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0011 WEST VIEW LANE - Health
11 West View R�ge Centerville A=248 031 UPC 12534 ' No.2�, 1�OR No. �OQ t9 /3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i /Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for �h5poe;al 6p5tem (Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. I W2.(T� 1�� wTt-C.G� Owner's Name,Address,and Tel.No. C ex-,fie \ Assessor's Map/parcel 2-Lie 3 SAME' i Installer's Name,Address,and Tel.No, Designer's Name,Address and Tel.No. Sri J. Sal C5, UA13 Soo s3�-� 1vb Type of Building: Dwelling No.of Bedrooms Lot Size Co, ()Z sq.ft. Garbage Grinder (1* Other Type of Building Mon p_ No.of Persons 2 Showers(✓) Cafeteria(✓) Other Fixtures �—AJ ATORY i }' ere'.1 VA Si,j)-1 L Avonl�,,,? Design Flow(min.required) gpd Design flow provided J�� .9 iD gpd Plan Date A-AcA \nk o Number of sheets A p Revision Date Title QD94�1611 i Size of Septic Tank N 4--,j 1 5X A "Z TY,4 of S.A.S. S i N e's if I �1 b 3 -X lox Description of Soil Nature of Repairs or Alterations(Answer when applicable) :�?,Q C�-c A� ®\[+ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this f Health. igne Date Lk C Application Approved Date to Application Disapproved by: Date for the following reasons Permit No. Date Issued — -------- ------ -- —�z —————————— ry N. =;)_©o 6 1'73 ra "1 a €, t Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE; MASSACHUSETTS Yes 31. ZIpplication for Digpo!gal bpztem Con5tructton Permit � Application for a Permit to Construct Repair(X Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. i 1 U—)eSA V 14-W �r CC,( t Owner's Name,Address,and Tel.No. C2 \\0. Assessor's Map/Parcel 2y O 3 b b Sp,M E) 1 5 141, Installer's Name,Address,and Tel.No. Designer's Name,.Address and Tel.No. \s S-�-,6(. cy-i d 15\4 C S U�tH-53�o S39 3L9v� I Type of Building: Dwelling No.of Bedrooms Lot Size U.3CJ Z sq.ft. Garbage Grinder (/l/iA Other Type of Building NUfl4 No.of Persons 2 Showers(✓) Cafeteria(✓) I�Pw c�-roy`� )C LAUNDRI� Other Fixtures Design Flow(min.required) 3 gpd Design flow provided 33 3 i O gpd Plan Date A7A\Q QU Number of sheets I Revision Date Title ``�rMc�t� � 1� -5U-A Cj--N Q cyC-C, '�o Size of Septic Tank N aw 1 AG Tyye of S.A.S. 5 N F I I.TRA T Gz5 IUX 1 Description of Soil —\,z, pin Nature of Repairs or Alterations(Answer when applicable) 41'r-1 i i 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 thisfoa r> L Health. f Signed Date ApplicationApproved Date Application Disapproved by: Date for the following reasons Permit No. C0 — Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS" (Certificate of Compliance 1, THIS IS TO CERTIFY t e On-site Sewage Disposal System Constructed ( ) Repaired ( )� Upgraded ( !/� Abandoned( )by K ). at ` (,O-P.Srt' tJ 1 t r��c ✓r c C L has been constructed in accordance l with the pro ' ion @f Title 5 and the for Disposal System Construction Permit No. &60� - 7 3 dated �/ �9/ Installer !�'d Ve A-5 Designer ✓: {-\1 A4`'�-: #bedrooms // Approved design flow v 33o gpd The issuance of this permit gall no be(construed as a guarantee that the system w IIIf n on esi ned. Date 0,3 Inspector No. -3 Fee /,00 THE COMMONWEALTH OF MASSACHUSETTS - J, PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Ii5pont,*p5tem (Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade (!/< Abandon ( ) System located at 1\ �,,.. b'c— y f'w--- l--" ( -� \A 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 condif n Provided: Construction must be completed within three years of the da e of this pe Date L) /1 Approved Town of Barnstable Regulatory Services Thomas F. Geiler, Director r BARNSTABLE, 9 MASS. Public Health Division t639• ♦� p'FD1A°�� Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: c)(, I Designer: Shay Environmental Services, Inc. Installer: :R0 C Address: P.O. Box 627 Address: East Falmouth, MA 02536 Y�(2��� 21M, On O S C- was issued a permit to install a (date) (installer) septic system at LKZ4NN214 vi\ based on a design drawn by (address) iL Shay Environmental