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HomeMy WebLinkAbout0265 ARROWHEAD DRIVE - Health 265 ARROWHEAD RD., HYANNIS„ s.. A t e o j o � a m , � e a a a o o O � e a � e 1 TOWN OF BARnNSTABLE LOCATION `c <� T ,���,.c�.c-�C a�rSEWAGE#O0\ OZ0 rI ASSESSOR'S MAP&PARCEL INSTALLER'S DAME&PHONE NO. e ,a. EIT SEPTIC TANK CAPACITY �� S LEACHING FACILITY.(type) cw� �C�r•c ~� (size) NO.OF BEDROOMS OWNER le ?,, PERMIT DATE: �� k COMPLIANCE DATE: 3 (Q- I (9 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 Leaching Facility(If any wetlands exist within 300 feet of leaching facility) l Feet FURNISHEDBY�.Ys+.ac�,,,1�4� r c,,�• -� 77 v 3 3z 7 33 Y�r � 3? 3 y �C( No. ;0 (A- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for �MispoBal *pBtem Construction Permit Application for a Permit to Construct( ) Repair(t�Upgrade( ) Abandon( ) ❑Complete System ®'Individual Components Location Address or Lot No. 6 �"t"��`�"` Owner's Name Address,and Tel.No. fit' Q Assessor's Map/Parcel $- P d , Installer's Name Address,and Tel.No. Designer's Name,Address,and Tel.No. sS Gt0 e.�' Type of Building: r Dwelling No.of Bedrooms Lot Size `( . �8`� —sq.ft. Garbage Grinder( ) ' T Other Type of Building s ��i No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3,��O gpd Design flow provided gpd Plan Date 3 � Number of sheets Revision Date Title Size of Septic Tank `FAO 61.1 � 1 1n{Type of S.A.S r,ri'' l`�. G AA. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ,c V\ @, A A, Q, � 75�o O 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 of Health. Signed Date Application Approved by Date C r Application Disapproved by Date for the following reasons Permit No. Qn j I ko y o Date Issued 3 rF: � -"�'11 x: !1 $y..�r"L� :! "�Ff '�y�N:;:�k. v}.« <*.Nn �=• ��kr�.. a.�.�'r'Tn'. ,.. �..i:�.-+j"�' No. 'C ��' q-V Fee s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yew/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS �pfication for Misposal .6pstem Construction 3permit Application for Permit to Construct( ) Repair(Upgrade(-) Abandon( ) ❑Complete System 'Individual Components Location Address or Lot No. :)G.S Owner's Name,Address,and Tel.No. �`� 360-Sn�;7a Assessor's Map/Parcel p ep. aC�- Av, .o , Installer's Name,Address,and Tel.No. SZD'G-`T7`Z C-,pS.5 Designer's Name,Address,and Tel.No. 1e_`.3 Q Ss Coco Cl. w- Type of Building: Dwelling No.of Bedrooms Lot Size 'k 5: —sq.f. Garbage drinder( ) Other Type of Building `,-No.of Persons Showers( .). Cafeteria( ) Other Fixtures F s Design Flow(min.required) ,� 3 0 - gpd Design flow provided Z f gpd Plan Date 3 (g Ck. Number of sheets Revision Date Title Size of Septic Tank >�j�.����JType of S.A.S.C�+, -z--- S►�•2� Description of Soil Nature of Repairs or Alterations(Answer when applicable)_J.� 4\ - ���3-'Z ;, ,��• je Date last inspected: r_ Agreement: i" 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 of Health. + Signed Dates 3 I" 4 /� Application Approved by LVY Date f Application Disapproved by d Date for the following reasons 1 i Permit No.�/� 9 i)�S D Date Issued_ 3 I -_- -.:c-.-=__-.-_ -__ _- - - -• ----'-_-•----- -•----------------- --------- ---•- --•---'---•------'---'--- '--/- -'= ter'_- -__ THE COMMONWEALTH OF MASSACHUSETTS I BARNSTABLE,MASSACHUSETTS Certificate of Compliance _ THIS IS TO CERTIFY,that the On-site Sewage Disposals system Constructed(X Repaired(VI-f Upgraded( ) i Abandoned( )by �.�Cif iV��.. at C_C'" (:Z r ���e�-�l ���•P. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Nod()fq_--()�-f)dated 7, Iq / / q Installer �- a�-9 ' ���" �.ac.-e"- vt Designer #bedrooms Approved desig_.flow _ gpd :a The issuance of this permit s all not be Vonstrued as a guarantee that the system will function d signed. Date �-'1 Inspector _.1`-- -�.,.._...--r'� No.4014-M V Fee (M THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 16pstem Construction J)ermit . Permission is hereby granted to Construct(( Repair(j.,)-'_ Upgrade( ) Abandon( ) System located at 4c7 SQ rcn o�x��. �-"► �]� t ;-A. ���. 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. .