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HomeMy WebLinkAbout0798 SHOOTFLYING HILL RD - Health (2) 798 SHOOTFLYING HILL Centerville A = 192 — 042 I I »� I I 01"E° UPC 10259 a% No.H�1630R �Ra►. '� HASTINGS.YN Q No. (' 1. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Migozar *potem Congtruction 30er, ntt Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) El Complete System Individual Components Location Address or Lot No.--1 12 ' t� Owner's Name,Address and Tel.No.Is Assessor's Map/Parcel �C.IC re_r V a(IZ ' � Installer's Name,Address,and Tel.No. MA f Designer's Name,Address and Tel.No. Gores Umfus (CA I —D`f 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 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)__'ReP A CJL. '*J�' 90< 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 s Bofi of Health. Signed w `i3 Date lobs jc - Application Approved by Date o A Application Disapproved for following reasons Permit No. � 3 Date Issued o �— No. G 9 , , Fee THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS k 2pplication for Mir o0ar 6potem Construction 3permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ©Individual Components Location Address or Lot No. 9 c\`0(51- NJ In� N l l I Owner's Name,Address and Tel.No. .1 Assessor's Map/Parcel �'l A'r9(v,lit_ v Q S f t rn Installer's Name,Address,and Tel.No. rAA — I q Q - Desigger's Name,Address and Tel.No. Gor o^ Umpos OagrcAl —0`( NI Type of Building: t Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) .10A Other Fixtures t. � 4� 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) 'R 2.( /A CA. 'N 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 Board of Health. Signed A Date /D ks 1,4- r Application Approved by A y t f— Date i o l i r 2 C � ` T y a Application Disapproved for�wing reasons Permit No. I1 - 3 a AV Date Issued /o/ 7 / THE COMMONWEALTH OF MASSACHUSETTS A BARNSTABLE, MASSACHUSETTS Certificate of Compliance , THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(/ )Upgraded( ) Abandoned( )by e_n )n OuA at ' 9� Sh 1 — �n 1-I has been constructed in accordance with the provisions of Title 5 and the or Disposal System Construction Permit No t 12 ` 2 dated .10 / z- Installer G;1r24)^ /.3u&plr t Designer ' The issuance of this permit shall not be construed as guarantee that the system will designed. Date ';� -Inspector No. d (� '� - Fee Ocv THE COMMONWEALTWOF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Miopooar *potem C2onotruction permit 7 80< (frAtr Permission is hereby granted to Construct( )Repair �Upgrade( )Abandon( ) System located at �_dSC S�oeT"Nw iA r 14, 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 nit. Date: r A 1 r r 1 _ Approved by r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DER R '!MENT OF ENVIRONMENTAL PRQTECTION. TITLE S OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION` Property Address: . 708 Shoot wig Hill Road Centerville,MA 02632r Owner's Name Vesa Ilomaki lUl/ Owner's Address: Date of Inspection: 0ctobenl,:2612 Name of.Inspector: (Please Pkiat).:James.M Ford Company Name: JaniesM Ford Mailing Address: P.O.Boz 49 Osterville,MA' 02655-0649 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT. I certify that have personally inspected the'sewage"disposal system at this address and that the information reported below.is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section.15.340"of Title 5 (310 CMR 15.000). The'system: Passes 'Conditionally Passes Needs Further Evaluation by the Local Approving Authority fails: E . Inspector's Signature: ? Date: October 24. 2012 The system inspector shall s b it a copy of.this inspection report to the Ap proving.'Authority(Board of Health or DEP)within 30 days of comp ting this inspection. If the system.is a shared system or has a design flow of 10,000 gpd or greater; the inspector and the,system owner shall submit the report to the appropriate regional office of the DER The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ,a .I ,,.