Services, Inc. dated — - 0(10 (designer) 7� I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. +' I certify that the septic system referenced above was installed with major changes (i.e. t greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to f - Ic A OF MgSSgcF. a CARMEN yGN (Install, ignature) o E. -A S{-iAY No. 1181 0 GIs-TIE S p,\fDC� esigner's Signatur (Affix Des! p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form I-a-1,7e TOWN OF BARNSTABLE LOCATION ( SEWAGE# '✓ILLAGE��A-;FC'✓V 1q 1 SSESSOR'S P&PARCEL INSTALLERS NAME&PHONE NO. i ���A SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: --0 Iy COMPLIANCEbATE: -!�bj A Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY O O � �ra qt(prr 9116/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems. Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, LtAr-t-j C : 3 4P)Y ,hereby certify that the engineered plan signed by me dated A concerning the property located at �� �� \�'� � �v=►I1c meets all of the following criteria: • This failed system is connected to a residential dwelling only..:There are.no commercial or business.uses.associated with the.dwelling. • The soil is.classified as.CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests.at the site without a health agent present. • There is no.increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information). 48,0b B) G.W. Elevation l Lb +adjustment for high G.W. DIFFERENCE BETWEEN A and B 3 J O SIGNED:_. DATE: _ 41 k9 I Q la NOTICE Based upon the above information; a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.doc *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. E--10' min. from SECTION A A ALL� ,, FRau THE Existing Foundation house to septic tank DislRitn"Box SHALL BE 12• �COVER TOP OF FOUNDATION = ELEV. too.00 (Assumed) tank covers rnuec 0-Box maet PROFILE YIB1P OF ADDITION TO LEACHING SYSTEM SET LEVEL FOR AT LEAST 2 FT. within 6 in. of nnk+hed graft rrRhin 6 in. of frfthed grade dads over Septk Tank-98.25 dada over D-Box- 98.00 orar SAS- 90 00 ' a -s, • s 3- of 1/8- - 1/2- Washed Peast 3-5'OUTLET 3/4-to 1 1/2 - Washed Crushed Stan KNOCKOUTS f iv C,toW a _ ss• f tz• eeFT Ij r� �4� PORT 70 BE S= 0.02 NEW5=0.01 or Gireoter 3 HOLEBoX 0 3' Modmam Lover Tap OF System-E1ev. _ � atSTALIED AIO TO E1E 1NTFIM C OF GRADE r : e' e' csv llN ° t EXIST. PPE S 10' to 1,500 GAL FROM EXIST.FOUMDAT1lIN ^ ^ 20' S. 0.01`per foot 0"EfhctM 155• b o a, m SEPTIC TANK Depth t.7s• CONCRETE F�FOUNDA > o H-10 «.•". N s' - PLAN SECTION CROSS-SECTION a ai a' 0 83 (10 inches) 5 Units a 625' - 3p'� r Q:c�, , �e' g SYSTEM PROFILE 6 in.of 3/4--, 1/2• a �; 31.25' 3 HOLE H-10 DISTRIBUTION BOX " _Not to Scale O0'^p°cted stone c o ; 1 a .- 3725' NOT TO SCALE W4901Rad * c S 0 3.5' 3'-� 3.5' a Effective Length A; 6 that 3/4'-1 1/2• o tO' 'e SOIL 611SORPTION SYSTEM (SAS) compacted stone < Effecti" W1dth W GENERAL NOTES o INFILTATF,OR HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN 1. Contractor is responsible for Digsafe notification, Verification of Utilities NOTE ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6` BELOW GRADE E (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes. NOTE: .OVERALL HEIGHT OF INFILTRATOR IS 18' FFECTIVE HEIGHT IS 10" 2. The septic tank on distri ution box shall be set W Bottom of rest Hob 2 Elev=as oo m /L Growdeater Observed_ NONE agg�p level on 6 of 3/4 -1 1%2 stone. 3. Backfill should be clean sand or gravel with no stones over 3" in size. PERCOLATION TEST 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance Test Pea rformed By. CARMEN E. SHAY,, R.S., C.S.E. Date Percolation Test: APRIL 15, with Title V of the Massachusetts state code, the approved plan and Local Regulations. Results witnessed By. WAIVER (Per Barnstable B.O.H.) 6. If, during. installation the contractor encounters an EXCAVATOR: Shay Env. Svcs. �-^aE Y Percolation Rate: Less Than 2 MPI ® 36" (i soil conditions or site conditions that are different _ from those shown on the soil log or in our design Test Hole Test Hole installation must halt do immediate notification be No. 1 No. 2 �-+ T - Environmental Services, Inc. DEPTH SOILS ELEV. DEPTH SOILS ELEV. (40 FOOT 5 l �l WAY) �, .