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TOWN OF BARNSTABLE
LOCATION 710 re J) , SEWAGE# s 2gS
VILLAGE A ESSOR'S MAP&PARCEL IQ hiol
INSTALLER'S NAME&PHONE NO. I,
SEPTIC TANK CAPACITY CAJ 0p
LEACHING FACILITY:(type) kj f b-e- (}OJA. (size) IS X.3 p
NO.OF BEDROOMS
OWNER R
PERMIT DATE: I22 j COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the 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 each' acility(If y w tlands exist within
300 feet of leac ' g lity) Feet
FURNISHED BY
o
No. '�W✓ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftplitation for 30isposal .pstPm Construction permit
s
Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) Eg'Complete System ❑Individual Components
Location Address or Lot No.7u PJLS� gar , U 6Cl Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel ��1J �{dk 6 r ico Ta tar
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size a?3 1 sq.ft. Garbage Grinder( )
Other Type of Building SM No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets / Revision Date
Title rulik,
Size of Septic Tank a4l, pe of S.A.S. �✓� }�//� 'o"I
Description of Soil A-
Nature of Repairs or Alterations(Answer when applicable) &14.
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 Certificate of
Compliance has been issued by this Board f alth.
S' ed Date 'L
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. — c,9j Date Issued
Fee
No. ✓ -,
THE-COIMMONWEALTH OF MASSACHUSETTS Entered m computer:
4- - Yes
PUBLIC HEALTH'-DIVISION - TOWN:OF BARNSTABLE, MASSACHUSETTS
ftpliLAtion for Mispo8Af *pstrm Construction Permit
Application for a Permit to Construct( ) Repair'( ) Upgrade( Abandon( ) [,complete System ❑Individual Components
Location Address or Lot No.70 4U S Owner's Name,Address,and Tel.No.
� All-�rl� IZ.d.Ct}t�t
Assessor's Map/Parcel Gj 01,r 4- I ar TaulDr
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:, - R
Dwelling No.of Bedrooms _ - ,.,,.Lot'Size 2-q ��� sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided' gpd
Plan Date O)LI/1 7 Number of sheets Revision Date
Title -Tip l�
r . a
Size of Septic Tank /, J pe of S.A.S.
Description of Soil f,la '/ / f
Nature of Repairs or Alterations(Answer when applicable) k '? I '
4
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 Certificate of
Compliance has been issued by this Board 6f Health.
Si-n-J Date
Application Approved by Date
' Application Disapproved by - Date
x,
for the following reasons
PermitNo. )}/� rIn _ Date Issu d G�✓ "�"`
___________ ___ _ ________________________
g THE COMMONWEALT) U SSACHUSETTS, ? f
BARNSTABLE,MASSACHUSETT
^ Xpr;tffic E of Copt Ciante ` -'
THIS IS TO CERTIFY,that the On-site ev ge Disposal system Constructed( ) Repaired_(,- Upgraded( V
Abandoned( )by
at
has been constructed in aceor'dance
with.the provisions of Titl�5 and the for Disposal SysteConstruction Permit Noy dated
Installer AAA r,x/ram a� 4(�t kh, Designer bit �4 -e _f 1 a
#bedrooms Z �,� Approved design flow gpd
The issuance of this permit shall 4t be cons d as a guarantee that the syste##rfi will -ion as designed.^
Date Inspector
------------------------------------------------------------------------------------ -- - - ------------------ ----------- ---------
No. C� Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( �� Abandon( )
System located at 6
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions. !t
Provided:Construction must be completed within three years of the date of this permit.
Dater -/I Approvq�dl by
i _
E
k
Town ®f Barnstable
'"E Regulatory Services
Thomas F. Geiler,Director
BAMWABLA
MAnPublic Health .Division
1639.ArFnr�as° Thomas McKean, Director
200'Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: Sewage Permit# Q/�"'o2 tl�ssessor's MapiParcel
Designer: Dow.CRC [�N aN�MN& (NO' Installer: QINN t�XCAVEFIQN 5��'({C
F
Address:' Address: ] r706 EI V J�
Yea VM F09:r MA 02-6 7 - U AW OZ_MPF
If
On �" 2(a I g Q��A/W� KW�,a was issued a permit to install a
(date) (installer)
septic system at 70 K- *WV MOO MAD, C_OD2IT based on a design drawn by
(address)
pANI�L A. 0,IA dated rev
(designer
I certify that the septic system.referenced above was installed substantially according to
the design, which may include minor approved.changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but.in accordance with State & Local Regulations. Plan revision or
ertified as-built by designer to follow.
