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0502 SKUNKNET ROAD - Health
502 SKUNKNET ROAD, CENTERVILLE A= 169 093.003 UPC 12543 No OR s`ts7cc:�. HASTINGS, [IN ti S w«a OV/ 6 No. Fee HE COMMOAWEALTTH OF MASSACHUSETTS Entered in computer: ' Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[pplitation for Misposal *pstrm Construction Vertu Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. S v a TT Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 9 Instta}lller's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 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) ® gpd Design flow provided gpd Plan Date ® / Number of sheets Revision Date Title Size of Septic d /a 0 4 6�1-4e of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) J'4f:df- � ' 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 th' oard o Health. Med Date ® ao Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued i No. ° Fee HH,0.CWMOI��WL''T EAH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ' Yes' application for Misposal *pstem (Construction permit Application for a Permit to Construct( ) Repair Vi�Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. S'.(�a��f.ti�`J'� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: .: DwellingNo.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building ��'�J' , No.of Persons Showers(- ) Cafeteria( ) Other Fixtures Design Flow(min.required) 'S O gpd Design flow provided , gpd Plan Date / v Number of sheets f Revision Date Title Size of Septic Tank _PT/.+✓d�_ /,a D Q �pe of S.A.S. Description of Soil 4 Nature of Repairs or Alterations(Answer when applicable) }'�r /,t�� �✓� I -_.. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i 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. Sig ed Date Application Approved by Date 1 / ( Application Disapproved by Date for the following reasons j r - Permit No. / Date Issued --------------- - — V. - `- - Th E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( f4/Upgraded( ) Abandoned( )by S:'/yy -/��' �.��/ X G !�7 / G ,P fi G at :Co Z 1--kAe e,7�,- '.t2, c4r,4, ,has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer �T ,y Z otC'//C ' Designer"iw,, °O/V - #bedrooms Approved desi n floc 1� o gpd The issuance,of t is permit shall not be construed as a guarantee that the system w'.1 fun fr /n as desi ed. Date Inspector G� �U✓ -------------t----------------------------------------- ----- --- ---------- --------------------------------------------------------- No. '11y, Fee t�� v / s /C v ! THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS _ - 30isposal 6pstem onstruttion Vermit -_- - Permission is hereby granted to Construct( ) Repair(6) Upgrade( ) Abandon( ) System located at ,�"o Q J,1 4w 4,7- -/c d 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 mus/be completed within three years of the date of this permit. Date I) Approved by e4l k(� 1 ' '/ �• TOWN OF BARNSTABLE LOCATION `?-6a `�' ) SEWAGE# ®� 'VILLAGE �e-�''���///Ze�' ASSESSOR'S MAP.&PARCELf�7 — "--03 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �lpsi�. LEACHING FACILITY:(type�T�I�`•�-�i�/r �- ��(size) NO.OF BEDROOMS 31 OWNER �1eZ— o� PERMIT DATE: �� e/� COMPLIANCE DATE: Separation Distance Between the: ® Gdef�7fG� �j Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /J Feet Private Water Supply Well and Leaching Facility(If any wells exist orr 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 19 ' a Ono . • TO' wn U Barnstable Regulatory Services ti Thomas F. Geiler, Director ` e MASS. ` Public Health Division v�Ar fD 39;.�a`�� Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 >Fa�xx:,5 8-790-6304 Date: //ate �3 Sewage Permit#�Q�� ��© Assessor's Map/Parcel llJ 1 q. 10, Installer & Designer Certification Form Designer: �104 U 6 6 Installer: Address: �I � � � Address: Pq✓*41^4 On V 6eP (✓as issued a permit to install a (date) (installer) I septic system at 5d10Ky4VWff t2014 based on a design drawn by (address) ^ I jV7 0(�Gj dated (� Z®! (designer) �ertify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local R '-Lions. Plan revision or certified as-built by designer to follow. Stripout (if r? cted and the soils r��kwere found satisfactory. OF 14gs� s DAVID b g �. :. (Installer's S' ature) MASON 9 No.1066 o c� /ST P � 4 i t esi., er s Signature) PLEASE RETURN TO BARNSTABLE PUBL,,, -%fE OF COMPLIANCE WILL NOT BE ISSUED UN i ii, i rtiJ r ORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercer itication fonn.doc Town of Barnstable P is of 1l�rq,� Department of Regulatory Services Public Realth Division bate 200 Main Street,Hyannis MA 02601 PfU p/IB�`SiA Date Scheduled _ I U 11? I Time DAM Fee lerl• o Soil Suitability .AAsse sment for Sewage Mp®snl Performed By plO B M " D Witnessed By: ])a t:( �nJ• Gyr�jjylr�� LOCATION& GENERAT,EV iORIVIATION Location Address Owner's Name j 02 S ku�kr�lz� lAd �J, �SVv )Owl�t ,Mciry Address I Assessor's Map/Parcel: I / 09 3-�003 Engineer's Name NEW CONSTRUCTION R8PAIR Telephone# CCVJJ«<�ltill ---FFF Land Use Sloes 96 ' P ( ) Surfacc Stones ' Distances from: Open Water Body ft Possible Wet Area • ft Drinking Wafer Well ft t Drainage Way fit Property Line ft Other It SI(ETCH'(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 1 Z �lar w f Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Waferin Hole: Weeping from Pit Noce Estimated Seasonal High Oroundwater DETEYUVI9NATION FOR SEASONAL HIGH WATER FABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soll Inottlae: In. Depth to weeping from side of obs_bole: bt, Groundwater Adjostment ft. Index Well# Reading Date: Index Well level Add,factor�• Af(.Cirnundwnfer Level rt s Observation PE,ECOLATI.O 1 TEST Dste- Time— Hole# -`,w 1 '['lore at 9" Depth of Perc V D Time tit 6" O� Start Pre-soak Time @ T Time(9"-611) End Pre-soak Rate MinJincl, / 2 X41 K I ( / Site Suitability Assessment: Site Passed Site Failed: Addltional Testing Needed(YIN)' Original: Public Healtb Division Observation Hole Data To Be Completed on Back----------- ***1f percolation test is to be conducted within 1001 of wetland,you)roust first notify the Barnstable COUservatiou Divisiou at least OUC (1) weep:prior to beginning. Q\SEPTIC\PERCFO RM.DOC , 1 DEEP-OBSERVATION HOLE.LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil. Ofher, Surface(in.) (USDA) (Munsell) Mottling (Structure,Slones;boulders. WSW ency,q6 Oravei) III t DEEP OBSERVATION ROUE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. o sisten y,%(3rayel) �rVl DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muusell) Mottling (Structure,Stones,Boulders. Cons I to cy,yb l3ravep DEEP OBSERVATION MOLE LOG Dole Depth from Soil Horizon Soil Texture Soil Color Sell Other Surface(in.) (USDA) (Munsell) Mottling (structure,Stones,Boulders. Consistency, 6 a Flood Insurance Rate Map: Above 500 year flood boundary No es Widdn 500 year boundary No '+ es Y Within 100 year flood boundary No Yes Deptli 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 abs rption system? If not,what is the depth of ha urally occurring pery ous material? Certification 10 I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environ enta Protection and that the above analysis was performed by me consistent with . the required training,experti nd p ie c described in 10 CMR 15.017. 11 Signature Date Q:\SEPTIC�PL_RCPORM.DOC TOWN OF BARNSTABLE LOCA,71ON 5 ��'E� 4�2d SEWAGE # V eiAGE 6 ' / AJSSSESS 'S MAP & LOT VISP8CTSR`SNAME&PHONE NO M"t`-/ SEPTIC TANK CAPACITY QO / }G !/ LEACHING FACILITY: (type) / 1��'S C Cn J (size) NO. OF BEDROOMS BUILDER OWNER ,-� 0/2d Md4e -Ll) Akoe�ea� PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: r 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 Facili Pqany wetlands exist- within 30QEe�of leachin �li ) _ Feet Furnished by /® / ✓1�JsGeG�`/��._ C' a �r �� - �� �� C a3 , e" 0o 6 � AUG 5UROFMSM BORTOLOTTI CONSTRUCTION,INC. 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 �V 508-771=9399 508428-8926 FAX: ..508-428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 5KLnKp,c_+ rd Date of Inspection: Z (DInspector's Name: Owner's Name and Address: 'Sf` CERTIFICATION STATEMENT• I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal/ystems. The System: V Passes Conditionally Passes Needs Further Evaluation By the cal Aproving Authority Fails Inspector's Signature: I Date: The System Inspector shall submit a c y of this inspection report to the Approving authority within thir- ty(30)days of completing 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUM ARY• A)SYS,XM PASSES: Y I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CNM 15.303. Any failure criteria not evaluated are indicated.