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HomeMy WebLinkAbout0621 OLD POST ROAD (CT & MM) - Health jr - - 621 OLD POST ROAD, COTUIT ` A= 054 015.001 LOCATION SEWAGE PERMIT NO. - 6al old P0sf ,8d VILLAGE ' =' INSTA LLER'S NAME i ADDRESS I JOHN A. AALTO BACKHOE SERVICE 150,Walnut Street I West Barnstable. Mace n?rtiR e U I L D E R OR OWNER DATE PERMIT ISSUED ' •DATE COMPLIANCE ISSUED ITL TOWN OF BARNSTABLE LOCATION foa?/ (�.� �°�-t`- SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. r SEPTIC TANK CAPACITY g LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR•OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No e 6 16-4 d lop PosA e o J - i DATE:_5/18'/94 PROPERTY ADDRESS: 621 Old_Post 'RoadM-_ Cotuit,Mass. 0263.5 E+6rENtb ———————— --------------- NAY, 2 2 1995 �THR�PT On .the. above date I ins ected the se tIc s Y stem at the above adds P P ,This system consists of the following: A. 1 -2000 gallon septic tank. B. ,1 -distribution box. < C. 2-.1000 gallon leaching pits: Based. on my Inspection, I certify ,the following conditions: A. This is a 'title'.fi:ve septic system ( .78 Code ) B. The septic system, is inproper`.working order at the present. time. SIGNATURE: , Name:- J.P.Macomber -Jr..- -- r Company: Box 66 Address: Centerville,Mass. 02632 508-775-3338 Phone: THIS CERTIFICATION DOES NOT CONSTITUTE A 'GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connections P.O. Box 66 Cei,lerville, MA 02632.0066 • 775.3338., 775.6412 _, 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM , Address of property GZ2 QLp 1Posz- Z0,4o CCT-L -r Owner's name �ob1s1 Date of Inspection MAC PART A CHECKLIST Check if the following have been done: Pumping information was requested of ..theYowner, occupant,, and Board of Health. -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. As built plans have been obtained and examined. Note if the are not available with N/A. y The facility .or dwelling was inspected for signs of sewage back-up. The site was inspected for''signs of breakout. ci All system components., excluding the SAS, have been located on the site. The septic tank manholes were uncovered,. opened, and the interior p'f! 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 SAS on the site has been determined based on existing information or approximated by non-intrusive methods.'- The facility owner (and occupants, if different from.'`owner) were - - provided with information on the proper maintenance of- SSDS. 5 TIIE:7v-A l 5 ti.._C>T PG'Sk 6 LA i_=0 l-0 2 1 G B EsDeZco VACS — Cx O V 2. L,6tA�►u Ge.C`. SCyj LUl�(2 S O/C 11 5 �PTiG TA' 2Tb, } �G '�02 (I-15i��T1� �s t•�1,4��...��tl� P�YI�z✓ PU MPS Y1�v �U�P�S , a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of, bedrooms S m`,Q&A —7 U-P number of current residents garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if availabl 05 �� d rz Cl e��i oaP� e '^�"°�u 7 Last date of occupancy C_1 A-,a CC—c,? t;6 P GENERAL INFORMATION Pumping records and source of information: 1f � 0 System pumped as part of inspection es o if yes, volume pumped y r no Reason for pumping: Type of system Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy ' Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) , Approximate age . of all components. Date installed, if known. Source information:' of 3/1 Sewage odors detected when arriving wing at the site, yes or no g SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) depth below grade: material of construction: _concrete metal FRP other(explain) dimensions: 2.000 �&j sludge depth' ,from:�top of sludge to bottom of outlet tee or..baffle scum thickness; distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle. 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, recommendations for repairs, etc. ) DvTLv'r cotQc- ^ �U ^0-/ram` , 1 Lr�� l�l© SC.'u wL -To L cT'rLC- 5C.to LA.-4 ep- I.lo u�—fl ram(,utiP DISTRIBUTION BOX: (locate on site plan) ?;>ELo`<-e 110vee depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage�, i"nto or out of box, recommendation for repairs., etc.), LOOKS C--mof� ©v.1��L C� KJ PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) � f 10 . SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART B k SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : l/ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: . Type leaching pits and number �- � � �-�� iTS. leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of pondirig, ; condition o vegetation, . recommendations for maintenance or repairs,etc. ) O S160.A &1, CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of .cesspool materials of construction , indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level 'of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: l (note condition -of soil, signs of hydraulic failure, - level of .ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) '- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM y PART B SYSTEM INFORMATION continued . SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' �J A : t� ;26 0-TTFtzs oA._k l a,.0 ALI. \IAA.TEP— <<i / op Psi ao DEPTH TO GROUNDWATER depth to P groundwater method of determination or approximation: FO:)V � . p 0 0 ��� 0� 5 f S �vt �, 1 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) Backup of `se`aage into facility? Discharge or pond'ing of effluent to the surface of the ground or surface waters? �o - Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? Required pumping 4 times or more in the last year? number of times pumped N 4 Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration?. tank failure imminent? •4r Is any portion of the SAS, cesspool or privy: below the hi4h groundwater elevation? o� within 50 feet of a surface water? D within . 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or `salt marsh ' (cesspools and privies only, not the. SAS) ? within 50 feet of a private wate r er supply well.. ac) 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 apalyzed to be acceptable, attach copy of well water analysis for co liform bacteria, volatile Qrganic compounds, ammonia nitrogen and nitrate nitrogen. o• MATERIAL and LABOR RECORD JOB NAME OAT jg JQa _OCATION QTY• OU) PO DESCRIPTION OF MATERIAL PRICE MOUNT ------------ r :7) G 3.1 g io ,,Y1'1 LABOR RECORD HOURS RATE AMOUNT MECHANIC$� HELPERS SIGNED TOTAL SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART D CERTIFICATION Inspector : Peter Sullivan PE Location : 621 Old Post Road Cotuit Date :May 17,1995 Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. Please note the summary of recommendations as presented in this form. Lastly please note 310CMR:15.302 Criteria for Inspection(1) "The inspection is not designed to provide information to demonstrate that the system will adequately serve the use to be placed upon it by the new owner. " ruly your Peter Sullivan PE or Distribution: rtTER Original to system owner suuivan Buyer Board of Heath No. 29733 '*TS O*AL E '` j a. r . ......3. THE COMMONWEALTH OF MASSACHUSETTS- BOAR ®F HEAL . .............OF. ..i .! .... -- ... -'✓:Q_ ..--_........_._..::.-_.._. Appliration for Utipngal Workii Timitrurfinit ramit Application is hereby made for a Permit to Construct ( or Repair (� ) an Individual Sewage Disposal System at: Lof -..A des le, or Lot No. Owner A,Lidress ---��� ..._,4- s�W. --. ........................•--•-•• :-:- -�---tom�.-.�p.'--1 •-.---.........-----------------...---------------- Installer Address QType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms...........................................Expansion Attic ( ` ) Garbage Grinder ( ) `4 Other—Type T e of Building No. of persons..............•______._..._. Showers — Cafeteria a YP g P ( ) ( ) Q, Other fixtures ........................................................ W Design Flow............._______________________________gallons per person per day. Total daily flow..........................................__gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter______________- Depth................ 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_________:_______._____- �T4 Test Pit No. 2.............___minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ri ------------------------- -....................................................................................................I Descriptionof Soil--------------------------------••----------------......_...--•--=-------------------------------------------------•-------------------------------................... V ------------ ---------------- -----...... ------------------------------------ ---•----------------------------------------------------------••----•-------`----------••••------•-•---•••-•-----•---•-------------•••••• .. ....................................... 0 Nature of Repairs r Alterations—Answer when applicable__ r ____ _ ��.___..__�_ __ ...�__.__.l®_0._0 -�--------_-- � ��` � - ----------- 14reement: t7 !�Y . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of.Compliance has been is b board f h .- Signed. •0' • • •... ••-- .-. ..._ •-•- •-• ... :_..•-- .•• / .