% j-,
' s
nstaller's Signature) '
�r
(Designer's Signature) (Affix DesignWs Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLUNCE TWILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
3
I
Q:Health/Septic/Designer Certification Form 3-26-04.doe
w '
THE�COOMAO�N®AL�TH OFu�^CHUSETTS KIP
__...
_,� ...OF....... /..... 1 7
Appliratiun -for ]iiivuiittl Works Tnnitrurtion Prrutit
Application is hereby
-._.mada for a Permit to
C -s-t�r�uct or Repair Re air 4( anividual Sewage Dis osal
S y Locatio dr or ot o.
Cb .. .......................
c/
s
wner Address
W
Installer Address
Q Type of BulldinEoe Size Lot_ ________________________Sq. feet
U Dwelling N ___
o. of Bedrooms..__.___.. _..______Expansion Attic ( ) Garbage Grinder (.�)
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtur s .....................................................
W Design Flow.. ................. .... 111ons per person per day. Total daily flow______ gallons.
------------
WSeptic T atkV Liquid capacity_ __ gallons Length................ Width------ Diameter................ Depth---_-___.....-
x Disposal Trench— o_ ____________________ Wi th.._-______—__�__ en th.... . .. _ aL aching area....................sq. ft.
Seepage Pit No.... I�.............. Diameter `s`D e ow nJ�j o a eacl ng t a------------------ ft.
Z '" ,other Distribution box ( ) Dosing tank
Percolation Test Results Performed by___________________________ �--t7 __-_-.__--_--- Date___........_._...._. °
a ---------------
a Test Pit No. I _______________minutes per inch Depth of Test Pit.................... Depth to ground water_.____-.____-_.._-.-___.
Test Pit No. 2................minutes per in h Depth f Test Pit.................... Depth to ground water__.__._____..____-
W ......
--------------------------------------
Description of Soil------------------------ /Lr = l „
x . . .... ... .........
V -----------'---------------------------------------------------------------------------------------------------------------------•--------------------•----------------------------------------------
W
UNature 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 Article NI 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.
Signed--- ...... - ------------------------- --------------------------------
Date
i, �� ate 7'
Application Approved BY------ = �l i{-- ---- >
Application Disapproved for the following reasons---------------=----------------------------------------------------------------------------------------------
..................................•-'--------------------------'------- -------------•--------------•---•..-------.------•-------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued........................................................
Date
No.... Finc.z ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD umHEALT v .
...._.OF........ ... .....
, pphrtttiuu -fur Biupouttl Morks Tuu,itrurtiuu Perutit
Application is hereby mad for a Per to C nstruct ( ) or Repair ( an Individual Sewage Disposal
Sys jem at:
Location ddr or oott No.
wner Address
W
� Installer Address
Q Type of Buildi Size Lot----------------------------Sq. feet
U Dwelling o. of Bedrooms------------ ---------------------------Expansion Attic ( ) Garbage Grinder ( )
04 Other—Type of Building ---------------------------- No. of persons.-______---_______----_•-_ Showers ( ) — Cafeteria ( )
0.i Other fixtures
Q --------------
w Design Flow................... :_..-_ �111ons per person per day. Total daily flow------- °�._ �----..-_..gallons.
WSeptic TarikV Liquid capacity-V'0 allons Length................ Width—............. Diame er__.--_-..---._ Depth----------------
W Disposal Trench— o. ..:......... Wi��drrtl�i __.— en th--.. „ �'" a caching area sq. ft.
Seepage Pit No. .--------- Diameter l.-.__.-- ---- D ow inl �-------------- 66kn eac�ng area----------........s�ft. 1
z Other Distribution box ( ) Dosing tank ( ) -�� Ito"
~" Percolation Test Results Performed by................... ...................................................... Date___----___--________ _. g
aTest Pit No. 1.-•-------------minutes per inch Depth of "Pest Pit.................... Depth to ground water ----------�
(%I Test Pit No. 2................minutes per inch Depth f Test Pit-.____-__-_.-__-___- Depth to ground water---------------.........
a �- ,.. --- ---------------------------------------------------------------- ---
DDescription of Soil------------------- :»p- w�._" - ._ ...-.----.---------------------------------
x
w
VNature 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 Article XI 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.