-Provided:Construction must be completed within three years of the date of this permit. Date 22 ` Approved by j V �,. Town of Barnstable Regulatory Services Richard V. Scali, Interim Director • BA&VSiABI.E. - •0 9 MAS& g Public Health Division iti7q• �0 p�fOMPIa Thomas McKean, Director 200 M-ain Street, Hyannis, MA 02601 OI'lice: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Dorm / Date: 3 i 27 f1 Se age Permit#Qo�R-Ot'O Assessor's Map\Parcel Z70 ` 72' Desibncr: Coin,-hq'iOw r, r S Installer: V Address: t S GeO yd r,r 1-G{ So'V h Address: Rg�j� (?13_ On 3 ,.is issued a permit to install a (date) ' (Installer) septic system at '2-(,5 Dr- based on a design drawn by (address) dated Mq ilch 6, 2-01 I / (dcsigner) V I certify that the septic system referenced above was installed substantially according to the clesign, which may include minor approved changes such as lateral relocation of the distribution boa and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. 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 Ilie septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if re(luired) was inspected and the soils were found satisfactory. I certify that the system referenced above was construct �,A' 1 . ance with the terms of the I\A approval letters(if applicable) 4, CAVIO c� COUGNi1N -M,� Noa '1091 , (Installer's Signature) ,w -T (Designer's Signature) (Affix Designer's Stamp L-Iere) PLEASE RETURN TO BARNSI'ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE, BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. OASCOODesigner Certification Farm Rev 8-14-13.doe I .rye EXISTING SOIL ABSORPTION SYSTEM I *2 TO BE ABANDONED IN PLACE. I 'EXISTING SOIL ABSORPTION SYSTEM 1*1 1.5 TO BE REMOVED FOR 5 FOOT MINIMUM BEYOND PROPOSED SOIL ABSORPTION SYSTEM. REPLACE EXCAVATED MATERIAL WITH CLEAN MEDIUM SAND PER TITLE 5. PROPOSED SOIL ♦ ABSORPTION ♦ SYSTEM S�� ® —SEE DETAIL 515 F+ ON BACK O � r N NO ,o�� O .O Jt4 NIMAL 2 GRADING ♦�52 - - - PROPOSED \ WATER LINE I OVERHEAD WIRE g \♦ i� j' �� DRAIN 52 Q \ � I � \ INSTALLER TO �(3 ♦ VERIFY LOCATIONS 00 �� ♦ OF ALL UNDERGROUND,10 UTILITIES BEFORE 0 EXCAVATING FOR SYSTEM. 0 THIS IS ACOLOR �? PLAN '� Of 16 107, USE COLOR PLAN ONLY �' `• �� �% 'y FOR INSTALLATION FULL DETAIL 1 T E L S BEST \ VIEWED IN FULL COLOR \ y L Q LOT 5 a AREA _ O 11205 sf+- PLAN BOOK 159 PAGE 41 PLAN \L 1 AjSR MAP 270 PCL 72 ALL �/ � SCALE: 1 in = 20 ft \ 20 40 ♦♦ =_ �i 51 O )q 20 51 PRINT ON 8-1/2 x 14 in P �Q PAPER FOR PROPER SCALE OF pip . 0 LEGEND SEPTIC COMPONENTS EXISTING 1500 GAL SEPTIC TANK GARB D � DISTRIBUTION BOX® I G R TEST PIT u W mv \ OWED Arj, i ELEVATION � �• i 52.75 \ TOP OF FOUN� THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM ! DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING PLACEMENT OF ADDITIONS, SHEDS, FENCES OR SWIMMING POOLS. OWNER ® MOUTHROAD SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. fAL SEWAGE DISPOSAL 0f#A 90 �P`ZHDFM4Ss9 `J(JCl©7` SYSTEM PLAN p o p DAVID 'yGJ, o DAVID DyG -TO SERVE EXISTING DWELLING D. s D. v NOT COUGHANOWR H COUGHANOWR N M I G U E L A N D 0 TO 3 D No. �� YANNI SANCHEZ SCALE b. No. v O `� •• C; OWNERIS) OF RECORD FGI � '9P E� �,� �ci P ROV revraw s � so � �.�c? 265 ARROWHEAD DRIVE ROAD WP HYANNIS, MA WEST ,yA/N 155 Geo Ryder Rd S PROPERTY ADDRESS HYANNIS, MA STREET Chothom, MA 02633 c Dovid L 0 C U S MA P 508 364 t 0894 PG.1I2 MARCH ROE3a ETE o4 i ION CCA LCC.?1UU!LATT I O NW SOIL EVALUATOR: DAVID D. COUGHANOWR, ASE #461 . DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD WITNESSED BY: UNWITNESSED TEST PIT 1 NO GROUNDWATER ENCOUNTERED SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS PERC AT 62 in - 2 MIN/INCH IN C SOILS USE EXISTING 1500 GALLON SEPTIC TANK IF IN ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL- OTHER SOUND STRUCTURAL CONDITION. IF NOT, INSTALL INCHES HORIZON TEXTURE (MUNSELL) MOTTLES NEW 1500 GALLON SEPTIC TANK. 51.90 0-10 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 48.90 10-38 B LOAMY SAND 10 YR 4/6 NONE FRIABLE rs !;OILABSORBTION SYSTEM: 40.90 38-132 C MEDIUM SAND 10 YR 6/4 NONE LOOSE THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES TEST PIT 2 NO GROUNDWATER ENCOUNTERED PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. 2 MINIINCH IN C SOILS THE 24 ft x 12.5 ft x 2 ft LEACHING GALLERY ELEVATION DEPTH SIL USDA SINCHES HORIZON TEXTUREOIL (MUINSEO)OR MOTTTLES SOIL OTHER DEPICTED BELOW CAN LEACH: 51.85 0-10 A LOAMY SAND 10 YR 2/2 NONE FRIABLE _ - P BOTTOM AREA ( 4 x 1 > - E 2 2.5 ft 300 s q 48.85. 10-36 B LOAMY SAND 10 YR 4/6 NONE FRIABLE SIDEWALL AREA = (24+24+12.5+12.5)x2 = 6 14 so. ft. 385 36-144 C MEDIUM SAND 10 YR 6/4 NONE LOOSE 9 TOTAL AREA = 446 sq. ft. FLOW CAPACITY = 0.74 x 446 = 330.04 gal/day INSTALL A 24 ft x 12.5 ft x 2 ft GALLERY AS CONFIGURED p p �p 2� �/� BELOW. FLOW CAPACITY = 330.04 gol/doy WHICH EXCEEDS 9500 GALLON S15(I-"T§(C TANK THE 330 gal/day REQUIRED FOR A THREE BEDROOM DESIGN. DIMENSIONS & DETAIL - - _ -- -_- --- - ___ -- ' USE EXISTING TANK IF STRUCTURALLY SOUND. 