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HomeMy WebLinkAbout1027 SHOOTFLYING HILL RD - Health 1027 SHOOTFLYING HILL RD., CENT. . A=191-029 UPC 12543 Boa No. 53 pR +A°�coNS°a HASTINGS, MN 1 1 TOWN OF ARNSTABLE LOCATION `® Sfiloo? 17 /L SEWAGE# 007— O _ LAGE CT�r�caa�Llr ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. ,/I/L. S-0 8 7,3 ;!—>Idl� SEPTIC TANK CAPACITY 0 0 LEACHING FACILITY.(type) ,�6 6 (a C �AM,ag� (size) 2 /p 3 3 NO.OF BEDROOMS OWNER /V PERMIT ATE: 3/93-7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ° $' Feet rrivate Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facili ) IY14 Feet FURNISHED BY L lily/ 0 I LJ AO I 4� G No. � Fee THE COMMONWEALTH OF MASSACHUSETTS, Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye 2pplication for Mt5po$af *pztem C01124rUCtiott permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) 1_J Complete System ❑Individual Components Location Address or Lot No. 10a7 SA o6 , Ili ill I � Owner's Name,Address,and Tel.No. IVY ' �1 tfiGe¢Garri�le /�VY)i1 e Assessor's Map/Parcel i 1 Cj ?A ` �� ZCf V -77578 L-SZ Installer's ame Addres and Tel.Die Desi ner's Name,Address and Tel.No. Z 8 vn,.T 3 GJo y4fitf VIN t} ZA 7 j 77/57z6 Type of Building: Dwelling No.of Bedrooms Lot SizeM ZI 7 sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers(3) Cafeteria( ) Other Fixtures Design Flow(min.required) 44oPD gpd Design flow provided `f"SS&FD gpd Plan Date /i' 3 ZU -7 Number of sheets Revision Date Title 7GVd (�6t✓ Size of Septic Tank J U yd ( Type of S.A.S. S��d � '( C kc4i­f-- 5_ Description of Soil Z_eJA- 'j f9v�� f -5A--L� y , (JO �✓ S ����( , Nature of Repairs or Alterations(Answer when applicable) 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 thi Board of Health. 17 Signed v !1' Date l�' G Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. !' Date Issued No. �j avf s.• „ / Fee t1�G ` 1 Entered in com uteri• VY ",THE COMMONWEALTH OF MASSACHUSETTS p -�; PUBLIC HEALTH DIVISION --TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z[ppYication for 0i2;po!6ar *p.5tem Conotruction permit Application for a Permit to Construct O Repair O Upgrade( .) Abandon O 'l_J Complete System ❑Individual Components Location Address or Lot No. /t0a7 j OTI 1h A1(( 0 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel (� L o-� Z c( 5'0 b Installer's Name,Address and Tel No 'V Desi ner's Name,Address and Tel.No. e�v� c sc&) uAr7 G•r t (tL!v?% p Z,673 77/5-Z6 Type of Building: Dwelling No.of Bedrooms Lot SizeM Z17 sq.8. Garbage Grinder ( ) Other Type of Building ��. No.of Persons o Showers c3) Cafeteria( ) Other Fixtures 3, . Design Flow(min.required) 44oc,?D gpd Design flow provided 455 5 &.F7> gpd Plan Date Z y 9 -7 Number of sheets Revision Date Title &GV d CGt r (,Kr A !I e /*yo c Tc c ti Size of Septic Tank J y Si4 1 Type of S.A.S. Description of soil Lc�My r .5�q'w�Y ,,�10 /O Cyf�, ,( , r� Nature of Repairs or Alterations(Answer when applicable) /� (� UG c�� c 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 thi Board of Health. Signed � � ,� r�- n ,. Date i j� ' G�-7 Application Approved by YI� :mot / i ,' ;i�/f Date v /+ Application:Disapproved by: Date for the following reasons L64-4 I Date Issued Permit No. 6 �� v ——————————————— ————— —— ——————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERT YY that the On ite Sewa,e( poosa/l�System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned )b /C J [� Vl1.,•'�—t� atEjVJ (q !f AV h been constructed in accordance with the provisions o.. Title 5 a d the fo©i�spo 11�S st�Construction Permit No. /''� dated V �!"C7 r . Installer Designer �.