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HomeMy WebLinkAbout0021 PEEP TOAD ROAD - Health 21 Peep Toad Road Centerville A= 173 - 066 _S ME A D_..I No. H163OR UPC 10259 smead.com • Made in USA �.��o& O f.; LO•CATIION l SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME & ADDRESS B UILDE R OR OWNER G AA1- oRf to �2e,i,06 v i C/el DA T E PEERMIT ISSUED DAT E COMPLIANCE ISSUED �_ .��/v j,� � i �� ��� TOWN OF BARNSTABLE LOCATION -*- �2 Za,a/ R1W SEWAGE# 07007"00�0 VILLAGE C-1>,'//C ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY /S O oy LEACHING FACILITY:(type) (size) 3 3 X /y NO.OF BEDROOMS OWNER A/,,y4 Ila PERMIT DATE: 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 �r l f F rrr^ 3 . FEE l No. � � / COMMONWEALTH OF MASSACHUSETTS 14 "` Board of Health,��mW 51p•1�3 &MA. APPLICATION FOR DISPOSAL SYSTPM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) - ❑Complete System 0 Individual Components e- 7&04`ems Location p 9 er=9-Pi�tie 19,4 lfV Map/Parcel# t,-& Address II.Pa 141fl� Lot# P Telephone# O�� h/,7�_ys�js '44- Owdt Designer's Nan EPFIE°`'J. DOYLE AND ASSOCUTE Address Address 42 CANTERBURY LANE a� fc� To4./ R.I. L-v� �%? FAST FALMOUTH.MASSAC US Telephone# Telephone# 508/540-2534 Type of Building P Lot Size 51Dsq.ft. e lin -No.of Bedrooms Garbage grinder ( ) t er-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) �7 0 gpd Calculated design flow ''5Q Design flow provided gpd Plan: Date I—L P47 Number of sheets Revision Date Title `�o-t�t�.� �iJ�7"�2� V" K'A'&I Description of Soil(s) elEL,A-s-y Soil Evaluator Form No. q Name of Soil Evaluator 15 " yew Date of Evaluation is✓ DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree n t to place the system' operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date I" .3- 0 5 -07 Inspections `�.ti• N• DO�k-'DOCJ FEE 0 COMMONWEALTH Of MASSACIIUSET1TS Board of Health, V7,:t �;��f3/a��,;MA. "` F APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT a Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components Location Z,, T��_rfv A Ownep=s-N- a a Map/Parcel# 9 1 -7Zpbi Address /.�2� �S Lot# ` 1P Telephone# Designer's NamSTEP)-IEN.1. 13O I i_ Address Tvp� Address EASTF 42 CANTER13URY LANE Telephone# Telephone# 508/540-2534 Type of Building Lot Size sq.,ft. Cweill g)-No.of Bedrooms_ t ar rf,+!,r✓ Garbage grinder( ) Oilier-Type of Building ..� No.of persons Showers ( ),Cafeteria( ) t Other Fixtures Design Flow(min.required) -27 Q gpd Calculated design flow Design flow provided gpd Plan: Date 1 v(IP Number of sheets 1 Revision Date Title Description of Soil(s) '�,,_�e���. �t 1,�, L.•F ,t [� Soil Evaluator Form No. C/ _ Name of Soil Evaluator Date of Evaluation w DESCRIPTION OF REPAIRS OR ALTERATIONS M 1 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree e not to place the system' operation until a Certificate of Compliance has been issued by the Board of Health. Signed 1�r2�i>� C �s Date 3' O Inspections bbv No. a _ FEE �V COMMONW LT14 OF MASSACHUSETTS Board of Health, Jar/ 5 r +,/c, , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (v),Abandoned ( ) by: Alf //V at n IL?,� : 4C',d tr V.it e has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 2-00 7-00(p dated 1 7 . Approved Design Flow 3 30 (gpd) Installer n T K-. Ati Designer: Inspector: L.610 . Date: .4-- / 7/f.1/ w_ � o The issuance of this permit shall not be construed as a guarantee that the system will function as designed. FEE i COMMONWEALTH OF MASSACHUSETTS Board of Health, 13,�r In 5/-/" 1 fe , Na. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is herebyranted to; Construct g ( ) `Repair( ) Upgrade(-) Abandon( ) an individual sewage disposal system at �' raa r�� � r� as described in the application for Disposal System Construction Permit No. �007-a 0'6 dated Provided: Construction shall be completed within three years of the date of this permit. All lod conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ( -5-67 Board of Health v SJ i � � x I r ^ � r r 1 S ir0 ti� c»i/'j ca d - S E I I - ! I - -- I u06-e- 'v I : I , I I ; c!�rr s I ' 14 I oe- I : I ' I I j I I i ! I �Ali ff I I r0 - I , , i i 1 I I t , I I I I I ' I I I � � - - - I _ I � I I i 1 i ! P e I i I I � I I , , I I I i I i I I i j j I 3( C.