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Home My WebLink About0018 RAYMOND STREET - Health 18 RAYMOND STREET, CENTERVILLE A=246-018 IN UPC 12534 No.2153LOR , HASTINGS,MN TOWN OF BARNSTABLE LOCATION 12' R6--0OIAJD RCAD SEWAGE # 0001 Ja6C-� VILLAG ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.R .r.59 J '5C=P-K C _7 2 , -77� SEPTIC TANK CAPACITY 1500 SCOTL' tAWIL-, %}000 POin.ia C"C'AR LEACHING FACILITY: (type) a VQn La-,(l c (size) a')4- tZ 7' aS ,r NO. OF BEDROOMS o2 /•; BUILDER OR OWNER PERMIT DATE: L4 (5 Lo\ -,,;, COMPLIANCE COMPLIANCE DATE: Sh 0I a 0-0 t 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 I L C�YWQI'Vb T�4 No. =I ol-O Lo Fe;5 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Ztppfication for �Digool *pztem Conttruction 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. 18 pnyo�d Rd. , Centervill Colin MsIsaac Assessor's apfl'azce Z q &-d 115 41 Chaske Ave. , Newton, MA Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P O Bbx 1089, Centerville Type of Building: Dwelling No.of Bedrooms 8 Lot Size sq.ft. Garbage Grinder( ) 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) Ti t 1 a—5 Gept J c sTstPm non s i -t-i nn of a 1500 gal. tank D-box, Pump station and 2 precast, concre e leach chambers with stone all around i(4 g Srzf4 y /d 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 Certifi- cate of Compliance has been issued by this oard of He Signed cr �'�, ,�/.`_ Date Application Approved by t:!C ' S()A R 0_e Date Liu U Application Disapproved for the following reasons Permit No. c9CO/—o?( o Date Issued Q No. W, ' (�V Fee$5 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. / ' Ye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ✓/ .F 2pprication for Mie;pogal *p.Mem Construction Permit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 18 Raymond Rd. , Centerville Colin MsIsaac Assessor's Map arcel Z L' &—v 1 ,8 41 Chaske Ave. , Newton, MA ,a Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P O Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Gunder.{ . ) Other Type of Building No.of Persohs, Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date I` Title Size of Septic Tank Type of S.A.S. Description of Soil a- 1 Nature of Repairs or Alterations(Answer when applicable)Title—5 s en t i r- s y s t ern r-nn 4i c t-i ncy � of a 1 500 gal. tank, D-box pump station and 2 .,,orefcast' 600ncre.te—,,_y,•'' each chambers with stone all around, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance f the'fore described on-site sewage disposarsystem in accordance with the provisions of Title 5 of the Environmental Code and not}to pldce the system in operation until a Certifi- cate of Compliance has;been issued b this oard of Health. p a y ✓�..• r Signed lv�1) 1 r M' Date /^ t 8 Application Approved by i4o U . -; ��k t��.F �'`w� ,Y"' �:' Date tl s � �k Application Disapproved for the following reasons ` { ..�, ——Permit No� �= -— -Date Issued ——-' THE COM1%0N1NE`A.TA OF MASSACHUSFJ7. S Mclsaac BARNSTABL-9;`MAS$ACHUSETTS Certif irate of (Compliance THIS IS TO CERTI , that the On-site Sewage Disposal System Constructed( )Repaired )Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service at 18 Raymond Rd. , Centerville has beenrcotd'stru�*d&��accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.--9C X) 7 1� . Installer Wm. E. Robinson Sr. Designer The issuance of this ermi shall not be construed as a guarantee that the Sys will fu 2i.estdesig kd. Date 3��.30 b Inspector --------------- Fee 1 U---- �' THE COMMONWEALTH OF MASSACHUSETTS fr � 0 r' PUBLIC HEALTHj111ft�ON=BAR STABLES MASSACHUSETTS McIsaac Xi5po5al *pZtemc Con.5truction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) System located at 18 Raymond Rd. , 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 permit. Date:/Ji0) Approved by W L s- t!6l99 - NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SICETCH AND APPLICATiOI�i FORA DISPOSAL WORKS CONSTRUMON PERMff(WTCSOUT DC�SCGNED PLANS) L William E_ Robinson.S%Cr6y certify teat the appiication f ff&spoW works. comvuction pew signed by me dated 9_,5--O , concerning ng the prope" locatedat 18 Raymond Rd. `, Centerville meeisaHofthe fonowing criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwdbng. The soil' as CLASS I and the percolation raw is less than or equal to 5 minutes