�,. #bedrooms Approved design�flow ' ° gpd The issuances of is pe&it sh� not be construed as a guarantee that the system 6hfu�nct•on s/dJe`sign d� 1/ f� D Date / Inspectorial ————— f / ------------- ---- �- — -— �— No. , /9 / � Fee � t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE, MASSACHUSETTS r/ lwizpozal *p!6tem Con5tructton Permit Permission is hereby grants to • onstruct ( ) Repair ) Upgrade (' ba don System locatedV1 N at 1 (y and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this perrilit., Date �� 1 Approved by q ti5 ZZd hPep aratiol of f'lans.ana Joeemcanu>» p U`^ I , 7 ✓`I` I-, - , Tne plans and specifications forfevery,cn-site system shall be prepared.as follows: (1) -Every system shall be designed by a Massachusetts Registered Professional Engineer or a'Massacizusetu Registered Sanitarian provided that such Sanitarian shall not-d esign a. System designed to discharge more than 2,000 gallons per day pu.*suant to 310 CMR 15.203. Any other agent of the owner•.may prepare plans for the repair of a system.designed to discharge not more than than 2,000 gallons per day pursuant to 310 CMR 15.203 provided they are revlewdd by:a Massachusetts Registered Sanitarian and approved by the approving authority; .(2). .Every:plan submitted for approval must be dated and bear thestamp and signature of - the designer, (3) Every plan for a new syst-erg or plan for the upgrade or expansion of an existing:syste7h Which requires a variance to a property•line setback distance,:must Also reference a plan which bears the stamp and signature of a Massachusetts- Licensed Land Surveyor in accordance with M.d.L. cI 112, (4) Every plan for a system shall be of suitable scale(one inch =40 feet or fewer for plot plans and one inch=Z0 feet or fewer for details of,system components). end.thrall.include. icn.on (a) the legal bonndar'es of the facility to be served. (b) the holder and location of any casements appurtenant to or which could impact the (c) the loca$on-of the all dwellings)or buildings) existing and proposed on the facility EVI and identifieatidri of those to be served by the system; '(d) 'tfre''lacation of ezistirig of proposed irnperYous areas,- inclddirig_driveways and 'parking areas; Y :(e) location and dirn sionsof th-e system (including reserve area); (f), system d-sign calculations, including design daily sewage flow, septic tank capacity (regturcd and provided); soil absorption system capacity (required and provided); and whether system is designed for garbage grinder; ( } North arrow and existing and proposed catstours; (h) .location and log of deep'observation hole tests including the date of test, existing grade elevations marked on each test, and he names of the represcntazivc of the VVV approving authority and-soil evaluator; . (i) location and results of percolation-tests includi�►g the cite-of test and tha names of 'the rcpzcscntative of the approving-authority, and soil evaluator-, . } name and c-rt1ricatinn numbcrof-thz-S�i1 E-valuator of-record; (k) location of every water supply,public and"private, I. within 400 feet of the proposed system location in the case of surface water supplies'and gravel packed public water supply wells, 2. wit, 250 feet of the proposed system location in the case;of tubular public water supply Vvells, and 3. within 130 feet.of the proposed system•location in the. case of private water supply wells, 1) location of-any surface waters of the Ccmmoawealth;r Tivers, bordering vegetate wetlands, salt marshes, inland or coastal banks, regulatory floodway, ytlocity zone, rivate surface water supplies, tributaries to Surface katerarupiubalar public waters,ccrtified