��� Date Application Approved By........... .....`... --n- -•--•---------------------•--------- ........ Date Application Disapproved for the following reasons:------•-----------------------------------------------------------------------------------------------------••-- ................•----------•-•---•--------------....---------•-----=-._......--------------•------------............................................................................................... Date PermitNo. ............................................... Issued....................................................... Date No...F. --- �.. FEB...�.......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH Wh OF. �' ...... ..................... .........i'.I .S.....�'� -.. ....................... Allp iration for Mgpooal Works TumUurtion ramit Application is hereby made for a Permit to Construct (Repair ( ) an Individual Sewage Disposal System at -.... .�� .:_...�.�'.. e ,l...............j U.......... ............F ..�" % ¢._: --.... Loci ._'A dress r or Lot No., f_.........<.1. .. r ................•-------... ............................................ Owner 4ddress ..........-•-•-•-•---•••• ............................... ..... .... Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 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. 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........................................................................................................................................................................ W . ....... -- ---------------•---•-•--•• =-•••••.... ---••-••-- UNature of Repairs or Alterations—Answer when applicable ------ ----- . ____.d__1 ............. ......:�'� Q ..------ ----- ---- ------ 1�greement: C The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ,edrbe boas d . f l tiY J % ,..//- Signed.,. G� .... � ........ - ........ Date Application Approved By........... ---=" �� ' ". --••---------••--------------------- .......... �-�- Date Application Disapproved for the following reasons:-------•---------•----•-------------•-------------------------------------------•----------------------•-•--•... ......•----•--•-•---••-••-•-•----....••••--••-----•----•---••-----••-••••-••--•••---••.................•---•--••-----•••---•------------••--•----••---•••--------------------------•-----------••••-•-- GDate PermitNo........ �.......�.._....--•-•••--••••------_. Issued•..•...--------••--• ......-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Tv� OF HEALTH .......r............:�..........:...OF.... � �(. . . ................................. Trdifirab of utpliaurr y THI,S�S T CERTIFY T,13a�t� t�e Individual Sewage Disposal System constructed ( Repaired ( ) b ...._.'`.., ....��.� '! '!. .. ------------------------•---------.................--------------------•••--••-•---•---........ ....... ----�._.. nstalle, at- . has been installed in accordance with the provisions of TIT E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......... _....(n............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................1.7...I..(?.. .......................... Inspector.....................�_�--•--------_----------•--------------•----.--- THE COMMONWEALTH OF MASSACHUSETTS BOARD ,-.::F HEALTH OF..... T:,_ " wP ....._.... F .J No...............•---•••-• EE.. ..' i0001 V111. Woo� rion Errant ..-- Permission is hereby granted...---�..-�� --• --��-----�-'�-r----�•----------------------•---......_............. to Construct, or Repair, ( ) an In ividual ewa a Disposal System __....-------------------------------•---•--•-•••--. -•--•-••-•.............---- Streetat No. �Il // as shown on the application for Disposal Works Construction Permit o._v_-JS_.••G----....... Dated-__t�� . ......................................... Board of Health DATE................ .................................................. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ' TOWN OF BARNSTABLE LOCATION p2 lof PC2Nt 0d SEWAGE # Ro VIL) AGE f J' �� - � ASSESSOR'S MAP & LOTLgff INSTALLER'S NAME & PHONE NO,4 to y kyr SEPTIC TANK CAPACITY LEACHING FACILITY:(type) a - O ( size) / f/ S NO. OF BEDROOMS S� PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER eaul c,9pft: o DATE PERMIT ISSUED: ',��� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 'A ti tA) o .,t `r - AWs-- No.... -�.