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Home My WebLink About0150 POINT ISABELLA ROAD - Health 150 POINT ISABELLA A=073-022 `i I� I'f� No., .o a - 7 Fee BOARD OF HEALTH TOWN OF BARNSTABLE/ 01ppYicatiou ,for Yell Cou5tructiou Permit Application is hereby made for a permit to Construct( ), Alter( ), , or Repair( ) an individual well at: �5� 7 1 n-f- :T 5 CZ. Location-Address I �� Assessors Map land Parcel n - �ti fir\ D o(�J IS-0 'P6i Owner '\ Address Installer- riller Address Type of Building Dwelling Other-Type of Building V\4)C)'�' v= No. of Persons Type of Well .r Y G,c. - t p 10 LA!IP VC' Capacity Purpose of Weller Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compli nce be ' sued b the Board of Health. Signed 3 /,3 z ' Da Application Approved By �. Date Application Disapproved for the following reasons: Date Permit No. 1p.0 0 - G'/7 Issued 3 i�� Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate of Co"Altered cc THIS IS TO CERTIFY,that the individual well Constructed( ( ), or Repaired( by _C A t' 1.* Installers at � a ��PA has been installed in accordance with the provisions of the Town oaf`Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. I O 30 607 Fee BOARD OF HEALTH :C? TOWN OF BARNSTABLE ZIppricatiou -for lVell Cow6tructiou Permit Application is hereby made for a permit to Construct( Alter r R Co o Repair( an individual well at: PP Y P ( ) ( ), P ( ) -a Location-Address ` Assessors Map and Parcel t13 C)�i �(Iti fi t/ � U �t n r. �-p� (, ";?-A- Owner ` W Address 1YIP-, LO ) VP,k1 c� cam tti��L�� `.� C \-ZC- � e\n�S rV I I Installer,Driller Address 1 Type of Building �.�� Dwelling I Other-Type of Building V\ No. of Persons 3 Type of Well T r v e c, ryt - i\n l). 'q 0 PVC Capacity -Al (-,r, l Purpose of Well i Agreement: ! The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board:of,Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compliance has. beenssued by/the Board of Health. ` J Signed r rI v ✓/ pt i Date Application Approved By ,d p . .34 r/.) x_ Date Application Disapproved for the following reasons: / Date Permit No. /,".J o 1 - 0 6'7 Issued 3/l,1) 7-, i Date e----------o-m-«+------------- -- ----- ------mk------------------------------------------------------ BOARD OF HEALTH TOWN OF BARNSTABLE r Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(Q Altered( ), or Repaired( by k 0e n AI0 � 1 A)Wo has been installed in accordance with the provisionsof the Town of Barnstable Board4f-Healih Private Well Protection Regulation as described in the application for Well Construction Permit No. #L e7/ Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date" Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Very Couttructiou Permit No. I, l r) 7 a -06 7 Fee � r Permission is hereby granted to r Installer to Construct or Repair( an individual well at: No. ns t r1 c3 b�� _ c 7 Street as shown on the application for a Well Construction Permit No. (A/9 U Dated" 31(j--, `7 Date Approved By 1 ��/�l"r✓;'' � r { SYSTEM :� PROFILE NOT TO SCALE •v�7'.-c (7..,.f- TOP FNON. FINISH GRADE OVER FINISH GRADE EL.— FINISH GRADE R2.G FINISH GRADE OVER OVER TRENCHES 31.-I � DIS'. BOX 31.2 SEPTIC TANK 32.4 y;'ARaJJJ,`t`•nI.RWIA . 12" MAX. �([�7,'<_l/hR.1, A7SS°Titrt°1JAlR'll'lRpiTRRT.�I�iART/ARP�cp ; i 31.0'o a TOTAL L FNGTH OF TRENCH 50'-6" OUTLET PIPE LEVEL ' 13" o FOR 2 FT. MIN. _ 8'-6" _ I QA4 30.56 30.3229.i5 s• 7 ',. ;p .. v. _ c S oAp i Z 4 C.1. OR PVC-TEES A-07 29.28 28.1r0 0 l o L� o O b�oA 2000 4fY B4FPLE - REN�VE ALL A G B UNSUITABLE MTETIIAL NITHIN B A. BSMT FL. GALLON DISTRIBUTION BOX OF LEACHING FACILITY AM7 AMACE NI7N CLEAN sAnn EL. oo' >p INSTALL ON LEVEL BASE '500 GALLON DRYWELLS' Ml PRECAST CONCRETE _ N1 FI-_!_O REINFORCED &. C�ZOUA D4/6TE�EL. S.$' �Ic:.�d.;o..ae'<eio:._os_$na T.;.agB.o;'e�_...a'_s':<•af TRENCH SECTION gerJcu ML�zK SEPTIC TANK _ �� u-2o Loaolt,G INSTALL ON LEVEL BASE NOTE: EXCAVATE 10 ELEV. G6.0laq G EL.29.2' LONER TO REMOVE ALL IMPERVIOUS r6 3. MATERIAL BENEATH THE LEACHING AREA vtAM. f2 MIN. - REPLACE EXCAVA TEO MATERIAL NI TH 16\col OCEAN. CLAY FREE SAND � � y �;� MASHED PEASTONE 3/4' - 1-1/2' NASNY:O .: `:.. 