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Town of Barnstabile
wok 4eae r��
atory Services
Reph
Richard V. Scali, Interim Director
x BARNS "
A,A39. ]Public Health Division
9.
Thomas Me. Kean, Dia•ector
200 Main Street, Hyannis, NIA 02601
Qffir.e: 508-862-4644 Fax: 508-790-6304,
Installer & Designer Certification Foi-in
Date: C'.Z 1-, �,f S Selvage >Permitao ��% i� � � 6Assessor's.Map\>Pm-cel^
Dcsil;aaca. f� i,;� nt'�s�C•,
allca a
Addi,ess: 'a d"s,sri d I �� Address: �'�� `��,%' _Sz
(Jr1
_ ✓4 ', %',�;C���"! - = �i�rr:? Was issued a.permit to install a
(date) (installer)
septic system at based oat a design drawn by
(adc Tess)
' -�� dated
(designer)
eI 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. Strip out (if required) was inspected and the soils
were found satisfactory,
I c"ertily that the septic system referenced above was installed with ta�ajor changes (i,c,
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
certified as-built by designer to follow, Strip out (if required) was inspected and the soils
were found satisfactory.
I certify tl ` the system referenced above was constructedy'..i�! a> nce with the terms
of t A a roval letters 1f applicable)
". DARr
i tl
.l r staIIe • Si nature)j
(I')esigr cr's`5ignature) +'� ' (Aff<� besig 9f ` um1) Here) — 1
I `
FLEA SE .ICI'VI�lN` O BARNS TABLE PUBLIC HEALTH D.1'411 ION. CERTIFICATE
�IIY)<i'Qt1NCE' _WILLNOT H.l'+ ISSUED UNTllL BOTH THIS 1'0R M ,4NJ) AS-
1RUL�t CARD X 111C�IV D BY THE RARNSTABLE PUBLIC I3IEAUC fI D.IVfSION.
'THAINK YOU.
Q;\SejXic\Designer Certification Form Rev 8-14-13.doc
L d 9LSOOL0008 '�N/OS:9L '15/OS:9L 9LOZ LL Z (Q3M> NOM=l
TOWN OF BARNSTABLE
LOCATION Z4O Indian Tram SEWAGE # 6
VILLAGE OZRry 0 1P— ' `ASSESSOR'S MAP & LOT 0
INSTALLER'S NAME&PHONE'NO.TWMfe- IAIA-4306
SEPTIC TANK CAPACITY _ZO`�O GA I d v-,
, CC ,Sco G-t- OC � ze) 13/XLEACHING FACILITY: /NO. OF BEDROOMS.
BUILDER OR OWNE 0►QS%&- �vt t AG
PERMITDATE: I �°Z 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 a .
within 300 feet of leaching facility) -Feet
Furnished by
r
k4 V Se
LISP, s3 - ti9,5
5 Ay - 49 � E4 - Is 5'
� ,
c�
�' pe 1 1
No. � • Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for �Diopogal 6p.5tem C n permit
Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) Complete System Individual Components
Location Address or Lot No.20 la►v y ftt Owner's Name,Address,and Tel.No. AI'CX `av how"C
Assessor'sMap/Parcel ()
7
Installer's Name,Address,and Tel.No.��"�L"�' esigner's Name,Address and Tel.No.ljG1l,W .
Type of Building: c —53)$ P 572 (�
Dwelling No.of Bedrooms `P Lot Size (Q2 J % 1 sq.ft. Garbage Grinder (Na)
Other Type of Building lf� �t No.of Persons 2 Showers"b) Cafeteria(01
Other Fixtures
Design Flow(min.required)_ gpd Design flow provided (an d
Plan Date l �� , I L� Number of sheets Revision Date 'a �
Title
Size of Septic Tank D0C> qIK Type of S.A.S. SwIV, ►-e- tt-eitaDescription of Soil G—W J Q�l/ W�iYh'► t?tA �O �uu
Nature of Repairs or Alterations(Answer when applicable)
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 o nvironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bo of H aIth.
77
Signed Date
Application Approved by Date Ix " ILI
Application Disapproved by: Date
for the following reasons
Permit No. d r Date Issued `j.
