HomeMy WebLinkAbout0096 DEBBIES LANE - Health 96 DEBBIE'S LANE
MARSTONS MILLS
A = 027-714-T00
ko Barnstable ;
SHETp�y Town of Barnstable
Regulatory Services Department ASAme"aN
BAEtNSTABLE, '
\90 AS Public Health Division
r60 MAf 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Inspectors Report:
April 16, 2009
Jaime A. Cabot, R. S.
Health Inspector
Health Division
Town of Barnstable --
RE: 96 Debbie's Lane, Marstons Mills
To Whom It May Concern:
On April 14, 2009 at 11:00am I was conducting an investigation of nuisance
complaints on Santuit Newtown Road ( Complaint ID : 25107) after having conducted
follow up inspections on Nuisance complaints having time available before my next
appointment I drove the surrounding area of Chippingstone Road, Chopteague lane,
Debbie's Lane and Spur Lane.
I Observed Sanitary Code Violations of Nuisance Ordinance and The State Sanitary
code at the property at 96 Debbie's Lane, Marstons Mills. From the Roadway I observed -
a large section of roof drainage gutter (15')detached from the house and hanging loosely
in front of the house, a violation of the State Sanitary Code Chapter II , 105 CMR
410.500: Owner's responsibility to maintain structural elements.
The following are violations of Town of Barnstable, Board of Health Nuisance
Regulations Chapter 353-1: Responsibilities of owner's and occupants. .- v
Observed from the Roadway were 2 empty 5 gallon buckets in the front yard area, a
cinder block and an automotive battery (next to the fence post at the left front lot corner.)
a mattress appears to have been discarded and was leaning against the left side of the
house.
I then stopped the vehicle and walked to the front door where a Man answered the door
I introduced myself and explained the reason for my visit, being that the debris in the
yard were Health Code Violations. The man said he lived there but did not own the house
a woman then came to the door when I again introduced my self and again explained the
violations and asked that they be corrected or I would return and issue a warning.
a
Mrs. Sylvester stated that this was new referring to an inspector investigating nuisance
complaints, the reason for my visit being the complaint forwarded to the Health
Department by Town Councilor Barry; I stated that there was I threat off layoffs in the
Health Department and that because of that I was writing more tickets. Mrs. Sylvester
then stated give me the warning and shut the door.
I left the property and returned to 200 Main St. Hyannis prior to my next appointment.
The Division Head was unavailable until the start of my next shift due to Board of Health
meeting to discuss the incident.
At 6:15 pm on April 141h, 2009 I received a phone call at my home by a man who
would not say who was calling, I took the phone from my Son who had answered the
phone and was asked if I was the Health Inspector who had been to Debbie's Lane I said
that I had been in the area on inspections but please contact me at my office with any
questions.
On April 15, 2009 the start of my next shift Mr. Mckean and I discussed what had
occurred and Mr. Mckean instructed me to obtain photographs of the house. After my
inspections I obtained several photographs. -
Respectfully Submitted,
dime Cabot �,.
No. �i O Fee 1
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Application for Migo!gar *pgtem Con.5truction Permit
Application for a Permit to Construct O Repair(14111upgrade O Abandon O ❑.Complete System ❑Individual Components
Location Address or Lot No.91[! DCWMe,. �,i. Owner's Name,Address,and Tel.No. (� S 5y1 Ue5kur
wit tags �`,LI.S Rf� 0e6lown W MrAi TG�s n,,��s
Assessor's Map/Parcel GZ7 —)IL(
CR1� SAY Installer's Name,.Address,and Tel.No. Designer's Name,Address and Tel.No. �,
�° �✓o 1 t \6v0 UAS NP.. G �A-775-673 S-
Type of Building:
Dwelling No.of Bedrooms Lot Size 2 65-6 sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33 gpd Design flow provided 3-� gpd
Plan Date T—Zs--og 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:
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 Enviro ental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bard of Health.