9 Oo§L A B S Oo R P§0 nNl PUMP & INSPECT TANK. REPLACE WITH A NEW S Y S TEMU CONSTRUCTION DETAIL 1500 GALLON TANK USE SHOREY PRECAST 50.0 GALLON LEACHING DRYWELL I in IF CRACKED. ROTTED TAPER OR OTHERWISE DRYWELL 24.0 ft COMPROMISED. co C� o 5 ft Q` 8 in N N I NOT STONE^ 8. ft ft TO 3.5 ft 5 8 5 I3.5 ft 10 t ft-6 SCALE 500 GALLON DRYWELL DIMENSIONS SIONS & DETAIL INSTALL ONE INSPECTION INLET OUTLET RISER TO WITHIN THREE COVER COVER USE INCHES OF FINAL GRADE & INDICATE LOCATION 3 IN DROP _n- H-10 ON AS-BUILT —►f110 FLOW LINEUNIT FROMin = 14 T 0` 33 OBUILDI '` D0 _ -..r in In — t 0 . j�D BOX -:o- - - - IDi� �`�' 48 in 0{OD D LIQUID GAS / J BAFFLE LEVEL 'i 5 102 r l n s hSroNe BasE CROSS SECTION VIEW SEPARATION BETWEEN INLET & OUTLET FABRIC OVER STONE TEES NO LESS THAN LIQUID DEPTH CROSS SECTION VIEW INSTALL AN APPROVED GEOTEXTILE _ 28 3/4 In TO . 24 in ■ 314 In TO p p np M in 1-1/2 In GRAVEL -n EFFECTIVE. Itil in GRAVEL DEPTH O0ST QBVT§OUV BOON UDB-3 H20Y DIMENSIONS PIPES EXITING D-BOX TO RUN LEVEL 46 in 58 in 46 in AND DETAIL FOR 2 FEET BEFORE PITCHING DOWN 150 in 12 In INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE c MIN NUS STARTING WORK. -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM —>. O REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC RONM TO CODE (310 CMR 15). SAS -INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND Q ° n UTILITIES BEFORE EXCAVATING'FOR SYSTEM. -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION 6 In STONE BASE OF LOW FLOW FIXTURES & APPLIANCES, AND PERIODIC PUMPING OF THE SEPTIC TANK. IL 21 ;� 2� CROSS SECTION VIEW -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 00 W p 0 F 0 [ TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE 4 in SCH. 40 PVC EL = 52.75 +— 6 in OF FINAL GRADE AND TO PITCH AT 1/8 ft MIN ( 51.75 _ DD-BOA MAX � � E�{0STING � USE H-20 I 48.75 EXISTING 1500 GALLON ° oo oa°o PRECAST �° � SCUP= TANK 48.75 °oo���°� DRYWELL soo 48.10 in EXISTING REFER TO DETAIL BOX STONE I SUL ABSOI3p��ON + 48.27 BASE 48.00 —REFER TO �Y,9T�M EXISTING rn roe a e rf New DETAIL BOX 13 ft 5 12 ft q LilNO GROUNDWATER BELOW 46.00 MOTTLING OBSERVED _ 39.85 SEWAGE DISPOSAL SYSTEM PLAN 265 ARROWHEAD DRIVE HYANNIS, MA MARCH 6, 2019 ETE-4366 PG 2/2 Town of Barnstable OF tHE Tp� lZcgulatory Services Thomas F. Geiler, Director • BARNMT BLE. y MASS.i639 Public Health .Dlvisimi • �0 AlFDN1°�� 'l'honlas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 lax: 508-790-6304 Installer & Designer Certification Form Date: ' C)l0 Designer: Eco—Tech Installer: Wm E Robinson Sr Septic Address: 43 Triangle Circle Address: PO Box 1089 Sandwich Centerville On J (y o6 Wm E Robinson Sr Septi<Was issued a permit to install a (da c) (installer) septic system at " tyw Lea d Dr based oil a design drawn by (address) Tye° ( CGH dated 03-01 —06 (designer) ertify 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 (Le. greater than 10' lateral relocation of the SAS or any vertical relocation of any component Of tll septic system) but in accordance with State & Local Regulations. Plan revision or certi �d as- uilt by designer to follow. DAVID yGN o D. COUGHANOWR nsta le ignature) No. 1093 GIs' E TE �i�►�i"�-- �7 SgNITARtPN (Designer's Signature) (Affix Designer's Stanip Here) PLEASE RETURN TO BARNS] PU13LIC HEALTH DIVISION. CERTIFICA1�1? Or COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARF RI CEIN"I-D BY THE BARNSTA13LE' PUBLIC 1-11"ALTL1 DIN1SION. FIL- i\`K YOU. Q: I-IcalthiScpticiDesigner Certification Dorm . .f:.; 1 . -��¢ �C. ; _. ?� - � � �� i Y I r ray, � --. `'�'�yx.'�"�' TOWN OF BARNSTABLE C iT1N1 ;ATIONSEWAGE #LAGE l I /fin 5 ASSESSOR'S MAP & LOT 2 70 LER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY rSC LEACHING FACILITY: (type) (size) /7.6 X Z-X L� NO.OF BEDROOMS 3 BUILDER OR OWNER M 'C�IliZ PERMITDATE: "?,-.,/9,0(0 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 Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by • mac, c�, J; `J'� = � r — r . �, No: ' Al 00.00V&r6j / Entered in computer: / THE COMMONWEALTH OF MASSACHUSETTS YeS VVV PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(pplication for Mizpozal *pgtem Co gtrUction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 3 6 0—5 6 7 2 265 Arrowhead .Dr Hyannis Miguel & Yanni Sanchez Assessor'sMap/Parcel 270M 265 Arrowhead Dr. Hyannis Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0.8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (10) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd 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) Install a new Title 5 septic system to plans of Eco-Tech, ETE-2261 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 t is Boyd 01 Health. J i Signe v ° Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued FNO... 1 `- Fe%100.