� �. j �S F� .......................... _..,THE COMMONWEALTH.OF MASSACHUS�TTS q � BOAR® OF HEALTH ` Town Barnstable. .................................OF......................................................................................... Appliration for Disposal Morks Tomitrnrtinn Vantit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Lot 3 ................---•----...................................................................... -• .••... ............ .•••. •, .-_.... ..•-•--•.............--••--...._......... Location-Address O 1 d post Roor t ad No. .......................................... ..... ............................................ ----------.•-----------7......................................................................... wner Address W Cotuit ---......-•------ ............... Installer Address � Type of Building Size Lot_4 8.,417---------Sq. feet Dwelling—No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder (y�s pa Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................ . W Design Flow............55__________________________ allons per person per day. Total daily qpw.........4 4 0.....__ gallons. WSeptic Tank—Liquid capacity...l5 O allons Length--11.-_0--- Width._......_....... Diameter................ Depth_5-'.4"____ x Disposal Trench—No..................... Width............ Total Length.....................Total leaching area....................sq. ft. Seepage Pit No........_............ Diameter......IQ......... Depth below inlet.....5_-6 7.... Total leaching area.....514 sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....Cape Cod Survey Consultant@te 8/22/83 �a Test Pit No. 1......2_......_minutes per inch Depth of Test Pit ..._... .......�...... Depth to ground water...-none Test Pit No. 2................minutes per inch Depth of Test Pit.........12_..... Depth to ground water.-n a ••••••-••-•---------•--•-•••-••••...........••-•-...---•••••---•--------...••-••---------••-•------------------•-....-• .......... O Description of Soil........T!jl 0-0 ' 7" woodloam, 0 ' 7"-2 ' 0" subsoil, ...................... . ---•-- 2 '_0"-12_'0" clean medium to coarse---sand S�fp U •..............•--•--••--•--.....•. . . . • • . . ----------------•••• -X ------ALLY-N.... -------------------------- (Cotuit Sand) '-•Tp#?---same----------._...---------- -•-•-•-- --•-•--- •••...--••.•••-• --._1N1lSON y 16 Nature of Repairs or Alterations—Answer when a livable........................................:......................... N..302.. Agreement: S ONA The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in the provisions of iITI U 5 of the State Sanitary Code—The undersigned further agrees not to place a system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... Date Application Approved By........ ....... Date Application Disapproved for the following reasons:............................................................................................................. •-••••.............••-••......---.....•••--•••--••••-••-•--••-•---••--•••••---•-•-----•---...------•••---••-•-•--•-••-••-••--•-•••--•----•--•--------•••--••---••••-----••---------•-••-•-•-•--•--•••--- Date PermitNo......................................................... Issued---------------•-------------••-•----•......--•--•-•--• d Date FEE............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town...\................OF...............Barnstable-' Apli iration for Digpvii al Workti Tonstrnrtiun rrntit Application is hereby made for a Permit to Construct ( yj or Repair ( ) an Individual Sewage Disposal System at Lot 3 Location-Address or Lot No. ' •---•-••----•-•-------............................•---------......---•-•-•----......__.._._._.... .............Q1d..P.nat...Road..`�............................................ Owner Address W ..._......� - a -----------------••-•------------.........._.__.........------•---•-•-•--•----•------- .............cat uit.._.....----••-•...............................•.................... Installer Address UType of Building Size Lot_4 8-r41; ......... feet Dwelling—No. of Bedrooms............. .....:...:...................Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................. No. of persons............................ Showers ( ) — Cafeteria (Y�s Otherfixtures -----------••-• •.............•---•-------•---... -••-•----•----------•---•------{'�--------------......------•---.....-•------............_... W Design Flow..........._55..........................gallons per person per day. Total daily flow,.,,..._440..__...._..............._..gallons. WSeptic Tank—Liquid capacity...1.5.0.Q0ons Lengthll'.O.". Width.....6.'.0:0- Diameter................ Depth.5!,4!l...... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage-Pit No..........2--------- Diameter......1.0_........ Depth below inlet..... ..fa.7_.... Total leaching area.....53-4.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by....Cape._Cod...S.uruey...Consult.an$tte.........8/22/8.11........... Test Pit No. 1......2........minutes per inch Depth of Test Pit--------- 2_..... Depth to ground water....nQneL.....__. GT4 Test Pit No. 2................minutes per inch Depth of Test Pit..�......1-2...... Depth to ground water.mL3 ---•-------------------------------------------------------•-•--•-------------•••-•- •-----•----•--.-------------..---...----.----- Q4 0 Description of Soil-••.I....TIP#l-�Q_� �-Z-.e---.t1S.2S2S11.oa�fi '_Z.°.-2_�0 re a11)J^Q1.1......-,• ......---•- O'�� STEP...... G 2--0..=1-2---0#1...c1~ean---medaum---to._.coarse...sand........ ----...... .---- � wiLs� w ---------------------------------(0otult--_$andl.;_..TPA2---same--------_-------- •----------• - � UNature of Repair or Alterations—Answer when ap lira le...............4 / .�•�.., '"a . t................................ .. 1-�-� -.................................................... ah.. -- ------ - ------------ -- - �Ffr,Es�r�a Agreement: S/QyAL�t1 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accord the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place m inns, operation until a Certificate of Compliance has been issued by the board of health. IA Signed...................................................................................... ................................ Date Application Approved By......... ..................................... Date Application Disapproved for the following reason __________________________ .............................. ._...__...._. ..................................-....................................................................................................................................................................... Date PermitNo................... :.................................. .. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... Trrtifiratr ,af TautpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by..........................................................................................-----•---------••---•--•--.......---..........----•------.......--•-•-•---...----•-•--•--•--••-----••---- Installer at------------------------•-----•-----.....-••---------...•-----•-••-...----•-•--••-----•--------------- has been installed in accordance with the provisions of TI i LE 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 WIJ& FUNCTION SATISFACTORY. DATE...,/./�Q�� Inspector -- -- ----- ----------•-•--••----•-------•-----•------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................I......................OF..................................................................................... No......................... FEE........................ Ding sal Workii T-5mitrnrti.orn pandt . Permissionis hereby granted.............-................................................................................................................................ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo............................................................................................................................................................................................... Street as shown on the application f Disposal Works Construction Permit No..................... Dated.......................................... f fy� ...............•-----•----.......-•---------------•----------•------------••-----...................---- DATE ... . v �` ...... Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Nab............... F�s....��.�.... THE COMMONWEALTH OF MASSACHUSETTS III BOARD OF HEALTH ------....TOWN .._................OF...........BARNSTABLE ----------------------'---------------......--------•---.............. ApplirFation for Uiipoiital Work.6 Tontitrur#ion ramit Application is hereby made for a Permit to Construct ( X) or Repair ( . ) an Individual Sewage Disposal System at: d Po t Road C uit, MA Lot 3 ...... .. ...._-• -••............ .. ......-•-...............---............•--•..... ..........-----.....----••----•------...-----•••--•-...........--•-••-•-••.....--•---.._._..--•••- c on-Address or Lot No. h. -• ............ .::. ................................•......... .......--•------------••...----••-----.....•--._...............---.........•-••--..............