l3upplypweIIs, water sup�lics or•suction lines, gr . • 1? wells; and She location of any nitrogen subsurface drains, leaching catch basins, or dry sensitive area identified'in 310 CNS 15.215 with L1 which portions of the groposcd stern are located. (m) location of water Lines and other subsurface utilities on the facility; (n) observed and adjusted ground-water elevation in the vicinity of the system; a) a complete prof•.le of the system; (p) •a note on the plan Iisting all variances to the provisions of 310 CMR 15.000 sought in conjunction with the p1ar.; (q) . the location and.elevation of one benchrnark.within 50 to 75 feet of the facility which is not siebjcct to dislocation or loss.d:ring consnvctich on-the ,acilrt}; {r) when•dosing is,proposed, 'complete design ana'speeiacation~of the.dosing system proposed including.but not limited to dbsing,chambereapacity (regvred and:proyided),' urnp curves and.specifications, number .of d'osina cycLis and depth per cycle; (s) when a Racirculatisig Sand Filter or equivalent alternative technology is required or roposed, a complete plan and specification for the system,including a hydraulic profilo; ( a locus plan,to show the location of the facility including the nearest existing three'the fility; and ., (u the street number and lot numtxr, if any, aLs of construct c'f�atians of the system. v) the materion.and.the sp Town of Barnstable °EVE l Regulatory Services Thomas F. Geiler, Director BARN BLE, S. �e� Public Health Division ATF039. Thomas McKean'Director 200 Main Street,Hyannis,MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form c/ Date: l d Sewage Permit# 00 Z — 90 Assessor's Map\Parcel Designer: J144 C Installer: GFrh/�/g Address: Address: (� 0 /!/� l� cue L LE D 2 6; On 7/ _ fiioJ) V, as issued a permit to install a (date) (installer) 11 � septic system at l o Z 7 6;� 11 based on a design drawn by (addre ) dated Y G (designer) It 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. 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 Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. � (Installer's Signature) w� ( esigne ' ignr (Affix De s Stamp 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:\Septic\Designer Certification Form Rev 03-09-06.doc F �. TOWN OF>BARNSTABLE � '�SST 'J�'- ►1lS ATION EWAGE # LOC .f � I y �-, y�I,p h(� ` ASSESSOR'S MAP & LOT _ INSTALLER'S I>.�MSE&PHONE NO. SEPTIC TAI4I,C TT APACY � `, LEACHING FACIL=: (type) ,fi�,f'� ��� . (size) NO.OF BEDROOMS .J BUILDER OR OWNER PERMTTDATE: /f—/4) 1 COMPLIANCE DATE: % ✓? Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bo/etlands ching Facility Feet Private Water Supply Well and Leaching Faciliwells exist on site or within 200 feet of leaching facility Feet Edge of-Wetland and Leaching Facility(If anyist within 300 feet of leaching facility) Feet Furnished by — - 4 7 J�` I v 0 / I ®\ _ TOWN OF BARNSTABLELWAGE L.X_i%_ ON 7 �-!��� '� � 'Id, - i� `#/ � �J ASSESSOR'S MAP& LOT '4 -ALLER'S'i &PHONE NO. /5 G �� /i�Es' %— S Z SEPTIC TANK,CAPACITY � ) LEACHING FACILnT: (type) � - �. (size) NO.OF BEDROOMS BUILDER OR OWNER .PERMITDATE: Il`t e— l COMPLIANCE DATE: Separation-Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Lfi Ching Facility Feet :Private Water Supply Welland Leaching Facility (If, y wells exist ~on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any etlands exist within 300 feet of leaching facility) Feet Furnished by �` `� .r C i, �.. �t �. �` � I ,� �� �� ,�� t _. ,, __.._ � � .._ �, �.� � A' ` \ `� ��; A`�� � � ' t ��� ;�� j�_ �� � i\ ,.