Signed_.. i ._.... •----••------------------ --------------------------------
Application Approved By--- u" � ' ? ---••-•---•-- Date
-te
Application Disapproved for the following reasons----------------------------------- ------- --------------------•--- --------------------------------------•--
----••-•••-•--•--•-•••--•---••-•-•-•-------------------------••••••-----------------••--------••-•----------------------------------------------------------------------------------------------------•-
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
Q(Ub1� Ci�pLC f Cy
--- � BOARD OF H' ALTH 4 . tom.
. `.1d.. .. .... .......OF................ ..................:..................................... ,
-_ 1,�
Vt: 7 (1rrtifirutr f (111nmplitturr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by.......? • •• -----... ... -- - - --------
Inns a$ler a
has been installed in a ordance with e provisions of Article XIj he State Sanitary Code as described in the
application for Disposal Works Construction Permit No--------------< ___ _d-.____-___ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
� •..-
DATE....................-........................................................... Inspector............................... ----------•--------•-------------------------
--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.�.....t .�. -,.......... ..of............... .... .............
.. -r.. -----.. "............
No.-- J'---�-�'---- FEE__ -...............
�i��uuttl �vrk,� ��u,�trurtiuit �rrutit
Permtssto is ereby granted---------------------------- ..........f------....---•••......----------•-. .............................................................
to Constr act ( or Repair ( ) an Individual Sew- e Disposal System
at No. A—��x�. "�' =r{°��,,.s �%��s_ �r � � � �����----------------_-----
treet
as shown on the application for Disposal Works Construction Per it No,/"_s-f_._._tt-) Dated..........................................
r7� Board of Health
DATE _ 4�` r' r
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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ON T-NF GF�QUNla ,gas .s�-�o�v�v oN TK/C PLA,�✓
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ASS. /Y 2 7
LEGEND D
SYSTEM PROFILE NOTES
SYSTEM DESIGN. PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) MARK CORNERS OF 1. DATUM IS NAVD 88
99- EXISTING CONTOUR LEACHING FIELD W/ PROVIDE INSPECTION PORTS TO
ACCESS COVERS TO WITHIN 6 OF FIN. GRADE REBAR SET 4" BELOW WITHIN 3" OF FINISH GRADE 2. MUNICIPAL WATER IS EXISTING
X 99•1 EXIST. SPOT ELEV. GARBAGE DISPOSER IS NOT ALLOWED TOP FOUND. EL. 20.9' GRADE 2% SLOPE 4
- CONTOUR - \ I15.5'-16.9' M � FILTER FABRIC --� � 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. School
-[99] PROPOSED DESIGN FLOW: 3 BEDROOMS ® 110 GPD - 330 GPD MINIM .75 OF COVER OVER PRECAST 12.8-13.5 TOP 11.82 FINISHED GRADE- 4" LOAM & SEED OR PAVE AS REQ. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS 5N,
198.4 PROPOSED SPOT EL. USE A 330 GPD DESIGN FLOW PRECAST H-10 TO BE AASHO H-LQ e° COtult
I RISERS (TYP.)
TH1 2'0 14.0 4"OSCH40 PVC CLEAN FILL 5. PIPE JOINTS TO BE MADE WATERTIGHT. Bay
TEST HOLE SEPTIC TANK: 330 GPD (2) = 660 °' 12"MMIN•SN7?DIM• PIPES LEVEL 1ST 2'
�" 78-
6-DRFORATED PVC 3'O.C. $=0.005 °
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH She// B�
2%. SLOPE OF GROUND **USE EXISTING 1000 GAL SEPTIC TANK 13.8't ; 10» 14" :, 0 310 CMR 15.000 (TITLE 5.) i �ffpf
'..'• TEE 1500 GAL H-10 TEE 3/4"-1-1 2" DOUBLE WASHED gSSe Bo
12.92 SEPTIC TANK 12.67 STONE LEACHING FIELD ° EPTH MIN BELOW INV. 00cus7
WATERTEST DBOX o 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TOUTILITY POLE LEACHING: a' LIQ. LEVEL cAs BAFFLE :.: -Oo°o°o°o°09 FOR LEVELNESS 11.47' EVEL BOTTOM o 11.30' BE USED FOR LOT LINE STAKING OR ANY OTHER v� Pine /�/ a°
ACME OR EQUAL °^P
FIRE HYDRANT 330 GPD / (.74) = 446 SF REQUIRED 11.69' 11.52' PURPOSE. on ge °
o
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING 15' X 30' = 450 SF OK ''.•..