0.� CF(ISY.EO STONE-..-. ._. I1` j o" oa:e 'a• 0 � I- —5•-2- a ��`90• aT -� � � GENER..'L_ NO IES -3'RENCH NIO H 1. ALL 8LEVATl0.': _ "': ": '^7_"" "'�"O NUMSER OF TRENCHES 1 R. ALL PIPES IA' -SiS%EH Hl/.^,:'Sc CAST N OR SCHFOUI.E 4 VC. ORSERVA TION PIT � 3. THE BOARD OF:"O %I HUST BE NOTIFIED r� .\ NHEN CONS TRUC 5':iN IS COF(PLETE PRIOR \ \\\\\ �q TO BCHANCE 1,1: PERCOLATION RATE.- P \ O \\ 4. ANY HE BOAR IiI 'HIS PLAN HUST BE APPROVED <5 MIN./IN. N =a / NITNESSEO BY.' // BY THE BOARD ��F HEALTH AND CAPE 6 ISCANOS 63.26� \�L\ y SURVEYING CO..;,'NC. O.MIOAANOA , S. MATERIALS ANO .;NSTALLATION SHALL BE IN Way BgyNg• BRO. OF HEALTH DESIGN DATA\ COMPLIANCE NI t, THE STriIE SANITARY AuG.17.2000 zb� \,� \\\ \ CODE - TITLE T I- AND LOCAL APPLICABLE DATE: --- -- wa RULES AND REG(LATIONs NUMBER OF BEDROOMS 6 Y� ¢ \\\ 6. NORTH ARRON I;,ED F RECORD PLANS ANDPURPOSES � O __ - EXISTING WOE OE�V. �` \ IS NOT TO BE /:•L-U FOR SOLAR PURPOSES FILL. GARBAGE DISPOSAL NO TO LE.T3JGSSE C'a2 MGV / \ 7, .FLOOD HAZARD CGNE_C (N_ON-HAZARD) 12 -.'.LOOM DAILY FLOW 660 GAL. 10'FF5E7f IG YSTEM "11 1pyr. c B. NArER SUPPLv__:,_. raNN HATER t3 s SEPTIC TANK REO'O. 100 GAL. I - LOGMY -AND 2000 GAL. SEPTIC TANK PROVIDED G LEACHING REQUIRED 660 GPO. 52 MEDIUM SIDENALL AREA e 254 S.F. t.f �'e.' 2 I O YR 4 254 S.F.X 0.74 G/S.F.- 188 GPD. �yR @><o s y BOTTOM AREA -665 S.F.L t(icrdu E=5 S.F.X O.74 G/S.F.--192 GPD W�0 ti'A - LEACHING PROVIDED 680 GPD ---O—faiO.,O5E0 ELEVATION 120 O NDWn'r -32--t;IIiTING CONTOUR SEPTIC SYSTEM UPGRADE =s \ U. / t_(:RVATION PIT e ALL A B B UNSUITABLE HA7ERIAL L rs�wleurlDN Box PROPOSED SEWAGE DISPOSAL SYSTEM ?\ NITNIN 6 FT. Lam THE LEACHING FACILITY IS 70 ____' SE REWYE0 AA17 REPLACED MITI/CLEAN SAAD __ Tf'ENCH PREPARED FOR . Iz\\ SO J 0 T:LPi7C TANK FINE ART ENTERPRISES uOUSE I \' \ PA2GEL 22. 'p= L HSE.NO. ?50 PT.ISABELLA RD. a2 2.0OGt2.E5 i=;=i ,S.S.SERVE AREA C.OTUIT-BARNSTABLE-MASS.. Y. r''IPE''INVERT ELEVATION CA TE: AU 1-1,2C.7J �(7� \\\\\-- G' CAPE& ISLANDS ENGIN BRING T \\\\ P-.LOT PLAN •` e SCALE AS NO%EO zc 73 22 50 m/clsicai BOO FALMOUTH ROAD - SUITE 301 _.-_..' . PLAN NO. 50817001MA SHPEE,MASS. _148&A 68... No. �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pplication for i0i$po!6a1 *pttem Cow5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. l�'� %C Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: C Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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) Date last inspected: Agreements 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 by this Board of Health. Signed Date Application Approved by Date Application Disapproved for the following reas ns Permit No. Date Issued No. C� � - �OV Fee G�� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes A PUBLIC HEALTH DIVISION - TOWN OF 0 RRNSTABLE., MASSACHUSETTS �� Zipprication for �Diooe;ar *r5tem (Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )AbL don( ) El Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No.� Assessor's Map/Parcel (9—?3_C) Installer's Name,Address,and Tel.No; Designer's Name,Address and Tel.No. Type of Building: / �'� J Dwelling No.of Bedrooms 16 Lot Size sq. ft. Garbage Grinder( ) Other Type'of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets "w4 Revision Date Title ',Size of Septic Tank Type of S.A.S. t t Description of Soil I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement!, g 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 by this Board of Health. Signed Date Application Approved by _ Date Application Disapproved for the following reas ns Permit No. '' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CE TIFY that the On-site ewage D'spos 1 System Constructed( Repaired ( )Upgraded( ) Abandoned( )by ds' at Gge , -4to has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2.0" dated Installer Designer The issuance of this perxrut shall not be construed as a guarantee that the syst ill f ccA�asgn- ^ „ Date �/ 3�?aJ7/� Inspector J+ ' ——— —— —————————————————— —————————— No. ��n Fee — -- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS IigPoiarPgtem (fonotruction Permit Permission is hereby.,granted toDConstruct(ti cRepair( )Upgrade( Aban on_( ) Systern-4ocated at �� T D +�C�`. l�S��a�.