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Home My WebLink About0864 SHOOTFLYING HILL RD - Health 864;Shootflying Dill RoA& Centerville 21, S M E A D* Na MNWR UPC 1U34 snNd oom • Mak In UM A�1 TOWN OF BARNSTABLE LOCATION �f/�'��"/WEWAGE# VILLAGE G g:.'�-✓a��✓// ASSESSOR'S MAP.&PARCEL,,- �67 INSTALLER'S NAME&PHONE NO. Zed® SEPTIC TANK CAPACITYcote LEACHING FACILITY:(type) ICA64 e�"4 (size) NO.OF BEDROOMS OWNER PERMIT DATE: e�� COMPLIANCE DATE: Separation Distance Between the: jAr® Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility oaf 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 dIIL-i7 L7 f� 74 oat I� II Q�r ��. 6 9 -iP row 6 ,X T, No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in co pater: i PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitatlon for -Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) Complete System ❑Individual Components Location Address or Lot No. -0, J'i -7-,X��//i��jS/j�� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Z9� ® �'f" O��,4 /", J �O ' Installer'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 e�y�.� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '� a gpd Design flow provided y� gpd Plan Date 9�—�� Number of sheets J Revision Date Title Size of Septic Tank1^/`9r1W Type of S.A.S. Description of Soil CP4Te e Nature of Repairs or Alterations(Answer when applicable) L.N 41' 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 Board of(Sf H ign Date Application Approved by Date Application Disapproved Date for the following reasons Permit No. .4 Date Issued No. 'Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: / PUBLIC HEALTH DIVISION,,-.TOWN OF BARNSTABLE, MASSACHUSETTS Yes RppIication for Misposal i�pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) Complete System ❑Individual Components Location Address or Lot No.(Y!5'*'O- J/fvo7.X l ( Owner's Name,Address,and Tel.No. Assessors Map/Parcel /y,2 S«S"' Installer'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 �ZP No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 gpd Design flow provided y9 gpd Plan. Date 00"`/�—/6� Number of sheets ' Revision Date Title Size of Septic Tank,4_14"141 Type of S.A.S. Description of Soil X4s1e— „Co Nature of Repairs or Alterations(Answer when applicable) LP414C�',L�/✓ 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 Board ofrH , oe igned Date / �d Application Approved by � �� Date Application Disapproved b ..«^` Date for the following reasons Permit No. .� Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(') Abandoned( )by r� 5rgFp at ��s'' �!'.�/�o��//�'Tr/S��LI��D has been con u t in acl with the provisions of Title 5 and the for Disposal System Construction Permit N . ' ed InstalleNZP1W L �B4ci'lr,,�" Designer +� � «/,j,1P nqp OF P. #bedrooms 3 Approved desig w 3S% gpd The issuance of th, pe 't``shall not be construed as a guarantee that the system will Lnctio s designed. Date I Inspector No. r x---y---------��--------- -------------------------------------------------------------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,,-"SACHUSETTS Misposal 6pstem Construction i3ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( Abandon( ) f System located at 00 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:Construct, �t a co/ie,e within three years of the date of this permit. DateApproved by From: 08/23/2016 07:09 #233 P.001/001 Town of Barnstable `71Er°'�o Regulatory Services Richard V.Scali,Interim Director BABNSTABIE. ";s 10� Public Health W.Vision �FnMA+s Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: e) 2��1� Sewage Permit# Assessor's MaplParcel Designer: �'�� L _ Installer: Address: =�( Lj� �Lyi�( Address: On �� 1��\ � was issued a permit-to install a (da l (installer) {(�� septic system at f14 S > }L � �� RAP based on a design drawn by (ad s) i dated (designer) _ _ 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. Strip out (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 Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in co njiance with the terms of the IAA approval letters(if applicable) t�Q�rl4gs`5.�tv UAVU le s S' tune) IVIASOPJ �7 No'1066 E (Designer's Signature) (Affix Dest t-,.;ram pam 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. QAseptic\Designer Certification Form Rev 8-14-13.doc y�1t+a Town of Barnstable P# Departitnent of Regulatory Services Public Health Division Date 200 Main Street,Hyannis MA 02601 • rfL)hAA'1 A . CA Date Scheduled Time Fee Pd.—A I U0 -v cal Soil Suitability A►.ssessment for ,Sewa e I)iSposal Performed By: C Witnessed By: , LOCATION & GENERAL INFORMATION Location Address . Name / �.G�,/✓� AddressCPA�? 