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Home My WebLink About0041 KEEL WAY - Health (3) 41 KEEL WAY, CENTERVILLE -- A=247-170 r ,r No.-............. ....... Fiza.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z TOWN OF BARNSTABLE Appliratiun for Biupuuul Works Toutitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (.�an Individual Sewage Disposal System at: ZLocation- ld, 1 or Lot No. ....NIA�J G2 C L_.,d ��- Is �7 Owner Address --•-•- _-----------------------•-•-------------------••--••----•--••---.......---••-•. 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 ( ) a' Other fixtures ................ .............. . . W Design Flow................./Z_Q.................gallons per person per day. Total daily flow........2.2.6......................gallons. WSeptic Tank—Liquid capacity) gallons Length---------------- Width................ Diameter---------------- Depth_............. Wi x Disposal Trench—No. ......j----------- dth_.__f0_...X Total Length_�7._?.5�. Total leaching area_336._�'''P'sq. ft. Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (A ) Dosing tank ( ) a Percolation Test Results Performed by.___�:_._. �.��. .......................... d -6_9 Date-- -------------------------•------- ,� Test Pit No. 1___L -.__-minutes per inch Depth of Test Pit....t3 a`I__. Depth to ground water...NQ______________ (%, Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ C4 .---....--••.............................................•------._......._-•-----••------------•-•--......................................................... 0 Description of Soil......................... U -•----•---------•---•---•-••-------•--•••- ------------------------------------------ ---------------------------------------•------------------ W x ....................................................--------------------------------------------------------------------------------------------------------------------------------------------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issued by the board of health. Signed ..--- ----- -- --------------------------------------------- f --- :.>n ..... ... Date Application,Approved By "� ``~` C . .............. / ... Date Application Disapproved for the following reafonr: ... ......................... ..........�.. ��•.•-........ ... --------- --- ...---- -.....------- ..--------- ....---------------------- ...------------...........y------. ............ .................... I v 7 e l ! Z 7— � Dare PermitNo. ............................ ------------------- Issued .................................................................... Date TOWN OF BARNSTABLE C t� LOCATION `7 ��r`�'L lti'AM SEWAGE VILLAGE � -�-°?.��+I� _ ASSESSOR'S MAP & LOT 4 y 7• 70 INSTALLER'S NAME&PHONE NO. �L rJ Out V3a'C%s 3 SEPTIC TANK CAPACITY LEACHING FACILITY: (size) NO.OF BEDROOMS BUILDER OR OWNER 06 ---64e— Lya 01, PERMITDATE: _COMPLIANCE DATE: Separation Distance Between the: ��- Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 'S 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 aching Facility(If any wetlands exist within 300 feet o g fac ) r/ d'y Feet. Furnished by 0 0 THE CON ONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cgextifirate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( '�) by a......��....................................... ....................... ..............---------*............ --------.----. .. .......................... L has been installed in accordance wit the provisions of TITLE 5 of The State Environmental,Code as described in the application for Disposal Works Construction Permit No. ......................................... dated ............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...........................�.. ,...'._ - —------------------............. Inspector ... .......... ... .. ........................................... r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......� ... TOWN OF BARNSTABLE ....... FEE..............!......... Disposal Work,5 Tons#rudwit "Prrutit Permission is hereby granted..........G v �------- ---•---•-- ............................... to Construct ( ) or Repair (/) an Individual Sewage Disposal System atNo....