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Home My WebLink About0012 JUSTICE DOUGLAS WAY - Health I 12 Justice Douglas Way Centerville -- -- A= 191 — 190 N . . �GU7 / 1 ' tJQ0.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Mid onl *pgtem Cow5truction fgrmtt Application for a Permit to Construct( ) Repair(X) Upgrade( ) Abandon( ) 91complete System ❑Individual Components Location Address or Lot No. Owner's Name Address,and Tel.No. 7 71 —1 21 1 12 Justice Douglas Way Anita dranetz AssessorsMap/Parce1191 /19 0 Centerville 12 Justice Douglas Way Centervillp Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4-0 8 9 4 Wm E Robinson ,Sr Septic Eco-Tech PO Box 1089., Centerville 1 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 5 Lot Size sq.ft. Garbage.Grinder PO) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 5�w gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 septic system to plans of Eco-Tech, #ETE-2752 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 this Board of aIt Signed 't Date/a- 9, Application Approved by Date �U—g—U-� Application Disapproved by: Date for the following reasons Permit No. IOU-7— y,)7 Date Issued No. . (/U 7 $1 10.0 0 / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION = TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYication for Oil�loml *pgtem Construction Permit Application for a Permit to Construct( Repair O Upgrade O Abandon( [ Complete System ❑Individual Components Location Address or Lot No. Owner's Name Address,and Tel.No. 7 71-1 21 1 12 Justice Douglas Way Anita �renetz Assessor's Map/Parcel 191 /190 Centerville 12 . Justice Douglas Way i Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4-0 8 9 4 Wm E RobinsonsSr Septic Eco—Tech I PO Box 1089. Centerville 143 Triangle Cir, Sandithh Type of Building: Dwelling No.of Bedrooms 5 Lot Size sq. ft. Garbage Grinder (no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 septic system to plans of Eco-Tech, #ETE-2752 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 this Board of al /& - 9, w Signed I C.. Date Application Approved by14- Date /[;- - u -7 Application Disapproved by: J Date for the following reasons " Permit No. 2 Uo-7- L/5-y Date Issued /o y A- -----------------—————— ————-—————— -———THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Dranetz certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by Wm E Robinson Sr Septic at 12 Justice Douglas Way, Centerville has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2011 L/ dated Installer Designer #bedrooms ,> Approved design flow TS 0 gpd The issuance of this permit shall of be construed as a guarantee that the ssem" m will f ction a ddesigned. Date /0 1��Q __! Inspec}ors ------------------------------------- No. 0:7 9 $fQ0.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Dranetz &5po!6ar �&p5tem Con0truction Permit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at 12 Justice Douglas Way, Centerville 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 p . Date (° / Approved by - ��f Town of Barnstable Regulatory Services Thomas F. Geiler,Director URNSTABLE MAW Public Health Division i659' ,0� - ''�Fc+ °i Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-79M304. Installer&Designer Certification Form y .Date: Sewage Permit# �� Assessor's Map\Parcel Designer: Eco-Tech Installer: Wm E Robinson Sr Septic Address: _ 43 Triangle Circle Address: PO Box 1089 Sandwich Centerville Wm E Robinson .sr septa issued a permit to install a (date) (installer). 12 Justice Douglas Way Cente septic system at g Y► 1iXsleAk .a design drawn by (address) Eco-Tech dated 09-28-07 (designer) 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:. 