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Home My WebLink About0131 SETH PARKER ROAD - Health 131 SIETH PARKE R Centerville A = 170 — 191 SMEAD No.2-153LOR UPC 12634 .m..dAms • Me&In USA NW- 9 r.. TOWN OF BARNSTABLE LOCATION SEWAGE# D �_VILLAGE ASSESSOR'S MAP&PARCEL 1 W- 1q1 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY te;K(/'nAc4, lcnD 6&L LEACHING FACILITY:(type) (size) �-< ;x I,CA-, NO.OF BEDROOMS OWNER PERMIT DATE: `- 16 COMPLIANCE DATE: I��— 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) P`( Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 1 Feet FURNISHED BY DeN,f✓ ��t �rrtfio-yr�..s f 131 k. co i p l - 91 J.JDeparti=t of Regulatory.services '__> Public Reafth-Division 3D'qte_"/4 / • , r�o �, 200 Main Street,Hyannis MA 02601 �Z 2 � Date Scheduled .1J / Traw Fee Fdlo / D o' (10 Soil SuMahility AssesS ent for 1 e �Isposal Performed By; Witnessed Sy: Lv A? Location Address //l��' �/ ��v✓ ` Oyvner's Name M�l/P�✓J l,'�iv��t�-✓y� Address Assmsor's Map/Parcel: Engineer's Name �1 --'Ca o e NEW CONSTRUCTION REPAIR Telephone# Land Use: La c/9�J Slopes(R6) � Surface Slopes N O n e Distance's firom: Open Water Body �Q G fl Possible Wet Area lac fit Drinking Water Well ft Drainage Way 7 fC .Property Line 7 ft Other Et SI 'TCM(Street name,dimensions of lot,exact locations of test holes&pore tests;locate wetlands'in proximity to holes) �u 2Z O o c Parent material(geologic) l�C l G s Depth tp Badrgclt 00 Depth'to Groundwater: StandingWaterin bole: /V .- . Weeping from Pith = N e!�4 Estinnated Seasonal�lgh Groundwater NZA- D�YFE��TION FOR SEASONAL EaGH WATER TOLE Method Used: (Al Depth Observed standing in obs.hole: lu, .:Deptl�;tb,s4l1 moulr s. . ltl, Depth to wcepingfrom side of obs.hole: ln, CIr[} udwatarAdju8thwank fr IndexWelIi# Rcading))Akc; IndexWa111c,Ye1_:. _ Ad�. Itbr, s..� A[j.:[�lY?Ui1rA5YptBrl.tYs1 ,— FERC'OJCr.MON r.10EF, Observation Hole# - Depth,ofPerc. - .�o Time AtG" Start Pre-soak Time @ _ _— 'l itno(9u-G„) )rod Pre-Soak RateMindluc:h Z =,7/) � Sits Suitability Assessment: S1Cv Pnsseii _J,L sitr Fnilod: Additional Testing Needed MN) A . Original: Public health Dlvisloa Observation Holr,Data To Be Completed on Back---- —-_- **9-lf Percolatttibu test is to be cosaducted wit].i ua 100 of wet ad,you avast-Arst-aotify the JB2=stable ConseTvataon Division at least one(1)weeR prior to beginning. Q.,15EPTICIPERCP0RM DOC [ // Vs T Dcpth ftorn Sall Horizon Sail.Toxture Shcl'Color Sail, offitr Surface(in.) (1rSD•A) (NlunselI) Mottling. (Struatura,Stoneg;Boulders, • _ o i`ton cy.9�'Cravcll ' 0 — ZC) �0-zy 5 l0: Zq- 30 5 ayk 30- 132- /y 215-Y /� S70 G rot ve l D ,-�- 0B8Pul ONMU� LQG ' Depthfrom Soil Horizon S'oil`Texturo Soil color Sail Other Surface(in) (USDA) (Munsell) Mottling (Stracture,Stones,Boulders, ansis en 9a Grave � g �3 � S 3/Z 23-3 2- L 5 lays 1/�F 32 -3 9'� 101Iy 5°% Grct ve/' DEEP OBSERVATION ROLE LOG Role W" Deptfi•rroni SoilHorizon SallTo%= Sail Color Soil Othar, Surface(in.) (USDA) (Munsell) Mottling (Stractarn Stones,Boulders. Consiqtwry. G e Depth from Sail Horizon Soil Texture Solt Color Soll Other Surface(in.) (USDA.) (Munsell) Mottling (Structure,Stones',Moulders, ' Co si Eett b ., ------------- Flood 7nsaaxic6,RattALa'p; Above 500•year;floodboundary No— Yes . Wf thin 500ycar boundary_ No Yes ' Within 100 year flood boundary No. Yes. Depth.of Mafupalln 0cmatinglarvions Ma.�torlal Does at least four feet of naf arally occurring pet'viou material exist in all areas obs6rved thfpughout tho area proposed.for the sail absorptibn system! If not,what is the depth of naturally occurring pervious matai'1817 - Cci�i�ca$ian r certify that on Z (date)Z fiavapassed the soil evaluator examination approved by the Dopaltment Of BnvirOUMOntal Protection and tbarthe above analysis was perfbnned by me consistent with . the required training,cxperdge and experience described in�10 CUR 15.017. Date Signature V p:�s,>;rrlc�r�l�cl�ort>�n roc . . sue THE COMMONWEALTH OF MASSACHUSETTS c BOAR® F HEALTH ......OF... .......................... A liratiou for Dis uial Works Toustrurtion Frrmit Appl tion is hereb made for a Permit to Construct (' r Repair ( ) an Individual Sewage Disposal Syst t: � �/• r... _...... L Addr + or Lot N ... ` �P.................................. w n� ljddress FWj •.. •..... O----------•---- 2!2.4 ............................... •---- ..... . Installer Address .1�- U Type of Building Size Lot../5_.?!V...Sq. feet Dwelling—No. of Bedrooms___...