((Or I i i I I : i I i L. L.1,14 .ra o f. �3 /son ; � ��w✓JIr4'f; �+ I I i I � , i i AK JI!)�n I _ if �r I g0-VIO �XS i I AA- ----1--1 --i L I - - - � I i All 01 Al- tip - 1�4ii ► - � L I - --t ., 4 R.. !! i Ov + JL i i - -1�_ -- ---- ---- -- -- - _.- j AL- a - Town of:Barnstable Regulatory Services Thomas F. Geiler,Director ■AMSTABM MASS Public Health Division 4639. ♦0 rEp " Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:_508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: m-u-cl Sewage Permit# %A2o -vo Assessor's Map\Parcel Designer: Installer: Address: F 42 CANTERBURY LANE J. DUYLL AND L�Ti '�IC TO . SJTR�C� EAST FAWG T-H MAG 2 n rw errs VA 02536 Address: -ck ap -VAG 508/540-2534 Mamstons us, R7A 02648 On egl - e AAi,eL-,) was issued a permit to install a (date) (installer) septic system at Si ��,���'��n,;� ` � based on a design drawn by (address) dated i-Z - ze-D[., design ) I ertify 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 re ug_ired) was inspected and the soils were found satisfactory. `1 of Ar tfs�9�t ®,,A A AAA / � CHRISTINE Cs\ ®®��(N Or I iFS34�®® ' i s �~ CyFAIRNENY ERFv ( aInstaller's Signs No. 926 (Al STEPHEN Gas C ® " pOYLE SANITAR�P`� c� =37- Desi er e( gn 's gnatu ) (Affix Designers Stamp H PLEASE RETURN 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. Q:\Septic\Designer Certification Form Rev 03-09-06.doc lime Town of Barnstable Department of Regulatory Services MMWSTANA AF Public Health DivisionNAM Hate t679. 200 Main street,Hyannis MA 02601 �p MKt Date Scheduled � �v Time /01 Fee Pd. Soill Suitability Assessment for Sewage Di osal Performed By: ✓ . I 1 Witnessed By: _ Q Location Address LOCATION& GENERAL INFORMATION hVl t o ct,Ar�,:l.@•l� Owner's Name 1 /ie Address Assessor's Map/Parcel: 7 3 !o Pt 110 / ��aP Tv r �� / ��� Engineer's Name c /f�v�n. NEW CONSTRUCTION REPAIR Telephone# Q� Land Use'�l(, t:::- 7 Slopes(%) Surface Stones Distances from: Open Water Body I ft Possible Wet Area-1 g Drinking Water Well Drainage Way�j 4 9 Property Line '7�_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) U� `N � �5 Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: i Ze, CD Weeping from Pit Face q. Estimated Seasonal High Oroundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: / 77 Depth Observed s nding in obs.hole: 1•T in. Depth to soil mottles: In;.e; Depth to weeping from side of obs.hole: 40 i Oroundwate AdJustttlent ft jl� Index Well# Reading Date: i t-01. Index Well level Adj.�etorrn Adj.droundwate:bevel Z� PERCOLATION TEST note r t xhtte.l�,;1 Observation Hole# �_ 7 71me at 9" Depth of Pere Time at 6" Start Pre-soak Time @ :t7C I Z'_W(.� Time(9"-611) End Pre-soak I Z Rate Min./Inch L Z } Site Suitability Assessment: Site Passed�� Sitc Pailed: Additional Testing Needed(Y/N) . Original:Public Health Division 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:%SEPTICVERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil er Surface(in.) (USDA) , (Munsell) Mottling (Structure,Stones,Boulders. i to vel (owl y�l b DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil they Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o s' 3 er LIZ �. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color. Soil then Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConQstency.%G C) 0 `-emu-1 vgl�- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Co o._ S L 1 Flood Insurance Rate Map: Above 500 year flood boundary No— yes—Z Within 500 year boundary No--V—/ Yes ' Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi s material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pery ous material? Certification I certify that on '7 1 (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,experti a and�experie�ncedes�cribedin 310 CMR 15.017. Signature Date 191 ''''b • Q:\SEPTjC%PERCFORM.DOC L O CAT ION SEWAGE PERMIT NO. VILLAGE c- INSTA LLER.'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED ,Z�- �h DATE COMPLIANCE ISSUED �/ / d� �, �i pL P No � FEs... ® .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEAL�H ..............oF....... . .............................. Appliration for Dispasal Iforks Tumitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (7,1'an Individual Sewage Disposal System at* ..... ... .._...11� G�'�.......