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HomeMy WebLinkAbout0065 PLEASANT PINES AVE - Health (2) 65 Pleasant Pines Ave Centerville A = 233 052 SMEAD No.2-153LOR UPC 12534 smead.com • Made In USA p�(�N1bSgtODUC�IlNE OFTFHSAPROGRAtAOIFI www3Ft�rso�¢utota� gg Q TOWN OF BARNSTABLE PP�� S� ) LOCATION b� \ s,Gh�C 'PVW � SEWAGE# t�U U / U- I VILLAGE CkNV PJ k , ASSESSOR'S MAP&PARCEL 33 s). INSTALLER'S NAME&PHONE NO. coM r-A Svc �q Q 6 0 b J SEPTIC TANK CAPACITY X j S� �C� 1 dUt1 Gc,�. �sm0 CH.t�L-r LEACHING FACILITY: (type) C�,GAb(&*size) NO.OF BEDROOMS 3 I OWNER- 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 BYe \ G� s 1a�.�a� � o ® ut� an Q � S No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ' ftpYicatiou for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System Eelndiidual Components Location Address or Lot No. �p�' P\4: ti,S C� pA�ems. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Sc6 .c. VC il3 01 �ti r M,o�: S.j�.�«r�S S?® Qox tip 3a it-Dt^N�s �. a Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 ® gpd Design flow provided gpd Plan Date `— r / /k Number of sheets Revision Date Title r Size of Septic Tank �')CC3+ /SL (j t- OO®b Type of S.A.S. �s�L C AAb-vs Description of Soil ��- Pc�h c Q✓��n/�L-t/ in !z k c A 's V.Skt L.) C r,(j Nature of Repairs or Alterations(Answer when applicable) �p® G-r—k— Cy r_^6,r s 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 Health. rr Signed Date 3 Application Approved by �. Date 3'2, 1 /ff Application Disapproved by Date for the following reasons 3 Permit No. �d _ b Date Issued No. �` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Misposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair(✓Upgrade{ ) Abandon( ) ❑Complete System ®"Ind vidual Components Location Address or Lot No. \,q�� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 23 \ Installer's Name Address and Tel.No. i Designer's Name Address,and Tel.No. Name,Address, tl3 al d �Kr Mo��ln ve.{ ,c,S �?t Go)• 1.6 Jau' n S M Q 3,( O t c Type of Building: � )--I if C>44 I DwellingNo.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -3 0 gpd Design flow provided (y ' gpd Plan Date o —3 �/�/ /�( Number of sheets Revision Date r Title Size of Septic Tank -y(S� /1 Cj t 160.6 Type of S.A.S. 4,j j c SW 4;c,L -C k&M6"Ut Description of Soil f'uM p C k,(,A L.� k i St S hlr.1� MC +C) SCAC� Nature of Repairs or Alterations(Answer when applicable) (A CYr\ Cvc_j,U,trS to [.T4Urk_ 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 Health. tt Signed Q. _ � ' Date ppPlication Approved by ( ;_ ���1. RU t p l 5, t Date ✓� w - - Application Disapproved by Date for the following reasons Permit No. '9-01 R b Date Issued 3 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On n--site Sewage Disposal system Constructed( ) Repaired(161/) Upgraded( ) Abandoned( )by S C d C1 lN& n at -C 1,JkC been constructed in accordance with the provisions of Title 5 and the for''Disposal System Construction Permit No. ;C/9 f dated Installer SC,.OA M �rt,�,A,.V_ Designer #bedrooms Approved design flow , t�f�X and The issuance of this perrtvt shall n t be construed as a guarantee that the system will fi�incf o" n asec�esigned. Date /p� Inspector - -------------------------------------------------------------------- No. o�O/o 0 r Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposai 6pstem Construction permit Permission is hereby granted to Construct( ) R�epaair l ) Upgrade( ) Abandon( ) System located at \e Cl 5 C V t f I s and.as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 permit. - - J , Date , Approved by Town of Barnstable Regulatory Services Richard V.Scali,Interim Director ]Public Health Division ' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form f Date: � Sewage Permit# ao JL D Assessor's Map\Parcel /'1 Designer: V1 t{F_1,z