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"septid'system)but-iti accordance with-State&Local Regulations. Plan revision or'- certified as-built by designer to follow. t10F Mq�9 .. ey AV D D. G-4 (Installers Signature) COUGMANOWRCn No: 1093 tSTEVL SgNITAR�P�. (Designer's Signature)- (Affix Designer's Stamp Here) PLEASE :.::RETURN:`TO ::BARNSTABLE' PUBLIC-: HEALTH - DRISION. CERIMCATE OF .. COMPLIANCE '%ML NOT.:.BE ISSUED.UNTIL BOTH THIS -FORM AND AS-BUILT .CARD ARE RECEIVED.BY.THE BARNSTABLE-PUBLIC-HEALTH DIVISION.-THANK YOU. ::Q:Health%Septic/Designei Certification Forrh 346-04d6c.. TOWN OF BARNSTABLE LOCATION F SEWAGE# aZ00)"ySt{ VILLAGE ASSESSOR'S MAP&PARCEL I!q J 1rJ0 INSTALLERS NAME&PHONE NO. 2G6tri 500 SEPTIC TANK CAPACITY ISO O LEACHING FACILITY:(type) /}c(�t°�y 6AI-1Qny(size) 42,V. i 3 X Z NO.OF BEDROOMS 5' OWNER f0f 114 C7R19W 1�-7 PERMIT DATE: 0 COMPLIANCE DATE: J�h", 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 ► ®//4713 0 2., Glo y or ' 3 L 0 r 0 , . 2- a � CO 3 SG` far r -'Town of Barnstable P# Department of Regulatory Services Public Health Division Date 7, Z� rasp. 200 MF Street,Hyannis MA 02601 Date Scheduled Time Fee Pd. . r -Soil Suitability Assessment for Sewage Disposal i - C � T. r C�S c ff Performed By: �1Gi,V:"�l. � ��'�!�` � � Witnessed By �� v�� . � n`1�� LOCATION&GENERAL INFORMATION Location Address 1-2_ JV 5y',� � 5 t Owner's Name A�►�° �- r tle�z. � r✓� ��. T Address 12-3 U i c� �0u5 r, y -- - - - - Gt'ur�Prv_ll� Assessor's Map/Parcel: v` �t(a Engineer's Name N V,i *� : NEW CONSTRUCTION t REPAIR Telephone# go-K 76v+ Land Use «-C:_e7 l&611 iGC Slopes(%) 0 Surface Stones Distances from: Open Water Body S V+ ft Possible Wet Area (`}6+ ft Drinking Water Well 06 t ft Drainage Way 0 ft Property Line = ft Other s ft } i r ,: r-„ SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to hole�.c) , co - GROUNDWATER ADJUSTMENT- EXISTING f EXISTING GROUNDWATER LEVEL �\ BASED ON TOWN OF BARNSTABLE i GS / GIS DEPARTMENT RECORDS. zi, INDICATED GW 34.00 ; INDEX WELL SDW-252 �O C \ ♦ ZONE D . READING DATE AUGUST. 2007 READING 47.4 ADJUSTMENT 3.6 ADJUSTED GW 37.6 Parent material(geologic) ! Depth to Bedrock Depth to Groundwater Standing Water in Hole: a Weeping from Pit Facet e Estimated Seasonal High Groundwater Sew e� ,i41 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: SeU_* G,100 V r-_ Depth Observed standing in obs.hole: ___._in, Depth to soil mottles: In. Depth to weeping from side of obs.hole: in. Glroundwater Adjustment ft. Index Well# Reading Date: Index Well level_.� Ae, AdI,factor Adj.Groundwater Level nrLr PERCOLATION TEST ngtp 1*o7 Tim, 2?1 Y) LIL Observation � 9 Hole# // Time at 9�� _.Y.___.� It Depth of Perc U 6 l hh Time at 6" ) Start Pre-soak Time @ S 7 _ 'lime(9"•6") f1 End Pre-soak io Rate Min./Inch 2 rnQ i Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division ,, '."s Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\.SEPT[C\PERCFORM.DOC Oy TEST L DATE OF TEST: SEPTEMBER 26 2007 t G SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DAVID STANTON, HEALTH DEPT. PERC NUMBER: 11960 TEST PIT 1 NO GROUNDWATER ENCOUNTERED PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 66 1n - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA_ SOIL SOIL COLOR SOIL OTHER 1 (INCHES) HORIZON TEXTURE 51.45 (MUNSELLI MOTTLING -4 O WOOD LOAM 10 YR 3/3 NONE FRIABLE t 4-6 E _ LOAMY SAND 10 YR 3/1 NONE FRIABLE 6-10 A SANDY LOAM 10 YR 4/4 NONE FRIABLE 48.28 10-38 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 1 38-82 CI LOAMY MED SAND 10 YR 6/4 NONE 82-138 C2 LOOSE 39.95 MEDUIM SAND 10 YR 5/4 NONE LOOSE