�r /. � .......................................... ..••••--•-------------•----------............. Lo ati n- or 11de�,� Lot No.............................................. .............................................. Address - -•-------------f Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '404 Other—T e of Building No. of persons............................ Showers — Cafeteria aOther 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ((X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 4- Descriptionof Soil-----------. �. --------------------------------••-------•--------------------------...----------- x U ---•••••------------------•-----------------------------------.....•---------------...........------.....----------------------------------------------------------------------------------'-----...---- x ----••-------------------------------------------------------------------------------------------------------•------------------ ------------------------------------------------ U Nature of Repairs or Alterations—Answer when applicable.....__. __G-.__....:.1� .................................................. -----------------------------------------------•-----•----•---•----•----------•----.....---............----...---------------------...-----....-----------------------•------------------------'-...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'ssued by th boar of healt . Signed. --------- 4...... . .�� ate OA Application Approved By........ .....- .....!..J.. ....................................•- . � - /--- Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------•-••--•---- -----------------------------•------------•----------------------------------------._............._..-••-------------......------------------•------------------------- ............................... Date PermitNo......................................................... Issued....................................................... Date N .-'! Fres..:........?..........`.......... t t4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH .....OF...... ............................... Appliratilan for Dispngttl iVorkii Toustrnr#ilan rrmi# Application is hereby made for .a Permit to Construct ( ) or Repair (A,'r an Individual Sewage Disposal System at* A........ ...------ --•-• -------••-•-•--•--•-------------- ....- ------ F } gcat'og, Address or Lot No. s : �� ------•••-•-•-----.....-•-----------•-.....--•-------------------------•-------.........__...-- tIt �7;rd ra s �, Address a ...........................'-�r-••---. r r:�1/i.. °......_.'._.....' -'r:`r......_...:' r..........................................••--•--...._.._..._......__..._.._................_..__. Installer Address UType of Building, Size Lot............................Sq. feet Dwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa-I Other—Type of Building ____________________________ No. of persons...................._------- Showers ( ) — Cafeteria ( ) a � - Other fixtures -----•-------------------------•---•-------------------------------------•------------- -----------------------------------•--....--•--.._:..._..:__. WDesign 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................... 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------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ x -- ............ O Description of Soil............. —! =_ %¢tea '' x 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 T IIL LE 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 boar of health / ............................ _ .. ? 0e, Date Application Approved By °� Application Disapproved for the following reasons:--------- •-----••••----------•---------------------------•--.-.---------...---.......................... ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued_........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................................... Trrtif iratr ,af Tampliatta THIS I�ITO RTIFY, #at the Individual, ewage Disposal System constructed ( ) or Repaired y ,,,rr. �- has been installed in accordance with the provisions of TITIF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit .......... dated---Z-1 eTEE ,____________________ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARA THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD O-F HEALTH • "'ram-�— e .e �✓` �j � {er/� ,/erg /"/ r Y �� N �`..