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Home My WebLink About0080 OLD KINGS ROAD - Health j Old Kings Road, Cotuit (44 /o) -A= 022-097 / (� TOWN F BARNSTABLE ? LOCATION t-.11U7 xd `/!/GS SEWAGE # — O VILLAGE C,TU Y—r e ASSESSOR'S MAP & LOT a9 -10 7~I INSTALLER'S NAME&PHONE NO. l d Z�c YA711V 6 5o*9< SEPTIC TANK CAPACITY LEACHING FACII.TTY: (type) /0/!1/4fi4.(size)A<//d X Z '46JA NO.OF BEDROOMS 3 BUILDER OR OWNER 004, PERMTTDATE: 19:'Zzl—ffjj?� 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 Feet within 300 feet f leachin facility) Furnished by ,� /r'!� - - a ~� 4� .� �� M � � � .„v +v �+ '� `- • . °� � "�nl �. .. �`� "� y° r� �l ` �1 \ r I � � ti; `� � 4 c � � , �'� � � � �9 � � No. 11 Fee /�D THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Mtopogof *proem Cot%trurtton Permit Application is hereby made for a Permit to Construct( 4r Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. oO l Owner's ame,Address and Tel.No. doQ o� ,�jul-s RD U1 =S5 e,>,'JGo7,* C07-�1T P•®• mix 2aD� v.�r- Ai.4- OZFs3S Inst ler's Name,Add ss,and Tel.No. Designer's Name,Address and Tel.No. jreb /Z MA.i."J 7" ¢7e-9/31 S /I�7�Z vi 1 L v Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow RX PZXSoA) gallons per day. Calculated daily flow 33D gallons. Plan Date 3/9 94 Number of sheets Z- Revision Date Title C x rL.,&1X) )Ro7- A W AJ 61W.19` S- Awi6 4W&-1t"A r�RxP�2 f,�ya:/•� Description of Soil _fANb 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 bee sue 'hy js Board of Healt 1 /� Signed �.�• Date Application Approved b, Application Disapproved for the following reasons Permit No. / `— l yV Date Issued No. f Phi"`° .. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC'HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS. ZIpprication for. lkgozat *pttem Comgtructiou Permit Application is hereby made for a Permit to Construct( L-<Or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. 101 Owner's Name,Address and Tel.No. �0 01-D em6-,e ,t?� U14 ,lA�Es G..vcorrA 00709- !�.�. max gao4 Ins ller's Name,A(! ss,and Tel.13o. L Designer's Name,Address and Tel.No. 3 �r(b t-KAVA7 v 11, '(7le-9131 ri IType of Building: Dwelling No.of Bedrooms _ Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 5S 94- 01X9v,,lJ gallons per day. Calculated daily flow gallons. Plan Date 315P•94 Number of sheets %. Revision Date Title CA;wrrcigw R107- 1112L,4).l iv 4,gV.,T' rtg_ JAn-jb^C e;Ak;orrA tl,ema +n��Ar- Description of So SRn1a Nature of Repairs or Alterations(Answer when applicable) _ Date last inspected: x 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 Titles of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee sue 'by�sB"oard of Health.Signed />�� Date Application Approved b Application Disapproved for the following reasons , Permit No. / G— /O 7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS f PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Certificate of (Compliance L THIS IS' S TO C RT Y,that a On-site Sewage Disposal System installed(k)or repaired/replaced( )on by b-X64VA 701A49 for TZMz_f a4- ID 1 0 has been constructed in accordance r with the provisions of Title 5 and ge for Disposal,System Construction Permit No.9 G —/y dated 3 Use of this system is conditioned on compliance with the provisions set forth low: No. L y — y Fee THE COMMONWEALTH OF MASSACHUSETTS i PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Permission is hereby granted to to construct(e)repair( )an On-site Sewage System located at /OI 61,dl 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. All construction must be completed within two years of the date below. Date: Approved by E �y1c,►-a DATA : ` '51tJ&-s FAMIL`` 3 E PLAhl oh! BAGIL u�r Ao GA¢t3A&c "W LeT lot OLTD V-11JGS - -VM Ly PLOW = 3 x I t o =',0 GPp -swnG TANIL s ` ..D 7=%w4406PD U4 1 r74o (AL. a•PvG PrPcr Lw 6"CUL1'lt �esmi — vIST 4pft.1GAT1ON A k >=olv. �x Wig: a o GPD s o`t4- SF s 44&SF 4d �IPPUC.