NO GROUNDWATER ENCOUNTERED TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 80 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTHj1ZLO USDA SOIL SOIL COLOR SOIL OTHER 51.30 (INCHES) TEXTURE (MUNSELL) . . MOTTLING 0-4 WOOD LOAM 10 YR 3/3 NONE FRIABLE 4-7 LOAMY SAND 10 YR 4/1 NONE FRIABLE Z-11 SANDY LOAM10 YR 4/4 NONE FRIABLE 48.30 11-36 , LOAMY SAND 10 YR 5/6 NONE FRIABLE 36-66 LOAMY MED SAND 10 YR 6/4 NONE68-126 EDUIM SAND LOOSE 40.80 10 YR 5/4 NONE LOOSE DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stoues;Boulders, nsi to Flood Insurance Rate Mao• 1 Above 500 year flood boundary No_ Yes_.V____,/ Within 500 year boundary No , /, - un L Yes UlJ j Within 100 year flood boundary No Z Yes Depth of Naturaliv OccurAn 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? eS If not,what is the depth of naturally occurring pervious material? L .= Certification -I certi �� L l fy that on -5 (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 w'the required training, �ttrainin(gg,,expertise and experience described in 310 CUR 15.017. �tN OF^ASS cy Si nature W �/ �E # 9 g Date SPPf 2��6� ��° DAVID �m o D. . COUGHANOWR Q:\SEPTICVERCFORM.DOC `r0 C E N S- i� FVAL11P�0 L OCI E PERMIT 1JO. VILLAGE '. INST R IJO E ADDRESS BUILDE 5 W & E. It" ADDRESS DATE PERMIT ISSUED - - - - - - - DATE COMPLI /NICE ISSUED : 2 r No -82.. 14 LN Fizs..........•00........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........:....T.ow.n................O F.........Ba=ata 13.a=atable....................................................... Appliration for Dhgpoii al lVorkii Tnntrurtion rnmit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: .....026OZ............................................................................................ . Location-Address or Lot No. 12..juetce_.D o? s.waX�..Centerv-ille,-- ...._02632 Owner Address W A & B Cese ��,__,5egie................................................. 12$..Bishops_Terrae,__Hyannis,___MA_ 02601 ,-� Installer Address d Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms....................3.. .___.Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ---------------------_-.-. No. of persons............................ Showers ( ) — Cafeteria ( ) w Other fixtures ---------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ 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 tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-___________.__--_____. (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.:--.-_____----.--.-__-. •---=---••------------------------------••------......-•---•------..........----•-•-•----•----.......----...............................------....--•--.•-•-. Descriptionof Soil..Sand--------------------•-•---•-----•-•------..............----••--•------•--------------------------.....----------- x w UNature of Repairs or Alterations—Answer when applicable------installa------ of.a__1000_gallon_pxe-cast, stone..packed__lea.ch_•,pit__with_extra__stene___�sverflow�___________ __ __ __ _ __ . . . . . . ----------------------------------- 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 bard health. 7 .Signed, = rj J 31 1•/82 Application Approved By.... .., �. J..... e ::.... 31 �182-•------ Date Application Disapproved for the following reasons:................................................................................................................ ---------------------•-------•---.........---•--------------......---------------•--....---•-----------••----------------..--------------------------------...---------------.......................... Date PermitNo..........82- ..................................... Issued............. 