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. V- , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTSYeS w �4 A' plication for Migpo$al 6pgte' �0n5truction Permit A licat on for a Permit to,onstruct Repair •' U r'ade Abandon pp ( ) p ( � Upgrade( ) ( ) Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 3 6 0—5 6 7 2 t 265 Arrowhead Dr Hyannis Miguel & Yanni Sanchez Assessor'sMap/parcel 270/7� 265 Arrowhead Dr, Hyannis 8776 364=0894 Installer's Name,Address,and Tel.No. 775- Des ner's Name,Address and Tel.No. - Wm E Robinson Sr Septic E�co—Tech ; Box 1089 Centerville 43 Triangle Cir, Sand*#ch Type of Building: • .a t Dwelling No.of Bedrooms 3 Lot S'ize., sq.ft. Garbage Grinder Po) Other Type of Building No.of Persons " Showers( )\,Cafeteria( ) �.. Other Fixtures R Design Flow(min.required) gpd Design flow provided f~ gpd r Plan Date Number of sheets Revision Date Title ` "w Size of Septic Tank Typeof S.A.S. -Description of Soil tic Title -5 ll ta a new se Nature of Repairs or Alterations(Answer when applicable) Ins P system to plans of co—Tech, #ETE-2267 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 t is Bo d o Health. _ ? ' Signed o y, / // a m 13-J y� �p ,� _ Date Application Approved by �/1 /ti_ /� �� Date Application Disapproved by: Date - for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS Sanchez BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( X ) Upgraded ( ) Abandoned( )by Wm E Robinson Sr Septic Service 265 Arrowhead Drive, Hyannis at Z1, : has,been co structe cordance I with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 3 f/YI U� Installer Designer #bedrooms, Approved design flow �Z)y gpd The issuance of this permit shall not be construed as a guarantee that the system wi I n tion`as des ig ed. S Date 31�0 /�� Inspector i�dw• - -————— ————————————————r- —————————————————— r Fee 1 0 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS SarPtBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS igpo.5a[:.p!6tem Con5truction Permit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at 265 Arrowhead Drive, Hyannis ' and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be co plete ithin three years of the date of th' et nit. Date 9L Approved by 3/r o� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292-5500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Cotntnissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: Name of Ow Address of Owner: Date of Inspection: /� n Name of Inspector:(Please Print)[ !.(�' AI v 1 I am a DEP approved system inspector pursuant to Section 15.340 of'rite 5(310 CMR 15.000) Company Name: GJBBS CESSPOOL SERVICE Mailing Address: 2 QR'01=E LANF Telephone Number: r CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site;ewaisposal systems. The system: _ Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails ! J�{napect«'s signtu are: Date: / ®.®. The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty(30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to ttre system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS o �l �` revised 9/2/98 Page I of 11 ;0 Printed on Recycled Paper i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM • . PART A CERTIFICATION (continued) r Aldr9ss. (ti OILowner: Date of Ins 9SU INSPECTIO �z�r: �C eck A, B, C, of•D: A. SYSTEM PASSES: I have not found any information which Indicates that any of the failure conditions described in 310 CMR 16.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Indicate yes, no, or not determined(Y, N, or NO). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection:•or the septic tank, whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A C TIFICATION (c Hued) �i Property A Owner: Data of Ins C. FURTHER EVALUATI N IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has aseptic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. I _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 P2ge3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (corttinued) _-• Property A s: � 6" Owner: Date of Ins 00 D. SYSTEM FAILS. You must Indicate either 'Yes" or "No" to each of the following: I have determined that one or more of the following failure•conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No L/ Backup of sewage into tacility,or system component*due-to an overloaded or-clogged SAS-or-cesspool. LfDischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. t/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. �l Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. 1.�Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. l Any portion of a cesspool or privy is 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 analyzed to be acceptable, attach copy of well water analysis for . coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either 'Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply ---- the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA) or a mapped Zone 11 of a public . water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEIMAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property A 5 Owner: Date of Ins y0 Check if the following have been done: You must Indicate either "Yes' or "No' as to each of the following: Yes NJ� — I! Pumping information was provided by the owner,occupant,or Board of Health. — �— None of the system components have.been pumped;foratJeast two weeks an&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 they are not available with N/A. The facility or dwelling was inspected far signs of sewage back-up. C�The system does not receive non-sanitary or industrial waste flow. ✓/ The site was inspected for signs of brealtout. All system components, excluding the Soil Absorption System,have been located on the site. L_! — The septic tank manholes were uncovered,opened,and the interior of 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 Soil Absorption System on-the site has been determined based on: Existing information. For example, Plana:B.O.H. Determined in the field (if an of the fa�ae criteria related to Part C is at issue, — — y approximation of distance is unacceptable) 115:302(3)(b)] v The facility owner(and occupants,if differeatfrom.owner) were provided.with infounatiomon.thapropermaintenamc.I' SubSurface Disposal Systems. revised 9/2/98 Pages of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C TEM INFO AT �.Jwner: Data of Ins ��� 0 FLOW CONDITIONS RESIDENTIAL- Design Design flow: V g.p.d./bedroom. Number of bedrooms(design):-3 Number of bedrooms(actual):_ Total DESIGN flow Number of current residents. Garbage grinder(yes or no): (J Laundry(separate system) (yes or no): ! If yes, separate inspection required Laundry system inspected jyas or no) Seasonal use(yes or no): ' y Water meter readings,if a ai ble(last two year's usage(gpd):/�iEG(1N Sump Pump(yes or no): Last date of occupancy: COMMERCIAURVDUSTRIAL: Type of establishment: Design flow: gpd ( Based on 15.203) Basis of design flow Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings,if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION �—.JUMPING RECORDS and source of information: System pumped as part of inspection- (yes or no)_ If yes, volume pumped: gallons 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APFPtOXIMA7r,XAGE of all components,date installed(if known)and source of information: — — � q Sewage odors detected when arriving at the site:(yes or no) revised 9/2/98 P2ge6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYS M INFORM PON(continued) . roperty A s: Jwner: Date of Ins n BUILDING SEWER: (Locate on site plan) Depth below grade:_ Material of construction:_cast iron_40 PVC_other(explain) Distance from private water supply well or suction line Diameter Comments:(condition of joints,venting, evidence of leakage,-etc.) SEPTIC TANK: (locate on site plan) y Depth below grade: Material of construction:_concrete_metal_Fiberglass _Polyethylene—other(explain) If tank is metal, list age_ Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: C> Sludge depth: Distance 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: How dimensions were determined: omments: (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, etc.) GREASE TRAP- (locate on site pl n Depth below grade:_ Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimensions: 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: Date of last pumping: 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,etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM=ORMATIO c timed) Toperty A / 'Owner: Date of Ins TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass Polyethylene_other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX.— ( locate on site plan) Depth of liquid level above outlet invert: t .omments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) — — PUMP CHAMBER: (locate on site plan) Pumps in working order:(Yes or No) Alarms in working order(Yes or No) ' Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) - c revised. 9/2/98 Page 8 or 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C • C SYSTE FORMATION(continued) 'roperty A s: C2 lQ J Date of Ins SOIL ABSORPTION SYSTEM(SAS) (locate on site plan,if possible; excavation not required,location may be approximated by non-intrusive methods) If not located, explain: Type. - leaching pits,number:: leeching chambers,number:_1 leaching galleries,number:_ leaching trenches,number, length: leaching fields, number, dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: • (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) CESSPOOLS:_ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: 1 )epth 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, etc.) PRIVY:_ (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C • SYSTEORMATI nued! ?roperty A ess: Owner: Date of Inspection/� SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate aU wells within 100' (Locate where public water supply comes into house) i--L- r: revised 9/2/98 Page 10or11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM FORMATIO (continued) 3roperty Address: Owner: Date of Ins NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater3)eet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site (Abutting property, observation hole. basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps i Checked pumping records Checked locab excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) I ...: revised 9/2/98 Page 11 of 11 ; . 5/18/99 Dear Mr Caouette , It became evident with this cutrent meter reading that we mis—read your meter in the past and overcharged you $52 . 20. To adjust to this I have credited your account for this amount and no payment is due. We are sorry for any inconvenience this may have caused. If you have any questions , please call our office . Sincerely, Barnstable STATEMENT ^rr�� 47 Old Yarmouth Road 5/1 B/99 L�1 P.O.Box 326 BILLING DATE: C O M P A N Y Hyannis,MA 02601-0326 ACCOUNT NO.!'?70 072 Pleasenoleat'Y CREDIT BALANCE name or address changes NO FIAYME*N"C' NECESSARY F a ALFRED CAOUE•TTE 265 ARROWHEAD DRIVE. L_ HYANNIS MA 0260:1.-2450 J Please return top portion of invoice with payment. Make checks payable to:Bamstable Water Company See reverse side for outer important notices. _ BWC/A4WP Bal11St1ble Water Company 47 Old Yarmouth Road Hyannls MA 02601,-0326 508l175 0063 CUSTOMER NAME SE VICE LOCATIO ACCOUNT NUMBER Al.Ff1EC�` C:AOUETTE" 265 .,ARRC)WIEAD DR TIE -:270 072 I. CUSTOMER TYPE RATE WATER SERVICE DAYS METER READING CONSUMPTION ;i From To Previous Current cu.ff. . ROUTE #3 RES. . R .: ,2/iZ/99 :` 5/WO91 95100 91500 p Consimption :. TOTAL - DAYS TOTAL fw,. 22.130 Analysis cu ft cu Tals YFAR. ;.q 0 PRIOF! CREDIT BAL 52.20C • �b !VEAR 14 *MI::::TER EXCHANGE "! i YOUR; 'WATER CHARGE' INCLUDES., MINIMUM CHARGE 22: 80 � • OPPORTUNITY DANCES-WITH THOSE WHO ARE READY ON TI IE DANCE FLOOR. H JACKSON BROWN JR 7 (. BILLING DATE: TERMS: AUchargeagreduetatien_rendered. • • r ',1 5/1E3/99 rreasepayay=j b/15/99 • 29.40C TOWN OF BARNSTABLE r r ON _ YA(D �l N►-� SEWAGE # ,: 'E IA T.AA- S ASSESSOR'S MAP & LOT 2 7L--DJ-1. ,4 ALLER'S NAME&PHONE NO. l %� ` SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �c�G`U'ra7-dam (size) c�'�2•/l NO.OF BEDROOMS BUILDER OR OWNER b rlQv-2 11%�_ PERMTTDATE: 5 Z y. COMPLIANCE DATE: 9 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ` T , 8 , 10 `A000 r j � +T �Y No. = n Fee THE C6MMONWEALTH OF MASSACHUSETTS Entered in computer: � Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mi5pogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(✓)Upgrade(' )"Abandon( ) ❑Complete System. ❑Individual Components Location Address or Lot No.Q&5 A9,QOW Veo,0 Drue- Owner's Name,Address and Tel.No. Assessor's Map/Parcel ��O� C1� �1�YtivG� GC^,O