� ***This report only desciibes',conditions`at.the time of inspection.and under the conditions'of use afthat time. This inspection does not Address how the system will perform in the future raider the same or different conditions of use. i^ ! .Title 5.Inspe6tion Form 6/15/2000 ,,1 €,, page d /z� w Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) I Property Address: 798 Shootllyniz Hill Road Centerville, ALMA Owner: Vesa Ilonmki. i Date of Inspection: October 1, 2012 Inspection Summary: Clieck A,B,C,D or E%ALWAYS complete all of Section D A. System Passes: i ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes! One or more system comr .ponents as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of(he replacement or repair,as approved by the Board of Health,will pass. Answeryes,no-or not d.etermined.(Y,N,ND,)in the for the following statements. If"not determined",please explain. i`.:. ,,t.r,, i The septic tank is metal and over 20 years old*or the septic.tank(whether metal.or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance : indicating that the,tank is less than 20'years old is available. ND explain: r ,.;r,r Observation of sewage backup.or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced.' obstruction is removed distribution box is leveled or replaced ND explain: The system required pumpinggmore than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced 'obstiuction is removed ND explain: 2 Page 3 of 11 j . OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A L CERTIFICATION (continued) Property Address: 798 Shootflyine Hill Road Centerville MA Owner: Vesa Iloniakiu Date of Inspection: October l 2012 C. Further Evaluation is Required by the:Board of Health: i Conditions exist which require further evaluation by the Board of Health in order to deterinine if the system i is failing to protect public health,safety or the environment. 1. System will pass unless,Board of Health determines in accordance with 310 CMR 15.303 (1)(b) that the i system is not functioning in a manner which will protect public health,safety and the environment: I Cesspool or privy is within 50 feet of'a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh i 2. System will fail unless the Board of Health (and Public Water Supplier,if any) determines that the system is functioning iir a manner that protects the public health,safety and environment: The system has a septic,tank and soil absorption system(SAS)and the SAS is within 100 feet of a _ surface water supply or:tributa'ry,to a surface.water supply. sty T — .r,,Xhe system has a septic tank and SAS and the.SAS is within a.Zone 1 of a public water supply. _ r' The system has a�septic.tank and SAS and the SAS is within 50 feet of a private water supply well. t :The system has a septic tank and SAS.and the SAS is less than 100 feet but 50 feet or more from a private water supply well**':,Method used to determine distance *'"This system passes if.the;well water analysis,performed.at a DEP certified laboratory, for coliforni bacteria and volatile organic.icompounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggereda-A copy of the analysis must be attached to this form. 3. Other: ' 3 . t Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, PART A j CERTIFICATION (continued) I Property Address: 798 Shootflyinz Hill Road Centerville MA Owner: Vesa Ilornaki. Date of Inspection: October 1 2012 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool j ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than /2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of.times pumped_. ✓ Any portion ofthei SAS,cesspool or privy is below high ground water elevation. i ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ ✓ Any portion of a cesspool,or privy is within a Zone 1 of a public well. j ✓ Any portion of,a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water let'supply well with