1 ................................. Date Fim$$....5,00........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH F. T.own..... _ F.......-I3ainstable------------••....................................................... Appliration for Disposal Works Tonstrurtiun "truth Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 1 ,�uat�e•i ° t a �A drer ervtile�;.. , ------e26¢2----------------------------------------- - .......................................... or Lot No. Ckarles.-menu................ ---------------------------------------------- 12..JusUce..DLougl,as..1lla rr-Cente ille*..N1I�.....02632 Owner Ad ress A.-&..H.�Cess�ol_Se race................................................. 128-.�iahaps._�e�raace.---Hyannis,--&...02601........ Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms................... ......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons_......_�......__....._.. Showers ( ) — Cafeteria ( ) t(lOther fixtures . -•--"-••------------------------------------------------- ............................ .............. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area. ................... ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) W Percolation Test Results Performed by----•--•-••--•-----••...................••--•-----•------•--..........--- Date........................................ Test Pit No. 1_______________minutes per inch Depth of Test Pit.................... Depth to ground water........................ f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... a ...............................................--•-••.............................•••....---.-•------•-•----••----•-.......-•-•-....---•••---._....---....•. O Description of Soil.Pi ................. U --------••-•-•--••••......-•-----•--•-••----••......------•..............•--•------••----............---.._.:. -----------------------------------••-•--•--•-•------------•---...........-•------•-•-•. ----------------------------------------------------•-------------------------------------••--------••... U Nature of Repairs or Alterations—Answer when applicable PP licable_--_.in8-tallatim.-.of..a,_.1000.gall-on.pmneast_, at-one'.packed..leaah_pit..Wi#.h..exhra..stone..(Qyex-lnw.)-=--------------------------•-•-----•--------••-••--------•-••----....---•-------- 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 �bbeeen.issued by the b and of health. Signed_ti:6 C�G'a -•�---------, .......3/1$�82. Date Application Approved By._. .......................... lB•82 Date Application Disapproved for the following reasons:-----•-------------•-----------•--••------------------••------•---------•------•----.-••--------------•...... .....-•••-•---••••••...............•--•-....---------•----•-•-------•--••-•------•----....---•------•••••---------------------•-----•••-----•--------------•--------•------------...................... DatePermit No.........82-........................................ Issued............31- --1 2 ............................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................Tom.............O F........Barn&ta li e.................................................. Tntifirate of Tnntpliattrr. THIS IS TO CERTIFY, That the Individual Sewage Disposal S stem constructed ( ) or Repaired (x ) by A_& B Cesspool Service._128_Bishops- Terrace, Hyann _M 02601 .................•-•--..........------•........_----•- at_.12 Justice Douglas Way, Centerville, �n talle62632 - Charles Dranetz ------•---•-------•----------•---------------•-••--•--------- has been installed in accordance with the provisions of T TLE 5 of The State Sanitary Code as es c * d in the application for Disposal Works Construction Permit No.....2-/Z:_L'................... dated_---------..._3 - -_..