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
oo°000°o°o°o°°°°°°°°°°°°°o°o°o°o°o°o°o°o°oo, C
°O°O°O°O°O°O°O°O°O°00000000000
°O°O°O°O°O°O°O°O°O°O°O°O° 1 0.80'
',o o^o_r n n_1.n o 0 0 0 o r.r_r_n_n_n.o 0
450 SF X .74 = 333 GPD OK 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED
WITHOUT INSPECTION BY BOARD OF HEALTH AND Nantucket
USE A 15' X 30' PIPE AND STONE LEACHING FIELD 6" CRUSHED STONE OR MECHANICAL
5.0' - PERMISSION OBTAINED FROM BOARD OF HEALTH.
COMPACTION. (15.221 [2]) Sound
10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING
( $ % SLOPE) (2 1 % SLOPE) 1 % SCOPE) ADJUSTED GROUNDWATER 5.8' DIGSAFE (1-888-344-7233) AND VERIFYING THE
( LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP
MA PRIOR TO COMMENCEMENT OF WORK.
APPROVED DATE BOARD OF HEALTH FOUNDATION 11 SEPTIC TANK 47' D' BOX 5' LEACHING SCALE 1"=2000'f
FACILITY 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
REMOVED BENEATH AND 5' AROUND THE PROPOSED ASSESSORS MAP 19 PARCEL 119
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS LEACHING FACILITY.
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND LOCUS IS WITHIN FEMA FLOOD ZONE AE (EL
REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 10) AND ZONE X AS SHOWN ON COMMUNITY
PANEL #25001 CO752J DATED 7/16/2014
C�
a
0 21
S84•4 "E TEST HOLE LOGS
216.40 ! '�
ENGINEER: CRAIG J. FERRARI, SE #13871
WITNESS: DAVID W. STANTON RS
DATE: 5/8/2019
CPERC. RATE _ < 2 MIN/INCH
` CLASS I SOILS PT# 19-9
jj PROVID 60' OF 40 MIL LINER AT 5' LID
�• OFF SA IN AREA SHOWN. TOP AT �s
ELEV. 11. ', BOTTOM AT EL. 7.8't o
ELEV. z ELEV.
0
\ 0„ 4 12' 0„ 4 12'
BENCHMARK: A A
THRESHOLD LS LS
lb lb \ =12.9' NAVD88\ �/ N 1OYR 6/1 10YR 6/1
OT 10 12" 14
1 - 34, 1 S.F.t
LS LS
36" 10YR 5/8 9, 10YR 5/8
EMO 'AL 0 UNSUITABL SOIL REQUIRED T 1 \
AR UND PERIM TER OF LE CHING FACILITY, / ��� 34" 9.1 '
DO TO SUITA E SOIL LAYE REPLACE T 2 O 1 n
WITH LEAN MED. AND, TO MEE "I
SPECIFI TIONS OF 10 MR 15.255( J co
2?
o 1 00 . 1 -PERC
Q ro C MS MS
v� rn o m
I n EXISTING WEW ADJ. DATA:
a o I = 10YR 7/4 10YR 7/4
29
DWELLING ZONE: A
9 i II TOF = 20.9 0 ADJ: 0.8'
APRIL 2019
96" 4' 96" 4'
GRA EL II DECK GROUNDWATER ENCOUNTERED 84 EL 5.0
DRIV
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Cp
+ \\ 18 22�
TITLE 5 SITE PLAN
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OF
#70 RUSHY MARSH ROAD
W W W 0 COTUIT, MA
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. 9 .51 PREPARED FOR
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�2So0 1a ESTATE OF IAN TAYLOR
A DATE: MAY 14, 2019
REV: JULY 15, 2019 (RAISE SAS, NEW SEPTIC TANK)
BYBR' Scale: 1"= 20'
N F-Mgssq -�N OF Mgssac 0 10 20 30 40 50 FEET
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DAI✓IiEL �u °� CA�!!EI_A. `
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OJAI._A n " CNIL- off 508-362-4541
No.40580 No 46502 � fax 508-362-9880
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down cape engineering, inc.
civil engineers
5-10\ c -� land surveyors
J 939 Main Street ( Rte 6A)
DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
DCE ## 19- > >5
19-115