- below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair,passes inspection. Indicate yes,nor,or not determined(Y,N,OR ND).Describe basis of determination in all instances. If "not determined",explain why not. .The septic tank is metal,cracked,structurally unsound,shows substantial:infiltration or enfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is,replaced with a conforming septic tank as approved by The Board ofHealth. Sewage backku orbreakout or hi static.water P high level observed in the distribution box is due to'broken or obstructed. i p pe(s)or due to'a broken;settled or uneven distribution box. The system will pass inspection rf(with approval ofvThe Board of Health):' DIY .. 3 'r y; ta.,- .- ii :c`',X;„. r.;.ro r:..✓":C s} ' ", t w_ .+` �r ..sy :�k+,, 'a ,''d:tt'-;� .�" .:. 'a�g u§ 1 a,~ �s r'x' s.;. r,. �..�5Ms". br:r:. 4'":. , :f..:� S u , 3'`f`Y,.."•'' l; rf SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four 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 Obstruction is removed r . C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 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. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this de termination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool Discharge or ponding of efluent 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 clog- ged SAS or cesspool: Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow Required pumping more than 4 times in the last year'NOT due to clogged or obstructed ptpe(s): Number of timespumped 2 mg, asF a x � � 2 f 4 k y S"6 M'w': * 1 K Sy,.�'C + ,�q s.,},F 5;? P 4•t' ... { a .S S i ^'v 2 %z Y .x. .., _+r € - iz. �"s �` � :.. ..1 = 1 a�. s,, .,.,3 �iy:,wv A .rJ�^'.ggt.,I..n'•.S] p r +`s a .� � :h r"' . s sc,,. sa ° ..,�. :T,- .Y�,. "r'+§yf;. � a �. ar +'N''.:.a ';„ � a•, .;;,d w �,ka`,�' .r- "_� {w :�a x xx t �_,+ �� ' '' Syr _k�x e�t„a i '.tt� t a>,��� a , r�:,.,.a a r;e1s`Y r �sk"', -x:,-. .-,r...., ��°.m.;.A."t�.. .;t?�' s 'tH ��<< ,..rx ,3c x � F •E y_�.'f? - �.5 ., �j..�=:.:, .u... :'vd"rt r.•,S M. _ ,:.Yr. p�u J w��;.+'� esK,..r''-'r ax3;+ s: :r X,v''.tKY, ...4,Y•=p,s, 4`, y."4.e�. � w.. fyt. ..-.Y+'i,�Fr,2�x�,�' ';�,:3 ??' r -F.;-�: .,k�:: �.;x eau"„1a.;.fi�'•r'�l�,, t�,•- �.�'.f�':�$. ,��r {.. }r.�.. k�-.,�'r� .mr �' rosfi} �-`•+�r ,rF a.•' «i�f � ` r�".r.,;r «t:,�Fs �...o �.t. ." �, � �i''k:-'�. �. ,.. ..�,^.. ,ai'- z.-f,p.... .w •� ri:�"i.. 4` �.�W,,a,,., �ii`'4.. •"'g*�,.'v�v`.. sf..� w :�.:. 7 .�,y.' �Yld;.�,..C-�?., ,4.�3�� +, c> r .�„:.y.}.� r�. ;�`, //°.as �',u_: 3�. ,�,,,.; '�_.. �„ z?t. �'.� �` .:«,ar:'. �. �,;. ..ah r,. tr, �._ ". ..a .+.�,x, .-:� a .�,•G"s-�a`•rit� -ce•. ' , e 8 � c,r C �3�• -rd w a r.< i>zr u.fy h f fi<� �,;' �,,�tvr',��, ,�"�� w�,x*�5,, .,�; �' .,4 ,< � b.« �r�' ,�F+�,,�m.,Ltt,f�,7 ro,'.',ne�{ �„c,wg�...,r �.ti'.�.. '�i. �7•v� a.. ? :,. � s4 �ara�i �: .e.•'�'''s� . .: :.� ` X+.fi� C v�k .,s7 ,,�.,�t`t.e,.. ,a�+� ,�4-^�' k �.r.� Y M�.r�.n-r��5 r '. I - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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 I of a public well. 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 supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: The system is within 400 Feet of a surface drinking water supply The system is within 200 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. The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check if,Qte following have been done: _<, ,4)umping information was requested of the owner,occupant,and Board of Health. / None of the system components have been pumped for atleast two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been / introduced into the system recently or as part of this inspection. OA -built plans have been obtained and examined. Note if they are not available with N/A. e facility or dwelling was inspected for signs of sewage back-up. e system does not receive non-sanitary or industrial waste flow. e site was inspected for signs of breakout. system components,:excluding the Soil Absorption System,have been located on site. e septic tank manholes were uncovered,opened,and the,interior of the septic tank was in- s ed for condition of baffles or tees,material of coil fr ction,'dimerisions,`depth of liquid, depth;of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on existing tnformation or approximated by.non-tntrusiye methods. t 3 f F 1 �. a a " c ra at a •Y; s '4 a + a ¢ n1 r y$ V4" ^'f 3Wq} "'�,5 X.7,"�''3.$- �F Fr. �a'r�i4.�,- d y.P ::-+'k v .��',�'t».. .