,o� � •. �.aT.E 7 cj ..�5- 1 t �- 131Cr 3� pG. ZI / LE,er/.cY 7 4T 7 yV,=- u oA t o►�l SHow.i/ ' E�EO.v COMPLY.S !.v/TX/TyE S/OEit/E B,4XT�,2'.€ ot/YE ,d�v�.SETIAG` .eEQV/�EMENr_S,O� Ti-/� .E'E�.sr�ecl .o�vo.Sv,2yEya�S - TOWiV LOG.aTE.O y1//Thy/y T.�/E �YOa�PG.Q/mot/, � a 7=-9- g S T//!f Boa v /s iVoT I3AfEQ oN.4�V/iY.ST,� _� -//s1EiYr'.fv,2t/�Ys1N0 TyE aF.S �;_ --------------- ' S�K/�yE•���iV s.�oIJGO�aT!iE USED. To F.ST�tdL/.S.y Lar-L.//VE,S N KEY: INGCONTOUR:---- SEPTIC SYSTEM DESIGN SEPTIC SYSTEM SECTION GpQ��4 PROPOSED CONTOUR:............. EXISTING SPOT ELEVATION:25.5 2"PEASTONE FLOW ESTIMATE: Q PROPOSED SPOT ELEVATION:25.5 3 BEDROOMS AT 110 GAL/DAY- 330 GAL/DAY 93.5 COVERS WITHIN 6" 3/4"-1 1/2" tiF OF FINISHED GRAD WASHED STONE TEST HOLE* TOP OF n,,,� UTILITY POLE: p FOUNDATION `' -�=-a f INSPECTION PORT FENCE LINE: SEPTIC TANK: "�"` �� - ;���� ������ ELEV.-87.5 Q HYDRANT: 330 GAL/DAY x 2 DAYS= 660 GAL RETAINING WALL:0 3'MAX. USE 1000 GALLON SEPTIC TANK (EXISTING) E COVER LEACHING AREA: 89.92R (1'MIN) �-LOCUS (EXISTING) ELEV. 89 88 71 USE 3-500 GALLON CHAMBERS(8.5'x 4.8'x 2'EFF. DEPTH)WITH 90.52 ELEV. ELEV. ° 84.5 LOCATION MAP ELEV. D-BOX H H LOT 1 (15,271 SF) ELEV. 2'OF STONE AROUND SIDES AND 4'AT ENDS (33.5'x 8.8'x 2'DEEP) (6"STONE UNDER) 2'-4' 2'-4' ASSESSORS MAP: 194 PARCEL:84 1000 GAL PLAN BOOK:389, PAGE:27 '+8,g)x 2 x 2= 169 SF (0.74)= 25 GAL/DAY' SEPTIC TANK 33.5'x 8.8' SIDE AREA: (33.5 FLOOD ZONE:C 86 5 3-500 GALLON CHAMBERS WITH BOTTOM AREA: 33.5'x 8.8'=295 SF (0.74)=218 GAL/DAY OUTLET PIPE 2'OF STONE AROUND SIDES AND 4' UNDER SLAB TEE SIZES:(TO BE CONFIRMED) ELEV. AT ENDS (33.5'x 8.8'x 2'DEEP) INLET:6"U 13"DOWN TO BE VENTED CAPACITY=343 GAL/DAY OUTLET:6"OP, 14"DOWN GAS BAFFLE ( ) AT OUTLET TEE (H-20) N TH-1 90.0 TH-2 90.0 TEST HOLE LOGS ELEV. ELEV. BED GARAGE � 6" FILL g�� FILL BEDENGINEER: THOMAS McLELLAN,P.E. O/A HORIZON O/A HORIZON LIVING ROOM ROOM LOAMY SAND LOAMY SAND ROOM WITNESS: DAVID STANTON,R.S. 18„ 10YR 3/1 88.5 18" 10YR 3/1 88.5 �LQ DATE: 5-5-10 B HORIZON B HORIZON PERCOLATION RATE: <2 MIN/IN LOAMY SAND LOAMY SAND DININBED 30" 10YR 5/8 87.5 30" 10YR 5/8 87.5 KITCHEN AREA BATH ROOM MEDIUM HORIZON C HORIMEDIUZON BATH SAND 9 2.5Y 7/2 2.5Y 7/2 BENCHMARK AT 132"1 79.0 132"1 79.0 \ MAG NAIL \ ELEVATION=89.93 EXISTING FLOOR PLAN NO GROUND WATER ENCOUNTERED 94 \\ /,,- EDGE OF PqV NOTES Stone all 90 1.VERTICAL DATUM: ASSUMED q 96 ,100 10p 33, 2. MUNICAPAL WATER IS AVAILABLE. ��� PAVED 3.SCHEDULE 40-4"PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. 0 ,6 �. DRIVE \ 92� \ 4.ALL PRECAST UNITS SUBJECT TO TRAFFIC LOADS TO CONFORM WITH AASHTO H-20 SPECIFICATIONS. 98 1 \ N 1 \ 5. PIPE PITCH= 1/4" PER FOOT(UNLESS NOTED OTHERWISE). \ N�`r 6. FIRST 2'OF PIPE OUT OF D-BOX TO BE SET LEVEL. 1� rn 88 7.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE USE OF A GARBAGE DISPOSAL. 8.ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE STATE OF MASS. ENVIRONMENTAL o _ CODE(TITLE FIVE)AND LOCAL HEALTH REGULATIONS. 0 II PROPOSED 40 MIL POLY LINER cV W v I (44'x T DEEP) 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR TO CONSTRUCTION. TOP OF LINER=87.0 100 BOTTOM ELEVATION=84.0 10. FIELD SURVEY PROVIDED BY TERRY A.WARNER, P.L.S., HARWICH, MA. 11.THIS PLAN REQUIRES THE REVIEW AND APPROVAL OF ONE OR MORE TOWN DEPARTMENTS AND / 10 F GARAGE th-1 86 IS SUBJECT TO CHANGE UNTIL SUCH TIME. ( ; � � EXISTING �? ) 12. EXISTING LEACH PIT IS TO BE PUMPED AND FILLED WITH SAND OR REMOVED. �n 3 BEDROOM O DWELLING it13. D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. top fnd.= 100.99 Jm top fnd 96.34 Q 14.VENT PIPE TO BE ADDED TO PROPOSED LEACH AREA TO ALLOW NORTH WEST CORNER .= Q� J basement floor=93.5 ST th-2 TO BE 5'-6'DEEP,(SOUTH EAST CORNER 3'DEEP). 100 10' _/ � � \ C / DECK i// / { %LPG/� \ 84 SITE PLAN 84 9e o f�a l - 98 kn 7---- '1 ` \`` � LOCATION: 4 HALYARD WAY, CENTERVILLE, MA 86 a THv'AAS1 PREPARED FOR: ss s McLELLAN f 94 CIVIL EDWARD MIKSIS 92 0 ,pNo.3o471�a " _ DATE:5-17-10 SCALE: V=20' 4 N 8 °34'40 173,79`"W Stockade Fence 90 88 � � /SZE� BENCHMARK AT - E8,3044 EL ELEVATION S 89°46'11"W N=93.06 ONOTUBE 559 -4 �t BASS RIVER ENGINEERING THOMAS J. McLELLAN, P.E. P.O. BOX 1163, EAST DENNIS,MA 02641 M10-15 508-385-3426