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Home My WebLink About0048 ERIN LANE - Health r, - 48 ERIN LANE, HYANNIS o TOWN OF BARNSTABLE LOCAno'i ` SEWAGE # V ?�LAGE - 06 ASSESSOR'S MAP&LLT�®o—�—C�J INSTALLER'S NAME&PHONE 140. A SEPTIC TANK CAPACITY LEACHING FACELITY: (type) {' (size) two NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: 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 Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by e �� y lam, n �� e�a� - � s . c- -� � ¢- f, � � �i s ,ff`_ r_ .��`�' d// fJ TOWN OF BARNSTABLE F, r La; ATION l- SEWAGE # VILLAGE IY/14, Alls ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. j!F'L,lis /3,c'as lisT. �� Ga3� SEPTIC TANK CAPACITY fOoo LEACHING FACILITY:(type) /•6X y (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATERPv�JLiG BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �. - 3 VARIANCE GRANTED: Yes No . 1 Q ' D �s i Vll No. 2Lo (ro ' �� Fee l THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLation for Disposal *pstpm Construction permit Application for a Permit to Construct( ) Repair(Y� Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. G �/ (,� {� OY,0#6 Owner's Name,Address,and Tel.No. 5'14EiCA 4- 1 p 5pell�> Assessor's Map/Parcel 29IL01-71605 4e &YAJ LANE k 41VA/ Installer's Name,Address,and Tel.No. 5C2-q 77—8$ 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) AZ Lr gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) RiW 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 Heal Signed C Date �1—3-ao t h Application Approved by Date 2�773 jf,2 Application Disapproved by Date for the following reasons Permit No. V Date Issued .. ..... .. .. a �.�.....--.�.a,... .�,..+. ., aV" ., }.• .-. ..-^r r'r� ..._ _ _ _. ... No. y 0 t - Va Fee 1 (' THE COMMONWEALTH OF MASSACHUSETTS Entered in Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair(k Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. L f g &:�d ( W67' HYXA/,,#6 Owner's Name,Address,and Tel.No. 57.4C,144 -4- 04VI D SpEI't-', Assessor's Map/Parcel a9 ®/'7 aQ 5 Lid A)J�J/ Installer's Name,Address,and Tel.No. $OS'q 71—$$'1 1 Designer's Name,Address,and Tel.No. c�4oEwID1r 6rj77=-?lE5 S Type of Building: 1v i -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 Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) RItRGQCt D 6 0 x 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 Heal . p Signed Date Application Approved by - - - Date - Application Disapproved by ` Date for the following reasons Permit No. O V 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 6 4 P 6r--Gy 1 D& &iV SPA yc E6 LZX—' at 42 C/ZJ 11) W)E HYAAM I_S has been constructed in accordance a with the provisions of Title 5 and the for Disposal System Construction Permit No 020(6— 61�'IL dated . 3 /f Installer �i/�P�kJf [ &�) /Z1s Designer MIA A #bedrooms Approved design flow gpd The issuance of this permit hall not -e construed as a guarantee that the systems, \ desygned. Date �oC - Inspector -------------------------------------------------------------------------------------- --__---- -- ----- ------- -----/ -------------- No. �t� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at �6 &;LIN LAX)C MMwi/ 5 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. 1 Provided:Construction must be completed within three years of the date of this permit. 2 ! z Date � 7 � � �o Approved by 1 / j a •{i •i': COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Graci DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAULCELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION 1 g,�4 Property Address: 48 ERIN LANE HYANNIS a �'�� ~ 0 0 S Name of Owner HEAFEY ae Address of Owner: 43 RUSTLEWOOD RIDGE FLORANCE MA.01062 Date of Inspection: 1/26/00 "' FHB 1 5 20p� Name of Inspector:(Please Print)JOHN GRACI 1 am a DEP approved system inspector pursuant to Secdon 15.340 of Tide 5(310 CMR 15.000) 7000F Ate, DF.r. Company Name: n/a Mailing Address: n/a Telephone Number: n/a ' CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of Inspection.The Inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes The Inpection is based on criteria defined in Title V Conditionally Passes code 310 CMR 15.303.My findings are of how the system is _ Needs Further Ev I tion By the Local Approving Authority performing at the time of the Inspection.My Inspection does _ Fails not Imply any warranty or guarantee of the longgevity of the septic system and any of Its components useful life. Inspector's Signature: Date:1/27/00 The System Inspector sh I submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SEPTIC TANK NOW AND MAINTAINING EVERY ONE TO TWO YEARS. revised 9/2/98 Page 1 of 11 k SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 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 IN ACCORDANCE WITH 310 CMR 16.303(1)(b)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 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 ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, _ The system has a septic tank and soil absorption system and the SAS 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 that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance n/a_(approximation not valid). 