___.----.------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION,;,SATISFACTORY. DATE_..3/``...82. - --------------- Inspector......, !/ -------•------••-------------------------------•------••--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L`L.. Town OF......Barnstable ..................•............. No82-................. FED$ 5,00 ......... Disposal Works Tnntrnrtion rrnti# Permission is hereby granted..... ._&..B..Cesspool Service ---... to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at No...12 Justice Douglas a ,� Cen+,erville _1�A 02�iz - Charles Dranetz ------------------------------•-•------••--•-------•-----•-•----.............••. Street as shown on the application for Disposal Works Construction Permit No82............... Dated •' ! Datd.._.......__.....3�lA/82 , - - --------- ------------•----------------- DATE. 3/$/82 B50K,6f Health -------------- •.....•---•......--•--•......---------•..........FORM 1255 HOBBS & WARREN. INC., PUBLISHERS y` L4CAT10 SEWAGE PERMIT NO. ti VILLAGE INS A LLER'S NAME & ADDRESS SUILDER OR QANER DATE PERMIT ISSUED �� DAT E COMPLIANCE ISSUED 3�� e^n r Ott A- Ida) 94 I 7-r7 N 6 i O �vEw LOC-ATIVO 1-N-ST-ALt=E-R�S-►J-�,1�/-1-E—�-A-D-DR-E-S-S 8 U t-L;.-D-E—R 5 iJ D 1J►TE—P—E—R-t�/�1�T 1 SSU E-D '—��a d��__ - �--I c��%� �, P . ..,. �< . .. _. . ��- - �� ' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OR HEALTH >...... -OF._... `7 .?... .................. Appliratinn -for Biipagat Vork,6 Cnow4rurtion 1hruti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ?SS steLit, J . =�A�;W�,rs -------- ---------------- .......................--....... o -----------------------....----------------------- roc ion- Lot Owner •---•--•.................. ..........................................-....................................................... Addre. W Y 1/L!4!Y.�.... ........... .............••.... .... ._ _.. Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms------------------_---_•___-_.----____-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons..._------------------------ Showers ( ) — Cafeteria ( ) w Other fixtures ------------------------------ -... W Design Flow------------—S-D.....................gallons per person per day. Total daily flow------- ____-_--.-..--.-.-gallons. WSeptic Tank—Liquid capacity/0,11'0-gallons Length---------------- Width................ Diameter---------------- Depth................ x Disposal Trench—No. .._. Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..1 .41, "` Diameter.................... Depth below inlet.................... Total leaching area....-.-._-.--___--sq. it. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by------- -----------------------------------------------------•......•---- Date---------------------------------------- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--------................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--------------------- , -----•---------------------------------------------------------------------------------------------------- O Description of Soil X V ....._...-•------------------------------•------..............--•.....--•-•-••--••--------------...-----•-•--------•-•-----------...... •-••--•--•--------.......