�.I.....-j o --.... ......---•. ............:............. Street ��_��! as shown on the application for Disposal Works Construction P rmit No....... . ........ Dated.._. _........... .. .�. � �- �2 ................. �� Board of Health DATE................................................................................ FORM 36508 HOBBS B WARREN,INC.,PUBLISHERS i 1 No..... .7 ".� ' Fps.........5 .THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z TOWN OF BARNSTABLE Appliration for Di-lipm3a1 Works Tomitriirtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (/ an Individual Sewage Disposal System at: ........7.../- ' ............. `-Z................................. --•---...-----------------•---•----------... .......................................... Location-Address or Lot No. /�A... .. C 1............................................-e _ nr l Owner Address Installer Address Type of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms......--2--------------------------------Expansion Attic ( ) Garbage Grinder (A/P aOther—Type of Building ............................ No. of persons..............--------..---- Showers ( ) — Cafeteria Otherfixtures .-----•-----------------------------------------------.....---..........----------------................----•-•----•---............................... W Design Flow................./L 0.................gallons per person per day. Total daily flow......... ......................gallons. Septic Tank—Liquid capacity* )gallons Length................ Width. f--.. Diameter--.......---.... Depth....... ...... W Disposal Trench—No. ......1........... Width..../QtSl Total Length. Total leaching area..3Z~ P'sq. ft. Seepage Pit No-------------_----- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (A ) Dosing tank ( ) aPercolation Test Results Performed by----`h....... ! ! .1�...:.................................... Date..�.d...............95;-............ Test Pit No. I...A-_3-....minutes per inch Depth of Test P ..... Depth to ground water...P.0............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit...---.............. Depth to ground water........................ W •--•••-•-•••---•------------•••••--•-•-.....----•••••-••••-••-....•••-••........•-•---......._•--•.................•••......-•-...-••••-................••... 0 Description of Soil...................... .......-••.•.... --• ---------•-------------------------•------------•------------------••---------------------•--------- Vs\ - '`P-�__r...../�11J .........--------------------------------- -------------•----------------------...--- ....._... W U Nature of Repairs or Alterations—Answer when applicable...............................--............................................................... .................................----•---............----...........---------................•••-••••- -------------- ................................ Agreement: w The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has�pen issued by the board of health. , Signed ..... .�V....�L.:.. �. ...` ./� ... ........ Dace Application,Approved By . ... ... .......... .. . ........................ ....t_jg..:.. . ........................................ ' ........................................................ Dace Application Disapproved for the following reasons: . ............................................................................................................!................... ....................'.)...Q.....................---.......................................---.................................................................. ........................................ \ ( / O / Permit No. ..................F—.....'