k kA ks,>C Installer: 54'7 �• ��— �-" Address: it cam• -1 3,C lLV Address: QS 00es On 3 la i 14 56cn- k- was issued a permit to install a (date) (installer) septic system at L,�_ 21CQ C A\ - 'P�n_eS /4q-g&ed on a design drawn by (address) i Th=*�'tk,6� S, dated 11(0 (F( / (designer) v 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. Strip out (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 i of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed En,-_j n, ce with the terms of the I\A approval letters(if applicable) { ( nstaller's Signature) �_ } (Designer's Signature) (Affix Designer's Stamp Here) 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. QASepticlDesigner Certification Fort Rev 8-14-13.doc l PTown of Barnstable y��oF'THE Regulatory Services P • -�- Thomas F. 'e G �ler Director ■ax►vsraeLe, ' MASS. q1639• Public Health Division j ♦0 prE0 A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: V Designer: Eagle Surveying Installer: Wm E Robinson Sr Address: 923 Route 6A Address: PO Box 1089 Yarmouthport Centervile On Wm E Robinson Sr Sept irwas issued a permit to install a (date) (installer) septic system at 65Pleasant Pines Ave, CenterviMIs d on a design drawn by _.(address) Eacvle Surveying dated 08-30-04 (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 co?nponent of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. HEN (Installer' G Mgr ''s Signature) �;, tj a,�i�r�� ,i far.•; `\ t ti;xato�6 40 tl r tii3 (Designer's Signature) 7 - (Affix Designer's Stamp Here) .: 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:Health/Septic/Designer Certification Form L TOWN OF BARNSTABLE Ta(i >a 1�' , 6'!�. • '>°C+�CA� Pi;"9 Ave, SEWAGE # �q 5 D VILLAGE CMIk,-,ale ASSESSOR'S MAP & LOT,939 5� INSTALLER'S NAME&PHONE NO. l..i+�. t,�ab,�i�� Str'i� !�:cc 5bT-�1� K 7X SEPTIC TANK CAPACITY /COD G�4� t /erm Gee/ Amr C-Ar""A f LEACHINGFACILITY: (type) p1XS10 6`1 brVf d( (size) /3Ya;�,� NO.OF BEDROOMS ��1 ;:BUILDER OR OWNER D)PJ)-x PERMIT DATE: 1 o `1 9- e;y COMPLIANCE DATE:J9- 7-o V Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 or 01 g � 0 A- � � iy A- 13 D-.3 33' C a l ° 3 B,ti1i �Q� D L� No. V - Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliration for ]Disposal *pstem ConstrUttion permit Application for a Permit to Construct( ) Repair(<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components L cation A4djess or Lot No. �t,�Ys 2 v / Owner's Name,Address, d Tel.No. .5 7"��d1� v T TiWE /'Ia� ssessor's Map/Parce , o S Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 14QG14 e-d-A�,ST o Y »s 36' Type of Building: Zv 12-17-01 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 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 ol 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 Signed Date �� l Application Approved by Date f 2 1 7 - O c j Application Disapproved by Date for the following reasons Permit No. 90 0� — 14 I 1 Date Issued ----------- --------------------------- - - - - - - - - ----- - - - -- No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computel: Yes '. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS' 2ppfttatiott for MiSposal 6pstettt Construction 3oertttit I t _ , Application for a Permit to Construct( ) Repair(<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components, issessor's cation Address or Lot No. � ��,�rE r v � Owner's Name,Address,and Tel.No. 5 �As,q{y T IJWE �`��y S�a�a� r✓o1lT,i Map/Parce (� S Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: TV 12 -17-Q1 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 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) A,56,�� P, ,6F /-/1 p 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�ealth. Signed. //. Date Application Approved by Date ) — 17 Application Disapproved by Date for the following reasons Permit