V`e_rTC_1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. U6� 6ms bar R2 fly Type of Building: • Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �c �Z7 gallons per day. Calculated daily flow 3 L,9k gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tan o Type of S.A.S. �'w2(i-:Tr4.T6(ts Description of Soil SAnO Nature of Repairs or Alterations(Answer when applicable) WST 14 k 0->e [1 Ca,OGr»:1� L fvk7rri2S lc� / 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 vironmental Cod and not to place the system in operation until a Certifi- cate of Compliance has been issued b this Signed Date J1` Application Approved by ' u Date —�3a — zo Application Disapproved for the following reasons 1� Permit No. Date Issued '�. T , • >> . {fib - ��� , No. / / ~/'''�; - Fee TFHr -.OAIMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZlppYication for ]Digpoml *pgtem Congtruction Permit Application for a Permit to Constrict( )Repair(/upgrade( )Abandon( ) O Complete System -O Individual Components Location Address or Lot No. Ai22DW k%eAQ pr'o-ff_ Owner's Name,Address and Tel.No. Assessor'sMap/Parcel �-� 0- O-)� �, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. a-eOSG- Keb�%ks 6 A�rcr Rom. Type of Building: Dwelling No.of Bedrooms �J' Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Desig n Flow 33U gallons per day. Calculated daily flow 3 4 ck gallons. Plan Date Number of sheets Revision Date Title i Size of Septic TankL po -l) \ ;�CM Type of S.A.S. TL r',t—T r,,7V o rc .S Description of Soil MGM S � i Nature of Repairs or Alterations(Answer when applicable) s V-57 A- —Tyo►w�- 1Si� ��� nn� t, rG�G�iw �(�ILT✓kY�✓1S lc�%� i I 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 Eavironmental Code nd not to place the system in operation until a Certifi- cate of Compliance has been issued b this B eal Signed Date 57-4547 Application Approved by 'r/� AA1 4, a. Date Application Disapproved for the following reasons i Permit No. Date Issued S-_?C3 f 7 -------------------------------- - ------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY that t e On-gite-Se, age Disposal System Constructed ( )Repaired ( )Upgraded Abandoned( )by �, �� at ! L1-2' adyye,Q_ 'OIL Iye— 1 f i has been constructed in accordance I with the provisions of Title 5 and the for Disposal System Construction Permit No. 7-x 7 dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date _ — '� Inspector _ 1 � 7 ��"o`� � ---------------------------— No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS t 1=igpogal *pgtem Congtruction°Vermit Permission is hereby granted to Construct( )Repair pgrade( )Abandon System located at (Gt �-(Z (�lt•ice. _ U� bw� 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:Construction must be completed within three years of the date of this pei-mit. Date: < Approved by TOWN OF BARNSTABLE LOCATTO.N /Jlt�l�F-40 &Nr SEWAGE # - 7 VILLAGE- t��cT..� S ASSESSOR'S MAP& LOT a 70-of j— INSTALLER'S NAME&PHONE NO. 12_ IG SEPTIC TANK CAPACITY J OU LEACHING FACILITY: (type) Z' `L-7`��f a�S (size) r�S 2•/lrZ NO.OF:BEDROOMS BUILDtk-OR OWNER 1n Uv--Z i C PERMTTDATE: .`� :Z ry ' COMPLIANCE DATE: Separation Distance Between the: Maximum.Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private.Water.Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of W.edand and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ,}(Ird005, Re � rya NOTICE: This Form is to be used for the Repair O Fa ded Septic,.Systtems Only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL ' WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS).- V hereby certify that the application for disposal;works construction permit signed by me dated 15�—3O f , concerning the' property located at a S Q`Q ow� ��- tneets'all of the following criteria: " • There are no wetlands within 300 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system The observed groundwater table is 14 feet or greater below the bottom of the leaching facility U There is no increase in flow and/or change in use proposed There are no variances requested eQuested or needed. SIGNED: DATE: J LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. i Y ��I _ y�w _ .. .. ' � � .. r. � t O ^ \1��/ ,J v) (� ' � ` � 1 �. c�. �� - _ _ i ` i �-� r �� -FLOW PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS RAISE COVERS TO WITHIN TOP OF FOINDATION 6 to OF FINAL GRADE EL = 52.75 +- ONE INSPECTION RISER FOR LEACHING GALLERY �1�p�� 2' LAYER OF 1/8' �D-BOX 