•-- W i Owner Address Installer Address + Type of Building Size Lot----841Z__..........Sq. feet U Dwelling—No. of Bedrooms___.......__3.............................Expansion Attic ( ) Garbage Grinder (X ) a`4 Other—T e of Building No. of persons............................ Showers Other—Type g --------•------•------------ P ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------•••-----•••-•••••......•--•-•------------•-------•---••----•••-•-••-•--..........----•------•-- W Design Flow.......55................................gallons per person per day. Total daily flow..........10...__.._________....._____.�allons. WSeptic Tank—Liquid capacity---1500_gallons Length.l 0'•6" Width.5 8....... Diameter................ Depth 5._8..._.... x Disposal Trench—No. .................... Width-....____._..__..._. Total Length.................... Total leaching area_____...............Sq. ft. Seepage Pit No.................... Diameter.......12_'__...._ Depth below inlet_5&7......... Total leaching area-_327........sq. ft. z Other Distribution box ( X) Dosing tank ( ) '—' Percolation Test Results Performed by_Cape..Cod_ Surve....Consultants______._ Date....-8122�83..___..._ a Test Pit No. 1..2_...........minutes per inch Depth of Test Pit.____.122'__._._._ Depth to ground water......... VVOF - Gt, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.__.. - .. ..__ . P4 -----------------------•-------------••-------------...----•------------.........----------............ d>� .. ROGER yG D Description of Soil....T,P, �_l -_-_•0-8"_Wood...Loam-,__$_-L24" Subsoils 24"-144 !`Med, Coar. PAUL V ..sand---(Cot.uit-•-sand.).. T.P. 4�I. Same__as T..........................................P .�l ............................................. " ����2D Z CA CIVIL Z ................... -•-----•-•----.......•-------------•------•--••••-•-•---•-------•-•----•---••••-------------............----...•--•------•--•--••-•-••••--•--...--•--•-••---•._ °° � --�..T• U Nature of Repairs or Alterations—Answer when applicable-------------------------------------------------------- __- ----------___ g��®N LNG -----------------------------------•--------------------------......-----------•--..............---...-----.....-------------••----.....---••••-- Agreement: •Z S g The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste in accordance with the provisions of TIT1Z 5 of the State Sanitary 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. ned.....-•.......••-•--------------------------------------------------------•......- Application Approve y. .. ...... ••-••-•••-•---•---•-•--•-••-------•-----•---•------•-•••-_.:.. /Date Application Disapproved r th following reasons-................................................................................................................ -----•---•--Date-------------- PermitNo....................................................... Issued-------••---•----•------•-• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / ....................................OF..................................................................................... C rrtifirtttr of ToutpliFanre T S T IFY, That the Individual Sewage Disp al .Sy ns uct ( ) or Repaired by.. 3...... .. .. .... n er at --...-----••-•-•------ ------- has been installed in accordance with the provisions of Tlmr'' S of he State Sanitary Code a d �d in the application for Disposal Works Construction Permit No.--ffi_-J__'__�� ........... dated-._. .... ... .......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector................................................................................... AV THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN BARNSTABLE ------- - ------ ...................OF............................-................ .......-.......................... Appliration for Ui5poiial Works Tonotrurtion tirrutit Application is hereby made for a Permit to Construct ( X) or Repair ( • ) an Individual Sewage Disposal System at: 601d P"t Road;- C uit, MA Lot 3 ... �........._. . ................................==---------_. ............------------•---------•-......._----- ---------------------•----------------•------• oc ion-Address or Lot No. i' Owner Address W /1 Installer Address Type of Building Size Lot.__48417----••----_Sq. feet Dwelling—No. of Bedrooms___.___.____3 ......................_......Expansion Attic ( ) Garbage Grinder (X ) Other—Type of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures -------------------------------------------------------------------------------------------------------------•-•---------------------.._....