No. 90 0� — L/ Date Issued 7 �f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Coatpfiante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( ).by ``� /L G �� at h ��=11 S j},v / l r1 lr f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.A2 009 1-1 0-dated 0 Installer Designer #bedrooms D 17`0 Approved design flow gp d The issuance of tKis permit shall not be construed as a guarantee that the system will,£uncti6 n as desiighed. Date 1"2-11 7 / 5 Inspector Z/1.P d _ •1 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION=BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair(/- Upgrade( ) Abandon( ) System located at �/r�a _.5r A and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 pe . Date f 7-d A roved by, PP No.^�� _4�7,sa) Fe$1 an ,an THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:i�"L 4 Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Mi!6pool &pMem Cou5tructiou Permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 3 6 2—2 2 6 4 A&5or,P14a gnt .Pines Ave, Centerville Maurice Dupuis 233 52 65 Pleasant Pines Ave Centervilic Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and Tel.No. 3 6 2—81 3 2 Wm E Robinson Sr Septic Eagle Surveying 923 Rte 6A, Yarmouthport � PO box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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 1 e a c h system to plans of Eagle Surveying, 04-019 . 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 Certifi- cate of Compliance has been issued by this ar Health. Signed Daty Application Approved by Date_/uThT Application Disapproved for thY following reasons Permit No. Date Issued /V /9^U No. .?U4 y SSA ,K Feer 1 Q Q_0 0 THE COMMONWEALTH OF MASSACKUS.ET-TyS" Entered in computer:✓ , Yes - PUBLIC HEALTH-DIVISION -TOWNOF BARNSTABLES MASSACHUSETTS ZI.Pprication`for Mi!5po!gAU**pgtem Construction Permit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 3 6 2—2 26 4 65 P� sent Pines Ave Centervil e Maurice Dupuis Assessor's 'ap/ azce 233/52 65 Pleasant Pines Ave Centervill( Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designegle Surveying Name,Address and Tel.No. — > a Wm E Robinson Sr Septic 9 PO box 1089, Centerville 23 Rte 6A, Yarmouthport Type of Building: _ Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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( ns er hen p licable Install a new Title 5 leach system Ito plans o `eagle S rve ing, #04-019. 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 withnite provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by thisj1oar f Health.t ,Signed ! ✓' DateA;1 v Application Approved by -T K,. &P-1 Date /U—/,-_/~U Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS Dupuis BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired ( X )Upgraded ( ) Abant° ed Wm E Robinson Sr Septic Service at P(leasyant Ptnes Ave, centerviIie has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. .Z dated Installer Designer r`` , I ) t The issuance of this a+rmi shall not be construed as a guarantee that the syst�-m w,ih function as sign- Date I z I �� Inspector ——— No. f/JL/ ----------------------- Fee+1 Q0.00 Dupuis THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS ligogal *pgtem Construction Permit Permission is hereby granted to Construct( )Repair(X)Upgrade( )Abandon( ) System located at 65 Plesant Pines Ave, 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 pe?mif Date:_. IO _ / Approved by V i Town of Barnstable Regulatory Services Thomas F. Geiler, Director BMW9rABM + 9�A 6`9 ��� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: �U L Designer: Eagle Surveying Installer: Wm E Robinson Sr Address: 923 Route 6A Address: PO Box 1089 Yarmouthport Centervile Wm E .Robi•nson Sr_ ,Sd ti P On vas issued a permit to install a . (date) (installer) septic system af65Plea-sant--Pines