� .... ..... .................. F.......... .•-••--•. ...._.... -_._..-- --•-•...._........_......... �.'.--...` - . �.... FEE. Permission is hereby granted_____._ ,<v............................. ..................... ... .._._.__ ° ...............................•-•--- to Construct ( ) Repair (..4,a.n Individual Sewage Disposa ystetu at N0, _ ° ` Street Construction Permit I'�dy Z/_1277_____ Dated__ ,/_;a �c___________________ as shown on the application for Disposal Works Co r PP P )1 Board of Health DATE..............................................-•---........ ..---- FORM 1255 A. M. SULKIN, INC., BOSTON _ -� �. s- No................_........ ( FEs....l..................... THE COMMONWEALTH OF MASSACHUSETTS # 't BOARD OF ;HEALTH ...........j-a.12.A.... .........OF........... TA ApplirFatiuri for Dispuual Works 6witrurtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: k-�dl.................... .------...............-- ............p ......��?, °D......... 1 // Location-Add or Lot No. D [7....Q- -a.a.�C� C �s.f��.lx��?c�t i..Qla�....Za.. Owner Address a1 C-----•.....A .na v .....---•...............•----••....------------ .............------------------------------------------------------------------------------------- Installer Address UType of Buildings Size Lot...!CJ.r ......Sq. feet Dwelling—No. of Bedrooms............3...........................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ...-----------------------------------••--------------------••--••-•-----• ---------------•--•--•----•---•--------------•--....................---- d W Design Flow.............�.15..............ss.�,�.,,..��..._.gallons per person per day. Total !aily ow................. ................gallons. WSeptic Tank—Liquid capacitykjCV--gallons Length_B_-(P.__.. Width_ `Q..... Diameter________________ Depth.AA.5!_T x Disposal Trench—No. .................... Width...... Total Length___.........._l.... Total leaching area....................sq. ft. Seepage Pit No........... ......... Diameter........ a....... Depth below inlet.................... Total leaching area..% ....sq. ft. - ZOther Distribution box (�,) Dosing tank ( ) Percolation Test Results Performed P•.(S:..... Date... , Test Pit No. 1................minutes per inch Depth of Test Pit.._......'L.......... Depth to ground water...... j ------- Test Pit No. 2.....2......minutes per inch Depth of Test Pit........12�._._.. Depth to ground water------Alt........... Q+' -- ............................................o------------•-•------------•-- ----------------------------------- Description of Soil---©-�,'--•......... ... '...4� i1.a........•.......Z i4-----.M .... . W U ---•---------- •----------------------------- ------- ------------------------------- ----------------------------------------- •-------- •................................................................... W VNature 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 TITI.L 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 health o Date Application Approved B Date Application Disapproved for the following reasons:................................................................................................................ .................................•••--•----....•---•---------•--------•------............-•-•----------••-••--------•--------•-----. ---------••-•---•---•---•-•------------ ................. Date PermitNo......................................................--- Issued....................................................... Date 4__ i6 7f 7f A Nd......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ..... .14...........---...OF......:.. A a AOU_ ............... ­.......................................................... Applir'atiou for, Dispaual Works Tomitrartion ramit Application-,is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............ma c!a...... ...... ...aso........... .......................................... .. ........... ................ Location-Address or Lot No. ....................4—------------------------ ---------------------------------------------- .................................................................................................. Owner Address ......... . ........... Installer Address Type of Buildi Size Lot...... ........:.:........Sq.� feet U Dwelling�f No. of Bedrooms.............3...........................Expansion Attic Garbage Grinder ( ) P4 Other—Type of Building ------------------------_- No. of persons....................._____.. Showers Cafeteria ( ) P4Other fixtures.. ................................................................................................................................................ Design Flow............55............ ---------gallons per person per day. Total daily flow................,;*-o _ W __.____.__.____.gallons. 1:4 Septic Tank—Liquid capacityIOM.�gallons Length,_Q._4!_!,L"... Width.4!1fLCr_. Diameter................ Depth.*_. ' .'j-" Disposal Trench—No..................... Width...._............... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._......_I........... Diameter.......4:;mt....... Depth below inlet.......j6m...... Total leaching area.'Zawm.....sq. f t. Z Other Distribution box Dosing tank .............................. Performed by.,4E�& YY'rl -)Dot"" P'C_ late....'�Z'Percolation Test Results . ..AT?�!4A. ............................................ Test Pit No. I.....04, --------Mi i uttes per inch Depth of Test Pit......W........... Depth to ground water.....J!Z2............. Test Pit No. 2....1.......minutes per inch Depth of Test Pit.......12 ....... Depth to ground water-----Ii!........... P1i...... . .. . ................................................................................................................................. ---- ---- --P .... qA... .................. ......&tex�...... ------------------------------------ �4 Description o f Soil--- Lo U ....................I.................................................................................................................................................................................. ............... ........................................................................................................................................................................................ U Nature Repairs or Alterations—Answer when applicable............................................................................................... ...........m............................................................................................................................................................................................. Agreement.: The undersigned agrees.jo,install the aforedescribed Individual Sewage Disposal System i6 accordance with the provisions of TITTLE 5'of the State Sahitary Code—The undersigned further agrees not to place the system in opie,faiion until a Certifica4 of Compliance has been issued by the board of health. S' ned. .......................................................... .......................... Date Application Approved By..... ... ..... �.................................... ----- t ---------- ri Application Disapproved for the following reasons:...................1 Dae .............................................................................................. ....................................................................................................................................................................................................... Date PermitNo........................ .......................... Issued............................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ............OF...... ........................... Tntifiratr of Tautphattrit THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by!t.................................................... ---------?------------------------------------------------------- .. ............................................................. Installer ar.. "'o..... - ... .............................................----------- has been installed in accordance with the ovisions of T 5 of The State Sanitary,Code.as described in the application for Disposal Works Construction Permit NOCT.