•........ ...........•........___....Expansion Attic (*'Q Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) PA Other fi tures W Design Flow.......:q._:._.�6. " _.-—-____ -_gallons per peon per day. Total daily flow-----�a ...............gallons. 04 Septic Tank Disposal Trench Li Noc. achy.- Width . Len Total Length Width.............. Total leaching area__Depth-_.....sq..ft Seepage Pit No.....(A- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-.--------_-___-.____ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------•••--------------•-----------------------------------------•--•-...........---------------------- ••--------------------------------------------- Descriptionof Soil.................................................................................-------------------------------------------------------------------------........-•_.. x W •----•--•-••---- --- . . . ............................. ------------•-----•----------••••-••••---•----•--••-•---•------•---•••-----•-----•--•••...------......•-•---------••......................... UNature of Repairs or Alterations—Answer when applicable-----------------------------------------------------------------------------------•_---------. ---•----•-------------•---•-------••-------•---.-••------------•-•••--•••-••--•••-••••--------------•--•--•---•-•-•-••--•---••••-------•--•-----•--••-••.................••••---•••--•-----------•...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage osal System in accordance with the provisions of iI i' p �of the State Sanitary Code— The undersigned fur r agrees not to place the system in operation until a Cci4ikiclte - Complianc as been is d y the boar f he ,_. r f . Date / Application Approved By................... •---- ...: --- ................................. .............. Date Application Disapproved for the following reasons:---------•--•----•-----•---...------••--------------------------------------------------------------------•-.... ----------------------------•------•--------•---------------....----•-----•--------------------------••--•------•-•----•••••-------•---••----•-•-----••--•-----•-••-••--------•-----------••••-••----•-- Date Permit No......... ..�• -�-�-�-- p Issued ............. Date �w y� yam- ...--- c--• � .� Fps............................ , THE COMMONWEALTH OF MASSACHUSETTS BOARD -OF HEALTH �y-.- . .. .._....oF.. : Applira#inn for Bhgpoii al Vorkg Toutitrnrtilan Permit Application is hereby made for a Permit to'Construct (`"') or Repair ( ) an Individual Sewage Disposal Syssttrezn at y ........................' r° .. _�................. ........... �. .__� •-_•___ ....._......._......._..........._. �4 attcih Addr ss r or Lot � ,`' / + Ofw�r'er Address . W ______________' .-R•--"' ......----.......'°_T .---- ......---• ./ .... ----------------------------------------- Installer Address d Type of Building Size Lot �-�.f_ " �....Sq. feet Dwelling—No. of Bedrooms..........................................................................Expansion Attic ('4 '') Garbage Grinder (e"7) —' aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixture4_............................ W Design Flow............::: :. .................gallons per person per day. Total daily flow-------- ?. ...__:__________gallons. WSeptic Tank—Liquid capacity.._.----4kallons 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. it. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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........................ a --•--------•--•-----•---•--•-------------------------------•................................................................................................ 0 Description of Soil....................................................................................................................................................................... x U ----•---•----•----••------•-•-•-•----•----...•-----•--------•----------------------•---------------•------••------------•-•••. •----------•-•-------•-•-•--...-------------••-•-•••-•---•--...._.....