^L.x '�:'t #`a'{4 �'$�.4;t,✓.."_�,e. 4�:- �"3 ,f•�.. �'.,� a '`� ,ktC > `M § 7 ='c7t''y*z..:q.'�� ''� T _.•��� .'_-,�_u.,�. r` Kx..'1'J?,P.G.0 �'n�.' ',;+asa: .5..:. `�' 3`z Y �. ti ,�.'Ti�' ?��--:-ia ra. a -.�34�� hF � �aa 4w•�'x4 .six "2 S' _ .5.,..;.. ;.. x:, ti ,�c��,`-t :. ..,>4 x �.��.."�.'�a � f � d..�' � ``�. b � i5 :rr `$.s, 2 -• ;% �: g ,: ., � � ate'-a3a +� �. •g�,,s.¢ � a•as{'" +€�:... '�' V'�''"�'k �.,�..�5;i a��',,, ac' �.�'�'(� `,`#?tf•�"'`4 Rl'.d+b} k„ ,t- '„`e �r„ t�,i $s;ry „�., +dt c„ayr.s:,'�,,. i��;,`fr�. .. ,; �-. �y�`a,4WK3� .`��-,i„''�., 1.Y.'5... '3f .� ,.,a�*'.'S'u;� t _.k",. 7 '+�a. �sc� rta.' �3+.,,yy�>'.5 a,.::h._ � Y�.+::}'"�;a 1a''�y, �,;' ,„..�,• y x�W; y:, ^""�Y?.:x�` -'*i �.:w�i�i^�. 's�5'a.<=.'k +4:,z�• � 3�' �'���r nik'�w:.. .T-:,-; - ji �.�=�;idyv a��cyr.�w= {.Fs." ��,. r�Y ._;;,afa s?h K �z.�.y�„���:' t 'i a: MC-� '� r,: „ �•� �to; :�;+�_'s t'�,5, §v .r.;�,, '1>�:s"" x:''e'�'� ��^". �a'�x a'�,`, t." '' :�c� ,��'' �" ��1. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) ---,,—1 he facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS' RESIDENTIAL: Design Flow: ;50 allons Number of Bedrooms: 3 Number of Current Residents: 15 Garbage Grinder: . Laundry Connected To System: &6 Seasonal Use: �a Water Meter Readings,if available: Last Date of Occupancy: Wrr e11-�- O MER ALLIND TSTRi_A - Type of Establishment: Design Flow: . .. gallons/day Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: a System Pumped as part of inspection: If y ,volume pumped: gallons Reason for pumping: TYPE OF.SYSTEM: _T Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool , Privy Shared System(If yes,attach previous inspection records,.if any) Other(explain): APPROXIMATE AGE o all co ponen date installed(if known)and source of information: terr, e3 Sewage odors,detected'wlien amvingat the site: -4 mt a x +t ; h 'rrn 2y a�4n " M1:f,,.y?r' ,4 r--#x 7 t _ �. tgi N.. v. #� ,x <L*�y �• y. a.. ?''ti i• i 3 y �3 ,z M1yt . a'a 1 k r f s t §,r 3,,. '*r�`p.J�'.e•'j�'?rry ' Y'r•Yt +sk?'f yi 1 "S ? �y ,� 4 .". ^rr a y �' y:w.1r t, e�' :Y# e Y :: i?;. s°.mkxn s 3yE. v„6- ° ?�� e t ' rk r°s yeN ..s'. , _ 1 sNt sf,r fn, „' .+5+.f' •,waS. }y �`,� w+r +�,'S7a�p � ;_. 4,3�1 s•.: Y t. a,:..3 ,a S..r`,�, 'r ...� i �,..:,::;� 'Fa. 2,�Y�.- ^• '� �.�:4s•,. {._ '.�t.kt' '-' �A r .�.,�+� ..,4d y �:.�,.'�-s f. v p ;x• '�4� Y t..,n � ? '��° ��.'�" ,w � a 5+ /,4'� va� �t� {{�'v,v -ar; '15� .,,t•. '{�",,.'�, $..'�k ,.•tu ::'4.., ?,'k �r-, , 1'Y �&,C.fy ten'°„. �. i:.• -... ���a�:.� .:��#'. ��`"; r.. .,++`t. ..y,. q.. �`'� .,-ads' r l� +��''� -}, 5,.;� � �.a F" ^a„k;,. {:1r" C �, ,_ ..,. ..,:;� ,;„. fi d'�, �.? �. '� ;� �...�' � r., ...rw i ;'�3; a .r': ,.'?� '��' �.•„3 x 5 .;,.�� �.�rrP' �,� ��� a. -,,,r at��' .,: :.w� ;n:i'',r,:•R c - v�' C ., sr.e ... .�. ,, 4r.., f^...�?�, r � �€ ,�� z..:. '� �� ?.4�<,�!,t�r:,€�,� �.,. +�� t�i�y: ,r rk:$ :.t .n k N o4t:.� � lr:. l"d r%., } > +k' �h'€{.. 7t 't i xat� x �w''����•`X•k � .„i ' �'� ` �M1 i$'�r o �=rrjlr'� n..�.'}�,wr: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: Depth below grade: ' 6 Material of Construction: /concrete metal FRP Other (explain) Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: 251 inches Distance from bottom of scum to bottom.of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integn ,evidence of leakage,etc.) - Ci Wo• 1. 1C kl r a e GREASE TRAP: WA- Depth Below Grade: Material of Construction:_concrete metal FRP Other (explain) Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction:_concre-te_metal_FRP_Other(ex-plain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: ,„ r Depth of liquid level above outlet invert: lqu I ►�•t P�ULt, ` p oulrle-" Noe- Comments: (note if level and distribution i equal,evidence of solids c rryover,evidence of leakage into or,put of box,etc.) — JpOX C1 " (,tl'X l� eve box 5 1�t?, Yl i Pl PUMP CHAMBER:_ Pump is in working order: Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) _=5_ �Mx y,i. H - 1a;1,,,, o-....:-, ,�-: ,�:�§ �.;•:: sty "�s5 �,:w5.'�° ,,,, ^�.b.E z;,. � ap'..�'� � ,.._g.�.;-� 3y,:� � yam.5 �:E`7:sx-,. .fit'-�,._,�'?^.,.J' '�k���.�.,...,, e 1 ;�` 'w3.��,., �_ -n ;�.W'3 u. ��. & d' "�.+"i�` k ''fix r� �y.:s� ��,�..'��&'�. - '�,.,;,w ..;.� `'Ei...�_ x.. �?�#yw3,'�• yr+e'r .;r's"'�9 ..,.-�',� .