Ave, Centerv"iWj d-on a design drawn by (address) .Eacvle Surveying dated 08-30-04 (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 septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. (Installer's Signature) *� CIVIL &354 `1 fn (Designer's Signature) (Affix Designer's Stamp Here) 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:Health/Septic/Desiper Certification Form a.3nssl 3 3 N V I I d W 0 3 31VO s Jl 03AsS1 11my3d 31V0 N3 NMO NO b 3 011 n 8 SS3I100V 1 3 N VV s.V311 V1SNI 39V111A ON 11mv3d 3 9 VM3S NOI,LVw91 sA y� i � 3� � � , � � 3 '�; ,� -- - - __ ,. Gw • �_ q. /l. ���'-�li - - � � � e.__ --�r� _c.�G_�--mac,__.•--c.Vic+ - --- ` B i.'' .y � ..� .'�C � . �5 _, _ �<. �a -. :. _ - . - if ` . . . 1 1� • ! �.. �. M � � - I ate,��� .�r....�..�.��.�� �� _ _ �.�����. +.�.. �. � �.�.�---�r.�.�.��La�� ��' �. .� ,.. ��.. i.� .ten ,� - � .��v. 00 No......79'. s.�' . F�$..... :5.'.0°...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF - HEALTH .....................Town.--------OF.....------..Barnstable .... ...............................................••--- Alip iratiun for Disposal Works Tons rnr#iun rerun Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: �, s Ave.R.�...0 enterville ... 3 "�d ........................................................ Maurice Du uisat.on-Aaaress .... Pleasant Pinea °A te:°', Centerville ....._...- P-.......... ............................••••-•-•.... .... . .....------................. A & B Cesspool Service 128 Bishops Ter .V6 Hyannis P ........ ' ... Installer Address Type of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms.......... ..............................Expansion .Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons..........:Z.......__.__.. Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------•-•--••-•-•-._......... 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........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•-•---•----••--•-----•••••--•-••-•--••..............•---•---••--•------•-•---............----•-••.......................................................... ODescription of Soil------------+San&...............................•-----•-••-•••------•---•--•--•-•-•--•--•--•----•-----•-----....-••-----•-•-•--••.-...•-•....•--.............._.. . W V ..............................................................................•----•-••---.....-•----......--•---------•----••-•-•...----•-•-••.....---•---•-•.........-----•-••-•-----•--••-----•-••--- W UNature of Repairs or Alterations—Answer when applicable nstallation...of..a...l_t6QQ...gallon...__. ....se p ti o---tank,---7.---di atributi-on...b.ox..and...a__6 00...gallon---atone-... ankeel._.j with Agreement: extra stone) leach- pit (overflow) , The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LIT:•. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is�ethe d health. ign --•- >v��................•--- 71 e 131 9...-_-... Application Approved By=--- � -----.....7�1 �`�9 Application Disapproved for the following reasons:............... .-•--------••---•----------•-----•-......._..-_-_.._...............Date ............ -•--------•--------------•-----------•------•------••--•-•-----------•---------------........------....-------------•-••••-••------•-••-----•-•-•--••-----•••----------------------------------••--•---- 1 Date Permit No.....?9`T9�.......................................... Issued_...------.. •13-•-79......------------------. Date M. No.•--79-....` .. F�s.........5...00....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .--.....Town---.....OF.............Barnstable .... ... . .....................•---------....---•--.....---•------ A#p iratio for �-4paii al Works Towitrurtiun rrutit Application is,�e4114_mad`ey for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal stein at: ' .. a.. nes...Av�.,E.a.._Centery 11e ......