no,acceptable water quality analysis. [This system passes if the well water analysis, performed at a DFP:_certified laboratory,for coliform bacteria and volatile organic compounds indicates thaf_the well is,free from pollution from that facility and the presence of ammonia t lit.nitrogen and jjiti ate nitrogen.is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)_The system fails: Have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should:contact the Board of Health to determine what will be necessaryto correct the failure. E. Large System: To be considered a large system thesystem must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or`.`no'-'pto each of the following: (The following criteria apply,to large.systems in addition to the criteria above) Yes No ; F1 the system is.within„40Q feet of a surface drinking water supply the system is within200 feet of a tributary to a surface drinking water supply the system is located,in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public�water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered.a significant threat under Section E,orTailed under Section D shall upgrade the system in accordance'with 310 CMR 15.304. The system owner should'eontact.,the appropriate. regional office of the.Department. 4 , j Page 5 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART B I CHECKLIST Property Address: 798 Shoot yin'g Hill Road Centerville, MA Owner: Vesa 110maki Date of Inspection: October 1, 2012 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: r� Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? _✓ Has the system received normal flows in the previous two week period? l ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ i Were as built plans-of the system obtained and examined? (If they were not available note as N/A) 1, ✓ or-dwelling,inspected for signs of sewage back up?Was the facility ✓ Was the site inspected for signs of break out? ✓ 'l i Were all system,components,excluding the SAS,located on site? ✓ Were the septicrtankMai-lioles uncovered,opened;and the interior of the tank inspected for the condition of the baffles or tees,material o£constiuction,dimensions,depth of liquid,depth of sludge and depth of scum? f Was the facility,lowncr,(nd occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on:. Yes No ✓ Existing infonnatioh For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation.of distance i is unacceptable) [310`CMR 15.302(3)(b)]. •:11 v l l i i!L''� ' lE. 5 1 it Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 798 Shootflying Hill Road Centerville, MA Owner: Vesa Ilomaki. Date of Inspection: October 1, 2012 FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110_gpd x#of bedrooms): 3.30 Number of current residents: 0 Does residence have a garbage grinder(yes'or no): n/a Is laundry on a separate sewage system(yes or no): No (if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): . No Water meter readings, if:available(last 2 years usage(gpd)): Unavailable Sump Pump (yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL I}j 1:.�_ Type of.establishment: . ;r Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): i` Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary.waste discharged to the Title 5 system(yes or no): Water meter readings, if available,:,,.!,r a,' Last date of occupancy/use: OTHER,(describe): GENERAL INFORMATION Pumping Records I (.. 