---------------- ----------------- W V 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 Article XI of the State Sanitary Code—The undersigned f rther agrees not to place the system in operation until a Certificate of Compliance has been issued by th erd of alth. i ned ` 7 g Dat Application Approved BY `� � � �. ---- ---- � 7 Daty/ a Application Disapproved for the following reasons-------------------------------------- -------------------=-----------------------------------•---------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- // Date Permit No. Issued.., f �7 -•-•--••---- Date No..... -..... FEE............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ;HEALTH _.. ... .......-----OF....... .? l,.! r. � ..� ........ , pplirtt#inn -for Uitivoiitt1 Works Towitrur#ion Prrinit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --------------------------- ------------------- -•-------.... -------_-••••--------•--••••••.._...-•••-•-•••-... f.oca4ion-Address --•or.Lot-3V- .i W_�^�` 4 3'-' ------' -----?....::!.......... ......•.......--•-•----•••_ .......•..._..._...__..._......_....•.. ._____•_•____•___•___•_•___.._....._.__.................... ,Wa •... --- =�.. _ ..... _ >�%'..._= ,....- ........... ............. 1"� -----------------------•---------- Installer Address Type of Building Size Lot............................Sq. feet -. Dwelling—No. of Bedrooms________________ ,?----------------------Expansion Attic ( ) Garbage Grinder ( ) Pam-, Other—Type of Building ___________________________• No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Pa Other fixtures ------------------------------ - w Design Flow............ ..U_-__.._.....__.gallons per person per day. Total daily flow......._., ._............--.-gallons. WSeptic T•tnk—Liquid capacity-��-_-__-_gallons Length---------------- Width---------------- Diameter---------------- Depth.-..-..---_-__. x Disposal Trench—No _. _+ "2.__ Width.............._..__ Total Length---_---__-_-..__--._ Total leaching area_.--.-----_--__-__sq. ft. Seepage Pit No.. 1* -_-_ Diameter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY-------------............................................................ Date............-..------------------------ ,� Test Pit No. 1................minutes per inch Depth of "Pest Pit................;... Depth to ground water..-.-__-_---------.-_--. 44 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 - --- ----- -- DDescription of Soil - �{_ .. -----••--------------------------------- •....._...--------.......-- -------------•---•-••------ U w U 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 Article XI 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 h alth. `fit igned............•---------�------------------------------------------------------------- --- `-- Date t Application Approved BY _= � 0'� ----- --�-- 7; ( Datsl Application Disapproved for the following reasons:...... ............................ _.._........_................._..............................._._. -----------------•--..............••--••---•-----......---------•-----•-•-•-------•------•-••-----•-............-•--••---•------- --------------------------•---•---------------•---------------•-------- Date a Permit No.. Issued..�j_. v. _7< :..----••......•...... Dale THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAL ...............OF...... ! .,.i w17.. .. w,rdifirtttr of Tomptiaurr TH SST RTIF/ ,jThat the Individual Sewage Disposal System constructed ) or Repaired ( ) Insta . ............................ l e • iZ has been installed in accordance with the provisions of Article YX of T e State S� tart' Code as de ribed in the application for Disposal Works Construction Permit No............ .6__ ............. dated.��.s�.(��s 7.�i._...___... THE ISSUANCE OF THIS CERTIFECATE SHALL NOT BE CONSTRUED AS A GdJARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.