Signed Date 2
Application Approved by Date
Application Disapproved by: Date
for the following reasons
` ———— Permit No. — Od I Date Issued -7 2 v -----
Nd`0 i
o. / Fee '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Application for �Digonl 4§pmem Construction Permit
6
Application for a Permit to Construct( ) Repair(VZpgrade( ) Abandon( ) ❑.Complete System ❑Individual Components
Q�� Sc��laer
Location Address or Lot No. 1� eS '�, Owner's Name,Address;and Tel.No. 5 P the 3 1
M kftsto�S ���5 q(o Oe66e5 ID M'te_STG+35- rA,,LtS
Assessor's Map/Parcel G Z7 _)XI
Installer's Name,Address,and Tel.No. 5 � Designer's Name,Address and Tel.No.
t r\Xr�s�Ova W.-k\S Mb. 07414 P, 1695 fray. P. Sc l wc, Ste;7,5"-G73 5"
Type of Building:
Dwelling No.of Bedrooms Lot Size 76 656 sq. ft. Garbage Grinder ( )
r`. Other ,Type of Building No.of Personsl Showers( ) Cafeteria( )
Other--FixtCresl-7 it n ,
Design Flow(min.required) "�S gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of.Septic Tank Type of S.A.S.
l Descriptiontof Soil
Nature of Repairs or Alterations(Answer when applicable) Q���r� Ala�h ( AA
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 tlie`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 C� � ,... Date 7AI /x ,1 0
Application Approved by 0 /! _ Date �L
Application Disapproved by: Date ;
- r ,
for the following reasons
Permit No. DooZ '31 o Date Issued '' .C� ---- •------- ------
------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( VI/Upgraded ( )
Abandoned( )by
11
'at ��o I7R�i .;�! A 1 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. c,?)OR ' 2,1 dated -7 A)
Installer T�A.,O,00— Designer t ►o 1Il'- IF A eel a
#bedrooms Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system will ffuun"ction as designed-(,
Date f ' 5� (-7 Inspector { /�
———— —_ -- — _ -__-----��-- - -- --- ---- --
,q
No. � ;Look"3(o u——— Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
=i!5po$al *pgtem (Cow tuition Permit n
Permission is hereby granted to Construct ( ) air ( ,� Upgrade ( ) Abandon ( )
System located at R ��-
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 c mpleted within three years of the date of this permit.
Date �] 'd Approved by ----
.
Town of Barnstable
" of
'THE Regulatory Services
4� l
K
o„ Thomas F. Geller, Director
BARNSTABLE, * Public Health Division
MASS.
pr 1639. `0� Thomas McKean, Director
ED MA'S
200 Main Street, Hyannis,MA 02601
A
Office: 508-862-4644 Fax: 508-790-6304
Date: .3 ,-,:> 8 Sewage Permit# Assessor's Map/Parcel 2
Installer & Designer Certification Form
Designer: 8Installer: S'c'k — s�e,Je,�
Address: ,,��. � V112 Address:
On -712si0 8 C21 L -zayr,US was issued a permit to install a
(dat (installer)
/�i3Ol� 5�
septic system at ��1���3 "based on a design drawn by'
(address)
t!57-, . -'t/�+� dated 2-- 2-
(designer)
—f� ` 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. Stripout (if required) was inspected and the soils
were found satisfactory.
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
certified as-b)o by designer to follow. Stripout (if re uired) was inspected and the,soils
Qnsa
nd sfactory. ` j"OF ��
s
o� DANIEL E. y
BRAMAN
o N
s_Si ature) CIVIL
No. 32686C
GISTS
P
s
(Designer's Signature) (A fE5 s Stamp Here)
PLEASE RETURN TO BARNSTABLE 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.
gAoffice formsWesignercertification form.doc
N44 0 IY J V . ..
Soil S ' ab ity Assess»rent,�or Sewage Disposal 0
Performed fly: - Witnessed Dy; 1 V _' 01V� 0)
LOCATION & GENERAL INFORMATION
Location Address Owner's Name
Address
Assessor's Mnp/Parcel: Z, lingineer's Name4!�2yA.)