-•------- d W Design Flow------55 330 per person r,�lay. Total.jaily flow----_.....................................--_ppons. 9 Septic Tank—Liquid capacity_15©©_gallons Length iv-_6._____ tiVidth 5__8..-._.._ Diameter________________ Depth................ Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___--__-_._________ Diameter _.__._... Depth below inlet_5.'_67_________ Total leaching area__�z...___.....sq. tt. Z Other Distribution box (X ) Dosing tank 1� - Cape Cod �SurveY Consultants 8/22/83 Percolation Test Results Performed bY- ..............................................r --•-•----•-•-•------• Date....................... a Test Pit No. 1................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. tea. ....... c C ROGER 9e 0 ---•----- -- " -----••••• •---- id t� ..... . . ... ........... p�rUC m D Descri Description or Soli____T•P• 1 �'8 t7ood Loam, 8 24 Subsoil, 14 Med. Coa MiCHNiswiCz ---.___--• -- 1Vo.30420 x sand (Cotuit sand) T.P. Same as T.P. f61 ce v •-•------------------------------------------------------------•----------------=----•-----------•----•-•-----------------------------------------------••---•-•••----•---•• -------------------------------------------------------------------------------------------------------------------------- -----------------------------e-ys ........ tvl U Nature of Repairs or Alterations—Answer when applicable______________________________________________ ..__._.__ ---------------------------------•-------•----•- ---------------- -----------------------------------------------------...---------------------------•- • ----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposalm in accord nce with ("i m' the provisions of T T y E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certincate of Compliance has been issued by the board of health. gned •••-••--•----•----------------••---- ----------------------------------------------- Application Approve may___ �f Date Application Disapproved t following reasons:---------•-------•-------•------------------------- ...... _________________•---____.._.. / ---••----------------______------------------------------------------•---•-------._...-----•---•---•------•---------•.•.-------------- Date PermitNo--------------------------------------------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...........................................1.11._.....-.............................. kTrdifirtttr of Toutplianrr TrI'S`1--)T' R-TIFY, That the Individual, Sewage Dis al Syste -construe ( ) or Repaired b ��1��� /�C ::.. �F -. '� ..........................•-•----•-- J _ Instal r - ................-- -- -f-'�- has been installed in accordance with the provisions of I 5 of The State Sanitary Code a�d�rxbed in the application for Disposal Works Construction Permit No- _______________ j`' '�7 <'- PP P ---. dated THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................................................................._.......... Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��� l �.�•� ..................OF........-----._..--.._..-..-...._.......-.._......._.._._...._........___......---... N - l 0 J _..J:_._ FEE..... .............. o .�1 � �ono�rion pruti# ,: Permission i ereby granted--l '':'-•••-- = `== to Construct (' ) or Rep ) an;Individu^al/ e age Dsp Syst '` at No...................... = �_._..--3---..._. .............................................. f r Street f••` 3.', as shown on the a licati for Disposal Works Construction Permit N6�_�_:__ _... fed__________________________________________ c.. B•aid of Health '• DATE......................... •-•---•--••--•-•-•-••--••••••----••••---•--•----•--- 1 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • REVISIONS: / NO. DATE Er.914 h ,' f• -f. ter-.., zy y, ,/ V�, 7 Y0 /g9Y� ^.n 4 l __ 44 C. / - J OR cF c. •vo EXISTING QANfC REIna,NS PROPOSED IA711zz- r ' , C O CAW-, CTT FCL' 6Zf/V N, T . �/ c��.p .:r, r h �A/zA�E"; t '>.'• 1 � � V'r•"''# t t,�''r','�c� -. �?�t'�.,,jy= �.. L� A LK G(j ,li.f✓Jfi:, s7� J'^''"' .'G v1 �� � ' � } "' � ...a'" yN1., 1+ . � t,+'" � ,,, : ,- r.. k; ' r' ' ,,� ,,�"`. ti t ..,...-. � J �S ,S'd' . E^>r? ���h 7` _ . .�..3✓s.,dF" rr � d°'�" �. �:RK G/rr�t7 �' trl�'T` w � ar f� ...'•'^` .Y7' � .� � , MASS WORCESTER MASS 4r=7 HALIFAX, MASS. NORWELL, MASS. BEDFORD, MASS. LEXINGTON, MASS. HYANNIS, MASS. MANSFIELD, MASS. r �I CRANSTON, R.I. DERRY, N.H. Y ! .3 7 G L'CN.G ✓ D.