�.TDId AlZ6A ��SIbN PLAN. 1.€ALI{If4Y� GI�AM8Ee5 5rw--WALL. A 2r-,4 AO x'Z x2=I&OSF IrOTTOM A= ' 4c' 1 8: = 37.0-T- Fiwri+I 4Raac. -ram , 4aosF , Wl'TE L 5 Mtv�u�u1 zu. 3"tt" p�tct.ATIotJ vg-yZ 5011_ ctuf5 .I O sra+E a o o a to r _ � , • SN OF 'x{, ate' I� �� d. j 330 , -Spam""` SULLIVAN A. `{� NO.29733 8. SAXTS 9 CIVILco rQo�S-$fG�'10N D IF e. AMySryZoo. L PEars _ 'f ; � 0 top `' � vG 1A wrc lO&M d- trot i 9le tag 4Oxmy Lit c►�AM rcS 9� 4z�. "�' 4S� L +: SpaJD ,� Fy,010 SWflG. 't7►wL hlt�• . SAWb �'VEIOP'r•� WOME— PLOT CEVn ?Jo Go�t-o IT' R %01 PSM Mee. 14,M& (. posc-� 5�►l� J rl �, v_,4�E 3• I�j•9� GEm rl TVAT '1"4 E I+E rtwlPtyS vets T s1l:�c-ut4e AID - 10 211 P6. MS"V 2MVIQ6,MS T OF TVrAb 'mrVN 4F Am ' -2. PAW "J!oAP-1 I905LS A$-* I s (� LG1Gs.'Tm �� A HYS I NG Spw-JAL FLZVP �iA7�-v �N�. LAND St�eV6tYttrS •Wotr.ttt f N(Ap. . Id-,Igq(o Ct OST�¢Vtt.LL MA44. s VwM 5Vu,Dlw" s00LXP No- era APPLJ" T: I ES C,�Ico�rT� u�Sea 1b 6ST�►t5usfa PRcp�a•ry L ----------- ------ �..._�.__......_........ _ OF t /00. O Ap t �IBs Pier 3 .. . t ps ��. I��utuR.0 9�.+f � � 4► �f � i tzT Arl MA lk OF ' - • 5 � . 9�. _ ��s� , !,'' Tom, :�� i '�� _. I , NOF { �p,i►as►� `I �1D.29733 co CPAL k{-x.FFR. b E-..x - w v4TA wit�1G1..� FAM IL`{ 3 Q1�RG�NI tE PL.A I.L oN BAGtL u�JZb�� Ao GAlZ 3A`c 17A4 Ly FLOW = 3 V. I10 =OW 6m S>nG 'TA NL ' U I C 00 GAL• 4'PvC PPG �JK �ES�•11 _..., _ _ Keg ly,�6"cuL�c �wuz�Ee33o ��isra� visT. a,rinj Gq-moN AW A ZW'D• 01� r----aB S-So GPD s d SF z 44&SFF . dPPu/-k►-no&+ AMEA D251'W PLAA VII-=YV - L€AC'4'W--v GI�AM8Ee5 51t--WALL- AtKA=A0 xZ x2'k oSF IFOTTOM A¢mA - 4c; t 8 VIAL AWA. 400 sf u 3 MIX „ e7AL aAIV2 I ob y'a 00 Cup. G a N� 330 0 `emWAOW s-eNC Asa OF PETERFV J Su tvAN --- 52'=—d PaA.z N0.29733 a, 8' ctv:t. vo aio�e 9 GI$'f��4� `�' f ZOOS-SEG1'1O*1 D r- C 4IsrM3rSZ- Us - �PEQI f WD O 319:9� Fia=qBlot r T�- , � A Lakin pr,E 1W�1 IIII s $ 1OXMY Lr�wt CIiAMt3��C5 92 SAu� ' ►� C If 4' kle�, SAS �IE1�OP'r:� �OFII.� C T1�1�D ROT F'LAL 1 =8� LoeATtoN (�Tv I'T— . P' %01 pra: MAO. 14,Aq& ^PpSL� .,54ALr-- I C1: r-%y T't•WT 'IrtI E emu' Ate ?LAW P l P6, St3 4E� eimptj4's w T AMuNa LD'I� of J;GT5"v- zwvizsmswr OF Tu6 irvA OF )WAP J_S PAPG6L�'J --j�A i?M WAeLG A►* t S Wr LLX•ATG D W l Tl� N � _ S NYS I NG -ApseaAL FLwp 4A7-Az3P 7-ONI:• I.AIfD 4l,,w&YM4 •W101kaw MA9 - Id-,Iqq(,, fL� 0 19 C'� .05TWayl"A . MM4, awi$e s MOM BV u.,vI Ili 4"xpNOT" oa APFLJ4A T.' J Am E� (fwco`TTA 5 I ` � ` • i 3y'83o� Aw ' en40 I Fi77vAt 2C ' 20 ,f -T lit AAPI OF *0.29733 CML 'Abe ' Y j %o awd M� S-z- PC,,-. SOIL EVALUATOR FORM FORM 11 P age 1 of 3 Date: ,rake I.144k No. P— Commonwealth of MassachuSetts Massachusetts el m n r . . .Date: ....... Performed By: ..... . ...... X .. .........710-n.E ........................................................................................................................ ....... ... Witnessed By: ..... ....... Ad*m or 0. Lao 101 OLT, V—I W&r. R6 TckphM I 763r 60 ro 17, rjAw construction BRepair ❑ Office Review Yes Published Soil Survey ❑ Available: No 0 1-1.13........ ' Publication Scale Soil Map Unit ................. YearPublished .................................................................................... C—xC L-5*-s-5/.v .... Soil Limitations ............... Drainage Class Surficial Geologic Report Available: No. ❑ Yes E�4000 0,7 year Published Publication Scale Geologic Material (Map Unit) . .M..?.................................................................................................................................. or O ........................ ......................................................................................................... Landform ....................... Flood Insurance Rate Map: No Cl Yes Above 500 year flood boundary 0/yes Within 500 year flood boundary No ❑ Within 100,year flood boundary No �es 0 WetlandArea: ........................................................................ .................................. ........................ National Wetland Inventory Map (map unit) ................................ Program (map unit) .......................... Wetlands Conservancy J q�.�.'v'µ.. Current Water Resource Conditions(USGS): Month Range :Above Normal E]Normal �selci.vNormal C1 Othor References Reviewed: DEF APPROVED FORM 12107195 r� mM 22 Ace- 97 a FORM 11 - SOIL EVALUATOR rOK, Page 2 of ,z Location Address or Lot No. �� vc D �NLS /� Gores•r' , On- Review G Time:... Weather Deep w her Deep Hole Number Z•. Date:.:: .•: •` 9 Location (identify on site plan). �:. �... :.:::,....:r.:..,..::.::.. .,...... H...........,...��.w.�:. Slope 19b1 3�� Surface Stones .:-... . :� Land Use Vegetation Land form 4A ::..,.:::.::; :.::.,......,..:. .. .::.:::..:.:.......:.::.. .:,:.,:::::..,......... Position on landscape (sketch on the back) Distances from: 7Qr2 feet 7,pa. feet Drainage way Open Water Body z� ., feet Possible Wet Area ...� feet. Property Line .:. Drinking Water Well .7:/5p.. . feet Other . ::. »:,..»:..:....:„ DEEP OBSERVATION HOLE LOG' Other Depth from Soil Horizon Soil Texture Soil lllY $otl Gravel) Surface(Inches) (USDA) Mottling (structure,Stones,Boulders, Consistency, Z7, S,?ji 8 �,s f�rrL s c� C�S� ep tA 000 y of lift, 49 9 Dep�thtoBedrock: �.,acidc. dvTzv�S� Parent Material(geologic) Weeping from Pit Face: - Dsp•ti•)Groundwater. Standing Water in the Hole: Estiffisted Seasonal Nigh Ground Water. DEP APPROVED FORM 12/07/95 MAP zzAL 7 • FORM 11 - SOIL EVALUATOR FORM P / Page 3of3 Location Address or Lot No. /0/ pLD A�INAS Dtrm in 'o r nacl H' h r le Method Used: . ❑ Depth observed standing in observation hole ......... inches ❑ Depth Weeping from side of observation hole................... inches ❑ Depth to soil mottles ......,................:: inches . Ground water adjustment .....00... feet ber MAW. Reading Date �!�f,1...0 Index well level ...g'�... Index Well Num LL Adjustment factor .......�..!Q Adjusted ground water level ........7.:... ................... ryi �s Mate rial De th of Naturally Occurring Pe Does at least four feet of naturally occurring pervious materas I exist?in all seas em observed throughout the area proposed for the soil abso p tion If not, what is the depth of naturally occurring pervious material? Certification I certify that on tit 9110 (date) I have passe the soil evaluator examination approved by the epartment of Environmental,Protection eining expertise and expe and that the above aenc�e was performed by me consistent with the required described in 310 CMR 15.017. Signature Date ' DEP APPROVED FORM•12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. /a/ COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test* Observation Hale # Z Depth of Perc Cot Start Pre-soak /otza End Pte-soak 10,351 Time at 12" 3r Time at 9" /0;SGa Time at 6" �a Time W-61 S m q Rate Min./Inch "P 2 41N 49:ss Minimum of 1 percolation test must be performed in both the primary area AND reserve area Site Passed, ' Site Failed ❑ Performed. By: --r Witnessed By: � r`-1 1 �u'^� OP ,Air- 6 ts- Comments: �. .wM. M� . �............ yYi,4� zZ Qc� 97 i 2S 25 8' -tD( vs I � 830� IzS 049 47->