NEW CONSTRUCTION REPAIR Telephone q
Land Usc �' Slopes(%)10 Surface Stones
Distances from: Open Water Body n Possible Wet Area R Drinking Water Well n♦
Drainage Way jyC> n Property Line _el 0 Il Other n
SKETCH:(Street name,dimensions of lot,exact locations of test holes A pert tests,locale wetlands in proximity to holes)
oo
Parent material(geologic) (D-X.,ckz� Depth to Bedrock
Depth to Groundwater: Standing Water in l lolc: N Weeping from Pit Face
Estimated Seasonal I ligh Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment
Index Well k_ Reading Dale:_ Index Well level Adj.rector Adj.Groundwater Level_
PERCOLATION TEST Date Tlrnej=
Observation
Hole a Time at 9"
Depth of Perc Time at 6"
Start Pre-soak Time a Time(9"•6')
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Iicallh Division Observation Hole Data To Be Completed on Bach—�
t Copy: Applicant
DEEP OBSERVATION HOLE LOG Hole#
Dcplh from Soil I lorizon Sail Tcxturc Soil Color Soil. Other
Surface(in.) (USDA) (Mansell) Mottling (Structure.Stones,noulderes.
e
y3� SO C ��s � �/s c • � . s
0- ia G 5 .
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil I lorizon Soil 1'cxlurc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
e
to W L.S.
iv � V L. S.
DEEP OBSERVATION HOLE LOG Hole#
Dcplh from Soil I lorizon Soil Tcxturc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Doulderes.
e
DEEP OBSERVATION HOLE LOG Hole#
Depth from Sail I lorizon Soil•fcxlurc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
e
Flood Insurance Rate Man:
Above 500 year flood boundary No Yes. ..
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?
If not,what is the depth of naturally occurring pervious material?
Certification It
1 certify that on i°►gc� (date)I have passed the soil evaluator a amination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 C'MR 15.017. 1
q TOWN OF BARNSTABLE 2
LOCATION S SEWAGE
VILLAGE M'(&�Ns )N,% ►� ASSESSOR'S MAP&PARCEL ('} 7
INSTALLER'S NAME&PHONE NO. . 2ric_ � ��
SEPTIC TANK CAPACITY 1 oc)n
LEACH IN �l �
G FACILITY:(type) —�2 Q-Z (size)
NO. OF BEDROOMS
.OWNER ���P`-5a('
PERMIT DATE: I Zf3j h?, COMPLIANCE DATE:
ter--a —
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 C—
i
A 32 CS 3S
9 `
gig'
LA
c3Z, V �- S�
,
ZQo3-Vyg Fee----- --
BOARD OF HEALTH
TOWN OF BARNSTABLE
Zipplicat ion-*rVeil Co0tructionPermit
Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (Pan individual Well at:
Location — Address Assessors Map and Parcel
y��zs�P/ 94 a A:< /_, , /"kM -
------ ---------— -------- -- ---------------------------- --------
Owner Address
--------------------------------------------------------------- - -------------------------------------- -----
Installer — Driller Address
Type of Building
Dwelling N0"r e
Other - Type of Building---------------- No. of Persons---------- --------
Type of Well Y — ----— — Capacity-----------------——- —
Purpose of Well---
Agreement:
The undersigned agrees to install the aforedescribed 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 been issued by the Board of Health.