per inch. There arc no within 100 feel Of the proposed 9*W kV79em There arc no rivate wells within 150 feet of the proposed seplic S)Smi There is no i in flaw andlor change in use proposed • There are variances mquested or needed • The of the proposed leachmg facility will Mt be locan d less than&e face above the maximum adpmuhrater table devationa[Adjust the groundwater table using the Frimptor method w applicable) • If the '.kS.will be located with 250 foes of my vCgtumcd wetlands the boumn of the proposed leaching faa'lity will M be located less than 1bustem 4141 feet above the maximtmt adjusted groundtvater table elevation. Please complete the followimV r ) Top of Ground Such=Elevation(stag GIS infogmation) ?� B t G.W.Elevation +the MAX WO G.wA4ustment DIFFERENCE BETWEEN A and B /L%s 4 k l 9 SIGNED: V DATE: "�Q (Sketch proposed Plan of system on backj. or health folder cm 3 � 7�1" Jf a �LV l I t Y � —I Oil OF B TOWN ARNST. ABLE: LOCATION l RAy� ocoif,> RcAb SEWAGE # 000( -dto�, VILLAGE CC-yJ 9-\ff tC& ASSESSOR'S MAP & LOT Z�& INSTALLER'S NAME&PHONE NO. ( r15ouJ "5cZaKC _7'7C?-277jL SEPTIC TANK CAPACITY 1$60 5EO* �AWL k,60,o C6 LEACHING.FACILITY: (type) 02 'D(2 !LL,t;II (size) Q� t2 il a_ NO.OF BE&ROOMS BUILDER OR OWNER: PERMITDATE:�"14' COMPLIANCE bATE;. 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 fee*t'of leaching facility) Feet Edge`6f WC Leaching and 'chin g Facility(If any wetlands exist within 300feet of leaching facility) Feet: :Furnished by . . .7 V L _ Town of Barnstable P# Department of Health,Safety,and Environmental Services Public Health Division Date O� 367 Main Street,Hyannis MA 02601 HARNgrABM 16.1 'OrEeprr,� Date Schedul m Z4Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: C 7Z A/c- jZ csge-r, Witnessed By: C)ea CV AJ 17 �f-;) r .................................... .:.._........................................................................................_.._...._........................................._......._...................._._............ LOCATION+&i GENERAL. NFORMATION> _ ...... .... ........ _ _. _. .__ _... _ _ ._ .._.. _ _ _ _.._ ......... _ . .... ....... Location Address /,( y�oND Owner's Name G o( �U /►7�= S,�q C U l► ' rslVj _ _ Address f 8 2'l7Yr;-r<t�, 4 .-s7'—' C., V. Assessor's Map/Parcel: 2.d G / Engineer's Name 4 6 t c SZ y674 rpm NEW CONSTRUCTION REPAIR X Telephone# _-5'p r Land Use /Z.F -S1,P eriy 7—/.1 L. Slopes(%) J S Surface Stones Distances from: Open Water Body A444 ff Possible Wet Area �� R Drinking Water Well /l n R �. Drainage Way r9- R Property Line /� �� R Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) C � - 3r f \ -o ` Q 0 � eVa , Parent material(geologic) C /N TZ vim'/2 Depth to Bedrock ✓a Depth to Groundwater: Standing Water in Hole: / Weeping from Pit Face Estimated Seasonal High Groundwater 7- L DETEItNII1AON I�~OIt SEASOI�IA�. HOII'VVAIEIt.TABLE Method Used: V S a S Depth Observed standing in obs.hole: in. Depth to soil mottles r/otie in. Depth to weeping from side of obs.hole: __. in. Groundwater Adjustment 3. * R. lndex Well#Miw 0 Reading Date:.�.Q Index Well level Q./ _ Adj.factor_3 4 Adj.Groundwater Level PERCOLTIO1V TEST Anti ;Time Observation Hole# Time at 9" rr � Depth of Perc 42 -> S4 Time at 6" a Start Pre-soak Time @ Time(9"-6") 4 End Pre-soak T o T,q 4 Rate Min./Inch Z 4Site Suitability Assessment: Site Passed r Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant �EEY" OBSERVATION HOLE EOGI�I ;# Depth from Soil Horizon .Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n Consistency,°° ravel MGM - 7—n I/Tt 7 6 /3 Z HEEP OBSERVATION H+DLE L;±OG Hole;# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface from (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) � i DEEP (�$SRATt()N HOLE LOBIolie . . .,. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel 1) -V OBSERVATIOI'�1 HCJ�LE L(�G Hole# ... ... ::..; Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°°Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes_?S_ Within 500 year boundary No— Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system.? 1-yeS If not,what is the depth of naturally occurring pervious material? Certification I certify that on !moo 9f' (date)I have passed the soil evaluator examination approved by,the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date /'OJ/z 410