-----••-------------------------•-......--•-------••----------......._.........•--- Location-Address Maurice. Rupus Pleasant Pines °Ave:°', Centerville ,._. ---- -------------------•--..._..........---.................----•----•----..._......---......_______. "•+ caner aA 8c B Cyesspool ervice 12.. ...--------•. ..................... . ... Installer Address Type of Building Size Lot............................S q. feet Qwelling,No. of Bedrooms.........)____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ......................I.... No. of persons........ ............ Showers ( ) — Cafeteria ( ) Otherfixtures -----------------------------------------------------.••-••-....-••-•-•-•-•-•••---•-•----••-••••••--•-•-----•---...•••-•-----•...........-----..•.... WDesign Flow.................:..........................gallons per person per day. Total daily flow.....................................:......gallons. W Septic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ { x Disposal Trench—No..................... Width.................... Total Length.................... Total Teaching 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-----:.. a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rs, Test Pit No. 2... ..........minutes per inch Depth-of Test Pit.................... Depth to ground water........................ ---_---- O Description o Soil------------SanA•______________________•-------------•-----_____ x UW -------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------- Nature of Repairs or Alterations—Answer when applicableinstal.lat on---af_._a=1.,-0-©0---gallari....... se.gti-c---tank '..1---cl3-st-r-ibutidh.-_bax...and...a...600-.-va11-on...stone...nacked....(with. ` Agreement: extra stone) h.es�ch pit (overflow) . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Ti= 5� f the State Sanitary Code-The undersigned further agrees not to place the system in operation until a Certificate±of" ompliance has been issiLe theZVrd,,Pf health. Signed ------ -- ----------••---••--•----•--••-•••......••• ? 1 .? -.._.._ Wiz, r " r D Application Approved By..- - 1(b -------•••---•--•-•-•-' -•-------71137Ag `• f Date Application Disapproved for the following reasons________________ , ......---•------------•----------------•--------------•-••-•- ..-•--•-•••-•••-••..............•--•-----... .....•••-••......-•--•••••--••-•----•••-•--•••---•-•-...._--------------•------------------------•---------- ........................................... ' Date PermsNo. ................................................... Issued_.......................................................3/?9 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................`.......T 9wn.O F....Barns.t abl.e...................._......:_..............._ Tntifirat�e of Tuutph aurr THIS IS TOCERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired( X) by A & B Cesspool Service, 128 Bisho all ps errace, _Hyannis,__ a,. 02&Ol Pleasant Pines Ave. , Centerville, 526 at •--••• .......... ....... . ' 3� Maurice Duvu.is has been installed in accordance with the provisions of T IZ 5 bf h State Sanitary Code s described in the application for Disposal Works Construction Permit No------- ............................. dated_._..____3/79....:.._.___..__.. �° 4 THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....................................................................•-•--_..._. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ', Ys" Town OF Barnstable No:.......- '`. :, FEE...$�5.00....... Raposal Works %uatutrurtiogtUpamit , Permission. is hereby granted-lL..&___B...GesapoLo1-...Se-r`v.i.ce.,' 128...Bi—chaps...Tax....r... �IStanY]3.-8 to Construct ( ) or Repair (K ) an Individual Sewage Disposal System .. at-No...........P.lass_an.t---2inns...Ara,.......C.entervill-e_ 4�f. 2 rr•� - �1aur�.ce-.