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HomeMy WebLinkAbout1328 OLD POST ROAD (CT & MM) - Health F132780ld Post Road - Cotuit — — - -- - -- — - A= 057-010-002 Town of Barnstable P# ort� Department of Regtitatoq Services: an[wsrests w Public ]E�eath T)ivision Date f`1 ' A'i63A . 200 Main Street,Hyannis MA o2601.' I tFD MAC�' CIA e�htJI)R-Date ScheduledTime Fee Pd, j U ;Soil Suitability Assessment for S age Disposal Perf"ed gy: `� C-�� Witnessed By: LOCATION& GENERAL INFORMATION. Location Address 1-3 Z F C(t/ Pus•-f ✓l�V Owner's Name 7 M -PG V1(:. r - �' Address . IJ.Ct r aC X- 9-7',Z Ma /Parcel: 6-5- � d/ o Q02 �1/r}'�/.1� ��i�o�S Assessor's p _ Engineer's Name, NEW CONSTRU/CfION. !'� REPAIR Telephone# . 57 — 7 7-5'3V�� Land'Use 1.as`diA ly -l Slopes(�O) Z''� Surface Stones Distanecs.from: Open.Water Body, 30o ft. :Possible Wet Area .ff. Drinking Water t' ft Drainage Way ft Property Line Fr'—f Other ft f SKETCHI:(Street•:name,dimensions of'lot,_exact locations of test-holes&perc:tests,locate Wetlands in prox.imityto hoes) ' 1 C444- —� =. a. Z o"d �s d' ac/ Parent material:,(geologic) v� 5 Depth tb Bedrock. Depth to Groundwater.Standing Water in Hole: Weeping from Pit Face /l/d e .. :Estimated Seasonal High Groundwater. 7 Z Ll DE T'ERNUNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed:standing in obs.:holei in, Depth td soil mottles; in. Depth to weeping from side of ohs:hole: in. Groundwater Adjustment tt: dndex:Weii'# Reading'Date: lndex'Nell level � A41,factor - AdJ,(h»undwnter Level PERCOLATION'TEST Date Ttme _ Observation Hole# �Y�Z / Depth of Perc: S� u �4' / 'Mate at 6" qlS Start Pre-soak Time _ time(9'6"). t End Pre-soak Rate Min:/Inch Z L Z Site SuitabilityAssessmeut. Site Passed Site Failed: Additional Testing Needed(YIN) Original: Pnblie:Heatth'Division Observation Bole Data To lie Completed on Back----------- *If percolation test is'to:he conducted within 100, of wetland,you must first notify the Barnstable Conservation Division qt Ieast one(1)week prior to beginning. QAIS EPTIC\PERCFORM.LOC DEEP OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) lMunselq Mottling (Structure;Stones,Boulders.. Zonsten % ravel.f'y� 10 Y(r�dt�C- S "d 'Z•S_r-(-16 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel` A / &Yr$`—Z� Ci (ocsr.� S'a»�/ 1.o`fx-17F S awd 2 5"f b l6 �1d✓� DEEP OBSERVATION HOLE LOG Hole# '3 Depth from Soii.Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,.Boulders. Consistency. Gravel ZY_, 3z c mil. 5�.�'. z•s�`I` ` l DEEP OBSERVATION BOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Svrfacc(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, bnsi ten d 6 A Lea _e'e'�4 Flood Insurance Rate Map: Above 500 year flood'boundary No Yes� ,. WiNn!iW year boundary :No ll'•, Yes.,. Within too year flood boundary No V Yes ._ Depth of Naturally Occurring Pervious.Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system?. es If not,what is the depth of naturally occurring pervious material?. . . Certification I certify that on L( k R 9 ate)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in I IG CMR� 15:017.Q r"(� "1,� ( Signature Date -��-- Q:%SEPTIC�PERCFORM.DOC Flynn, Judith From: McKean, Thomas on behalf of Health Sent: Tuesday, September 08, 2015 8:08 AM To: Flynn, Judith Subject: FW: Septic inspection ,Swn -. Jtda. , A?" Ow, 2015 2: 15 RM , go'.. 3 iff u� ru, un adt av lw d a, p6" amn tip ta- WWQ a, a 1 6 (fed Ad &dl ff6m" `) , �n T6nlv 4 201 A + .,t 4 o4A W ano n P,a n,d....u , a, dc��...ua, pwJ kd d 1328. OU, Ad Zad ` wdwv, TU M 201 A J uin c W� a, PL urL.ff" � u Aq n, C/am" W"W . cauu ff W rn v � a/r ."IAC," wa6 wro,ted? X da 6 Paeern m 1 ° av" a, vw/- u"A lam' u , a&iumu at'tz & a. V U✓V WiMN C��UrNA/.YI/(A.)/ K Y � i 'V LOCATION SEWAGE PERMIT NO. VILLAGE � cTrUr I I N S T A LLER'S N , ME Z ADDRESS ��ls�s/mil fr`.Lb�-� �✓`�Z-� t eat 0R OWN ER DATE PERMIT ISSUED _ — DATE COMPLIANCE ISSUED i ....-�- � � �� � � � . �� �� �� �i � �, � k No Fms......a ........._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH •�1.. ................oF� f V�,�. � ............................... Appliration for Disposal Works Tnntrnrtiun.Permit Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal Sys em at: , . ... L. ......... ....................................................... ...•..\5 1.- E . ........................... Location-Address or r __.• �3 L .. .. ...� i 1_f fZ�3f dA�?t � � !rr ................................ Owner Address ......................................................... _ v ; .. ol. ------------------------ ----.... Installer Address U Type of Building Ceo-r-rAr*C-1 Zo© Size Lot.. 45 � ..�._..Sq. feet Dwelling—No. of Bedrooms-- ...................................Expansion Attic Ab Garbage Grinder Acs aOther—Type of Building ............................ No. of persons......................_..... Showers ( ) — Cafeteria ( } 0.' Other fi tures d . ---..-------------------------------------------•-----------•-----------....--•-------- ---- Design Flow....... .............................gallons per person per day. Total daily flow__._... -.:...................gallons. WSeptic Tank—Liquid capacity.14=gallons Length&62..... WidthA:77 0.. Diameter.."..... Depth..5�_--__ x Disposal Trench—No...................... Width.................... Total Length................. Total leaching area....................sq. ft. Seepage Pit No....... Diameter......10....... Depth below inlet....5.a ... Total leaching area.....LS sq. ft. Z Other Distribution boxyej Dosing tank (t1Ao a Percolation Test Results Performed by.................................... ..._.._........--•--•----•-•••.---.... Date........................................ ,� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................... G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------•------...._...