3) OTHER WA revised 9/2/98 Page 3 of 11 y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n/a. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X 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 ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the Invert pipe,is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: _ The system serves a facility with a design flow of 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: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IW PA)or a mapped Zone II of a public " water supply well) ' The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further Information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection B. SYSTEM CONDITIONALLY PASSES: Wa One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. n(a The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Wa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass Inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced nla 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 revised 9/2/98.. Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X None of the system components have been pumped for at least 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. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was Inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the Interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,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: X Existing Information,For example,Plan at BAH, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 11 5.302(3)(b)j X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 FLOW CONDITIONS RESIDENTIAL: Design flow:A10 g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual):.1 Total DESIGN flow: I30. Number of current residents:0 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JLQ. Seasonal use(yes or no):JLO Water meter readings,if available(last two year's usage(gpd): n& Sump Pump(yes or no): NO Last date of occupancy: 1110/00 COMMERGIAL/INDUSTRIAL Type of establishment: n& Design flow: n&gpd(Based on 15.203) Basis of design flow: xdA Grease trap present:(yes or no):JSLO Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ Water meter readings.if available:nla Last date of occupancy: n& OTHER: (Describe) nla Last date of occupancy: n& GENERAL INFORMATION PUMPING RECORDS and source of information: SYSTEM WAS PUMPED LAST SUMMER BY AGE System pumped as part of inspection:(yes or no):NQ If yes,volume pumped nLa. gallons Reason for pumping: nA TYPE OF SYSTEM X Septic tank/distribution boxisoil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes.attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: nLa APPROXIMATE AGE of all components,date installed(if known)and source of information: I } Sewage odors detected when arriving at the site:(yes or no): MO 1 l revised 9/2/98 Page 6 of 111 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 BUILDING SEWER: (Locate on site plan) Depth below grade: L'&"_ Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: Wa Comments: (condition of joints,venting,evidence of leakage,etc.) nLa SEPTIC TANK: X (locate on site plan) Depth below grade:'1 Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ nLa Dimensions: 18'6"H 6'7"W 4'10" 1 Sludge depth: $." Distance from top of sludge to bottom of outlet tee or baffle: M Scum thickness:-" Distance from top of scum to top of outlet tee or baffle: V Distance from bottom of scum to bottom of outlet tee or baffle: 4" How dimensions were determined: MEASURED 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.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING NOW AND EVERY ONE TO TWO YEARS FOR MAINTENANCE GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) n& Dimensions: n& Scum thickness: n& Distance from top of scum to top of outlet tee or baffle:imLa Distance from bottom of scum to bottom of outlet tee or baffle n& Date of last pumping: n& 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.) n& revised 9/2/98 Page 7 of 11 Y - i 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/28/00 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n& Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) n(a Dimensions: Wa Capacity: WA gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:_n/a_ Alarm In working order:Yes—No—: NO Date of previous pumping: nla Comments: (condition of inlet tee,condition of alarm and float switches,etc.) WA DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert:LEVEL L WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) DISTRIBUTION BOX IS STRUCTURALLY SOUND PUMP CHAMBER: NQ (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NQ Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) Wit revised 9/2/98 Page 8 of 11 j. - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1126/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n1a Type: leaching pits,number: TWO 1000 GAL PIT 1600 GAL PIT leaching chambers,number: -n& leaching galleries,number: -a& leaching trenches,number,length: nla leaching fields,number,dimensions: n& overflow cesspool,number: n& Alternative system: Wa Name of Technology: JVA Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PITS ARE STRUCTURALL SOUND AND FLINTIONING PROPERLY THE 600 GALLON PIT WAS 3/4 FULL THE OTHER IT WAS EMPTY. CESSPOOLS: _ (locate on site plan) Number and configuration: n1a Depth-top of liquid to Inlet invert: WA Depth of solids layer: n& Depth of scum layer. n1a Dimensions of cesspool: n/a Materials of construction: n& Indication of groundwater: n1a inflow(cesspool must be pumped as part of inspection)Wa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n1a PRIVY: _ (locate on site plan) Materials of construction:nla Dimensions:n/a Depth of solids: n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n& C I a revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1126/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) n/a � � d peel E A �vor,1 Ebro AP 4 61� lit DO PID revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 ERIN LANE HYANNIS Owner: HEAFEY Date of Inspection:1/26/00 NRCS Report name: n1a Soil Type: Wa Typical depth to groundwater: n& USGS Date website visited: Wa Observation Wells checked: NO Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records _ Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2198 Page 11 of 11 -9/ d c® 5 THE COMMONWEALTH OF MASSACHUSETTS APPROVED nt BOARD OF HEALTH TOWN OF BARNSTABLE ,� lirtttiPifor Diripwial Wor1w Towitriartiinn Urrmit Application is hereby made for a Permit to Construct ( ) or Repair (I/) an Individual Sewage Disposal System a . w OC36 I -:\d.. is `b Loti n Owner .9 - Address Installer Address Type of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms............ -------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons__-_____-___-_-___-_---.--_ Showers ( ) — Cafeteria ( ) G4 Other fixtures ...................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity- -_--____gallons Length---------------- Width................ Diameter------_......... Depth.............. 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fX4 Test Pit No. 2................nimutes per inch Depth of Test Pit.................... Depth to ground water....................... a ._....-•---.--•---------------•--•-...........-•••-•----•-•.......•••-•--•--•------------------•-•--......................................................... 0 Description of Soil............................................................................... ------------------------------------------------------------------------•---..._...---•- x x .......................... -------------------------------------------------------------------------------------------- .------ =---- ------ ............_. U Nature of Repairs or Alterations answer when ap Ii le---- � �✓ � .... —__• i r� % � `� 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 issued by the boardof health. / g 5 C % ------- G Signed .... p, Application Approved By ..........., e'� � .. � - rip ................................................................. _/.-� ..--.../ .... 4 J VDate Application Disapproved for the following reasons: ....................................... ..............................................._ --.._............------ ......... ........... ........................................ ...... . ........................ ................... ..-- ........................... ................Z -.................... Permit No. ....... ...".. ... Issued .............- .----............................. Date..... Date - .ram-ti.,y.��„rv��r.. -�.,,c�, _ _ __. _ .. r_ _ wr_� w• .. -- . No....L --� 3d' Fss....................OZ� THE COMMONWEALTH OF MASSACHUSETTS BOARD OE HEALTH TOWN OF BARNSTABLE Appliratiuu for Di!ivasal Wi urk,i Tomitrurtinn rami# Application is hereby made for a Permit to Construct ( ) or Repair (1,,/) an Individual Sewage Disposal System at. oC-11"I-Addr s 'or Lot - O cncr Addrets - W .............. 1�- - -•��-.'.� L� a Installer Address UType of Building Size Lot............................Sq. feet ., Dwelling— No. of Bedrooms............ -------------------- ....Expansion Attic ( ) Garbage Grinder14 ( ) 9L, Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------------- 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. -- 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f% Test Pit No. 2................minutes per inch Depth of Test Pit--.- ............ Depth to ground water........................ ;4 ---------------------------------------------------------•-•---------.__._-••••--••••--•••----_...-•......................................................... ODescription of Soil........................................................................................................................................................................ W = f f ... I"---''----- �!............... VNature of Repairs or Alterations—Answer when ap licable.-.._ - -. "Cy. �Q .-- � ��1/._--._�- ............. �- --�� ------=--•--•--��.-•--•--....--- ----., ---u-1 ......5--•----1 :.fir 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 issued by the board of health. Signed ....... . . ,......... . /. I..." .,�--' ." ------------------------------ . Dace Application Approved BY ' �.M.: ..� .. �:,-.......................................................................... Dme Application Disapproved for the following reasons: ............................. --'---- .........................---.............................................................. ............ . ...............................p.......................... . .........' . .... ................................ ..-- . ..... .......................I.. ........... Permit No. -------1...,3..'-/�_ ................................... Issued Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (fertifirate of (goraptianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by ............. ------- .............................................................................................................. at ...........:�W..... ................................................................................................. has been,n installed in accordance with the provision' sy6f 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. _�L` -:��.................. DATE......................... ............ ..............--------- ---------- Inspector .................................... ............................................ -------------------------------;---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No._ZI /.. FEE... 'lUark.5 Tanotrudian rrrnfit Permission is hereby,granted.....4eP A ............................................................. to Construct or Repair (111�an Individual '-ewage Disposal System at No.......— '7/ ...................................... ........................................ Street as shown on the application for Disposal Works C;n/struction Permit N\o._91-11�� Dated........................................... ;11.YD............................................................ ------------------------ DATE.......... .... ........................ Board of Health .......... FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS LOCATION / SEWAGE PERMIT NO. `l-U T -,� G/21 A,) VILLAGE INST ALL ER'S NAME A ADDRESS �i4 i,rJ i yf G U I L D E R OR OWNER GU "11� ale,C>5/ �G DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �� j/ � � �� Q -_� -' 1 ,� �' � �1 - �` THE COMMONWEALTH OF MASSACHUSETTS. BOARD OF HEALTH Application is hereby made for a Permit to Construct ( "j-"or Repair an Individual Sewage Disposal System at: Location-A&ress or Lot No. Owner A Type of Building Size Lot_$Aj�.9173-----------Sq. feet Z Other Distribution box ( ) Dosing tank ( ) 0-4 -----`--------------'---`-----------`----`-----------------`------`-----'--------^— ' g,-_—_—. The undersigned agrees to install the uforedescribed Individual Sewage Disposal System in accordance with Flzs.... �''............. �!. THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH ......... ...OF.. 1°.--........................ .................... Apli iratiun for R-4puutal Workii Tumitrnrtiun Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......�1_A_SS &�..--...... ......... ....................................................... Location-Address or Lot No. 1 e�.. .._. eta.—...... -CpKd..... ........... m...Q_4��.43:4..W•••.. r�......... ............... Owner Address a P�� ...._L..9a .D-Say . ' .. Installer Address Type of Building Size Lot./fit/.2. .........Sq. feet U Dwelling—No. of Bedrooms................ Q .....................Expansion Attic (—) Garbage Grinder (r-) 04 Other—Type of Building ...............".......... No. of persons........................ Showers Cafeteria (� ) Q' Other fixtures ..................................................... W Design Flow______2? _____________________________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. 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........................ ----•-......•---------------------------------------------------•----------•••-•..._._......--•-----........................................................ 0 Description of Soil........................................................................................................................................................................ x U •-••-••--•----•-•••••--•••-••-••••--•••-•-••-•••-••-----•-••••--•-•••-•...........................•-.......----•--•---•---•-•••---•-•••-•-•-•••-•--••••••-•--•-•••---••-•-•-•-••-•----••••....-••---••- x •..... 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 TIT s,;=. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by theboaro of health.. Signed--- -------- - -- - �c_��"C'��,�" -_-��-�---•- •-/�- -�---�-�=-�`,..-'------ Dace ApplicationApproved By.................................................................................................. ....................................... Date Application Disapproved for the following reasons-----------------------------•---------------------------------•--------------------------------------------_._.. -•---------------------------•••••----•........._...._._._....-••••••••••-•-••---•....................--••--•-......._..••-•••-••-•••----•---•••••---•-••••-. Date PermitNo.......................................... •--••--• Issued...----•-•-•-•-----••••...-•------•---•------•---•--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH n T-wrr#ifiratr of (91intlifiFanre THIS IS TO CER IFY That"eIndil..idual Sewage Disposal System constructed (4-)"'or Repairedby-•------------•............. �... •-- 1.......: r-.._......-•----------......-----...----•-------------•----------------------•-•---•--.....-- 'Installer at-•••--•--••�---`j�---- -•- has been installed in accordance with the pdvisio=.. ITLE 5 of The State Sanitary 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 WIL)l F)ANCTION SATISFACTORY. DATE...../Z/71./. .................•-•••-•-•-•-••--•-•------•-------••--.. Inspector.•--•-• -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..... a ............................. No......................... FEE......................:. Bill"PuuFal u ku �u #rnr_#iun amit Permission is hereby granted----- --••••• •_•••-••...••... ••• - ------------_..... .................................................... Construct ( �'or Repair ) an Individual Sege Disposal System . atNo. .. ........ -G�-.t.-------- ?.---•--------------------------------------------------------------------------------------•.---------- Street as shown on the application for Disposal Works Construction Permit No.__,,,........ ..... Dated.......................................... / lZI ---------•-••--•-•---•.-•-• ••-• ...••---•--•••----------•••--••-•••••.............•••.......__.....DAT Board of health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS _ SOIL LOG �. N0. 1 N0. 2 - 2 �>SITE PLAN f..S _...,w 5 E I TOP OF FOUNDATION El C2' AUV 'RD A L "A 6 . r nV /a SLQ10 �vr ti. LE iN a AR�t IN.EL. 973 •�. • r l INAL _ �._�_ . . IN.EI. 0,�.3 . 11 e EL R� a 2' COVER 1/8 3/8 WASHED STONE • 12 ��. 4.13 --� IN. EI I . ?�L_ r L9 ' ° n° — 3/4 1 1/Z WASHED STONE 0/B W/ 6 SUMP °� �� o ° .� ° �" • 4 LIQUID LEVEL M e a�� p ^ , 14 bpp0° ° • 6"EFF. DEPTH " m �� ,� b ` � PERC TEST 1 RESULTS • . F,1- 7� _ o I , fl p o ° D0G7 , i ° o O t PERC RATE : __S_.2;v-; v PRECAST SEPTIC TANK WITH ° 3 � PRECAST LEACHING PITS CAST IN PLACE INLET AND EL. �D r = # WHITNESSED NO.: _ _ SIZE : f��t� ��" i �� 11L _ - _ BOARD OF HEALTH OUTLET T S PER TITLE Y ,r ��"�' {� DATE: �'� ,:Lc�N<� x -y fo' v,. _: �_ �- g �-i,�.� � __._ �' 3- R�__. SIZE : PROFILE OF PROPOSED SEWAGE SYSTEM L,:�7j SYSTEM DESIGNED BY THE TOWN OF t :1 L = . .< REGULATIONS AND STATE TITLE Y FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE 1/4y= V 0 01 N . B . 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPET r =` 2. ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FOR THE FIRST 2 FEET OUT OF THE 0 / B WHICH SHALL BE LEVEL ' 3. DESIGN FLOW ._2� BEDROOMS AT 110 GALDAY PER BR . GAL/ DAY ` 1,' 331 _1 " SEPTIC TANK SIZE _ X GAL. USE �11_ — GAL. W/ GARBAGE DISPOSAL c�rcr LEACHING SYSTEM: USE :i LEA'HN `d s I 'IT ,a, � J �._n;., TJi A . x t,, � FF %.�.. • a EFFECTIVE AREA: SIDE ��s# = ► —�,,sE s' CEP, N -�� #MPS It✓�dJt tiaT� �.# A 4 j - BOTTOM TOTAL FLOW _---_ _----: _� TOTAL REQ'0 FLOW X I?zo W/ �_s GARBAGE DISPOSAL RESERVE FLOW 1+4�_ GAL/DAY __ REFERENCE PLANS : APPROVED B Y : --- - BOARD OF HEALTHr $` DATE : S/ SEWAGE LAN TE AN� P PROPERTY OWNER : W 1 LL 1 l,..l f 2 3 5 ate '�- G -