............................................. Issued .. /Z— J_19 � Dare ........................... .............. ................... Dace I, DEEP OBSERVATION HOLE LOGS " LOCUS: DEEP OBSERVATION HOLE_ #1 DEPTH FROM SOIL SOIL SOIL COLOR I SOIL wESr TOP OF D.O.H. 1 +7o5 SURFACE in. HORIZON TEXTURE (MUNSELL) MOTTLING OTHER s 1 Mp/N 10 IF- „_ a L, 1Q Lv� R 1 Ai?, �Vv 36.0s „ u rn�ta I —L�r �� S,L, ;A4rY �n�tht BOTTOM OF PERC AT.5-1"-Cog" TIME: 1:00 A-M �\ locus L.5, _�,OAMwf RATE: < Z-MjN,/Ir1"h DATE: IQ/(a/98 G.W.E 0 NONE PERFORMED BY. RICHARD JUDD WITNESSED 8 Y:-- .DUNNING TEST"4t P DEEP OBSERVATION HOLE 112 DEPTH FROM SOIL SOIL SOIL COLOR SOIL TOP OF D.O.H. 1 ! TEXTURE MUNSELL T7 -7570 - 1-78 BOTTOM OF PERC AT.• TIME: RATE: DATE: G.W.E PERFORMED BY.- RICHARD JUDD WITNESSED BY. DESIGN DATA: - 1. REQUIRED FLOW: 3 BEDROOMS X 110 GPD/B.R. _ 10 GPD 2. SEPTIC TANK CAPACITY: 330 GPD X 2 = (e- GPD --- m USE (1) 150f) GAL. VA-10 SEPTIC TANK � J. LEACH FACILITY DESIGN: 11�L9 I C46A0) for �Dy 10 i SIDE AREA:_. ,-Z_C_IO,a t z7+75 )X X 4r79 qa1,/S.fR i BOTTOM AREA: _._10,83'Xz7,75' Xi, $oja1,/5,f,_ TOTAL .} `*; Cgeso) Pscaeosep 15oa4a-. °'`� _ 33 g,5 8 _ c ro.q;'� Sr-V Trc. TA11K... �C 'GPD PROVIDED > 33 p GPD REQUIRED 'i RESERVE-AREA = 1009e LEACH CAPACITY USE� 1NFil-TICATAit_MAXtL�1lZ ( 5... !,l/ `TCrtIL. .`�1.i7 .,14"'^i �S�nN'.� kyDlj_......_._._... O (OK e4l.)AQ ESTIMATED HIGH GROUNDWATER CALCULATION NA R (USGS/CCC METHOD) �, �i EXrST. 3 B • J. T,Q F C4s•oa � �• (�� A , D L P.%5 T,� <7r1.EL INDEX WELL: it—ZONE. 0 $ ,; C-; PvSr a -FUI.r GEt-L RIB DATE OF READING: DEPTH TO GROUNDWATER: 77 GROUNDWATER LEVEL ADJUSTMENT: 0 75 } Exrsrr�tG ACTUAL GROUNDWATER LEVEL 0 SITE: EL= �lgl1K.{ KIIRC/V BuORCf{L� ESTIMATED (MAX) HIGH GROUNDWATER LEVEL: EL= 11 7?, �, I �t O ^'►7, a,c J GENERAL NOTES. 7. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN i-F; ACCORDANCE /TIT E 5 OF THE SANITARY CODE & ANY i APPLICABLE REGULATIONS. 2. FRIOR TO BACKFILLING THE INSTALLATION, 774E SANITARIAN - - _• - - 1-T -`�' �" & HEALTH AGENT SHALL BE NOTIFIED FOR INSPECTION. 3. ANY ALTERATIONS TO THIS DESIGN MUST BE APPROVED BY 1L_C 01*1E71.I�Q1 tiSf�l b 4. SYSTEM IS NOT DESIGNED FORA GARBAGE GRINDER. FtS^c� UqR '' `� --YA��D DRIVE z_.. THE SANITARIAN & BOARD OF HEALTH, IN WRITING. L ►1. WAA_ 5. THE INTALLER 1S TO VERIFY THE LOCATION(S) OF UTILITES, CESSPOOL(S) AND SEWER INVERTS PRIOR TO CONSTRUCTION. - 6. ALL UNSUITABLE MATERIAL WITHIN 5 FT. IN ALL DIRECTIONS �ERDAMAKY, ?FL.50,W,'.-(A55uME'p) .KE5MVE- ao FROM THE SOIL ABSORPTION SYSTEM SHALL BE REMOVED &" N. REPLACED W/CLEAN, COARSE SAND. _OF_w oop. ?F-.r ._.:. . ... :_ ...,.._ . U a0' 7. ALL FILL MATERIAL UTILIZED FOR THE SOIL ABSORPTION SYSTEM SHALL BE CLEAN, COARSE SAND FREE FROM DELETERIOUS MATERIAL AND SHALL HAVE A PERCOLATION RATE , OF LESS THAN 2 MIN./1N. BEFORE & AFTER PLACEMENT. �,IN OF 8. EXISTING CESSPOOL(S) TO BE PUMPED AND BACKFILLED PER �aQ OF ��°�� RICHARD�cyG� TITLE 5 ABANDONMENT PROCEDURES. P��N 1 S 9. DURING INSTALLATION, THE CONTRACTOR IS RESPONSIBLE TO �� MICHAEL � � JUDO. R. En PROVIDE A SAFE EXCAVATION AREA. S• 10. GROUND COVER OVER SEPTIC SYSTEM COMPONENTS SHALL o LADUE {' 9N0.1125 O NOT EXCEED 36". LD No.3,560 018TE 11. ALL GRAVITY SEWER PIPE SHALL BE 4" DIA. SCH 40 PVC (1/0,�;.o.L� �a \�,�0^ a s'�NITARI�N UNLESS OTHERWISE NOTED. THE MINIMUM SLOPE OF 4" DIA. o. SCH 40 PVC SHALL NOT BE LESS THAT 0.01 FT/FT. Rv• ��Ci(d c - !�f 111g8 12. WHEREVER SEPTIC LINES CROSS WATER SERVICE LINES OR WHEN WATER SERVICE LINES COME WITHIN 10' OF THE PROPOSED S.A.S. - PIPES SHALL BE CLASS 150 PRESSURE PIPE & SHOULD BE PRESSURE TESTED TO ASSURE WATER TIGHTNESS. COORDINATE WITH LOCAL WATER DEPARTMENT. - - - Rich and Judd, R.S. T.O. FDN. — NOTE - RAISE ALL COVERS TO LEAC'A CHAMBERS 775 Freemon's Way WITHIN 6" OF FINISHED GRADE Brewster, MA 02631 EL. ,} ,�,` DESIG"' LOADING H 20 (508) 896-9316 9" MIN. 9" MIN. 36" MAX 36" MAX. LEGEND., TITLE: SEpT/G �' cE P� J ��.yvgyl J/JI , H10 OUTLET PIPE TO ! q g- BE LEVEL FOR 2 FT. MIN. 0 0 ------+�----- EXISTING CONTOURS 1A7 PROPOSED CONTOURS OWNER: 7 �•4445 �.— WATER ZA 3F-L.A-1000 o GAS UNDERGROUND UTILITIES REVISIONS: el 05 AL. GAS BAFFLE No STONE TCEG,u�REt7 vNprcR•cKAMPjEfCS .' • OVER DIG - 1ia(1 +P-87 TEST HOLE OSEPTIC TANK TO BE INSTALLED ON A LEVEL STABLE MAP: Z q 7 PARCEL: /7o BASE 6" CRUSHED STONE REQUIRED DATE: 'f SCALE. PROPOSED SEPTIC SYSTEM — PROFILE . NOT TO SCALE — DWG NO..