��t C.c�r1 i�'��( 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:Constructs n must be completed within three years of the date of this e h. Date: Approved by G.4,-- �� M TOWN OF"BARNSTABLE .kA a ., LOCATION I S—y s �� SGE #o�$O6 —5 d VIILAGE .moo %U�f /!I/�sJ ASSESSOR'S MAP & LOT 93 ZZ INSTALLER'S N AME.&PHONE`NO: � lyS�lY SEPTIC TANK CAPACITY ._ LEACHING,FACILITY: (type) 52gD��g4� (size) p NO. OF BEDROOMS BUII DER.OR Q,Y�1 R •,i� PERMITDATE: c/—Z 3 -Ztw a .. 'COMP LIANCE :DATE: „ Separation Distance Between the:: Maximum Adjusted Groundwater Table and Bottom of Leaching.Facili.ty Feet Private Water Supply Well and Leaching Facility..(If any wells exist f on site or within 200"feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any we exist within.300 feet of leaching facility) Furnished by • Feet ------------- --_—�-- --�� "Q'4 � v 1 � Q 4* .!� \ 0 t - � 0A ,�-- fi _ _ ...� 1 f 3t TOWAT,OF BARNSTABLE LOCATION SkAGE #07-60� VILLAGE eO %Uzf %!7/4sS ASSESSOR'S.MAP &;LOT '93 ZZ" INSTALLER'S NAME&PHONE NO. &f 14- Co.,S SIZy-VVS C/ SEPTIC TANK CAPACITY c.Z LEACHING FACILITY: (type)r0o 42 (size) D loop— NO.-OF BEDROOMS BUILDER OR 0�1ER %sr,• •¢d/f �'i,.V4t /LlL 4C S PERMIT DATE: 9—Z 3 Z0 COMPLIANCE DATE: S— .Z 3 Separation Distance Between the:.. Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet . Private Water Supply-Well and Leaching Facility Jf any wells exist:. on site or within M feet of leaching facility) Feet ' Edge of Wetland and Leaching Facility(If any,wetlands exist within 300 feet of leaching facility) '; Feet Furnished.by F a � , • l Town of Barnstable P# Department of Health,Safety,and Environmental Services DIME, Public Health Division Date co-1\- SZ, 367 Main Street,Hyannis MA 02601 eAruvsueM Date Scheduled q n Time,3� lZ Fee Pd. `O0 00 y t. Soil Suitability*Assessment for,Sewage,Disposal Performed By: Witnessed By: LOCATIO & GENt4 ftAL INFOAMADON' Location Address` o �� (� 1 Owner's Name = sue cam.b C-0 L b Vh p dYL 1-C� G�L 11 Address Assessor's Map/Parcel: 0� O_f -1 3 �Cl Engineer's Nameeo,� EK4 NEW CONSTRUCTION REPAIR Telephone# `C '1-Z�Z Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft. Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact loc tjons of test holes&perc tMr,locateavetlan_ds in proximity to holes) ,d c 6, Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DET I2MINATIOIV F Yt SEASONAL IIIGH'WATEI. TABLE Method Used: Depth Observed standing in obs.hole: in. Depin io soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date. > Ttme Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time Q Time(9"-6") End Pre-soak Rate Min./inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public health Division Observation Hole Data To Be Completed on Back-� Copy: Applicant t ' DEEP.OBSERVATION HOLE LOG" I Hole# Depth from Soil Horizon Soil Texture , Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) f 11 Is" ) s 21`- 240 A o 2 /4 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil horizon Soil Texture Soii Color Soil Other I Surface(in.) (USDA) (Munsell). Mottling (Structure.Stones,Boulderes. Consistency.° Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) DEEP OBSERVATION HOLE LOG Hole# . Depth from Soil horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o Gravel) Flood Insurance Rate Mao: ' :iuove.`•v yea:';;Cv i l�i iuccy 'i1�_ yc.- Within 500 year boundary No Yes Within 100 year flood boundary No 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? Xe V If not,what is.the depth of naturally occurring pervious material? Certification I certify that on y/9s- (date)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 traini , xpertise and exp fence described in 310 CMR 15.017. 8 7 Signature - Date —