�i's^w��'�� �.,.,�.. SUBSURFACE SEWAGE DISPOSAL SOSAL U P SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits, number: Leaching chambers, number: Leaching galleries,number: Leaching trenches, number,length: Leaching fields, number,dimensions: ID I 1 IUD' x yA Overflow cesspool,number: Comments: (note condition of soil, signs of hydraulic failure level of ponding,condition of vegetation, etc.) NO si4Y?5 Ck N"L --Cail re-' CESSPOOLS: Number and configuration: Depth-cop of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soilk, signs.of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) -G- ' rv^-F 1,- k- � .k''€' *,. �..# r"'. , � E tt '! f +>` �,� a t ��''� ^u•^ L' t 'hs r} r ed, t jy 3 �.. t)s, �r q ;.�'t X. `L`�`n i '�. �., P ps w.a"��" :.. �,,- 4#�;y'�,`'k.:,v:.. y.{i.�3.,, ;'�' r.i.�N = t �'tY ...?"�" ..r�h'' ��F,.+.• �. !` ; tit �-` xr..::.^aa. s s.:,, ,;�.:.;h ,-t rar•.,+ts � ,F'yt `�c.F�z >�t -5°,,.L* ,,,,. ti..^ ,."6ti k:l �. .�.,•' t -, �,� 7p _y yrr,i,�k. {„i. 'ty'�}r.�; � ,'t:,�r,v x�:�S..rv� ,.�:: ,, !_.v„'n. r,S".,f'.r �o. a.,,,?"w,,., S' �'.,�.n .�.:C,.. '},,',�, r,v '�,A.. ;Y}....��, „$w.�{,.. ... ,.. '� a#. :,a.�->� s....J.._ ,;"�r.`f' ,��rf-.• ht ,^'in�y �{��, ...a^CA'.c�-�' .w.+ "( Y+; r �,,x�' �x �*.'s a w �b�. r... "�d. �Y` ;'% :+ ,�..t :Y,..e,. ��K'a+..,.., �f� e`.�,rt..,'k,rJ ,rm ... s,,h. �2 y^r.!c � h.M.1.: `Y'�s�iti='$:.. ,y .,•".^,`��++.;��v..�.,ti �A�,: .�, rrc .;t.- _'':�'> �i"�.."„%"f .�": ..���,g ,s� r s. ;k x, fr.. S.. .; ..� ^�... �1 3: -�s '��;_.d� 3s'°.a, ��.x. y y.. ;t;.�"l.r zt,n�{;'��'� r •„d� X_..- s4;, �,.r ^.;.i.,,.-. > ,.,.'�. ,?�,.... � ,,,� ,;s« 1.�. -orb ta''+.: � t: s;�'1�..p .n. a: r x �...c..•c� s„ ,:; �',,F, ."Ay�tea r r{y.;,' ,�:+.�. „,�y e*,�'=h d'4.1 a*.Y-.. r"�6'.G.n y,�^�• +"Ft.; I,., T� ,�r'�" ��a +�,',p..-sn ,:n 4H�'r'"�ir,h� +!�z. .tk'�. T ,:� s-;,"`A =�`' k�,y�.e. A �...X .,�..: '�r,{ r" ..F• ,.. '.I ��» :�s,.-r...f.`;`.�+y .x :'�a � x.hn� "���ti�. � .i.sC��., 4"�� M.. Y',. `.i.� .Y'f�'+� _" � � �^. s. g, �F, tF � a�gt s.. ,, r.�� 0:��,+.4,1`�a� f.. '"�. . �.:.,. �rk' �K ..�'� � x:.r �r�4: v�.� � �`� :•r.�'k�..��. � µ+�:�f.� � �...,,� ���. xF` .�: '�- L7,, n'&T�:.:.�SrIY...�,;r+.�'+,, �d,.',�"�.,.r. ,r�';¢.�'�' sY �..� C �; i'r` .^X`'y lea }y7 its to •t.w'���»��t.� ,., er'v �:_c'/u^���.� . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. AZ - Z6 � / 97- - Z3 siuserr.,) 0 DEPTH TO GROUNDWATER: i Depth to groundwater: �' Feet Method of Dete�nination or Approx mation: dU.Sei'r� drousrQ'i�o�`er y"i'Dis9 �,� -7- . r ..,,.sib..,XYEn_., ,�..'t<.�.... �'it d'#�.'�, `?� f �� {c�� �.'#'� � ;ti#�'�•F,,. '...�+ '�i•s��+ irv*.� �"��'*.F3.. �` � ¢a:,r I',•�'`� : t'" - i u � r � tSt t.-r:.s Ye�3,x i p.,... .�.. n ,.:Z..Tc x,. ., fJ;f•.. �.�. �.,.. :4 ., ...F`.K�, {�:�.� � ,1"F= .,;i'3 xk�- 5�:.�` �8-. �f- r€ n,.`�j.y� �y_v.T,h fict$�£�,�N.. �i4Y,ate , . r, x wM w• �.k.e:!�r 3 �� „iz3e+ e ems^. q�"y, ..'3 i,"�+.e`rJ +x`"i,c..�.s. ",�'.x.,., t .��a '�< �n r.ua*,s� � _��`'�' ,i'�`�c..� �.+� ,..�;3 �7. ��'X x �4% �.�•/ .'-i TOWN OF BARNSTABLE Lt=CATION e r^ SEWAGE # VILLAGE C ew J�f't�/A«' ASSESSOR'S MAP & LOT/ Q43 1 INSTALLER'S NAME & PHONE NO. 6�f� /� ��Af �/L ' 3 SEPTIC TANK CAPACITY ��� 0404 S I � � LEACHING FACILITY:(type)dl,-,$; (size)/ )i NO. OF BEDROOMS��PRIVATE WELL OR UBLIC WATER BUILDER OR O WNER A11CtAl 504,711 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes V .. �, � �� .� II � w'` � ? �1 �1 %t M` ® No..q VA PG) C� e 0� r � �ID lil.9 y. .- .. -��,� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -------.----.loulA............o....... App iratiou for Eliupu,ial Mark.5 Tomitrurtiun thrmit Application is hereby made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal System at: - -----••----•----------•--•------------ ............................................la?.....6....................................... Location A ress or Lot No. Ll �4� .._v�T_ vc-=�.�---------------------- A�!_ .. .mi-- O ner Address a .......................= --- ..... -=•----•---------•-•--......__. Installer Address Q Type of Building Size Lot._J�.' �`__ ._Sq--feet U Dwelling—No. of Bedrooms____________________ _______ _Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a'' Other fixtures __________________________________ _____ _ Design Flow.....................55 ...............gallons per person per day. Total daily flow______-_________________ ........____.____gallons. 1:4 Septic Tank—Liquid capacity/00D.gallons Length................ Width__..... Diameter---------------- Depth................ W x Disposal Trench—No. _______f.......... Width....... Total Length-------- Total leaching area....._4550 ft. Seepage Pit No----- -------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( il� Dosing tank ( ) Percolation Test Results Performed b Y:_1Y_ ____ Date------- l a Test Pit No. I-----"z-_._.minutes per inch Depth of Test Pit......../_,l_._...... Depth to ground water....A_S7__--_-_-- fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ /t ,`,� --•-t...... _-_,�QXI� —Ames ---------------•-••----•••------•-----•- ----- �� S�...K)•----•---•------ DESIGNING ENGJblF.1 1� EtS't'�IJ RVISt +J • ---_ IfvSTALLAI ION AN .... E��!! _IN_ 1 Z. -----------------------------------------------------------------------------------------------------------------------TW�-SYS.TEX4-.NI/AS INS WRITlhi'. U Nature of Repairs or Alterations—Answer when applicable.-----.-------------------rt�OR[DANCEY'AS NSTALLED__1N--STRi( Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—T undersigned further agrees not to place the system in operation until a Certificate of Complian een s e he oa• f health. Signed ..... .. ... ......... ------------- ---------------- ?............�5�-- Dace Application Approved By ................ ................... ............ ... .. Date Application Disapproved for the following reasons ---------------------------------.. ------. ...........................................--............ ............................................... / �Dare Permit No. F Issued --- ---1� �.?"„ .. are BAXTER & NYE, INC. Professional Land Surveyors and Civil Engineers 812 Main Street •Osterville, Massachusetts 02655 Tel. (508) 428-9131 FAX (508) 428-3750 WILLIAM C. NYE, P.L.S. -President PETER SULLIVAN, P.E. -Vice President-Engineering RICHARD A. BAXTER, P.L.S. -Vice President September 13 , 1993 Town of Barnstable Board of Health P .O. Box 534 367 •Main Street-Town Hall Hyannis ; Ma 02601 Re: John Baldner - Lot 93-3 Skunknet Road , Centerville Dear Board : In accordance with the terms of your permit I have provided supervision and inspection for the construction of the above referenced septic system. Based an these inspections it is my opinion that the system has been installed inaccordance with your requirements . I trust that this meets your present needs . Very truly yours , wpSer & Nye Inc . O Peter Sullivan , P. E. Vice President cc : John Baldner ZN OF 44,9 PETER ti SULLIVAN � .- No. 29733 "Mh i �O IST& �@ ' �FssioaAL E���c,� i I MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... J---.. OF '9 -l'45r146A16------------- Certifirtt#P of Complianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (L"', ) or Repaired ( ) by ..........................................---- -- .........-"I------,.�'------------ n �--sta l---1 er-......,..........---.:..----------------------.........------------------------------------------------------------------- 1 � ,r I : •n �_' � l,f�1�I 1 / has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ................................................ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................................................. ....................................... Inspector .. -----•--.........--------------------....--........ . ............ ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH vuixJ OF............ i..��lST9�...� No...:...... .....f..... FEE........................ Permissionis hereby granted.............................................................................................................................................. to Construct) or Repair, ( , ) an jndividual,SeWage,Disposal System atNo. ...........................i = I......`..� ��rf.�' --�.......rC �., -----` � -------•-------•--. ( Street r as shown on the application for Disposal Works Construction Permit No.____. Dated.._......�:.:"..�_.�.:���...__. C �� Board of Health DATE --._.... "1. ......................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS n P No......................... F:ns............................. THE COMMONWEALTH OF MASSACHUSETTS r 1 BOARD OF HEALTH Q.wN............OF...... App iration for Diipnaal Works Tonotrurtiurt Prrutit Application is hereby made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal System at SKv�tlk..l�T" � - 7'".1�.. Location-A ress or Lot No. ....................•-_........ .. .---•--....----•--•........-••---........ ............................................... owner Address W Installer Address ,f d Type of Building Size Lot.._`..._^'._�f__7`...��._Str^feet U Dwelling—No. of Bedrooms................... 3...................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria 04 Other fixtures --------------------------------------- - •. Design Flow..................... g P P P Y Y . ...._._..g...--- w ��______________gallons per person per day. Total Bail flow.._._..._._._.____._..__._..._...__.__.___.. Ions. WSeptic Tank—Liquid capacity/ gallons Length................ Width....... .._..._ Diameter................ De th•...._..__...._. x Disposal Trench—No.......4......._.. Width.......t.._. ._.. Total Length.......4�..... Total leaching area.....4157--Q--..sq. ft. Seepage Pit No---_---------------- Diameter--..-_---___--______ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ✓j Dosing tank ( ) q aPercolation Test Results Performed by---- 1��'1`� ..7�'___<�l -.�3__ j .--_-.-_--- Date......7. .�------'1.�_.____...- Test Pit No. 1------Z-----minutes per inch Depth of Test Pit-------- _.-..... Depth to ground water.....6A.$..i------ 'Test.Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___-______-___-----___. rr /' e '_ •-•-•--••....................... Description of Soil -.L......?1�1..........L�1 a'��7--•-••----.�A0...wYY.G..... � - ....................... v -•------------------------- - r M ;�`� w . 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 Environmental Code—Theey�undersigned further agrees not to place the system in operation until a Certificate of Compliance'has ee _ 'ss ed/by -t�ie o � ard f health. `�-n .✓..,i �� Signed -` I � ' ✓ � T , ,`yT Y ...-;- Date Application Approved By .............. t/ ----------- -'--------------------------------------= Date Application Disapproved for the following rearons:. '------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------`y---------------------------: ------.----------------------------------------- - ---..-.------------- - / 1 � l � fT .."`Dare Permit No. / r - Issued t L-_' 1 �`C .,.......... ... -. ate ---°-_-.---_-------------_---- .�_ r Asses is (1st Floor): SEP71`+ Asse is ap and lot nu ber 7 v O 9�-4�3 «VSTALLED 1N Cri1 Con rva n a "/ �� Wirth Tyr E Boar ealth(3rd floor: q� f ENTq 1f�J7TUL i Sewage Permit number d L C ®� Engineering Department(3rd floor): ATI House numbee Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2.-W P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 'I TYPE OF CONSTRUCTION Gf/QDd LAC TO THE INSPECTOR OF BUILDINGS: F`a The undersigned hereby applies for a permit according to the following information: Location LoT 3' 3 s 4-0/UTIV C' 7" /1C/ Ceti T,e . ?ze G Proposed Use SINGIe -2 /11/ /7�1&e-- Zoning District �' Fire District Name of Owner A�/f r- s�A`� Address_ Z T / OStlk ale Name of Builder �y r lati�f 171 Address Name of Architect Address g a lv�G�S Number of Rooms Foundation Exterior C&M14 �NG` e Roofing A�,'EZW13;?Gl Floors Interior✓� y Heating � � � � Plumbing-2 ! fS Fireplace f-1,102AZZ'16 �f'C Approximate Cost d7211 4-0 Area Diagram of Lot and Building with Dimensions Fee ^. 40 00 � a -0�. ..... S ON � N f T T�d � v OCCUPANCY PERMITS REQUIRED FOR NEW DWELLI GS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above con ructi Name onstruction Supervisor's License P�oFTHE)-,o TOWN OF BARNSTABLE OFFICE OF Besa9T4BLr YADd BOARD OF HEALTH y 039. � 367 MAIN STREET HYANNIS, MASS.02601 July 16, 1992 Peter Sullivan, P.E. Baxter & Nye Inc. 812 Main Street Osterville, MA 02655 Dear Mr. Sullivan: You are granted variances on behalf of your client, John Baldner, to construct an on-site sewage disposal system at Lot 6 Skunknet Road, Centerville, with the following conditions: ( 1) The septic system shall be installed in strict accordance to the submitted plans dated revised June 30, 1992 . (2 ) The designing engineer shall supervise the installation of the on-site sewage disposal system and certify in writing to the Board the system is installed in strict accordance with the revised plans dated June 30, 1992 . (3) The dwelling shall be connected to Town water. (4 ) The variances expire August 1, 1994 . The variances are granted because the system was designed in compliance with the application rate and the five (5) feet height separation requirements of . the On-Site Sewage Disposal Construction Regulation. It is the opinion .of the Board that the installation of a septic system in accordance with the designed plans will provide much greater protection than a system which is designed to only meet the State Title V requirements. Sincerely yours, Susan G. 