-- Inspector= ----- Inspector---- �� %" c� y V" THE COMMONWEALTH OF MASSACHUSETTS . - BOARD HEALTH _f ....... ... .........OF......................... 4...........•---- j No.../J ..... FEE.... ........... �i� tt g T #rur#i,aat Prrmif Permission i flereby grant,0 ----•30__? ---------=------------------ --------------•----------------- ......----- to Construe ) or e ir�) an In ua age Di o. ] Syste y� at No.'s'_9q 4qR.. -......---- -{.-- -•----•------- °.: Street el as shown on the application for Disposal orks Construction Pe o. _ __ __ __ ated__ `....... �. -7- 7 Board of•Health DATE-------......... ......................................... 4 FORM 125 5 HOBBS & WARREN. INC.. PUBLISHERS ?y i l "^,--�? c w� 1 � . B y (ffj ,� r) �� a� ��, ...-�� ., ��_,�,� , �'. .,�� :, �,_ �� CONTOURS E z <o DISTANCES ST GARBAGE GRINDER �cF EXISTING -� � EXIS o MINIMAL GRADING PROPOSED TO LEACHING GALLERY IS NOT ALLOWED o so WITH THIS DESIGN. 7J LOCUS ALL DISTANCES ARE IN DECIMAL BENCH MARK �^FEET NOT IN FEET AND'INCHES. C 5 L EGEND PAINT SPOT ON ,0500G�P op SCALE BULKHEAD CORNER p 3 O WP �z f EXISTING 3 5 ELEVATION = 53.00 z N ozw leas GALLON 2 o �u J ,, �„ m SEPTIC TANK 1 BARNSTABLE GIS DATUM ��/� m o c, a- A O m J C�7 mm n, 1500 GAL L ON `� B C �i r ` CENTERVILLE. MA �1 SEPTIC TANK ® B 1 20.5 13.4 29.6 ��/ i, 2 25.6 15.1 30.5 LOCUS MAP W d< .:: J EXISTING C 3 34.4 20.0 32.4 /��/® \'aa NOT TO SCALE m Q • 4 35.4 11.3 19.8 �� ♦ ,� z LEACH PIT O v U•• ,:•.:,_.,rir p 5 ti�6.8 52.2 49.9 / F F rtiitt.}?rr• N Of W J a '?':'r:k'r,.':'• v UJ 3 TEST PIT® D-BOX ❑ 41.5 f t x 12.83 f't x 2 f t 00 two " ' w No �� O P ♦ LEACHING GALLERY w ❑o DECIDUOUS CONIFEROUS ( 51 ��/ ~az _u zz UU)J z 3 Ir WO TREE 0jq TREE O \ Q(n <W UX /I: W w z � d��12-M 12-P / C7�b 12-0 wu J W Ill} U > p �C9 -NUMBER REFERS TO DIAMETER IN G,3 {� F' O ZJ(L �� Q J X 0 INCHES. LETTER DENOTES TYPE. 50 190- Q CD z (L❑ W w x O-OAK M-MAPLE P-PINE C-CEDAR }I� 8-M W W ❑ m E _j r lr 0 49 / i / UpOoo W 2 ❑ Z< v;. lJ W i� / ,. 12-0 {7 tj 12-0 J V < = m r:r;: w 48 ;•:;:a::•r;x \\ J W v •.,"•.,:;:iir: /ice / �� \ CD LL Z 0 J X �LL w '�Z O m `�� LOT 4 '° �� ; ❑ W v lfl °w°z W cn v o AREA = 15037 Li T u w z �� q-� X ow FCDc-n �p \� \ x �� -� c� l \ NOTES (ne Uz / \ o U = W`" �T \ / 52 EXISTING LEACH PITS ARE TO BE PUMPED. e o ~ m m `� \ �a� \ f VA COLLAPSED AND REMOVED OR FILLED. > 3 zz '9L / \ / \ / EXCAVATE ALL ASSOCIATED CONTAMINATED W Z p = �`\ \ \ / i SOILS IN VICINITY OF PROPOSED LEACHING WO F z~ m 3� �� GALLERY AND REPLACE WITH CLEAN MEDIUM W� cn o 3 `` � 4 \ / \ SAND PER TITLE 5. (n Ir m N \ \ V� \ i \ /�/ / A W > m m �� \ / P' �3m? EXISTING 1000 GALLON SEPTIC TANK IS TO GA 3 J U m \ ` �( �\ \ /�J� /�P / BE PUMPED AND REMOVED. INSTALL NEW e W W ` \ \ Oft 1500 GALLON SEPTIC TANK. < O \ W � w Q \ \ / / / e SEWAGE DISPOSAL SYSTEM PLAN z w cn ZO z \ ` QP 5Z �,�® ��j. -TO SERVE EXISTING DWELLING � � Cr) hH 3 QQ m ~ \ 2�S9ff — A 33.9 �t -- % EST. ANITA D. DRANETZ d 0 C710 z < 49 50 151 OWNER OF RECORD O Z o _j o U \\ GATE \ �` 12 JUSTICE DOUGLAS WAY ry O li m c.n f— �_ / zNOFAMgss ZHOFaias 1995 CENTERVILLE. MA LL Z + U�jw o`'� DRUID 9CyG p��' S9cti /�®N�A�� PROPERTY ADDRESS Z m m PLAN co D' C, 0 D D. 43 TRIANGLE CIRCLEASSESSORs MAP 191 PARCEL Ig�' I U C No.HANO R COUGHANOWR SANDWICH MA 02563 PLAN BOOK 272 PAGE 5B O o w SCALE: 1 In = 20 f t �F �o s �� o 506 364-0894 DATE: SEPTEMBER 28. 2007 0- w X �° 20 0 20 40 sq 'S T ESN O�� F E N su Pip JOB *E T E-2 T 5 2 PAGE I OF 2 VERSION: ff w THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM 0 10 20p�'QvnbP 2�' r�,�O� DEPICTED HEREON. FOR ANY OTHER CHANGES-TO PROPERTY INCLUDING � L4J PLACEMENT OF ADDITIONS, SHEDS, FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. 