No. Fee ' J�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
,p r PUBLIC HEALTH DIVISION -..TOWN OF BARNSTABLE, MASSACHUSETTS j
application for �Btzpoar *Pztem Cow5tructton Permit
.Application for a Permit to Construct/) Repair(. .) Upgrade( )+ Abandon( 4[]Complete System O'Individual Components" _
Location Address or Lot No.2 u C �l a �" ✓�`+! Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel 62 31 S -b35
01
Installer's Name,Address,and Tel.No.:f2a--4 ` c- 'Designer's Name,Address and Tel.No.�J P 11
Type of Building::Zli -50 X .x7-/ `` r
4. Dwelling No.of Bedrooms Lot Size lC�,y�� sq. ft. Garbage Grinder (No)
Other Type of Building'-)I VZ'^�� No.of Persons 2 Showers(vie) Cafeteria pJL)
Other Fixtures
Design Flow(min.required) Cc � gpd . Design flow provided 67 gpd
Plan Date } l O Number of sheets I Revision Date ;�" if l rrlp,—
Title
^" Size of Septic Tank �_ UUCP o`I�. Type of S.A.S. -� S iv, lire C 5lr 711 "elhl e J f y+
Description of Soil t1 r>a w� S U�-r� �u � j a y✓F 4��U�^r� r W L,] d.
one
,•Nature of Repairs or Alterations(Answer when applicable) i r
Date last inspected: ;, a{ ` t
s ,
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)IEnvironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boa`fi�off Hlealth.
Signed ,Date
-Da
Application Approved by Date 1 1 - vI
• f
F Application Disapproved by: ! Date
for the following reasons
Permit No. Date Issued I i
— ————— —— ———— ————————— —————THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
'R Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( )
Abandoned( )by at a 4 0 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.
P / 1 P Y oZ O I _ dated
Installer # Designer
#bedrooms. C., Approved desig• flows ((P 0 gpd
f
The issuance oft this perm i shall not be construed as a guarantee that the system will fun t on as design�d.
Date 2 1 Inspector l�. S
t I
---No. t -- .— 111 ----- ---- ----- Fee---------
No.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
wigpo5al *pgtem Congtructton Permit
Permission is hereby granted to Construct ) epair ( ) Upgradep( ) Abandon ( )
X System located at
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 completed within three years of the date of this per_
0
Date .� -` ( �' Approved by �-
r
Town of Barnstable
. . '• ., �� �� � Department of Health,Safety,and Environmental ronnental$ervices y{/)
,? A .4 'Pubiic He: tth Divigion . Date
a
367 Main Street,Hyannis MA 02601 ` y
p m µ. V.
me/ �w p
i Date Scheduled = Time fi Fee16
Pd
s vtl�Sui a,�i ssessment for �'eiva a Dtspvsd
PeifQrnted R :1k,,1 j 7 Y :Witnessed By
L AL
]LOCATION&'GENER <I �MA'I'I�1�
' a Owner s Name
Loca 6n fiddiess r,
=Addresslope,-19
r. �
,M•
Assessor's Engineer's Name GG -
NEW CONS't UMION d 'REPAIR Telephone
Y x � W�L L 0 cAs
Land Use D� 7Cr Slopes(%) Surface nes r
: I
Distances from:* open Water Body ft Possible Wet Area z Zcc> It �[�irdCnr�Water Well It
ft Property d_ ft Other
Drainage Way Line.
„. +
SKETCH;](Street,name,dimensions of tot,enact locations of test bpics&perc tests locate wetlands in procrmity to holes)° i
i 3 }
jj
•.4 ' s + \ s
+
s
er
e >
k,' a
r ( ,+„�, sin". a*Y ,.+, • �
1 {
, k n
'� a eg+ s, `� .xF '}�,�\ �5 k .yy.. y y e - •, a A - ..