'ask Chairman BOARD OF HEALTH TOWN OF BARNSTABLE SGR/bcs r BAX TER & 1YE9 INC. �. Professional Land Surveyors and Civil Engineers 812 Main Street •Osterville, Massachusetts 02655 Tel. (508) 428-9131 FAX (508) 428-3750 WILLIAM C. NYE, P.L.S.- President PETER SULLIVAN, P.E. -Vice President-Engineering RICHARD A. BAXTER, P.L.S. -Vice President September 13 , 1993 Town of Barnstable Board of Health P .O. Box 534 367 Main Street-Town Hall Hyannis , Ma 02601 Re : John Baldner Lot 93-3 Skunknet Road , Centerville Dear Board : i In accordance with the terms of your permit I have provided supervision and inspection for the construction of the above referenced septic system. Based on these inspections it is my opinion that the system has been installed inaccordance with your requirements . I trust that this meets your present needs . Very truly yours , er & Nye Inc . O Peter Sullivan , P. E . Vice President cc : John Ba 1 dner ���,jl1 OF ajj q PETER SULLIVAN No. 29133 �oe �0 1g T ERA FssjONAL E�`�'\` r MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS ASSESSORS 11AP : TEST -101- L LOGS - PARCEL .............. FLOOD ZONE: SOIL EVALUATOR _ . > 1) The installation shall eorl s with Title V and Town of #I, , �,: , 1 Boa d 01. f REFERENCE: WITNESS :--]NO)1> DATE: ? f `> Health Regulations. 2) The installer shall verify the location of utilities, sewer inverts and septic PERCOLATION RATE: components prior to installation and setting base elevations. - � ��}- -- l �• I�f �(�� � I,b 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first TN-2 two feet out of the d-box to the leaching shall be level. DAM n 4) This plan is not to be utilized for property line determination nor any other purpose other than the proposed system installation. 5) All septic components must meet Title V specifications. �-D 6) Parking shall not be constructed over HI septic components. ��`< � � t '� �b 7 The r p L 0 CA T O MAP - ZD $ �Zj� ) property is bounded by property corners and property lines. 8) The property owner shall review design considerations to approve of total desi;;n flow and number of bedrooms to be considered for design. Receipt of payment for the plan and installation based on the plan shall be deemed @ )0 approval of the design flow by the owner. I 9 The existingleaching hang or cesspools shall be and filled with material pumped a per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per Title V specs. 10)System components to be 10 feet from I•Y p om water]me. Sewer Imes mg the . water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if applicable. The proposed SAS is being installed below the water service SEPT I C SYSTEM DES] G N line. The line is to be sleeved as aforementioned and maintained in place. ----. i 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. FLOW ESTIMATE l2)The installer is to take caution in excavation ation around the gas line if such / rr�� exists. BEDROOMS AT 1 I V GAL/DAY/BEDROOIIA -;%`,� GAL/DAY i �--- 13)The installer shall verify the location, quantity and elevation of the sewer lines exiting the dwelling'prior to the installation. SEPTIC TANK 14 Thisi plan is representative only that a system can fit on a property meeting�Il \ Title V requirements. i GAL/DAY x 2 DAYS - GAL — USE GALLON SEPTIC TANK t kl`TMN SYSTEM OF DAVI S I DE, AREA Z ZGl �' l'3 L, , 7 - % �c�7 �''\ .r�G �� ; BOTTOM AREA: � TS SZ 15�-4D I r _ EPTIC SYSTEM SECTION /'12,&7 xA 4 \ q �''F '� lu ' Cbvl� l?_ - -Box 3� n/t�Ot� ID SEPTIC TAN C -�� -rj l J 7,Z o I 1 ZDDD S I- TE AND SEWAGE PLAN LOCATION : PRI=PARED FOR : = �$D _ 15f-�_ ° DAV I D R , MAS014IRS DATE: 0 -Z-b 2at o DBC ENVIRONMENTAL DESIGNS 3 I'AMT SANDWICH . MA J DATE IICAL111 AGENT - ( 508 ) 833- 2177 U 3 w - Z . I � ; I I i I ; ; i ; � ! I I * ; - . I : . � . I I I I I I . ! I ! I : � ,. � I I . ; I : � i I I i I . i ; I i ; i I I . I I i I I : I . . t : : . � I . ; I I � I . . � I ! . : . I I - I � I ! I I . . - . : I � - . ; ! I I ; i I : I I I � _l____..__.._- I——____�_._.__,____._- _--l... _ _. .,__--.-,. __ r ! . j I I I I . 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