\ �� 50 .00 No. Fee$ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mi5po5ar *pgtem Construction Permit Application for a Permit to Construct( )Repair(xx)Upgrade( )Abandon( ) O Complete System 0 Individual Components Location Address or Lot No. 0 2 7 S h o o t f ly ing H i 1.]owner's Name,Address and Tel.No. 7 7 5—8 3 2 Rd. Centerville Bruce Dunnett Assessor'sMap/Parcel 1 - (2Zct 1027 Shootflying Hill Rd, Centerville Installer's Name,Address,and Tel.No. 775-8776 Designer's Name,Address and Tel.No. W E Robinson Septic Service PO Box 1089 Centerville MA 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) 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 sand Nature of Repairs or Alterations(Answer when applicable) Install Title 5 leaching consisting of H-20 D—box and 2 H-20 leach chambers Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenanc of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envi nmental Co nd not to place the system in operation until a Certifi- cate of Compliance has been issue by this ealth. Signed A o Date/6 Application Approved by Date Application Disapproved for the following reasons r Permit No. Date Issued ti No. 9(?- ..�..�.K $50.00 Fee THE COMMONWEALTH OF MASSACHUSETTS/ Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes 01pplication for Zigpool *pgtem Construction Permit Application for a Permit to Construct( )Repair PCX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1027 S h o o t f ly ing H il IOwner's Name,Address and Tel.No. 7 7 5-843 2 Rd Centerville Bruce Dunnett Assessor'sMap/Parcel 11 ) - (2Z c1 1027 Shootflying Hill Rd , Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. W E Robinson Septic Service PO Box 1089 Centerville MA 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(no) Other Type of Building f'Person 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 sand. 4 {p � Nature of Repairs or Alterations(Answer when applicable) Install"Title T itle leaching 6onsisting off.-...H---20 D-box and. 2 H-20 leach -chambers Date last inspected: ry� — Agreement: The undersigned agrees to ensure the construction and maintenanc of the afore described on-site sewage disposal system in accordance with the provisions,of--Title 5 of the Envi nmental Co nd not to place the system in operation until a Certifi- cate of Compliance has been issue by this ealth. Signed 1 Application Approved by a, $ Date Application Disapproved for the following reasons KZ Permit No. ,t Date Issued __- „� ,' THE H- F-M•ACSSiiG�i'I ' TTS DunnettAR�VVSTABIE MASSACHUSETTS � Certificate of Compliance;/ THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repa jd X Upgraded( ) Abandoned( )by at 1027 Shoo flaring Hill Rd. Centerville ` constructe in cco ance with the provisions of Title 5 and the for Disposal System Construction Permit No. W E Robinson on Septic pt ie Service'Installer esgner The issuance of this Jpe t shall not be construed as a guarantee-that the sy ill fund n mats desig r Date ��/ d � �Inspector No. ��_'---------- /7�-^-��------------Fee �50.00 7 4 THE COMMONWEALTH OF M SSACHUSETTS Dunnett PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS _ Mi000l *pgtem Construction Permit Permission is hereby to SAfl,r System located at UUh O c Repair1 1 JUVaade, Abandon( ^ ) Centerville Installers W E Robinson Septic Service 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:Constructio m t b eted within three years of the date of t e it. d Date: ve Approved by � � 0 J NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated��^ � concerning the property located at 1027 Shootflying Hill Rd. Centerville, meets all of the following criteria: * There are no wetlands within 100 feet of the proposed leaching facility. * There are no private wells within 150 feet of the proposed septic system. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: n A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) VJ B)Observed Groundwater Table Evaluation(according to Health Division well map) v SIGNED: DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 20-1998 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). ED I TOWN OF BARNSTABLE LOCATION /0 S Poo 1 t'� SEWAGE # Y Vi'LLAGE r 'r- ASSESSOR'S MAP & LOT I INSTALLER'S NAME,& PHONE NO. SEPTIC TANK CAPACITY /G LEACHING FACILITY:(type) f 0 b 6 (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERS�sn►i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: J r'p'D VARIANCE GRANTED: Yes No r q� $30 . 00 No... /..3...�.... F>$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH p OWN OF BARNSTABLE p lirati it fur Diripwi l Wi urkii C onfitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 1027 Shoot Flying--Hill. Rd -------•-•--------••-•--------••--•-----------••••-------....••----------•---•--...•--••-.....--- Location-Address or Lot No. Mr. Du .................................•-----------••--••-....------••••----•---- •-----•--------------•-••----•-•-----•--•-.....--•--•---•---•----..._.............-••--••...•...-- Owner Address W W.E. Robinson Se tic Service P O Q 1_Q_S_9...� n esville ------------------- -------....._..------ ......---------------•-•---- --- -- Installer Address d Type of Building 3 Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ...................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit..................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit-_.__-_--...____---- Depth to ground water........................ pr .....-----•------------•----•--•--....__...••..................................•--------•---•-....--......................................................... 0 Description of Soil......................g-r-avel------•------------------------------•--------------------------------------•--------------------••---.-•-.--•••-•--••------_-•--- x -----••------••.................••-__-----•-----...... W -- -•---------------•--•------. ------•-------.._..----...------------•-------•-----------••--••------.......------------•.....----•--•-----------------------•-------••-------.............--•--•-•-- UNature of Repairs or Alterations—Answer when applicable---- emove-_c-aged...1 n...Gesspoo.1.... .................. ..install--....... r 000---gal...tank. -----••----- •---•-•--•--•---••-•--------------------••-•--•--••........_----•• 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—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d by the board of health. Signed ------------ Application �.�............ ..�.... ... _- - - ...... .---"-'----- Date Approved By .--------- ....._'��.tc,�,.,.—� .. ©�- ..._ ......................................................_.................................. are Application Disapproved for the following reasons: .................................................. ............ .............................................. .. ..... . /� g. Date PermitNo. - Lam.../.....`� ............ Issued ................................ .............................. Date %3- 6 98 1 $30.00 No. .....-....... Fins.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH >-2 -.2-v -gOWN OF BARNSTABLE Ap.Vltratiott for Ubip oul 1Uvrko C vnMrur#tun Vrrm t Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: ...11027 Shoot F1 ina Hill Rd .0. .......-•- -----------------Y-••-••--------i ---••-- .......................... .................................................................................................. Location-Address or Lot No. Mr. Dermett ......................