-Dupuia---....... et n ` t as shown on the application for Disposal Works Constructions e` i _ . .................. ........____........_.._ ..............................._ \` Board of Health + DATE................................................................................. 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TO pF STONE _.II..-�.�'.1,..,.I­.,.1��.��:..: .I�.�.I- 4 1!...V1 I��j-�,�.I'.�O-:..,.1_.1l.�..II.*�Il -�....:81,.Ig.V..��,...­. eNr 1,..,'­...I_­..-­' ,,1*-1,"L-"--I-;�.�,,...­,.,....1-;.;��:.% �..-..�I�.-.,....l,.,. ....:.�...'.�jIII".'..�..... .,...!.;�,.".- -,.....II-1—..�:.I.I'�� ;�I.�O:1...,m...I,"I4,�"I�1.,;-�"I".I�I,.'t.­ '. '! .-.%...I.:�;...�/a.�.-..1I�1.;.1.�.�I"...1. ,1. 8 _ , :IT N I.�...I. ei :: E Wp ,I II_,I�14�.I. II­ t.. 1. MUST BE: WITHIN flOUB, �' ACCESS..COVER , .. , 2. $ 6 OF F INISH GRADE CHAM BERs` 2 ':'SCH .4p PVC x . ' 4.500� . TONE .aRo ILEAC x 2 d-. y� Wl4 S UND'• 1� $'.r J� t�'J r f-.'.. 4' DlaAh:PiPE >, .. D'gOX c .. . 3 _ . . ,t , . - {000 GRL H :10 - : .. G CHAMBER - Exrs7rN PUMP 4 r000 GaL ` SEP 1'f C TANK CRUSHED STONE OR , b.. -: BASE l . COMPACTED S . [ T1pT -T0 SCALE : IRON PIPE 52 a . P (� O I ' ' . f20 OF-PAY �81d,!.BRB,FND /� 6T . S t �/EpT / i � / Ets51. : , , - . i ..r . . �. I", .�5 i VENT �o:. . .. . I. // `y__� I IA NQ TE S - IERAL :�� DESIGN.:ANp CONSTRUCTION > 2-�`00 GAiLOBERS,k r;S. FOR THE - ONLY. I 1�` -,. �Eacl+ToRE;:aanuNn. THtS..PLAN p-1SPOSAt, SYSTEM . SEWAGE g.!.9 D'-110X u� .. ''METER PIT. Ol THE MARKS I ! . QQ Ii VERTIGAL DATUM IS NGVD- FOR BENCH `:. , a - SEE SITE PLAN , SET. TERIALS AND I; !. A .1 ! y it .1 METHOD3:.�A_ N SNALL 4 - � {. � ' I8 ALL CONSTRU,C7i0,; SYSTEM :;` AN F OF ?THE SE1. r C F TLE.:5 ,.AND. L:pCAL` , mot' sO� ! �'sn.!� �t::. 'MA t NTEN T I MASS _ D E .P -- �. I: .� , CaNFORM T0, _ REGUTATt!?Ns Y I 'BOARD OF HEALTH UNDER ! . COMPONENTS LOCATED.' _ I GREATER: i . TEM I C:OR s I.. I i i tC srs TRAFF ALL,..SEPr TO ' o j cUL'AR ►TN- ' : I SUBJECT CAPABLE OF' W AREAS BE TH SNALL I N DEP I / .40 I*_ THAN, oAvs ,3 EEL L R �i4 AA !.. e STAND{NG H 20-'WH i-- �': _i.• .: 4 ,1` s ULE % ram, ,f , SCHED 40 OR PIP!* SNALL BE to / I Aj 'SEWER - `. 5.,:_ EQUAL l I , _ ` APPROVED SHALL $E. . w Y AND D 90 , ' a r I .'PUMP CHAMBER WATERTIGHT AND m I . SEPT{C TANK I I x 6 PRECAST CONCRETE. TESTED . .'"" I v RErNPORCED ,. E. WATER, ' . $HALL $ THAN ONE ;' D BOX S MORE +ti k- WATERPROOF THERE ► ` a FOR L.EYEL WHEK �1,` - L''�_ 6-- 45-.T `, WOOD RETAININli IYALL OUTLET ." CALL . -QIG SAFE - k.. CONS'TRUCT':10N WATER pEPT. \N\ BEFORE. THE LOCAL / D1 . SAFE AND UTIC I T;rES. rRON PIPE . el' {-888c- UNDERGROUND �� ` etsrpfDp' OF . FOR LOCATION . . SHALL N OT I FY THE INSTALLER TO CONSTRUCTION J \ `` SYSTEM PR(OR E Q I ` SEP r{C TWO :DAYS ._,. . U'L j NG OF rH 8 EHGrNEER fOW J= R SGHEt? r DESL�N --- ---- -TO AL, (u W o . E� J r OF THE SYSTEM iONS•_ 4 y \ ��/_ CTION_ CNSPECT k ! , 11. CONS TRU ; AND I 'wooD PUMPED DRY TO BE . 1OP . LEACH P f T E�tfsTlNs r . . " �� ,� EX;t S.T I NG P l:t LEACH /'� p rI I. . `.` BACKF - . „pfi ..r4 I . . .. PROPOSED ` O �i7� ` . P Ly{aA1BEa. !0 16.. I N , . PUN ei; 'KI'TCNEN RED It .. ROOK I '.. 1 1000 GaL OON EXISTINq . SEPTIC TANK 41 `0 01 N,1.NG II ,;, , . . ROOM II 4 .. - . .. - - PVC::WMET . w :... :,;;. . ROOMN6 4 PVC INLET. : HOLE yERCURY FLOAT SN , LH� I__ s,' Va vE.. . p(ytRY ON ' SPL/t T RA 1 L . ytwp 4N E t. w ptIMP ' po ,OFF:', r; . ,S 3 3 -4 I - - f -- ,, T TO SCALE ;, ` P UMP D TA PUMP CHAMBER -38 , . o'!FIG II Il I. IDOb Gal i R #� . { ..' _ E� ::NOTES EL o;wso ~EA 2G'• 34p+ S . F . h'. p S yS T sE>tra�E_Pu1d? MOD P .,, I A R: MYERS RESIDEMTIa1-_.. . ' PUNP r,0`BE . _ a. OR EOUAL,•,.: E ELEVAT NS St100- . STOP'Ar TH . . _ 36 pUMP SHALL SrARF AND WITH _I ___ -- h Y THE NFORMAN�E . INSTkLLETI STRICT CO V RE�B E ON5 w ``, 3 LL: BE_ . OHS.AND T1 TLE L TO' - - U, SHA S SPECIFI SNQULD B 3 THE.P . . . S =PUM,P, . .. . . P CNkNBER WITHOUT BOAR) PENCE ruaEa' - .