�- made to Carmen E. Shay 7. No vehicle or heavy machinery shall drive over the RICHT OF septic system unless noted as H-20 septic components. - 0 99.00 O 98.00 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. Sandy Loam Sandy Loam _1 00 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. 10 YR 3/2 10 YR 3/2 10. All solid piping, tees & fittings shall be 4" diameter 0"-6' Ae 98.50 0-_6. A, 97.50 Schedule 40 NSF PVC pipes with water tight joints. +dY Sandy ,�- �� '- - r Parcel #I & #z 11. Municipal Water is Connected to ALL OF The Residence and Abutting Loam Lam, _ �- �� £ 6,392 Square Feet +/- Properties Within 150 Feet. 10 YR 5/6 10 YR 5/b ��'/ 6-- 36" Be 96.00 6-_ - Be 95 00 ' DRIVEWAY ' " TES HOLE 11 THE PROPERTY LINES ARE APPROXIMATE AND Medium/Coorae Medium/Coarse 00 t' ELEV.= 99.00 COMPILED FROM THE SURVEY PLAN GENERATED BY Sand Sand a BAXTER do NYE. of OSTERVILLE, MA 2.5 Y 7/4 15 Y 7/4 ENTITLED "SUBDIVISION PLAN OF LAND IN Centerville. MA W.- 132 C, 36•- 132 C, RA01711 DATED JUNE 14, 1974, PLAN BOOK 284 PAGE 96 PROJECT BENCH MARK PORc�r L- _ AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN TOP OF FOUNDATION 8• --98 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN THE SEPTIC SYSTEM INSTALLATION. ELEV. = 100.00 (Assumed) eo �» � '"� 00 0 EXISTING CESSPOOLS TO BE PUMPED OUT AND FILLED IN PLACE IrXISI BEDR 0 ~: J110 ._ NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE SOUSE •. FROM THE EXISTING CESSPOOLS TO BE DISPOSED TEST HOLE #2 _ OF AS PER BOARD OF HEALTH SPECIFICATIONS. CRAWL 37. 5 is ELEV.= 98.00 SPACE Perc #1 FOUNDATION • THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Depth to Perc: 42` to 60" ` Perc Rate= 2 MPI f :': e'n: ASSESSORS MAP 268 PARCEL 057 . Groundwater Not Observed No Observed ESHWT i� 4M -�• ADJUSTED H2O Elev. = None ----1 % 40, LEEND D-Box i NEW X1 DENOTES PROPOSED 3-24-aAM. AOCFSS MAMi01ES i SEEPTIC500 L Z 6' 10.4 SPOT GRADE ,o'-s- 0 0 s. � .: •s., .,.:-. . Failed _ -` ,9 DENOTES EXISTING Fail ed X •,�' �\ ��--- 6 104.46 SPOT GRADE �;. cesspool i 64,9$ PROPERTY LINE MILT PL THE ACCESS COVERS FOR THE SEPTIC TANK, cDCP 96 PROPOSED CONTOUR DISTRIBUTION BOX AND LEACHING COMPONENT T. � �R„. ,��j1 SHALL BE RAISED TO WITHIN 6. OF ---- FINISHED GRADE. - - �,; 97 EXISTING CONTOUR STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TILE GAS BAFFLES OR EQUALS PLAN VIEW ON ALL OUTLET TEE ENDS � DEEP TEST HOLE & 3-24•RB+ABLE C PERCOLATION TEST LOCATION 6 FOOT STOCKADE FENCE min. Clearance ,r easr "LET s•rainy 2•min.Not to cubs t s.mta mid ou1LET � ,s. � .; , s•_T > s e. P LOT P LAN A. : r:- •� --� :�..�;- -. = OF PROPOSED SEPTIC SYSTEM UPGRADE 5!-W CROSS SECTION END-SECTION PREPARED FOR MS. ISABELLA E. BORDNER TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK AT NOT TO SALE # 11 WEST VIEW TERRACE May Substitute with 1500 gallon H-10 Polyethylene Tank-George O'Brien Co PORCH CENTERVILLE, MA Design Calculations o ' , Living o 1� `°`F , s REPARED BY: Room m �� Number of Bedrooms: 1 Equivalent to 110 Gal. a m l ti, Garbage Grinder- No Y (330 Gal./Day Min. per Title V) E. 0 /� Leaching Capacity Proposed: 330 Gol./Day Minimum (Min. Per Title V) _ �} CARMENNlie 1JHY Septic Tank : - 2 x 330 Gal./bay = 660 USE NEW 1,500 GAL Septic Tank. ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of CL min./inch Kitchen O. 1 Bottom Area: 0.74 gal/sq. ft. x 372.5 sq. ft. = 275.65 gallons Both /Dining �$' f� P.O. BOX 627 Sidewall Area: 0.74 gal./sq. ft. x 78.72 sq. ft. = 58.25 gallons 0 20 40 50 sG/ST��C, EAST FAlMOUTH, MA 02536 Providing: = 333.90 gallons gN JTARO Use- (5) INFILTRATOR HIGH CAPACITY H-20 UNITS. HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, 1 BE HOUSE FLOOR SCHEMATIC TEL/FAX 508-539-7966 TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE SCALE: 1"=20' DRAWN BY: CES DATE: APRIL 19, 2006 ON THE ENDS. NO STONE UNDER. SCALE: 1"=20' PROJECT#SD903 FILENAME: SD903PP.DWG SHEET 1 OF 1