� 1 / / C�odrfo B C N!? TE 5 : ,., /�/� i / PROPERTY L/,VLrS SHC&t w t'UERE COI,nP/Z FD ) 1,10•n7 P" 41V5 OF ALL ELE✓gTIONS SNOUW REFER ;rO/V.G V.C, 019Tur7'1, - 3, .B rr). U5ED, �-u ,O, /-7EFEf?EwCE 1294RK -h7 A" 0& 1 OC'/ATE,O r)/V So" r/: 510E OF rC c� t�oc T• 30 Sari r,,y�-C6 S r ti 0, 50"z1v C F .�O z 67 8 V/3 B /VE 4P, � `'�! �o o "V.C, V. I , 4=,� � -"" ''•`-1 •,,,./� S /=Oti //i/V9TE USE O/VGY- '' -- - �' � // Y 20 �4[L /�/�U/�OSE�C� P/GE5 �J/LG /3E T/QE.9 TEQ C C 9 c� S (DR •.` - ` N l' /Y )N-/_1tC4c "NG �'RESt/3Va TivE C'C ASS f3 „1Ob' /9iR. 1 i�.c5 . �.- !�' . ___, C COp O To BEGET,gT AFL M,e w CL_ - �. A[c c utr)aE R w&c 8 e' s vz T 7`/9t,9 TEG) c.C A. 2.S o R E-q u i v q l E/VT ..".ter, _�-�-- � f ,x y x � u R�� R E v 5 E -/ - QAp t�)��D i..,-•-- ��•4 �• SEC RR :''QNs�' , f /�� CAPE COD SURVEY �i/✓:_.Ir ri' fir " > 4 "5T 1 CONSULTANTS _u 3261 Main Street Route Barnstabie Village, Massachusetts• age. 02W4 'Mt / /`` y �,R p . l� .! ter• / r,,,r..,. ,...�,. , ^— r----�...�� .. �.�"'�'."� - ••"� DIVISK)N OF BOSTON SURVEY CONSULTANTS INC. ENGINEERING • SURVEYING • PLANNING __....__....._.• _/ a TITLE: X y a /!V (CC 7-u/ 7-) I I I Silvia & Silvia I Associates,,Inc. . o / Builders Developers Designers .Q/ oCA� .!io•✓ 619 Main Street ,K P° ! zoo Centerville, MA 775-1442 /V /7. oL0 / P� SCALE: / 3o' METERS FEET 0 DATE: -) xC --7 xL ( aysTEe �0 /rA�3aQs COMP./DESIGN: C' A- o ' -7 X 2 SCHOOL CHECK: r/=',� r DRAWN: C•,'c..,� h Ca Tv/T 7 x, ti FIELD: ,c L %N C0 TU T lS�X FILE NO: E3 %311:7w: P � DWG. NO: -1'38 JOB NO: C — /SS- 6 o SHEET: / OF: / DEAp n/ a 1 1 • 'e3 . REVISIONS: Mr PIT DA IA : DATE a� r�sr<N�. �� � �� ��� PERC. TEST DATA : SEPT1 C TANK DETAIL : smi ,�� .��L_ DIST. BOX DETAIL : LEACHING FACILITY DETA /L� � °"� TEST BY' G'.f t /1''� 1 - TO CaaFORM TO T/rLE 5 REOU/REMENI5 � 4'G c✓/ ':" i 1f TANK TO CONFORM TO TITLE 5 REOU/REMENTS. r- P. WrmesseD `° �.�' .' w , T J f f6Y t r A► 1-4 t.SR�'� ��.�31 r. 1�!` DATE ©f f�'ST/N�i ' E NO. OF OUTLETS .�• �, -• ,. ;� l -� £MOVEABLE COVER 11.E C.Q CAS' . o fr S 1G S BY a �� ram, 121 a. NHA!L� BROUGHT TO y r� ' 3"fJt;'1�/ f." . ISH GRADE. t. 2„PEASTO w LA4M AFX.G /2AUX.J"CL A r "' OUTLET PIPES/ £ /DEP(-H IF 7L�Sr• 'S 6 ,1lYN. 2 M N. 6„MIN. AS R OU RED• INLET RA /NLET TEE . LE EE ( B0X our r.r/NLET AND OUTLE4O" M/N/MUA/ ` �fYC•L SEPTiCTA sw OUTL ET TEE DEPTH TEES TO BE CAST L IOU/D DEPTH /4"Ar L I QUID DEPTH OF 4; -o t PRECAST GR 11 ., •, . I„ 2.. 6.. • cowo4ETE / t SEEmw P/T IRON SCHED.40 /9 S w! !?EPTK fA+�` TEST• ;. . `i P.VC. OR CAST/N 24 Fi . r'... , y. e, s C 0V /O PLACE CONCRETE 29`" „ ,. T' , ... ..• a '. �H �o lrAt7i r7 t 1 RAM C0WCR£rE , MIN. - CONSTRUCTION 34 " " " 8 BOTTOM ON LEVEL STABLEBASE (WATERTIGHT) ° `� I •' = /NLET TEE PROVIDED WHERE SLOPE �,t� ' . .• •.., . .. .. ...�.., . OFINLET PIPE EXCEEDS 0.08 / OR , / � , -r�• •T •-�' TANK TO BEABLE TO WITHSTAND . / t rrU. "t ) �L' ' '�1` •BOTTOM OF TANK ON LEVEL STABLE BASE IN A PUMPED SYSTEM. 20 m/N t t H-/O LOADING UK / • � //Y WASHED STONE i PAVEMENT OR IN DRIVE.H-20 LOADt DRIVE. UNDER PAVEMENT OR _ �' %fr��✓�5' .�r� 7� VI., i r%.✓ ; <,n t R K �y '' �. . fir?- �F• e�'.f4� 4'j. - nQ NO �-�- INVERT EL E VA TIONS: PLAN VIEW !. THIS DEAN/S FOR Th9E"DES/GN AND CONSTRUCT/ON OF ME SEWAGE ISPO SAL FAC/L/T Y ONL Y. SCALE / "_ ' s Z. A L L CONSTRUCT/ON METHODS AND MA TER/AL S SWALL CONFORM TO __ �/NV. AT SEPTIC TANK(/N) �a ' ,MASS. D.E.0 E. T/TL E 5 AND TH£�' �''�; BOARD OF - - _ IN AT SLEPT/C TANK(Q'lTI _. H£A4 rH REGULATIONS. , 3, ,015E 5GM' 4)4e 40 ,Vl a',E JN27a R. DR 1Vk_lk)ig a.:� �r.arv,�.. .� .ysr B� z.r K'�.` �; 2c� !�.oD►ir��r• __INV. AT D/ST, BOX(/N) • ��: AT D/ST. BOX(GI r) AT LEACHING FACILITY BOSTON, MASS. WORCESTER, MASS. HALIFAX, MASS. NORWELL, MASS. ` BEDFORD, MASS. LEXINGTON, MASS. HYANNIS, MASS. MANSFIELD, MASS. CRANSTON, R.I. DERRY, N.H. PROFI L E• scAtr - a c s DESIGN DA TA DES/GN FLOW: REQUIRED SEPTIC TANK Y# DXZaoa/o = 8 0 GAL. —` SEPTIC TANK PROVIDED = i GAL. CAPE COD SURVEY REQUIRED SIZE LEACHING FACILITY CONSULTANT 3261 Main Street•'Route 6A Barnstable Visage, Massachusetts DIVISION OF x BOSTON SURVEY CONSULTANTS INC. • SIZE OF LEACHING FAC/L/TY PROV/DED: ENGINEERING • SURVEY/NCB • PLANN1 TYPE OF SYSTEM TITLE: SECTION' SCALD I . __-, %' _ _ _____ _ a• SEWAGE DISPOSAL SYSTEM � ' - 2 _.. _ ---------- - __ =� DESIGN r )Al LOCUS PLANT FOR. SCALE: AS SHOWN METERS .,,<:: f; FEET 0 DATE: COMP./DESIGN: ' CHECK: -5,4 VV DRAWN: DA TUM� f + �✓ FIELD: ' , FILE NO., ' E3 !Eli:: DWG. NO: .r,, 7- JOBNC~: r . -- ':_. SHEET: I OF: N_ A. Al 4r .X r:. w- frr.:. , ,. .. a ..