` rHt,MAMUFkc. ,r-cueu..BE'2 €NGNE ruE PUtd =nyCti ACCESS COVERS MUST BE WITHIN MIN 2» ofi PEASTONE l N VER T ELEVATIONS : FIRST 2 ' TO 6' OF FINISH GRADE 9" MINIMUM, ACCESS COVERS MUST BE TO BE LEVEL OR FILTER FABRIC 39.0 FINISH GRADE 3' MAXIMUM COVER INVERT OUT PUMP CHAMBER: TEE 4*VENT W/CHARCOAL FILTER INVERT IN D I ST. BOX: 48.87 4 5 INVERT OUT DIST. BOX: 48.7 18' MIN I NVER T IN LEACH CHAMBER: 47.0 7 2 , �' 1/2' DIA. BOTTOM LEACH CHAMBER: 45.0 4' D1AM PIPE 2' SCH 40 PVC 4 .7 $ 45.0 DOUBLE WASHED STONE ADJUSTED GROUND WATER: N/A 4 .0 2-500 GAL LEACHING CHAMBERS OBSERVED GROUND WATER: N/A ` a EFFLUENT BO T TOM OF TEST HOLE #/; 38.6 FILTER 3 OUTLET W/4' STONE AROUND. 12.8'w x 25'1 x 2'd D-BOX H-20 EXISTING EXISTING DESIGN CR I TER I A : 1000 GAL PUMP CHAMBER A DESIGN FLOW: SEPTIC TANK 3 BEDROOMS AT 110 G.P.D. PER BEDROOM EOUALS 330 G.P.O. NO GARBAGE GRINDER PROF l L E : NOT TO SCALE \ .� IRON PIPE .�� SEPTIC TANK REQUIRED: 52.4 330 G.P.D. X 20ON - 660 GAL. SEPTIC TANK PROVIDED: 1000 GAL. EXISTING GENERAL NO TES : as`x GF OP %,, BRB FNo 7 SOIL ABSORPTION SYSTEM REQUIRED: EL-51,67 I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION 1 Y / DESIGN PERC RATE t 5 MIN/INCH OF THE SEWAGE DISPOSAL SYSTEM ONLY. 'Sz SOIL TEXTURAL CLASS - I - --\\ EFFLUENT LOAD 1 NG RATE - 0.74 GPD/SF 2. VERTICAL DATUM IS NGVD. FOR BENCH MARKS �// IRON PIPE 5/ 4 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED SET. SEE SI TE PLAN. I EXISTING .r` _51.9 --_---� -- PROVIDED: 2-500 GALLON LEACHING REPLACE J. ALL CONSTRUCTION METHODS AND MATERIALS AND \\ EXISTING METER P/T CHAMBERS W/4' STONE AROUND. A-47/ S.F. MA 1 NTENANCE OF THE SEP T l C SYSTEM SHALL 471 S.F. x 0.74 - 348 GPD CONFORM TO MASS, D.E.P, TITLE 5 AND LOCAL BOARD OF HEALTH REGULA T i ONS. sTP#ISOIL TEST PIT DA TA 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER so. l --- - -\ INDICATES INDICATES AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER PERCOLATION _ OBSERVED • ':• � ' \� �9 TEST - GROUNDWATER THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- � •.• •••��:_'•• .��•• ( - �,:�.•. ""• VENT 1 STANDING H-20 WHEEL LOADS. tea`\ �\ P10753 .. .'. /�2, ��' ~�•\ \\\ o. HOR 1 ZON TEXTURE COLOR 50.6 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR 2-500 kLON 4a LEACHING L`HAMBS /�' - �� LOAMY IOYR APPROVED EOUAL. + / \\ W/4\TONE AROUND 48 /\ �\ SAND 3/3 6. BEFORE CONSTRUCTION CALL "DIG-SAFE", /2" - - - - - - - - - - - - - - - - - 49.6 1-888-DIG-SAFE AND THE LOCAL WATER DEPT. / I \\`� ���ae l � B LOAMY IDYR , �� SAND 5/6 FOR LOCATION OF UNDERGROUND UTILITIES. 24" - - - - - 48.6 m \\ � FINE-MEDIUM 2.5Y 7. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE _ "t-- - — � SAND 6/2 DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION , SAND �\\ f� + �� \� �� OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE \ _ \ CONS TRUCT I ON INSPECTIONS. 8. EXISTING SEPTIC TANK. PUMP CHAMBER AND PUMPS \� TO BE INSPECTED FOR PROPER OPERATION, IRON PIPE i 9. EXISTING D-BOX TO BE REPLACED WITH A NEW H-20 D-BOX, IT SHALL BE WATER TESTED TO `✓ CHECK FOR LEVEL WHEN THERE IS MORE THAN ONE `�\\ f }44•a /j �'�I,` l 44^ NO WATER 38.6 OUTLET. DATE: JULY 21. 2004 TEST BY: STEPHEN HAAS ).• _ EXISTING \ > _ PUMP CHAMBER � I _ -' - "�-- WITNESSED 8Y: DAVE STANTON PERC RATE: C 2 MIN/INCH 41,2 EXISTING 1000 GAL °f 1 N N \\ SEPTIC TANk _' ''— DWELLING ING ----.__-- --- \ \ SpL I T RAIL �� \ AREA FE)CE \ — 20, 340± S.F. ----' ————————— ` _— —— y _ BOARD FE E 61WON eIPE EDGE OF )VA TER — �?q\ TOP WATER ELEV - 33.7 612412004 BEARSE S POND 3 SE' F T l C S YS TEM DES i ON 65 PLEASANT PINES AVE . MAP 233 . 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