e •' 4r a �` V
ai�.�tq�
k . . -C/�1...L «'„7VJ 0 Depthto I11G734VW\ ¢ t94 tyF A }
Parent ruatCdal(geologic) MJ71
z{. Depth to Groundwater:,Siandh*Water in Hole .9 Weeping from Pit Face
a+
• 1 ,
r
Estimated Seasonal High Grourtdvrater _
(p UMAm g8�p y�,gQ El R
Method Used:
Depth Observed standing in obs.hole: �° in.• .'Depth W soil nibUdes+ £ in:
be to weeping from side of obs,hole: in. `Groundevatcr Adjustment fl•
Index Well#_ !feeding Date: lndez Well level- Adj.factor Adj.Crroundwatex Level—
PE R+COLA'T_It ' ` u;tteli '.ritnog
*� � UbservatiQn s. "� ,�� � A
_-.vl•� ,
/ � F t.�
�.. s k... Hole N...: ni �
Depth of Perc 4 ,Time at 6"
Start Pre-soak Time® Tlme
o _ ,
PIS."
E-nd Pre-soak_
Rate MimAnch ' .c, Z Z �.•¢r/
Site Suitability Assessment: 4Site Passed Site'i uled Additional Testing Needed(Y/N)
Original: Public;Heaith Division Observation-Hale Data To Be Completed on Back
Copy: Applicant', ,q a ` �x•
'� `• .:DEEP OBSERVATION HOLE LOG Hole# /
y' Depth'from ,; ' Soil I lorizon Soil Texture,, Spit Color Soil Other
Surface m.) (USDA) �(Munsell Mottlin k .-
( ) ` ) g `'(.` }e ;,. Structure,Stones,`Boiilderes 4, .
G
we 57.4
DEED OBSERVATrON HOLE L 0 G
Depth from , Soil Homan 1 Soil Texture Soil Color Soil Utter
Surface(m} 1 USDA)!). ;R9ensel!) : Milding: .;(St_nsctrre,Stones,Boulderes.
a
.28. Z..�'. /'>
DEEP OBSERVATION HOLE LOG dole# . S
Dcpth from Soil Horizon Soil,rexture Soil Color Soil " . Other
Surface(in.) (USDA) (Munsell) Mottling_ (Structure,Stones,Boulderes.
tCongistencv.o Grmll
3z f G .- zs
DEEP OBSERVATION HOLE LOG . Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
e
IF
Flood lnsurariie hate Marc „ =
Alio ie'500 year flood boundary No ..Yes
�o r
VJithin'500 year boundary
Within.100 year flood bound' No Yes
bepth of Nkiirally Occurring Pervious Material ,
Does at least four feet of naturally occurring pervious material exist-itt all areas observed throughout the
acea p"roposed,for the soil absorption-system?
r7
If not,what is the depth b€raturalty o,c-6rrifll verviotJ'%materiaj?
Certification
I certify that on (date)I havepassed the soil evaluator examination approved by the
,Departiltent of Environmental Protection and that the above analysis was performed by me consistent with
the requir g,expert• a d experience described in 310 CMR 15.017.
Date
Signature
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DATE: ' 3/20/15
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DATE 3/20/15
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DATE: 3/2045
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DATE: 3/20/15
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FOUNDATION PLAN
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SCALE: va° I'.-a^ JOB, 150t
DRAWN BY: KiY
DATE= 3/20/15
S
-� 7:5
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O - - ----------- 296.80'
l� /, PROPOSED 48"TALL FENCE (T1'P.)