1/2' STON 3" DROP 11 FLOW LIN 10 - 14 48• GAS�� PRECAST 3/4'-11/4- BAFFLE DRYWELL STONE 48.75 6 In BOTTOM OF SOL AB 50.08 L STONE 48.38 LEACHING SSYSTEM�RPT[ON BASE 49.00 6 �n STONE BASE 49.55 GALLERY 48.25 5.00 ft 1500 GALLON (END VIEWI 46.25 SEPTIC TANK 19 FL el 5 FL 12.5 Ft bl 14 FL ADJUSTED Q 28.20 SEASONAL HIGH GROUNDWATER U1 _?5.0_0In F,< I6.4 Ft X X JED �Ln Z r X ;u cl rTl ...._�_Nr — - .,. ti�, p � I X (nD r ►� �. �Z +o Z O Z oo z >r-° I z pap 1 � r� m n<0 z o I O>LO f-o0 = I NBC) m rn P1 m Z cohf4, cn�n Z 3 y r m n 0 0 > rl II s Zc <� �n1D 3�m I 2 N z v I ►11 B w ,may I Z sls�s�� � N I 0 3m + zX _ I 3ln n ]b � ..00F es— rz p c� Z c� � m w rnr\j� 3 Lr)rn /� Q EOGE OF p j VEMEN�� > O Z rn n G7 -� 1' \R O/�/ z C 1,'HE,� { � N � oACo � D DR, U)S40 N - Z --� o rn VE ; O m G) g �T1 rn a Sr-> 3 r- f-T1 = cn k -� Nam' ` n m > m mZ2y j oln ��oo � M n _ > Z Cl� ��a r9 -+>�o Rl O y O rn�.Lrl m (n M m m m . >.,-' (-"I "I _'dl`�z " m mA� ' y C m Z Z r ya~�r, Z _u x nyp nGl�' V=03 vj rn mrn�zm Lc) o � Z C17 �O nm� �, -Irn -i c) a oN�N = 3 y00 m nn Zm m tom zcn o C ' t ^pro �o < 3 m > Z r 3 X O' n 8m a41I� a Z z � a� 0 FM ODaz �cn O ry � 3 m m -<o� w r > N Z T Z SOIL TEST LOG DESIGN CALCULATIONS a DATE OF TEST: FEBRUARY 24. 2006 SOIL EVALUATOR: DAVID D. COUGHANOWR. RS DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD WITNESS REOUIREMENT WAIVED - NO VARIANCES SOUGHT NO NCOUNTERED SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS TEST PIT 1 PARENT UMAATER AL NDWATER EPROGLAC AL OUTWASH INSTALL SHOREY PRECAST 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION = 51.90 +- PERC AT 52 In : 2 MIN/INCH IN C SOILS DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOIL ABSORBTION SYSTEM: A 24 f L x 12.5 Ft x 2 Ft LEACHING GALLERY CAN LEACH (INCHES[ HORIZON TEXTURE (MUNSELLI MOTTLING A6ot = ( 24 x 12.5 1 = 300 sF 51.90 Aedw = ( 24 + 24 + 12.5 + 12.5 I x 2 = 146 sF 0-10 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE Atot = 446 sF 48.90 10-38 B LOAMY SAND 10 YR 4/6 NONE FRIABLE Vt 0.74 x 446 = 330.04 GPD 38-132 C MEDIUM SAND 10 YR 6/4 NONE LOOSE USE A 24 Ft x 12.5 Ft x 2 Ft GALLERY. Vt = 330.04 GPD > 330 GPD REQUIRED 40.90 NO GRONCOUNTERED TEST PIT 2 PAARENTU MATERIAL: PROGLAC AL OUTWASH ELEVATION = 51.85 +- PERC AT 62 to : 2 MIN/INCH IN C SOILS °va SOIL USDA SOIL SOIL OR SOIL OTHER�SI HORIZON TEXTURE ( SELLII MOTTLING LEACHING GALLERY 500 GALLON DRYWEL 51.85 DIMENSIONS AND CETAIL 0-10 Ap LOAMY SAND 10 YR 212 NONE FRIABLE CONSTRUCTION DETAIL USE ate LMT 10-35 B LOAMY SAND 10 YR 4/6 NONE FRIABLE ORYWELL UNIT INSTALL ONE INSPECTION 48.85 8'-6'x 4'-10'3-t 2'-s' STON RISER TO WITHIN SIX INCHES OF FINAL GRADE 36-144 C MEDIUM SANG 10 YR 6/4 NONE LOOSE AND INDICATE LOCATION 39.85 24.0 FL ON AS-BUILT PLAN 2 Ft EFF. DEPTH .41 m m In O 33 NOTES N v o ��o00oo0o�a� Op00 11 GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN '..5' 8.5 8.5' 21 ALL LINES TO 6E SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 10 31 ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS 24.0 f t NOTSCA T 2 !r7 OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 151 41 INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. 51 EXISTING FIBERGLASS SEPTIC TANK IS TO BE PUMPED AND REMOVED. EXISTING LEACHING GALLERY IS TO BE ABANDONED IN PLACE OR REMOVED TO THE EXTENT THAT IT INTERFERES WITH THE PROPOSED LEACHING GALLERY. 61 ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE GROUNDWATER ADJUSTMENT 71 LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0' BEFORE PITCHING DOWN EXISTING GROUNDWATER LEVEL SEWAGE DISPOSAL SYSTEM PLAN MENT 81 ECO-TECH E N ES RON AND AL RECOMMENDS PUMPING OFNTHE LATION•- OF K OW FLOW FIXTURES BASED ON TOWN OF BARNSTABLE -TO SERVE EXISTING DWELLING THE AND APP . GIS DEPARTMENT RECORDS.' 91 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. 00 NOT INDICATED GW 25.00 MIGUEL AND YANNI SANCHEZ PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. / INDEX WELL MIW-29 101 INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. ZONE D 265 ARROWHEAD DRIVE HYANNIS. MA READING DATE JAN. 2006 111 SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE 'TO 6RAOE ON A LEVEL READING 7.6 STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH ADJUSTMENT 3.z ECO-TECH ENVIRONMENTAL SIX INCHES OF CRUSHED STONE HAS BEEN PUACEO'\TO,•'MINIMIZE UNEVEN SETTLING ADJUSTED GW 28.2 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-2261 I MARCH 1. 20051 1212J