-Iflego................. dated- .................... THE ISSdXNCE-OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM. WILL FUNCTION SATISFACTORY. DATE.—. /1/2.. 29......... .................... Inspector....0 ----............................ ------------I— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... OF.......A .................. o _JV.............................. N ........................ Rojivind Works Tomitudwitt Opirrutit Permission ission is hereby granted-------...............................................................................I..................................................... to ons, 41—) Mair an Indivi al Sewag Disposal S t C truct or R y:7, /..... at N ca., treet as shown on the application for Disposal Works Construction Per it N -------------------- Datedp,..,�_jfi•_27................. 0 ................. "k'4afdo 71� DATE-.-- ....................... ......................................... FORM 1255 Hci�BBS & WARREN. INC.. PUBLISHERS 3p�� b G•pi7. � - - ir7O /e • 4-9 r2 6.P.D. i7 U USA t O C70 r=A L.. i t x !G I sUcv-/AL.L AV-aA = t� S.P. 4-1. 3 icy SF 2.S 3 1S G.P.r). SKA �. 3 _ .!" dir t., t .o = 5o s.PD. TOTAL -C;,ESIGW =.425 G.pa• - 'TOT4 t_ 1:;)4.1 L-( FLOkc_! = 33D 6.PU. '` J ' d fLGbl_eT10cJ czeTE ���1U 2�4t►tJ o2l>:<F,. f �llc w I 10 ,. . GAI Q. tr;jr �O�a Tor 1'wo s toa.o 4. r...c•. s G"P.PE .•Y luv.� �7� s (ooc� luv •s1 � Epox g7� Sepric IWV. TIA W Ic (000 1G3 iNv. 1uv .tLsAr. , N 96.E A PIT '• WAIW61D /o� t,,,d•o+ I CSQTt7-1aiD Plzo�-1 L_� CAL (I+_¢p A.T!✓ 12 r r ^vp-4 ( GcrzTtl`-,{ TF4A-r Tt4G �vuN raTtati! 5taaw>.1 -A R F'GR.1_�.1GE. %4ZA!Go" GC- 4APLYG WITK TI-►� �jID�.L1E-1� + ( 'V 46jr-> SETt3AGK ;'cQUtCEAAE: tTS OP THE REG15'cc_IZ�v 1.A4.tG 5Ua`v�Yo�K TI-115 QLAW I s ►-IOT eA►SElD V" AN OSTeV-V%t_LG o MASS, ' Jy1-:'JAAE-kJ7 �jUt:�/t;*( T+aG- CaFG'S�T�i ,1�Gwl�D A4?Pt_IG/S.h.IT • ..r ;;c-: u�;cc.-� rc, ncrceM�Nc:; t..,o`c" t_1I��s . � t-,, F TOP OF FOUNDATION 65 98' °� � S -y ' �� ��� �1 Vi 3/4" - 1-1/2" Double Washed Crushed Stone 2" of 1/8" - 1/2" Peastane o o cb o�0 0 o p p o�Q,�o p p o00 $°p 0 ca o0 0 Finish Grade 0 62 6 f Fiirislr Grade de El BZ 6 000 0000 p0O pO o O p °°° �O �O p » 6„ EL= 62.6t' o°° p 'D o° o° pppo°O °oa,INV BO.51' 20Dia. JFiSLfi' 2lJ'Dia. ° 0 ° $� °O o0 00 00 00 2" of 1/8 - 1/2" Peastone El 59,61' 4' MAX. 6' MAX. 4' MAX_TOTAL FIELD WIDTH = 14' 0oa oo q op ca EL. 5&61' EFFECTIVE FIELD DEPTH = s"a 0 0 °0 00iQ" bfin. 14' 6tirr. INI� r9F INVERT ao 0 a INV EL INV EL EL= 59.11' ° 3/4" - 1-1/2" Double Washed5984' --\Below Flow Lure �--- 59.4 °�°°°�°°° °oo° 00o Crushed Stone °o°°0 0 og° o° °o o°$0oQ 59.59 °° Goo Liquid Level 46" 8 00 0 o0 0 °o�° °� o EI 58,4 4' DISTRIBUTION BOX TOTAL FIELD LENGTH" 33' No. of Fields o USGS GROUND WATER ADJUSTMENT 1500 GALLON SEPTIC TANK No. of Distribution Lines Each Field 2 INDEX WELL SDW 252 d- ZONE "B" Length of Distribution Lines 32.5 51.0' r ADJUSTMENT = 2.0' ADJUSTED HIGH GROUND WATER = EL. 53.44' ADJ. HIGH GROUND WATER ELEV. 53.44' 1500 GALLON REINFORCED CONCRETE SEPTIC TANK Minimum Construction Materials Per 310CMR 15.226(2) Strip-out Note: Tees shall be constructed of Schedule 40 PVC and shall extend a Remove all unsuitable material 5' around SAS BOTTOM OF TEST HOLE ELEV. minimum of 6" above the flow line of the septic tank and be on down to !the "C" layer and replace with clean the centerline of the septic tank located directly under the granular sand per 310 CMR 15.255 clean-out manhole. The inlet pipe elevation shall be no less than 2" nor more than 3" above the invert elevation of the outlet pipe. o Septic tank shall be installed level and true to grade on a level, /V7617, stable base that has been mechanically compacted and on which 1 `� 6" of crushed stone has been placed to ensure stability and o '4 00 LOT 10 65 4 to prevent settling. ul Q 15s503±.S.F. \ Septic tank shall have a minimum cover of 9" ti r HOLDER LN o o rn Two 20" manholes with readily removable impermeable covers o � Abandon � ""%,`� 66 � wo 0 of durable material shall be provided with access ports 10, ,n Existing 1 2' %,� \ 166 The outlet tee sha11 be equipped with gas baffle. septic System Zz \ r 64 i\LP // � ` LOCUS CPP� Design Data: z v' PROPOSE z j /�!