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PROPOSED m 7'X 7'
t / I G x I G' HOT rue
POOL SHEDin
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N ;�� ♦♦ ��, BUILDING LOCATION PLAN
FOR♦ � sue• ♦ ,�, oo -
�NOFatq� ♦♦ 2C ♦ /\g� 240 INDIAN TRAIL OSTERVILLE, MA
,•STEVEN W. PREPARED FOR
, ♦ t
R.3 y ♦�' 1 ALEX CHRISTIE DUHAMEL
f 5CALE: DATE: I DRAWN BY:
GO' 03-07-2017 TMW
JOB NUMBER: 12-04GA UV151ON: 5HEET NUMBER:
WELLER ASSOCIATES
P.O. BOX 417 CENTERVILLE, MA 02G32
TELEPHONE: (508) 328-4G92
EMAIL: trl5WCller@gmall.com
REGI5TERED LAND 5URVEYOR5 4 ENVIRONMENTAL CON5ULTANT5
Traverse PC
DEEP OBSERVATION HOLE LOGS INSTALL RISERS + COVERS TO PIPE5 TO BE LAID LEVEL FOR
WITHIN G" OF FINISH GRADE 2' OUT OF DISTRIBUTION BOX-
DATE: 1 1-20-201 2 P-13776 m
TEST BY: D. MEYER, RS (SEE PLAN VIEW FOR LOCATIONS)
WITNESS: D. DESMARAIS, HEALTH AGENT WATER TE5T D-BOX FOR 2" LAYER OF DOUBLE WASHED PEA5TONE J
lu
PERC RATE: < 2 MIN./INCH
LEVELNESS 4 FLOW OVER 3/a" - I %2" DOUBLE WASHED STONE CONC. i 1 oVC
EQUALIZATION BND. r i
1 1 In
�
In
DEEP OBSERVATION HOLE# EL. 2 1.O FND. i -
EL. 22.0 1 1
DEPTH SOIL SOIL SOIL COLOR SOIL - - _EL. 2 I .O EL. 2 1 .O
FROM HORIZON TEXTURE 01LCOLL) MOTTLING OTHER T.O.F. @ - - -` - 1 1 Q-
SURFACE 4"SCH 40 PVC 4"SCH TOP @ EL. 1 8.0 i U Q
A LOAMY SAND I OYRS/I PERC TEST @ 54" EL. 23.0 40 PVC 4"SCH 40 PVC 1 i
9"- 28" B LOAMY SAND I OYR5/8 24 GAL. < 1 5 MIN. 18.65 I OII 141I (5) 500 GAL PRECAST DRYWELLS 1 ch
1
28"- 144" C MEDIUM-COARSE SAND 2.5Y7/3 19.00 �... . 1 7.80 BOTTOM @ EL. 15.3 1
INSTALL GAS BAFFLE 17.97 1 O
In
IN OUTLET TEE 18.40 1 7.30 11 1 T)
:............................................. I 1 O Lli
PEEP OBSERVATION HOLE#2 EL 2 I.O INSTALL TANK 4 D-BOX 1
1 1 J
un
ON G"LAYER OF CRUSHED 6.3 22 I j Q
DEFT SOIL 501L 501L COLOR 501L OTHER 2000 GALLON PRECAST STONE 1 1
HORIZON TEXTURE (MUN5ELL) MOTTLING 20
SURFACE \ I DB-G
BOTTOM OF TEST HOLE \ I i
o"-9" A LOAMY SAND I oYR5/I I SEPTIC TANK 1 1 ZONING CLASSIFICATION: RF-I
i I (H-20) @ EL. 9.0 \ i
9"-32" LOAMY SAND 1 oYRs/8 I \ � MINIMUM LOT SIZE: 43560 S
B MINIMUM FRONTAGE: 20
32"- 144" C MEDIUM-COARSE SAND 2.5Y7/3 ` 1
1 1
\\ 1 "� � MINIMUM FRONT YARD: 30
If MINIMUM SIDE YARD: 15
` �.♦ i J MINIMUM REAR YARD: 15
i MAXIMUM BUILDING HEIGHT: 30
DEEP OB5ERVATION HOLE#3 EL. 21.O I i ��a`\ 1 1
n, 1 SALTWATER ESTUARY PROTECTION ZONE
DEPTH SOIL 501L SOIL COLOR 501L I '