_.......................................................................... .................................................................................................. ,Wa W'�' Robinson Owner .. ... Address --• ••• atQ... f - vi la ........................... Installer Address UType of Building 3 Size Lot............................Sq. feet .-, Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q Other fixtures ------------------------------------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width--.....----..... Diameter--...--...--.... Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter...--.--.........--. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ 04 Test Pit No. I................minutes per inch Depth of Test Pit--............---... Depth to ground water.--..................... fi Test Pit No. 2................minutes per inch Depth of Test Pit--.-----............ Depth to ground water.---................--.. P4 ...•--• -•.................•--••-•••-•--•••••••••-----------•••-•----•-•-----...••--•-------•-•••----.......---•--•--•--............•---.._.........__...... DDescription of Soil......................g-"ave ------•--••------••-•------••------------•------------------------ V ...................... ............. ••------------------------------------------------------------------- •----------------------- ------------------ -••-•••-------------- .---•---------- W UNature of Repairs or Alterations—Answer when applicable.-.remove--caved...]--tl--cerSr�pc��_-•-gt•-•---•---•_.-.-•. installa...1 , 000 gal...tanki............................ •.... . • ---•-.... --•-•....---•--•--•-••••................-•----•---•----...... 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—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the board of health. Signed --------Al .-I.....6•-- .............................�...� ....`". -.._;).... Dare Application Approved By ............ U..... .e - ---'-t...... .................... ....... � .. .... Dare Application Disapproved for the following reasons: . ............................................................. ......_........................................................ ........ ..................... .................... . ..................................... ..................... . . . . . . ...................------....................... ........................................ �Permit No. .......��.7J...�..la..... ..�....... Issued ........................................................Dare............ Dace THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE (ILlPrttfirate of 01.1ariptiance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x ) by ...W...E......Robinson...Septic- Service.. --------------------------------------------------- ---------------------------------------- 1027 Shoot Flying Hill Rd ................... . 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. ...,�,�...-.�'..r��------- dated ..-.................................._._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � DATE........ ......... .. ...Y.. .�...j... ............._........._..__.._...... Inspector --------- _...--- ..--- ---- --------____----------------®___,_,_,__ I,__._,----__-_,__----_- THE COMMONWEALTH OF MASSACHUSETTS v BOARD OF HEALTH TOWN OF BARNSTABLE NO......�.....�.C�..__ FEE...$30...............00....... Disposal Workg Tunotrttrtton "Vermtt Permission is hereby granted-----kd..-k;_--.Rob ns.c.n-.-.Se.rpL -?-G---fie =d C --------------------------------------------------•---•- to Construct ( ) or Repair (x) an Individual Sewage Disposal System atNo..1027 Shoot..Flyi?19...liUI_Rd.............................