--- W --------------------------------------------------------------------------------------------•---•-----•-•-••-•--•-••---•-•-------------••-------•--•-•----------------------• ......................... U Nature of Repairs or Alterations—Answer when applicable............................................•-__-_.---_--_----__...__............_._.__._._._._. --------------------------------------•--••-•------••-.----•-•----•-----------...-------------_.....----•---------•------------•----------••----•-•••---................_-----------•-----••--.._...---- Agreement: -07 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT l: s...: ;of the State Sanitary Code—The undersigned furd�- r agrees not to place the system in operation until a C at Complian�.e�has been issried by the board,of health +� r ,� �Zee f 1 g --------- -----------•----------- ---------- f-•--• ---.----- ...—.,-,•�------7--V�A� Application Approved BY � r� '�'"` ....................... __-=--:_�. Date Application Disapproved for the following reasons-----------------------------------•--------------------•---•---------------•--------.......................... ....-•-----• ---•---------------------------------••••--•--••••....---•-----------------------•-------------------••----•--------- -------------- Date Permit No--------- ....a Issued-....................................................... ------------- --- •--•----------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD �O~,'�F,�.HEALTH .1...... .... O F............. '�:'''. ...................................................... Trrtif iratr of Tomplitanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by--------------- �- �f >------- .. t ` staljer` {0/ at---•----------• --�'---- --• -- ---------•----•-------------------• •--•--••-• ---------- .-c.4.................... ....................................... has been installed in accordance with the provisions of ii" r' j 4 The -sate Sanitary Code ss robe In the�.� _ Q . application for Disposal Works Construction Permit No�_ T...__S _.a __,___.___ dated------- __ _._/_` ........... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUA ANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...........�/�...11�. -------.....•--••---••----_. Inspector---------------- ; THE COMMONWEALTH OF MASSACHUSETTS ,_----- BOARD OF HEALTH LDUJ�CJ N� _ FEE...... ......... Difiposgl Workii TFUnn#r ion "permit Permission is hereby granted------.. =- ,,,'.T_.._... o..p'.................................................................................. to Construct ( ) or Repair ( ),an I�tdividual Sew5a a Di oral System - s' ' J:reet as shown on the application for isposal Works Construction Permit NtE ..9 Dated----- / ----------- �—--= --- ........--- Board of Health DATE......................=-----•-•--•----------•--•........................................................... FORM I255 HOBBS & WARREN. INC., PUBLISHERS .. �>✓51 Gs11 T?1�'TA '—'� 9� _ 1 b 5•UCH 4 ✓' 1NEcLE.�;I-AM)L�('3�ED�t+tS __ a_-' - ---- 1.1a a ;I t S�nGTi�uC: 33U x�SD�G s �Q956rP"? � 1.S ri iz �� LVIT I ustr 1 oaa C-�.cio►.t 56Qn�To,►.�K � ;, � T. ; 7tsyo5lr'prT�- use 46 A zv. r 1s6 STr �J `}� C 'v�cm!*�sosF Cr 2,6: 3Z5CFD - sous `T'oT•�1,.. 'I7 fits t tr�l Fc..o v.J t 425 6c ti� ` �� `� � - To-rA 33 o Ec•PD —t r-tCA1A-rta1J'RA.TC 114.E PLTER AXTEIR Nt 2-4v't:3 F' n o, 43.4 z.-o 5 Q 'P►sr. 5c 10aa NI . R R tu�41.5 tN�!Q1•S T�uK D Wim Vor i wIl S 34-M1�Vkx C ERTIFI ED pI-n- ' PI,AN EL LO cA-t-tz�N !�`_.�._ _:,I i l._L— 8. P1-AX 'Rv-FF-:RENcF- fOT E: I 1 GF-zT'1FY 714A-r74m ��ssb SHavSrQ �EelS��E� �ty-R NF-ZF-2:)" czal�CAt—`t5 W r7A 714E AN-Q -6'F— ra Ae—eK "REG11��E�4 Et�T'S nF- A E h� 'rav , . _ ! - L � _ - 1..Z:;,CAM= W1Tt4}1iJ `rHF- -'Locup LIixA. THis R-ANj 15 NZ�T�AS�p DNAN INSTRUMENT 'I --- SURYCY AND 1 HE oFF5ES .-5Ho\,VN 5WUL-D ?qc>T jl _� �� e�'�....�..�y ,3E uSE� Ta ESi'!�$L15N t_aT l_1NES. aAAOWN OF BARNSTABLE L'OCATIOI /�� 1�N Q x..�eA SEWAGE ell �41.LAGE(feydj?2l/i`(`Q ASSESSOR'S MAP & LOT1 �STALLER'S NAME & PHONE NO��OLlt�- Cc-9 L4� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) //< r" �! (size) NO. OF BEDROOMS_ 3�PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �� l( I DATE PERMIT ISSUED: " DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No .7d