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Home My WebLink About0203 COTUIT BAY DRIVE - Health tW 8 N"ATUIT BAY Dot, COTUIT �� MAP=56 PAR.-035 ��`� ZoT 6 #'ZOO TOWN OF BARNSTABLE e II' LOCATION ce,:r j iT 8.9 Y aei J c SEWAGE # -3 2 9 VILLAGE Co T V a T ASSESSOR'S MAP & LOT I 6�� INSTALLER'S NAME&PHONE NO. R •C k 7 G y� SEPTIC TANK CAPACITY P 1 S—O p 6 ' LEACHING FACILITY: (type) .9 S00 G,d (size) NO.OF BEDROOMS S BUILDER OR OWNER e 3 ggr PERMIT DATE: �� 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 Die Pal ' 3 - z 2- 3 -- 37" 3o - S— sf f!6 SZ - No. 177—. / X/ Fee �s� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migool *pztem Construction permit Application for a Permit to Construct%)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components LocepoA Address or Lot No. LCIT G6 l�t1 f • Owner's Name,Address and Tel.No. Assessor's Itip/Parcel M �o tr'L 3� 4 Z(,S-L "Asq r�q 7?— Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W5A.L Z e S Car ✓iu_L-4 wt�l Type of Building: Dwelling No.of Bedrooms Lot Size I o sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 556 gallons per day. Calculated daily flow 5150. gallons. Plan Date MA-1 161. 1q,11 Number of sheets ;—Z!!!!! Revision Date Title SR S�cJ��G5 Size of Septic Tank Type of S.A.S.�4 Sty® ��K-• �� r , �l q-` Description of Soils l�l 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 Certifi- cate of Compliance has been issued b this Board of Health. Signed C Date Application Approved by Date Application Disapproved for a fol wing reasons Permit No. Date Issued t;o'r" 49'8 TOWN OF BARNSTABLE .'LOCATON Co'Tu i TS! �J6' SEWAGE # VII,LAGE Ty i T ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. (S .C.? 7 2 e y�y SEPTIC TANK CAPACITY 6 LEACHING FACILITY: (type) TSo �� o (size) l2 'X, •Z NO.OF BEDROOMS S BUILDER OR OWNER o is Jr.L►'f AIL PERMTTDATE: COMPLIANCE DATE: Z 2:2 Separation Distance Between the: "Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Priyate 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 -.._------- _ ..... £ £-S• — L 00 a h 8 G 9 s �•z� o o 0 0 01 � O-Lbt WN .................................. iYa . d No. Fee 9 THE COMMONWEALTH OF MASS CHUSETTS= Entered in computer: P ? gam - es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Oi5pozar *pztem Congtruction Permit Application for a Permit to Construct )Repair( )Upgrade( )Abandon( ) ❑Complete System 1:1 Individual Components Location Address or Lot No.LoT r-13 r " "Ea- Co Owner's Name,Address and Tel.No. '��d''r/►'i A ' 1 IL LA_ Assessor's Map/Parcel 34 M Kl r-t�} r•t-A '�- 24S t. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 05lIF-4z • at Sx o. gaK �1� �'�n�luT�► r�� } Type of Building: Dwelling No.of Bedrooms Lot Size (4 0 sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow SrjU gallons per day.,Calculated daily flow gallons. Plan Date Number of sheets aiy Z,Revision Date Title r S� W� t0..J t Size of Septic Tank I C%D A4!�; Type of S.A.S. 5da 4 L. De 1.15 G � 6� � Description of Soil _ 4 � `Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: NI 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 Certifi-` cate of Compliance has been issued b this Board of Health: Signed _! Date ; { Application Approved by t Date ApplicAtion Disapproved for a fol wing reasons 4,- Permit No. Cf 7 t, A Date Issued THE COMMONWEALTH OF MAS§ACHUSETTS BARNSTABLE,'MASSACHUSETTS ; (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired( )Upgraded( . ) Abandoned( )by at 1 has been constructed in accordance with the provisions of Title 5.and the for Dispo 1 System Construction Permit No. �' dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will funFtion as designed. Date Inspector ------------------- ---',.-------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS migo$al *p$tem Con6truction Permit Permission is hereby granted to Construct )Repair( )Upgrade( )Abandon( ) System located at 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:Construction must be completed within three years of the date of this permit. Date: — `/ Approved by _ 1 r Town of Barnstable P# Department of Health,Safety,and Environmental Services Public Health Division Date Qn 367 Main Street,Hyannis MA 02601 RARNMBIA NABIL °iE16yq. Date Scheduled i '��7 Time �Z��t Fee Pd. . Soil Suitabilit Assessment r4or Sewage Disposat .