2';i Source of information: Unavailable Was system pumped as part of iheiinspection(yes or no): Yes If yes,volume pumped: gallons'=-How was quantity pumped determined? Reason for pumping: Mantenahce TYPE OF SYSTEM 5! ✓ Septic tank,distribution.box,soil absorption system Single cesspool Overflow cesspool Privyl''1! Shared;system(yes or,no) (if yes,:attach previous inspection records,if airy) Irmovative/Alternative fecluiology. Attach a copy,of the current operation and maintenance contract(to be obtained fromsystem owner) Tight Tank Attach a copy of the DEP approval Other(.describe): , . Approximate age'of.all components,.date ins'ialled(if known)and source of.iriformation: Installed on unknown date Were sewage odors detected when arriving at the site(yes or no): No lit C Page 7 of 11 f OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C j SYSTEM INFORMATION (continued) Property Address: 798 Shoot flving Hill Road Centerville MA Owner: mesa Iloniaki Date of Inspection: October 1 2012, i BUILDING SEWER(locate on site plan) Depth below grade: i Materials of construction: cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,'evidence of leakage;etc.): i SEPTIC TANK: ✓ (locate on site plan) Depth below grade'`.. 10" Material of construction: ✓>concrete,.:: —metal —fiberglass polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no):certificate) (attach a copy of Dimensions: 1000 ag_l_ Sludge depth: Distance from top of sludge to,bottoni of outlet tee or baffle: 28" Scum thickness: 3" J.' Distance from top of scum to top:of outlet tee or baffle: S" Distance froiii bottom of scum to bottom of outlet tee or baffle: 101, How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.). Tees ivere remit. The covers were 10"below grade. GREASE TRAP: None (locate on.ste plan) Depth below grade: Material of construction: _concretei<'t metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness::, i ; Distance from top-of scum to top of outletaee or baffle: Distance from bottom of scum to:bo_ttom of outlet tee.or.baffle: Date of last pumping: Comments(on.puriiping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to.outlet:invert, evidence of leakage,etc.):. Page 8 of 11 + .OFFICIA _L INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM ! PART C SYSTEM INFORMATION (continued) i Property Address: 798 Shootflyinz Hill Road Centerville, MA Owner: Vesa Ilarnaki Date of Inspection: October 1 2012 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection) (locate on site plan) t. Depth below grade: Material of construction: _concrete _metal __fiberglass ._polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working Brier(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert Even Comments(note if box is level.and dts't'rbution!to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.) 4 ,: Tlie D-box wds'broken dow7i:A4ew.D-b6x was installed. See ermit#2012-323. The cover is 2"below rade.. PUMP CHAMBER: None '(locate on site plan) Pumps in working`order(yes.or no -'tc Alarms in working.order(yes or:no) ..:.._. Comments(note.condition of pump.chamber,":condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM I PART C SYSTEM INFORMATION (continued) Property Address: 798 Shootflvira.g Hill Road Centerville, MA: Owner: Vesa Ilomaki. Date of Inspection: October 1, 2012 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) I I ' If SAS not located explain why: I Type ✓ leaching pits,number: 1 -leach pit leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching+fields;number;{dimeiisioiis' overflow cesspool,ntunber Innovative/alternative system Type/natme..of technology: Continents.(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): There ivas no sign of failure from the pit The pit was dry A camera was used for the inspection CESSPOOLS: ; None (cesspool must b:e pumped as part of inspection)(locate on site plan) Number and configuration Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: b:;... .:. Dimensions of cesspool: Materials of construction: r<, Indication of groundwater inflow.(yes..or-no): Comments (note.condition of soil,signs.ofhydraulic failure,level of ponding,condition of vegetation, etc.): PRIVY: None'. (locate on site plan)._.- - Materials of construction Dimensions M.': Etr,. 