------.................................................................................. Street as shown on the application for Disposal Works Construction Permit No.q,��Ic�- Dated..----- �-'.20--`�3_.-•- a ............................................. DATE. a �` 3.................................... Board of Health FORM 36506 HOBBS&WARREN,INC..PUBLISHERS TOP OF Proposed Addition Wall Raise covers to within 6 of STANDARD NOTES O 1 ES FOUNDATION finish grade install risers as needed L 60. 00 Garage TCFISill 59. 00 1) THIS PLAN IS FOR THE INSTALLATION / REPAIR OF A SEPTIC SYSTEM. Garage Sla b El = 58. 30 59 Of 2) ALL INSTALLATION PROCEDURES AND MATERIALS SHALL CONFORM TO 310 CMR 15.000, THE STATE ENVIRONMENTAL CODE, Proposed 6" GROUND SURFACE EL TITLE 5, AND THE TOWN OF _-_ Barnstable_ SUBSURFACE DISPOSAL REGULATIONS. PVC Collar 71 - DETERMINATION HAS BEEN MADE AS TO COMPLIANCE OF AVAILABLE PROPERTY'INFORMATION WITH RECORDED DEEDS & Gaskit Proposed 3) DETER D Box OR ZONING REGULATIONS. YP ) 4,� MIN 2' LAYER DOUBLE WASHED T ical 55. 05 4) THIS PROPERTY IS SERVICED BY TOWN WATER TOP EL 1/8"- 112' STONE 58. 0 2 MIN-3 MAX 5) THERE ARE NO KNOWN WELLS WITHIN 100' OF THE PROPOSED SOIL ABSORPTION SYSTEM INVERT EL „ '� 6) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE 56.22 10 56. 05 24 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY Existing 14 - - - - - - - - - - EFFECTIVE INVEf,'? EL ^, IN EL - - - - - - - - - UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE, ACCESS, INSPECTION q INSTALL SIDE WALL GAS 54.59 PUMPING OR REPAIR. 56. 42 N BAFFLE 54. 42 54.30 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION 56.22 IN EL 3/4 - 1 1/2 DOUBLE INVERT EL INV EL INV EL (Three 500 Gal Cone) (H-10) WASHED STONE SYSTEM, EXCEPT WHEN VENTING HAS BEEN PROVIDED Proposed Proposed chambers w14' stona all around 4� Garage Invert „ ' 52.30 BOTTOM EL 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6" STONE BASE 6 STONE' BASE (4„-10, x B,-6x 2,-9,) TO ENSURE STABILITY AND PREVENT SETTLING. 10) OUTLET DISTRIBUTION LINES SHALL, REMAIN LEVEL FOR A MINIMUM OF THE FIRST TWO FEET OF THEIR LENGTH. 1,500 Gal Septic Tank � �I 11) ALL SYSTEM COMPONENTS SHALL BE CAT'ABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' S = 0. 033 S = 0.06 1 1 S = 0. 01 `� OF DRIVEWAYS OR PARKING OR TURNING,AREAS, IN WHICH. CASE H-20 COMPONENTS SHALL BE USED. 54' '- 24 12' EL 45.3 12) ALL BUILDING SEWER LINES SHALL HAVE AN INNER DIAMETER OF 4" AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC. BOTTOM OF TEST HOLE DTH fl 13) THE DEPTH OF THE TOP OF ALL SYSTEM COMPONENTS SHALL NOT EXCEED 36" UNLESS VENTING HAS BEEN PROVIDED. 33. 5' NO GRO UND WATER � 14) IN THE AREAS OF EXCAVATION, EXISTING GRADES SHALL BE REESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS. 15) IF SOILS ARE ENCOUNTERED DURING THE EXCA VA TION OF THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM THE DEEP OBSERVATION HOLE LOG, CONTACT EAS SURVEY, INC AMD TOWN BOH BEFORE PROCEEDING. 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO CONSTRUCTION S OR REVISIONS TO SEPTIC DESIGN 'REQUIRE NOTIFICATION N/�, 17) CHANGE Map 91 TO A & M LAND SEW VICES AND TO WN BOH FOR REVIEW AND APPRO VA Pa rC el 3O 18) CONTRACTOR SHALL NOTIFY TOWN AND DESIGN ENGINEER AT LEAST 24 - 48 HOURS PRIOR TO INSPECTION(S). O � _N/F Map 191 nor 6' Parcel 96 DEEP OBSERVATION DEEP OBSERVATION ; � 60 HOLE LOG HOLE LOG 5g.8) �\ Test Hole #1 Test Hole #2 64 / (EL = 58.3 f) (EL = 59.8 f �\ O D�p� Flev Soil Soil Soil D p h lev Soil Soil Soil m tft) Horizon Texture Color �m ft) Horizon Texture Color 58 I (USDA) (Munsell) (USDA) (Munsell) p Lot 13 & 12A o - s' 57•8 OEA LOAMY SAND 10YR4/3 0 - 6" 59.3 OEA LOAMY SAND 10 YR4/3 ~ � (59.4) 52 g8) 10YR5/1 10YR5/1 L'ne s" - 24" 56.3 B SANDY LOAM 7.5YR5/6 6" = 26" 57.6 B SANDY LOAM 7.5YR5/6 \� 8, 1 �t. Tam = so.zo ,� �' r = 1175. 