� .f Performed By: 2t MM06 Witnessed By: . LOCATION &:GENERAL INFORMATION Location Address LOT (mb e t eA J Owner's Name h�-_ :e��IT, He, l - ( Address s' Assessor's Map/Parcel: Engineer's Name '{iAeLLE2 -1 A!z9bCY NEW CONSTRUCTION ► REPAIR ' Telephone# C4, C, Land Use Slopes(%) o Surface Stones Distances from: Open Water Body' � ft Possible Wet Area i ft Drinking Water Well 1Aft Drainage Way Q-14 I, Property Line t+ V.V ft Other ;ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) -Tb t f � Parent material(geologic) 6. Depth to Bedrock 4 2TO J' ' Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face P•1 Estimated Seasonal High Groundwater D TER NATNATIO FOR'SEASt�NA OH A i F,R"I'�113, E .: . . Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. -Index Well# Reading Date: Index Well level Adj.factor A j.Yroundwater Level PERCOLATION>TEST Uate rime Observation 2 Hole# Time at 9" Depth of Perc ?', tv Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch 2 ,'714 t Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Rick--� Copy: Applicant 4 A. "DEEP OBSERVATION.HOLE LOG '`Hole#` `l" Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°'Gravel) C�r�tp it O 10 r0 DEEP OBSERVATION HOLE LOG Hole' '2 Depth from I Soil Horizon Soil Texture i Soil Color I Soil I Other Surface(in.) (USDA) (viunseil) R Mottling (St:ucture,Stones,Boulderes. Consistency,%Gravel) CD4 to L 2s DEE :OBSERVATIO:N HOLE LOG Hole P #o Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. C nsistenc %Gravel Y r ` I I DEEP OBSERVATION"HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) y E Flood Insuralice Rate 11iao: Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes s Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio s material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? n - . Certification k' a �, I certify that on , l (date)I have passed the soil evaluator examination approved by the Department of Environment Protection and that the above analysis was performed by me consistent with the required tr ' ,=expeisend Perience,described in 310 CMR 15.017. v, Signature Date i/ ' "� r . TEST HOLE LOG DATE:= V L =SOIL EVALUATOR. WITNESSc�.�_.acw�r_i%ni� PERC RATE: /O V/Z S / r /o x lk C 8 s �o vz s/.s sA Aix zS� l ' /Zo /� . fig• f DESIGN DATA r DAILY FLOW:(5)BDRMS z 110 GPDPD r SEPTIC TANK:SSo GPD z 200%-//moo GPD USE:/5 GALLON PRECAST SEPTIC TANK LEACHING,FACILITY: USE: C � -:��2Y�✓G_GCS"� _w�-y�f_��---;� CAPACITY: SIDEWALL:--/'V0 x'Z-lc BOTTOM:-/_.3�x.yZ _a_, TOTAL:._'. V DANIEL E. CyG BRAM2A =,w„t.. :��...-,.,�....w- _.- -'tom �;...:.:- -._"..-- .3,.. .;•:. , +'Ya aft,., �'�'=2�.. i +�.�'',�' 'N tir NOTES: ; y . dd :.o o � IS M�� 41 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. ^r Ll 2. PIPE TO BE LAID LEVEL FOR 2.OUT OF DISTRIBUTION h �� BOX. Sti9VE 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE. - 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEL 2'LAYER OF YV PF.ASTONS OVn aN'•1 lW WASHED STONE ALL AROUND TOP OF FOUND. (�EL yS-c� io, 14, 35:4 IJ 92. ZS ± . 1,-6VE rZ 7�Q A cry,, SEPTIC SYSTEM PROFILE SITE SEWAGE PLAN GENERAL NOTES FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES ABOVE AND UNDERGROUND,PRIOR TO ANY EXCAVATION OR CONSTRUCTION. L SEPTIC SYSTEM TO BE INSTALLED IN COMPL LANCE w1TH PREPARED FOR 310 cMR IL 00:TITLE V. i}r K S.THIS PUN 3 NOT TOKUSED FOR PROPWYLIIdE 4 4.ALL DISf UHBIBD AR8.A8 TO LOANED AND SMED.� '•DATE: �A.y-r9 �� SCALE: /_._9�30% ;�: S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY `' r REQUlRZD INSPECTIONS PO iA tUy�":,+•;S'.Ai' �h, � .:'' n; .;+'F..«-.;ft.... L:.pr.a�.,.Y. ri s e., .. .. .- .. - `•� �� -fir t r �'_ '�.,�'�17'.t;,, �',74 5 X; NFN WELLED & ASSOCIATES 31645`FALMOUTH ROAD CENTERVHJA MA. 0202 ; f k M TEL:'(S08) M73S FAX: (S08)77S-07S4 APPROVED BY: _- s• Tj N ' 3 i COiyy �tvCI / U� ct S S113S�� co Ile Ap v n � � _ i �� •� � 0 � , � �� ,off y D / w 1 . f I • r 1x i x�,}iit ty�i'�f 4 • .w `� s � x w' a .� t _ �g