FROM OTHER \ ` -' I 1
HORIZON TEXTURE (MUN5ELL) MOTTLING I I --
SUKFACE I ; 296.8I li II
O"-9" A LOAMY SAND I OYR5/1 PERC TEST @ 54 I \ 1
9"-32" B LOAMY SAND I OYR5/8 1 i i I i
24 GAL. < 15 MIN.
32"- 1 32" C MEDIUM-COARSE SAND I 2.5Y7/3
1 I
1 1 I 1 1
1 1 I I 1
1 I I 1 1
DEEP 055ERVATION HOLE#4 EL. 21.0
; Q I I 1
DEPTH 501E 501L 501L COLOR SOIL i LOT I V 1� `II FROM HORIZON TEXTURE (MUN5ELL) MOTTLING OTHER
SURFACE 1 :-Ai
01.-& A LOAMY SAND I OYR5/1
I � \
8"-33" B LOAMY SAND I OYR5/8 .i., i I ¢ i v
G3489 . 2 5 . F. _
32"- 132" C MEDIUM-COARSE SAND 2.5Y7/3 19.5
NOTE: NO GROUNDWATER ENCOUNTERED IN ANY TEST HOLE 1 . 4 G AC RES I 1
\
i � \
I I I
20 ---
PROP05ED 4'
f FENCE AROUND f/ ,� \\ / /♦ �.�
POOL AREA04
,/ ,',�i \\` i `/ ♦♦♦♦ ♦```
NO
1 1 � / � rr
1 \ /
\
1\ 22. 1
00
\ \ 6
\ \ I 00,
000,
- i
00
DESIGN DATA
00
DAILY FLOW: (G) BDRM5. x I 10 GPD GGO GPD
SEPTIC TANK: GGO GPD x 200% = 1 320 GFD
// ',. `.�, �.1 ---�,'� / USE: 2000 GAL. PRECAST SEPTIC TANK
D5E RIGS)OUTLET
BOX:DB-G (H-20)
�,'`� �`;.'� ,' SOIL ABSORPTION SYSTEM:
\ (G) BEDROOM ,-' ��' �`�� j� ,' � USE: (5) 500 GAL. PRECAST DRYWELLS LINED
DWELLING 22 w/4' OF DOUBLE WASHED STONE ALL AROUND
T.O.F. @ EL. 23.0 ,'. \\;
\ CAPACITY:
\ BOTTOM: 13 x 50.5 x 0.74 = 485. 1 GPD
\\ °\ • �� 0 TH#t i I X ,.' \ ' ��' TOTAL: 10 I x 2 x 0.74 = 6�3.0 GPD
1 GPD
cw
TH#4 FZAf�f
` \ ` \ , , A\o r "�
\` \\ � • ® / \ \ .' `ems %� STEVEN � �... - . .._
RUM I No 9
\ . 1 40
_. .p a
VENT1STE�ti
21 .8+ -'' LAND s , /TAR\P� r
S
\
TBM = EL. 2 1 .0 S 1TE PLAN Of LAND
�\ \\ TOP OF CONC. BND. ,-' �,•
\ \ �.
FOR
,\ GENERAL NOTES 240 INDIAN TRAIL 05TERVILLE (OYSTER HARBOR5), MA
\ \ PREPARED FOR
+ 1 . 5EPTIC 5Y5TEM 15 TO BE INSTALLED IN ACCORDANCE WITH
21 .5 , BAY%-If B U I LD I N G
♦-,., ,. 3 LO CMR I S.00: TITLE V
SCALE: DATE: DRAWN BY:
2. TH15 5EPTIC 5Y5TEM 15 NOT DE51GNED FOR THE U5E OF A 1 " = 20' 1 2- 1 1 -201 4 TMW
GARBAGE D15PO5AL.
JOB NUMBER: REV15ION: SHEET NUMBER:
3. TH15 PLAN 15 NOT TO BE USED FOR PROPERTY LINE DETERMINATION. 1 2-04GA 02-24-201 5 5P- 1
4. CONTRACTOR SHALL PROVIDE 48 HOUR NOTICE TO DI-51GN
--' ENGINEER FOR ANY REQUIRED INSPECTIONS.
WELLER * ASSOCIATES
5. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ANY I G45 FALMOUTH RD., SUITE F9
UTILITY, ABOVE OR UNDERGROUND, PRIOR TO ANY EXCAVATION P.O. BOX 417 CENTERVILLE, MA 02G32
OR CONSTRUCTION. TELEPHONE: (508) 328-4692
EMAIL: trl5weller@gmall.com
REGISTERED LAND SURVEYORS ENVIRONMENTAL CONSULTANTS
Traverse PC