'het;. Depth of solids: f'" ri ;trL Comments(note!condition of soil,sighs of Hydraulic Failure,level of ponding,condition of vegetation etc.): ri.l t. r, lo" { Page 10 of.11 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPO SAL SYSTEM INSPECTION FORM PART C i SYSTEM INFORMATION continu t ( ed) Property Address: 798 Shootflynu Hill Road Centei ville MA Owner: Vesa Ilo.naki Date of Inspection:., October 1, 2012 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage:disposal system including ties to at least two.permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. ,I 1; 3 O r 10 . " Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 798 Shootflyin-a Hill Road Centerville, AM Owner: Vesa.Ilonzaki' Date of Inspection: October 1 2012 SITE EXAM Slope Surface-water Check cellar I Shallow wells J Estimated depth to ground water 35 +/- feet I • t iPlease indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked%ivith local Board'ofmHealth-explain: tovo-arayhlc and water contours rnays - Checked with local excayatpys;;installers-(attach documentation) Accessed USGS database-explain: You must describe how you established.the high ground water.elevation: Using Barnstable toyoQrayhhc and water'contottrs7nays the maps were showing approximately 35'+/ to-around ivater at this site. rt s , This report has been prepared only for the septic system and components described herein. This septic system has been irzspectetl?arid passed as;of rthe_date',of inspection,This report is not a warranty or guarantee that the system will: fiuzction properly in the f itul e� rTlzere have been no warr•anlies or•guarantees,either expressed, written or implied, relating,to the septic sy�stenz 1theb7spection, this report and/or any components of the septic system viihich liaise not been located and urspected n . r I,T�OWN OF BARNSTABLE LOCATION S' ` lA 11,11 SEWAGE# VILLAGE QQKF�(V��4 ASS SSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ( Ob LEACHING FACILITY: (type) ��— (size) NO.OF BEDROOMS 3 FOWNER ASA ��OnnA 1 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 FURNISHEDBY "rnspe.&TIon 1 O t aoi-a- ip � B a ag 3y 3 � S1 No... W "1 LI Fim$ ...........�........ J� �� I,� THE COMMONWEALTH OF MASSACHUSETTS Ix BOAR® HEALTH J ........ 0F......... `! 'r ++. ..... .-- --.---•----- -------- a� ApptirFatioaa for Dhip aal Marks Tomitrurti.nat Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at• _ .............�!,%...r .�r..... ............... ........... t __ .._.< 4 a4....- ocation Address or Lot No. .......... ....•. .......... <! ------ ~J"........... sc�!. 1. ).............................. ddress �; p.... ?1..... u 1. r � = °' ......... ��q t,v�sue......--- Installer Address dType of Building Size Lot.4—v.J.6 ....Sq. feet V Dwelling—No. of Bedrooms___..... .....Expansion Attic (Ad Garbage Grinder C ) ` Other—Type T e of Building pLa yp g .../AT............... No. of persons.........5+--------------- Showers ( ) Cafeteria ( ) P4 Other fixtures .•-••••......•• •-•---....••... . W Design Flow_._._ 'S_...............................gallons per person per day. Total daily flow__._.3._�---------_---_------._._..gallons. W Septic Tank—Liquid capacity./ 'gallons Length................ Width..... .......... Diameter-____-_.____-__- Depth................ x Disposal Trench—No. .....0,0.�... Width.................... Total Length___- •__.__. Total leaching area--- ft. Seepage Pit No--------------------- iameter.................... Depth below inlet................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tQk ( .,,/� a Percolation Test Resul 2 Performed by...__./�`______-KC. .. .......:-.G.._��tV Date . �j,.�� ��.......ez < o Test Pit No. 1................minutes per inch Depth of Test it.......t.3_.__.. Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------.................. ►� Uy �tl. 3P� dal�v/�-.. O Description of Soil----••• ----- �................ ...................... w gve- ------------------------------- ! / _ �. ••--•••••:-•-----------------------------1 ...f.. .......... -------- . U Nature of Repairs or Alterations—Answer when applicable.............................................................................................. .............