� � E �P�E Q 14'x 22' o i ��� r SAC Three Bedrooms = 3 X 110 gpd = 330 gpd Required Flow ,c \ ADDITION "," i �'�� N? 51' NO BASE)AENT z65 I C� No Garbage Disposal Allowed r \ - _ -, .., /.'> . <•. __ _T ` p 'Co \. l\LR_� 6, �u i / f ifi5�XIST/ryG / Use: teach Field 33� x 14'W x Q.5' E#f De thr � PAVED With Two 4" PVC Distribution Lines (32.5" Long) 63 DRIVES a 33 x 14 = 462 S.F. , 63 ,1\ o z r / r��rc, 64 po 462 x a 74 = 341 GPD Total Design Flow , ,1- TP 5 w taw 17` rP2 10 i !� % W --W �Ir PRECAST REINFORCED CONCRETE DISTRIBUTION BOX ' r 63 z I Exist. ! EXEST�E�YG . 64 r Install on a level base Tank DWELLING � T C) C' Minimum wall thickness = ,2" Q 1 ` C 'i Minimum inside dimension = 12 0 �I ; T:t�.E. 9 - i Outlet inverts shall be equal to each other and at w I� 24.1' I � ro ASSESSORS DATA: FEIIYIIA DATA: ZONE 'C" 2" minimum below inlet revert. rP 3 ; rP I r 1 MAP 173 PARCEL 66 PANEL 250001 0015 C The distribution lines from the distribution box shall all have ; 63 , 63 ! MAP REV AUG. 19, 1985 equal inverts as determined by flooding the distribution box to / 2s.5' _% ,- '' r- , -fi 62 the height of the distribution line invert after all lines have 61 \ �� �4.� _ REFERENCE DEED. 2778-279 1 in lace. ��, - it '`P REFERENCE` PLAN 313 - 16 been sealed p Invert adjustments shall be made by filling with durable and z �r ZONING DISTRICT RF nondeformable material permanently fastened to the line or 576*1?' gay 62 r OVERLAY DISTRICT AP AND RPOD reconstructing the lines until all inverts are of equal elevation. E -` - - -� r� LOCUS ADDRESS.- \ f #21 PEEP TOAD ROAD, CENTER VILLE, MA 60- _ \ 61 _ 1,34 72 '! GENERAL CONSTRUCTION NOTES 61 H OF SITE AND SEPTIC PLC 1. All the workmanship and materials shall conform to R E.P Title 5wor and the Town of Barnstable rules and regulations for the subsurface - 60 r o`' CHg1STIfV Prepared For. E disposal of sewage. ► FAIRNeNY 2. At least one access port over tank tees shall' be accessible GRAPHIC SCAB r " No. 926 l PEEP TOAD ROAD within 6" of finish grade, with any remaining access ports brought �F01g-F�Rwo to within 6" of finish grade. 20 o 10 20 40 80q T tiA In 3. All components of the sanitary system shall be capable of ` .-- �°er� .�tev711e, 1a�'sa c.� use t is withstanding H-10 loading unless they are under or within 10 ftas q of drives or parking H-20 loading shall be used under or within t 2-2 �►�b 10 ft of drives or parking unless noted. Plastic equals may be { '� �E ►► d� Scal& I" = 20' Date: December 28, 206 used in lieu of all precast units. i inch = f oT+, ®► ��H t� USG5 GROUND WATER ADJUSTMENT ®��P G\STER 0 Ec'�Gs� Prepared B•y.' 4. The excavator/contractor shall call dig safe and verify the location HEALTH AGENT: Donna o�s�� �: INDEX WELL SDW 252 a �o� P� �� * StephenJ. Doyle and Associates of all site utilities prior to any excavation, and shall be responsible for TEST DATE: 12-19-06 ZONE "B" , a srE�H�N N r 42 Canterbury Lane' E. Falmouth, A!A 02536 ADJUSTMENT = 2.0' ► all matters relating to electric easements. SOIL EVALUATOR: S. Doyle ADJUSTED HIGH GROUND WATER = EL. 53.44' 4 DD 55 TJ ► Telephone. 508/540-2534 5. Sewer pipes shall be 4 Schedule 40 PVC laid at a min. 0.02 slope. 6. An masanr units used to bring covers to grade shall be TH #1 EL. 63.5' TH #2 EL 63.1' TH #3 EL. 60.94' TH #4 EL. 62.0' � A�OF_SS�o��� v _ �� -�,,T,?„� ,� �Z-�, �',� � � Y Y PERC <2 MIN/INCH PERC <2 MIN/INCH PERC <2 MIN/INCH PERC <2 MIN/� INCH 0 ►�� �d UPv`��� mortared in place. - -- 0" -�---- o" 011 7. FzniSh grade Shall have a minimum slope of 002 ft per foot. A SL 10YR 3/2 A SL 10YR 3/2 A SL 10YR 3/2 A SL 10YR 3/2 8. Pump and abandon old septic system. 8" $" B LS 10YR 5/6 8 8„ ��'M �° " 9. The excavator/contractor shall be responsible to check all grades B LS 10YR 5/6 B LS 10YR 5/6 EL. 57.94' 36" B LS 10YR 5/6 and elevations and to contact Doyle Associates of any discepaneies, EL. 60.5' 36 EL. 60.1' 36" C1 FINE SILTY EL 59.0' 36" SAND 60" (EL. 55.94') prior to construction. C PERC 62 4 C 2 C2 FINE SAND 2.5Y C PERC 62" 10. The excavator contractor shall be responsible to contact FINE SAND 2.5Y 6/4 FINE SAND .5Y 6/4 din 2.5Y 6/4 FINE SAND Doyle Associates 24 hours prior to any required inspections. EI. 51.44' standing Water 120" 120" 120" 1 120" NO. DATE QE$Cf?lPTfC}1V EL, 53.5' (NO WATER) EL. 53.1' (NO WATER) EL. 50.94' EL. 52.0' (NO WATER)