9aZ o2.3 Assessor's Map/Parcel: o ST Engineer's Name,,ee��iKPO W '1�� NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(96) Surface Stones .. Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Dralnago Way ft Property Line ft Other ft SIKE,TCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock ------------ Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL,HIG' H WATER TABLE Depth Observed standing In obs.hole: ih, Depol to sell mottles: Depth to weeping from side of obs,hole: Itt. Index Well# 11L Groundwater Adjustment fit. Reading Date: Index Well levol _ A�,tclar A,1J CIt'nundwater Level,,,,_, PERCOLATION TEST b�tp �ritttm Observation I Hole# �T Time at 9" Depth of Pere I�•' Time a[G" Start Pre-soak Time Q Time(9"-6") End Pre-soak •r 1 RateMih./Ittch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) . Original: Public Health Division Observation Hole Data To Be Completed on Back---------= ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\S EPTIC\PERCFORM.DOC DEEP-OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Shcl Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsi_ stcncy,96(3raye1l LIS 10 10111 r 1- 0 .y . .V 10 DEEP OBSERVATION HOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in_) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% ra DEEP OBSERVATION HOLE LOG Hole# Depth from Sol Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, i Flood Insurance Rate Maps Above 500 year flood boundary No_ Yes Within 500 year boundary No t%+ es Within 100 year flood boundary No,, Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pery o taterial exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depL of aturally occurring per ions material? _ Certifiication 10CI certify that on (date)I_have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with . the required training,experflPR an a erience described in 10 CMR 15.017. . - Signat Datt; Q:\S EPT1C\PRRCPORM.DOC ASSESSORS MAP : Iz -- ----- - TEST HOLE LOGS PARCEL : `y v_ -- — --._. .-.._T 1) The installation shall corny, with Title V auJ 'i o�vr► o(60,1, Board ol- �' 1 SO)I L EVALUATOR : � /b C � C [iealth Re ulations. FLOOD ZONE: moo/ �� — ----- ____ g WII TNESS : /'>AL//C �� 2) The installer shall verify the location of utilities, sewer inverts and septic REFERENCE: �� +� �/1�? 6' f�� DATE: ;? O components prior to installation and setting base elevations. PERCOLAT ION RATE: Z MAN 3 All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first p6n-&) `'' ~� }'- - -- two feet out of the d-box to the intehing shall be level. � Y•� '�� a y. ant ,\V/ _ TH- I TH-2 4) This plan is not to be utilized for.property line determination nor any other purpose other than the proposed system installation. AJ A t �b 5) All septic components must meet Title V specifications. '� !C9 ►2� 1 1 N 1 +',`3 / 6) Parking shall not be constricted over II10 septic components. �J c3 7) The property is bounded by property corners and property lines. /1) ,� �� h g 1C 8) The property owner sliall review design considerations to approve of total LOCATION MAP 0 ; (O --- design 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 J1C� approval of the design flow by the owner. 602'� t� W 9) The existing leaching or cesspools shall be pumped and filled with material �� D ! 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 water line. Sewer lines crossing the _ waterline shall be sleeved with 4 inch SCE i 40 PVC with ends routed if g 5ti . applicable. The proposed SAS is being a li a le. installed below the water service pp P P l line. The line is to be sleeved as aforementioned and maintained in place. SEPTIC SYSTEM DESIGN 11) if a garbage grinder exists it is to be removed and is the responsibility of the 1 0 p owner to ensure such. 0 _ - FLOW 'STIMATE 12)The installer is to take caution in excavation around the gas line ifsuch exists. BEDROOMS AT //D GAL/DAY/BEDROOM ��- GAL/DAY 13)T'ne installer shall verify the location, quantity and elevation of the sewer g lines exiting the dwellin ' rior to� g p the installation. SEPTIC TANK 14)This plan is representative only that a system can fit on a property meeting Title V requirements. —3�"* jAL/DAY x 2 DAYS -�� GAL i / USE /, GALLON SEPTIC TANK ' 4LAMCPTION 'SYSTEM ►Aw to , A / Z' / S 1 DE AREA: '� ?� -i- �� 7iX �� - I �o DAVID � B. G \� BOTTOM AREA: �� r MASON v No* toss a ay+i , �STvEP� (� "`r'tN1TAFtAP� ' Yr SEPTIC SYSTEM SECTION r to 5IM0 I � b (WO to ��b� 0 GAL �� I d .— lo-l.n SEPTIC TANK SITE AND SEWAGE PLAN LOCATION : 41 &4 �H71 �X I l� PREPARED FOR : 71M ut f In H4AwWit M SCALE � o o DAV 1 D B . MASON RS DATE: k Znib DBC ENVIRONMENIfAL DESIGNS w DATE HEALTH AGENT EAST SANDWICH . MA 3 ( 508 ) 833- 2177 W Z