-......................................................................................................................................................................................... Agreement: • The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until��Con has been ' sue by board of healt . ----•••• -•-••-. ••..Ct(�.� --- ------ --------••- Application Approved By---------•-• --•-- Date Application Disapproved for the following reasons:................................---------•----------------•-----•-•-•----...................................... ..--•-•----•---•--•-......---•--•..........•••-•.........••-•...----•...••---•-••--.....•---••------...•••-----••••---••••----•----•-----••-----•-•...•----------------•-•....------•••••-•-••......... Date PermitNo....._... ._.... Z------. Issued........................................................ '� Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA 01 Kt:. y ............................. ,vf ! THE COMMONWEALTH OF MASSACHUSETTS 1 . - BOARD OF HEALTH ....... =:� � .--......OF..........: �................................. ,. ........................... Applirattion for Biopoii al Works Tonstrurtion pamit - ,.Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ry ( , �.�c ram• / • M J JY 7 k (P 8� f'} r L1 � �._ _d i 4! .... ................ .... ........ ......_........L..... ..,y.............6. _ .._ H Location-Address F /� or Lot No. .............. •.---•••---•....r:✓/1?Jt=. .. ?' . :y�J )� ,f �: .- r- t-----------•---•----...----•------- ,r f f own J .� �' ...� Address , ......................................................... w' . .................... ).rs.� ._ f e f �, •r- . r r .. .... >t Installer Address / Type of Building Size Lot._ r ti.? ?-.....Sq. feet U DwellingNo. of Bedrooms ................. .....Ex Expansion Attic — --------- p Garbage Grinder ( ) aOther—Type of Building ..t+ ::=................ No. of persons.........:V................ Showers ( ) — Cafeteria ( ) Other fixtures Design Flow..--. "----------------•••••--• ---••-......••••. .____._gallons per person per day. Total daily flow.._.:: W g g P P P Y• Y ..........................gallons. W Septic Tank—Liquid capacity...... :.'gallons Length................ Width......._........ Diameter----............ Dep�h-� --------------- t!_ x Disposal Trench—No. r..: _ _... Width.................... Total Length.................... Total leaching area___--:..__.........sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area. ................. ft. Z ' Other Distribution box ( fir Dosing tank ( )' , . / ~" Percolation Test Results_ Performed by..__..'`.............. . - ••` � �- • �-�•-•f Date:!�_'�:'_�•-✓____.._�.�:_._______h Test Pit No. I....... ......minutes per inch Depth of Test Pit....... ...... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... •-•----- r• .. -----_ --•.................••-_. O Description of Soil =- `�' Z....:............................V-'''�.... fir', r�, ✓ .. ..... - r , .......................................................................................... ..........._ _ _. r , �l ..................................... (t t f` • ! / �v T7 t` t !„ f? '. y}, } --- UNature of Repairs or Alterations—Answer when applicable...___.......................................................................................... --------------•---....•--=--•--•--..............-------•--------------••••-••-•---......•-•--.......-•••-•••••••-----•---•-.....••--•-------•••••---••-•-••-••-•••••--•--••---•-•----•-•-------••....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the*provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until Cert ficate 6Comp nc�e has bee.gkue F by t o board of health, Wined = '..................................r �' r vu -.� Application Approved BY......• -- ••• ..":....:--•-_-:.. ......----- Llll-f-- p....... ----•--•---•................ Bate Application Disapproved for the following reasons------------------•------------•------•--------------•-------------------------------------.........•--•.......-- -•---------------------------•---------•--------....---------...........-;.. -------,.................................................................................................................. Permit No.......... ..... � .......................................................na ---..... Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ............................... �rrtifirttt of Tont �i�anre THIS.IS TO C RTIFY,,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Installer at............ f- ; `P ......................................... �I'__f__/__ i/ dj✓ /' /..t 1 P t? r , k�C s'r✓J�.�/ -- ------... -••••••••----••-•••-••••-•-••-......-•----•-••---•-•--................................... has been installed in accordance with the provisions of TITLE 5 p 1 ' _ of The State Sanitary Code as described in the r application for Disposal Works Construction Permit No_�w,67.._& `*2......... dated___._.. :tn..................... THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...............!f�j... .... —A...n-.$....7..--••.............. Inspector------ �- -�i ...-- ------- -.�..�.---------•----•- -----•--._....--•--•-•--•-- THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HEALT rl ca N ........-(°-----...... FEE...... ............. Disposal Workil Tonotrurtion rrntit Permission is hereby granted......... y .l....... .___....__._..................... ------------------•••.•.••.....•••---.....•••.•.•.........._.. to Construct ( ) or Repair-(- ) an Individual Sewage Dis osal System r i at No Streetf -f / as shown on the application for Disposal Works Construction Permit No.._.____ .__ �'Dated..•.�_�_;/__�d ,�.................. Board of Health DATE------------------------•----..._.....------•---•----------•-----•-•---•-•------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Town of Barnstable Geographic Information System May 5,2015 0 , 192138 tt #303 ff 192057 21201X—/ 191015 -�q #773 #93 #100 # 39 212011 1 v 192037002 192030 �4� #120 r #774 #230 Q 2 V Q182014 192038 192148 #785 } #786' V #292 ! Z 212020 f #119 1 s � ' 192042 1920 t #798 #214 p 192013 ` #801t 1 1 1920 9001 --- - -------- 212019 #143 k292149 62 192026 #198 ,,,,`4 192012 212018 192041 #161 #834 192160 Ems #248 won 1L920309002 806 y~1 ® 212017002 192011 �., #186 212017001 #839 #176 192151 ® 192040 #236 #844 us 192010 192043 191 L 2�J C,� } #857 It 416 212023 21 G1- 192056 #2 #12 #398 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:192 Parcel:037002 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel ppp 1"=100'may not meet established map accuracy standards. The parcel lines on this map Owner.KARNIALA,R ANNELI TR Total Assessed Value:$310200 . are only graphic representations of Assessors tax parcels. They are not true property Co-Owner.ANNELI KARNIALA TRUST Acreage:1.67 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:774 SHOOTFLYING HILL RD such as building locations. Buffer 1 4 ?�� � /TQWIy OF BARNSTABLE LOCATIONLO-raY S/a0dr a� /`±L //4V SEWAGE �-- _— q VILLAGE �Sffle�L �'� ASSESSOR'S MAP & LOT/�v� (z STALLER'S NAME & PHONE NO.f�F- SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER` �/�;1 r� 1171cl lW � DATE PERMIT ISSUED: 7 / L r9 DATE .COMPLIANCE ISSUED: - VARIANCE GRANTED: Yes NO �/� �� �� ��, "�� 1 ��� �� , ^��/ �a ��` . y' I y ; all 2.5 g ru,�r- Ile I z 9 9'Pc/ j$ 90 '.� \ 1 3 G\ p _ IAT.H c 175 /�%X�? 0 — t"''awe ry,: 'r`• .�e � .� I G .y ;."� ,. , k A,16 "R Ila N", e Pa e 1124 \. 2. o 9 i `► o� PAUCA. IELMY ScyN E NqN�t�g17,' No. 0050 O ' 1.0 LEGEND EXISTING SPOT ELEVATION 0„0 EXISTING CONTOUR --- 0 --- - F'LUT PLAN FINISHED SPOT ELEVATION FINISHED CONTOUR 0 ,C077' Z s,,,1aoT-Fi-y/,vc. N I c.�* R NOTE: The 'location of any existing undc�rg,•omid sewera&e �,��� TE2 V ic.c.