1 K *DATE V TEST: SEPTEMBER 26. 200'� D E S ICALCULATIONS SOIL TEST LOG WIITINESSEDUBY:DC DAVID SDTANOTON. HEDALTH DEFT. G N PERC NUMBER: 11960 DESIGN FLOW: 5 BEDROOMS X 110 GPD = 550 GPD NO GROUNDWATER ENCOUNTERED OUTWASH SEPTIC. TANK: 550 GPD X 2 DAYS = 1100 GALLONS TEST PIT INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PERC AT 66 in - 2 MIN/INCH IN C SOILS DISTRIBUTION BOX: USE 3 OUTLET D-BOX. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOIL ABSORBTION SYSTEM: A 41.5 Ft x 12.63 ft x 2 FL LEACHING GALLERY CAN LEACH 51.45 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING A6ot = ( 41.5 x 12.83 ) = 532.85 sf 0-4 O WOOD LOAM 10 YR 3/3 NONE FRIABLE A s d w = ( 41.5 + 41.5 + 12.63 + 12.83 l x 2 = 217.32 sf ALct. = 749.77 sf 4-6 E LOAMY SAND 10 YR 3/1 NONE FRIABLE Vtt 0.74 x 749.77 = 554.B3 GPD 6-10 A SANDY LOAM 10 YR 4/4 NONE FRIABLE USE A 41.5 Ft. x 12.83 Ft. x 2 Ft. GALLERY. Vt = 554.83 GPD > 550 GPD REOUIRED 10-38 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 48.28 38-82 Cl LOAMY MED SAND 10 YR 6/4 NONE LOOSE 82-138 C2 MEDUIM SAND 10 YR 5/4 NONE LOOSE 39.95 L EA CHING GA L L ER Y TEST PIT 2 NO GROUNDWATER ENCOUNTERED USE SHOREY PRECAST 500 GALLON NOT TO PARENT MATERIAL: PROGLACIAL OUTWASH LEACHING DRYWELL (H-10 LOADING) SCALE 1500 GALLON SEPTIC TANK PERC AT 60 in - 2 MIN/INCH IN C SOILS DIMENSIONS AND DETAIL NOT TO ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER CONSTRUCTION DETAIL USE SHOREY ST-1500-H-10 SCALE (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 51.30 DRYWELL UNIT STON 7 0-4 O WOOD LOAM 10 YR 3/3 NONE FRIABLE 1 In 4-7 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 41.5 f t TAPER Q 7-11 A SANDY LOAM 10 YR 4/4 NONE FRIABLE 48.30 11-36 B LOAMY SAND 10 YR 5/6 NONE FRIABLE m �p �O O� Q4 m �0 5 Ft- m 36-68 Cl LOAMY MED SAND 10 YR 6/4 NONE LOOSE N m-, N o 8 in 68-126 C2 MEDUIM SAND 10 YR 5/4 NONE LOOSE 40.60 4 ft e.5 Ft 4 f't 6.5 Ft 11 4 FE 8.5 Ft 4 ft 41.5 f t g �� GROUNDWATER ADJUSTMENT 10 EXISTING GROUNDWATER LEVEL 500 GALLON DRYWELL BASED ON TOWN OF BARNSTABLE DIMENSIONS AND DETAIL GIS DEPARTMENT RECORDS. INLET CENTER OUTLET USE H-10 L"IT INSTALL ONE INSPECTION END 'COVER END INDICATED GW 34.00 RISER TO WITHIN THREE INCHES OF FINAL GRADE a• •..a.......zu.0.z :.0.; ..au'AF2ia.. A INDEX WELL SDW-252 3 IN DROP ZONE D AND INDICATE LOCATION �( FLOW LINE ON AS-BUILT PLAN ---► --► READING DATE AUGUST. 2007 FR pI 10 ,, - 14 TO READING 47.4 ADJUSTMENT 3.8 ,n D-Box ADJUSTED GW 37.8 33 , LIQIn UID GAS LEVEL BAFFLE NOTES c�Op��Op��O� In . moo moo 00 D INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. o0 0 5g i� 18z l� - 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS CROSS SECTION VIEW OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. - . _�, CROSS SECTION VIEW SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED:OR REMOVED. 2 in PEASTONE 2 in PEASTONE 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST- .IN PLACE. o o -TO SERVE EXISTING DWELLING 71 ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION� OF' .)LOW .FLOW-FIXTURES 28 314u,ro EFFECTIVE To Zs ANITP� D. DRANITZ AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC` T•ANK.�- - In -v2,,,cyzAVEL DEPTH 1-1u+�� to 8) ,SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADIN.G:'`DO NOT 12 JUSTICE DOUGLAS WAY CENTERVILLE, MA PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. '* . � ` '- , ' 48 in 58 In 48 In EEO-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL- AND TRUE TO GRAD E''ON A LEVEL 154 in STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. FABRIC IN PLACE OF THE 2 ,n. PEASTONE LAYER SPECIFIED. ETE-27521 SEPTEMBER 26, 20071 1 212