--•-----------------...... ---------•---•-------------- ------------- ---------------- ---------.-. --.:. 0 Description of Soil........................................................................................................................................................................ V ---------------•-•••-•---........-•----•-•----------•-•-----------------------•--.....---•-.....----.....-----•-------- --------------- W -•--------------- ---------------------- U Nature 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 iI'=- S of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' b- the bo r of health. Si d.--.... t3 to PPlication Approved By •--. ......---•--•-----•...................•--•- Date Application Disapproved forte ollowing reasons:...................................... _........................................................................... ....................•----......-•----•--...--•---•-----------•-------------------------........--------....--------------------------------------...----------------- ------------.... -•-•---------•--- Date PermitNo.......................................................... Issued....................................................... Date • No..... .� Fss.......:-)._�.�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............OF.......�5 .`��3 .a �...t............................. Alip irFation for Di4ponttl Workii Tomitrurtion antic Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal SystCm at: ....... ...... . ...............................•...... .....� � .. �- .!......, .......................... Location-Address or Lot No. ......................—........................Ownerr .............................................. A........................................•• ---•..............•----....._....---........••--dd--ress--•......_..----•-•...............••............ W Installer Address Type of Building C,,- z-- ( Zbo vA Size Lot... ---Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( Garbage Grinder ( V aOther—Type of Building ............................ No. of persons............................ Showers ( — Cafeteria ( ) P4Othe_r fix .--•••-••••--•••--•--------------•---•---•-•-••-•-----•-•••----•----•••---•-••- W Design Flow......:S2.155............................gallons per person per day. Total daily flow.........Z-Q.....................gallons. WSeptic Tank—Liquid capacity.... gallons Length_5.:6P..... Width.'.-!Q- Diameter...`...... Depth..S._.` x Disposal Trench—No..................... Width._...__............ Total Length................. Total leaching area....................sq. ft. q Seepage Pit No._..__..-n-__----__. Diameter....... __..._. Depth below inlet......5L�...... Total leaching area...... 2 sq. ft. Z Other Distribution box V4_5 Dosing tank (�6)0 aPercolation Test Results Performed by.......................................................................... Date........................................ Test 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 W ----------------------------------------------•-------------------------------------------------------------------------------------------------------------------------------------------------....... U Nature 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 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 issued by the board of health. Si -••-----------------------------------------•-----....-----------•---- -- ------•D...----•--•------- plication Approved BY � .. ......................................•--••- ---•---•-� -- 5t�-. Date Application Disapproved for t e ollowing reasons---------------••---------------------------------------•----------------------------------•---•----••-•--------- ..............•-----•-----•--•-•-----•--...--•-•-•-----------•---••-------•---•-••------.....-------••----•••---••-----------------•---------•-•--•--- ------•-- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................I................OF..................................................................................... �rrtifirFate of TontpliFano THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) -fZ•E-�------....FL1.L.LER. by-••-........_ Installer at---------------- ----- !L p-----..P.P ----....-- D:--------- c7-T v 1.7------•----------------........-------------•--•----•--------------. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...------ 7 C�......... dated-.......................................... THE ISSUANCE-OF THIS CERTIFICATE SHALL NOT BE CON764 UED AS A GUARANT E THAT THE SYSTEM WILL FUNCTION SATISFACTORY Inspector DATE .........�..1..�$�:........ ......... ..-........................ ------• ---..... .--•... .._.:. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................................................................... 0 Fjo No......................... FEE....................... �` �in�o�aal ork� �on,��ratr�ion rrnti� Permission is hereby granted.......... (f ..........E t . ...K....-•-.... ...... ...... to Construct ( X or Repair ( ) an ndividual Sewage Disposal System at No................ ...........f,_1L.(:)....... .Z)_ 7.........12.1).......... 37 V-I-F ._.._.. ,.-..Street as shown on the application for Disposal 1�!orks Construction'Permit No:-9=5­:-_ 6K Dated.......................................... _. Board of Health DATE................ ............................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 7� ss -:5IDcvoaLL AZTEA \�OM 2?5 c�sc�r�uCx CAPaLrn( 78 S Ca.1.0 = -TD-T-'A,!-PEE>16,t COD c L rxst \ N , .1�1 2" P Pit► t '" �?C �-' f` 1 I 1 lot ( t Q a , i lv - 97.S 95s-o _ , o 9Z,C�sZpn C w 9- ? z' 97.E svbNc t PETER o SULLIVAN --IPA-7-F- �I a, AYE° . ST P y 1 L0CAT1© H 5 E W A G E PERMIT- MQeA 'PILLAGE, i INSTA LLER'S NAME I A0D,RESS � OR OWNER j L i HATE PERMIT 15SUEC ._ .� Y j DATE. C 0 M P L I A H C t ISSUEC i -- ---- - i �r