� wells, or other utilities shown on this plan i5 approx ; � _. imate only as determined from records and/or verbalu , x; 3 information. The contractor is responsible f,or. the I verification of the existing locations in the field. SCALE' /" o DATE , , 11 .t-10�DiN LEVY & ELDREDGE ASSOCIATES, INC. CLIENT. • � i CERTIFY THAT THE. PROPOSED JOB NO. a6O3p` ®UIL'DINp SHOWN ON THIS PLAN ENGINEERS-LANDSCAPE ARCHITECTS CONFORMS 'TU T H k l U I N(� LAWS PLANNERS-LAND SURVEYORS �Y e OF C�IVJTG�V/LAG, 712 MAIN STREET CH. BY' MYANNiS, MA93. SHEETLOF 2 A KG- AN 51,1N EYOR /VOTE /F E/TNER TN,ESFPT/C TANk OR - r 20 FT MtN: LA'ACH/wG P/T ARE MORff TNA/V /2N84,L0J'V wE� ,� o cx.�TF c r' /AM E .E C A A O T N E 4 R A 2 ID a SNAL.L &AF B°QOUGNT TO 4)?A D, - EXTRA q'PVC P/P� �I RO/Y COVER. S/7A DE USEO Q t/E°4Vy C ST/ ELEV =�oq.©• CONCRETE MIAt. PITCH ,. IF/IV ,DR/VEN/A Y - -. ERS FT. .- coC PE •,. f8 R _ 2 . MiN. CONCRL�TE O .4oE CO✓. CLEAN .SAND /L.L u/ Level - U/� D _ LAYER D - L Y gr e„ Sct/�ms� 7 - oo or V a'-J/S' m 0 0 .f { • .pd PE 1- �a�.�_ �s/!L. s e 1, o • • •• v e yyASHFO 570NE 141N:P/TC/! 4r SEPTIC T� N D/ST v�` � • •BOX 0� • /E•QF F••E C.•T/••✓E•►•. ••' i'•.e a a•i a /2sm • • • o • D�PTX • • • • • o o WASHED STONE -a s /SIX 3 7 7 Z-$ s � o • t . • o • • • • I -- ° ' • e . • • . • • • pp•� PRECAST SE.�AGE a. 4 O/T OR EOu/V. ff o • • • • • • a o AwAPT &AEV T - • 4'90 C7A L INYER7' AT BU/LDl1VC, Q4 V a�Y- / F7 O/AJ►9. C CSEE T�WUj-A770N� INLET SEPTIC Ti4N.K 0�4 FT, y—�T r,42 c�1��:... aIJ7LET SEPTIC • -AN1•(___ Fr. GROuVD Hr,47-ER TAOLE / /ON X ' BOX OF INLET DASTR BUT FT. SECT/ON OtITLETD/ST/�IBtIT/OIV MX F7 SEWA(a� OIa�'IOOaS/G8 L .���STEM A/VLI=T LEACHING ®/T } FT 7-,aZ11.ATION ZRACHO/VC IO/` ' 471t4ENS10N A Sei FT SCALE �4°° = /=0� D/>'JENS/ON $ ¢O F-r. DES/GA+1 CRITERIA FT ^' I{I!lMDER OF EE®Ro®�9Sa . "�I (,AROAGE D/SROSAL TOTAL EsT/1VZ4-reD FLD1w. 310 0.44./DAY SOIL TEST ,*/ SOIL TEST002 NU14,9ER 0F.44-ACHIMa P/Y: I , �0OS D�T,E OF SOIL TEST F �c sy CI1 c%as A! S/OE LE°�C/0/NG PER P1T 1 S/ SCR FT. D�_ 2 7 i s BY ` RESULTS I�//T/VESSED BOTTOM LEygCN/MG PER P/T �� $Q. FT . Sv c c- 'OeACOLAT/ON RATE,*I TOTAL LEACH/NC- AREA 26 SQ F7: RCOLA7"/ON RATE J 2 RESERI�E LE°4CN>NG AREA SQ FT. C�/}:ZS �� SOILS T .�T - S70 OF�� ��SHOFtijgs � _ I( U � wT`Z? L L� PAU L A. u+ P A U L LEVY f'a 1 A. rn . No. 1G617 N �; L E V;Y �/ ,- 3 , LEVY& ELDREDGE ASSOCIATES, INC. ` No.10050 p L�S�= 7t2 MAIN 9-r HYANNl9, MASS . nary O/(tii� r9 �� !v �Q Gof12S� Si{N1� 7 G� P SfQ sTE �' �'7,� NO GROUNt� YV,4TER ENCOUNTERL�O cAZOA17":.3- -:DATE: ._f4//Z GROwlo Li/•L!7"ER AT ELE!/ JOB ND. -2-- tt{a ' � IOW � � ;S }atl �k "r�• t �� IV 60 l 6;ZtolSO - 10Mi.a \ \ \ 2x ll \.ri' ; 3 Y / Yf Q j ~' ma's i t i t i �• t So iij 10 77, /U& 1/�/S'T: .�/" LE•AC'IJ f t �I'���L3 �R` �n Jw �7 ` \\ ART p�0� JJJPPP 'x ; \ 40 i Ila: to 'Al Ila 33, TZ ♦fit\ \ \�/U... ,r 43 R `. �NAF - P A U 12 A4� y� A. kLQ)E(HY No.L. 0050 O LEGEND srE .� EXISTING SPOT ELEVATION OxO EXISTIiV1YB CONTOUR --- p --- - NLUT -1'-LAN FINISHED SPOT ELEVATION FINISHED CONTOUR 0 � �off' SKooTF�yincG.. H t t. R N4Tf: The -location of any existing underg,•cttutd'• sewerage, r y�,��e� �T�[� vi���-----�-=,�� wells, or other utilities shown on this p—lan i� .�pj�ix ' w` ra imate only as determined from records and/or verbal A BLC_ A information. 'rive contractor is responsible: for the Y;X '�t Mt verification of the existinglocations;tin'the 'field. ' t'� Y0" 9CALE� t�,.r� Ym -{DA'TE,,,, rJ _..,- �,/`--IYaSv :;f y'ytwd�'C 'r3'y t + "•+ '+v+ ifs t'• f'_ LEVY & ELDREDGE ASSOCIATES INC. CLIENT-_ g-�-0/"Ir,- I,*G THAT fj HE. PR0N0SEC ` 8Go3c� 0UIL�IN ',� « �{d JOB .MO 0 SNOWN" ON, _THIS NL AN° ENGINEERS-LANDSCAPEARCHITEC7S fCONFORMISTO THt• fl O IN(i LAWS PLANNERS-LAND SURVEYORS s' OR�by ; ~ F / /� $ w p i {n� 712 MAIN STREET, ON. By r• , ; HYA NN I S, MASS. SNEET.L.OF v 2 r' A � x"k EG��� °M ND 51'1.`H fYOR i-• r.'�A .ox'F S'ie5t� .�„�nn n�:'i..�r.4�t�.i . + - _ .. �tt}. �f�Wq�� '•s ry �Eb r� ��"'r twt; ,^ �•+'^.;....w.��'W'