21 ' r` q. Center Top Step (� __ 24" 40" 55.0 C1 COARSE SAND 10YR6/6 26" - 38" 56.6 C1 COARSE SAND 10YR6/6 1�q �� AI t6' VE-0,01JIF Eic,>T- N'at G 15% 15% Gravel 0. 8 7-� .A des er L - 12 74 _ Gravel o 62 1,00o �� 5- A.B .» e . k_,.__. .__ _ (5g.1) Bldg #10f Lure 40" 156" 45.3 C2 MEDIUM SAN 2.5Y7/4 38" - 144" 47.8 C2 MEDIUM SAND 2.5Y7/4 r 72) v-�d�,5-00 Gal 4 Bdr 52 � . . ,� TCF = 60. 0 �-I basin R1m , rJ ep lie Tank 0� Deep Obs Hole Date: 4/26/07 Deep Obs Hole Dater 4/26/07 11 ,�i Soil Evaluator: ED STONE `LJ Q Soil Evaluator: ED STONE 60 2) Proposed ~+ f '� Witnessed By: DONNA MIORANDI Witnessed By: DONNA MIORANDI O 7 g.2) Perc Rate: 2 MIN/IN ® 52" Perc Rate: ll 60 -Box (5 o O Soil Survey Description: CARVER Soil Survey Description: CARVER �- G ,-f` 52 4� Geologic Material: GLACIAL OUTWASH MORRAINE Geologic Material: GLACIAL OUTWASH MORRAINE Depth to Standing Water: NA'�� 'Jr , DTH 8) 54 e ( � Depth to Weeping Water: NA Depth to Weeping Water: NA ^^`` nf�`� Depth to Wee in Water: NA Shed 2(5g, !r' Zo S6 O O `\ p� Depth to Mottling(Color): NA Depth to Mottling(Color). NA 'y e ¢. O O Est Seasonal High GW: NA Est Seasonal High GW: NA 1 ,/ :• r 1r��1i�j Prop Inv / / M O �( USGS Observation Well: NA out 56.42 l `QJ Date Observation Well: NA Date of Last Measurement: �.7 �•�.,/ O Date of Last Measurement: NA NA Comments: Comments: 1n Facility t .•.3• ,•�:_:::.-. ,z1 rn � Q'_ Proposed Leaching y ��6, . .. o C , O Proposed N/F Three 500 Gallon Cone Chambers x - /TY I Ma 191 Stone All Around (583 • . #1 S1Addltlo a 3o I O Pa r�1 95 With 4 06.0� �� ® Present Residence Existing 4 Bdr 1 �� To Be Reconfigured, 58 81.50' ' b N 84 o � Elimina to (1 Bdr) -32�Q W Exist cone chambers to be pumpe `-,crushed and or removed as per Titl V I Main Res, Proposed 3 Bdr .4 a h��rq �06. 13 Addition, Garage/Loft 1 Bdr AssEssoxs MAP 191 LOT 29 Map 191 Exist. cc-Acj-F Pr- 60 be pumped, Total Proposed _ 4 Bdr crushed and sand filled with clean1 e PI a n �T Parcel 235 sand as per Title V. for proposed Bib Bdr ]�} 7 --"A /�} TWo Car Garage .Addition Ki t # Bdr Bib JL� N t7V T LPLPrepared Fam Din #4 Bdr Appli a n t/O w For.- Dunnett #3 B. Rm Rm 4 Zoned RD1AP James Number of Bedrooms: Liv Garbage Grinder: NO Rm - Setbacks Located At Design Flow: 440 . . Second Floor Front 30 1027 I2 S y, N. T.S. (110 Gal/BR/Day x Number of BR) side 15 00t Flying Hill First Floor Septic Tank: �� , �� y 1, 1500 Rear 15 Centerville, MA 02632 N. TS Ile (Minimum - Design Flow x 200%) Gal Leaching Area: Deed Reference PREPARED BY Bib Sidewall: C83016 A & M Land Services Bdr 618 Route 28 Unit 3 #1 Bib 1 2 83 2 K (2 Sidewalls x _ __Ft x _ __Ft) + West Yarmouth, MA 02673 lt Bdr #¢ Bdr (2 Endwalls x 33. 5 FT x __ _Ft) 185. 3 Plan Reference Fam Din 3 L. C plan 24 654 B (508) 771-LAND (5263} Rm Rm 6Bottom: 429. 8 Lo is (13 & 12AJ � � of � P J ��.� S , 33. 5 12. 83 wlr , sw SCALE 1 20 , DATE- May 3, 200 7 _- Ft x -- --Ft) � Liv Bdr14. Rm #2 Fema Ma Ref Long Term Acceptance Rate (LTAR): P ; sl*2MM36 a �1A363 si �c.2304p o� Second Floor Leaching Area Design Capacity: 455 GPD 250001 0015 REV. s1t ` r�"'� N. T.S. g g p Y °��Fvrg a+ �Ho sux °� r� ,r �=r9; 'tf *f,;:.. ",." k ,< First Floor (Sidewall Area + Bottom Area) x LTAR Zone C July 2, 1992N. T.S. 14 JA AN c i- DWG. NO. 4 008 SHEET 1 OF 1 Existing Floor Plan ,, 455 GPD Provided - 440 GPD Required = 15 Reserve it