Signed- YA?
d e
12103
Application Approved By - '5 . -- f D
date
Application Disapproved for the following reasons:----------- -—------ ---— -----
----------- - -------------------- ---- -
date
Permit No. C/l)ZGb 3--(��{ --- Issued---- -— --�---- ----------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of COMPliance
THIS IS TO CERTIFY, Th/at the
Individual Well Constructed ( ), Altered ( ), or Repaired (&-T
by Installer
-------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No ? -6g--Dated L� 2/G
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- ---- - - — Inspector— - —-------------------- ----—----
i
No. ---------- f Fee----
BOARD OF HEALTH CC V/
TOWN OF £ BARNSTABLE �
Applicat ion-for Well Conotruction Permit
Application` is hereby made for a permit to Construct ( ), Alter ( ), or Repair (a''ran individual Well at:
J��_ /J O�r�S ie) �+or�yo s �, llr op _ j fq_7`O0
Location — Address. / p Assessors Map and Parcel
j� /�
— Owner Address
n '
Installer — Driller Address
Type of Building
o - c
i Dwelling M"--- ------- — ---------
—
Other - Type of Building No. of Persons-----------------------------------
Type of Well y -- — Capacity-------------------=—--
Purpose of Well---
Agreement:
The undersigned agrees to install the aforedescribed 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 off-Compliance has been issued by the Board of Health.
i Signed �'*� !-�,, /f�'--__—___--— — _�.� Y/a-' ----
d e
Application Approved By — _ —J /D 2 G.3__—__
date
Application Disapproved for the following reasons:------------------
date
/0 2. G
} Permit No. 2�3`v - --- Issued---— -- -�---� - -- ------
date
BOARD OF HEALTH
i
TOWN OF BARNSTABLE Certificate Of COMPhance
THIS IS'TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( _r
----------------
-- --------------------------------------------------------
�— — Installer
at L6
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Iy
Regulation as described in the application for Well Construction Permit Not- 3—�y --Dated -G ------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL j
SYSTEM WILL FUNCTION SATISFACTORY.
I
DATE-—------ —- -- Inspector— ——-- - -- - --- ---='
r
t
BOARD OF HEALTH '
TOWN OF BARNSTABLE
--,,h Well Con$tructionVermit
No. W2c3 :G1-1? Fee— ----
_ _—
Permission is hereby granted- A4 Sc""'
to Construct ( ), Alter ( ), or Repair ( y'an Individual Well at:
9c . 19.E 94"s Lam, _
-------------------------------
Street
I
as shown on the application for a Well Construction Permit
Z 003" U4r' ------- Dated--- -- G 3
J .
—— —-— - --------------
Board of Health
DATE--- / 1 — --
i
i
TOWN OF BARNSTABLE
LOCATION \p"C �� ���,Qpt per, SEWAGE
NVILLAGE �tS j j,C6 K\�S ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. 2 Cp& Q0-7\cS %Qk
NSEPTIC TANK CAPACITY \000 GO\ 'QcecaS7 COnC(e-Te
\ LEACHING FACILITY:(type)%e caS�-\ Cooct e-Te T Z (size) C OC) G A\
T)TTDT T!ti R)]�TCD
NO. OF BEDROOMS 3 CPRIVATE WELL R �z.., ..._���
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE . COMPLIANCE ISSUED:/
VARIANCE GRANTED: Yes ' No /
C
3,�
o'
1 .�a
� �
6y ,
��
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� e we it
Fss...........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HgP
AJZTH---------------------OF.........11t!lJ..............: ..............................................
Appliratiun for Disposal Works.Tonstrur#inn Prrutit
Application is hereby made for a Permit to Construct (LI/Or Repair ( ) an Individual Sewage Disposal
Sys
. ..__..—�........ �f .... ...................................----------.._................................. ......
Location-Address or Lot No.
... ... ......... _ ._ .. .................. ............
..._... ..... ...........-- -----------•--............_...:.•------------•--.............................
ner ' Address
...:.. .......•............. ......------------......._............._............_...........
V Installer Address
Type of Building Size Lot_-m; A ........Sq. feet
Dwelling—No. of Bedrooms--•.. ..-..�..........................Expansion Attic Garbage Grinder (�f
'4 Other—Type T e of Building _.......... No. of persons............................ Showers — Cafeteria
a YP g -------•--- P ( ) ( )
04
Other iixtures ------------------------------------•-----......................----- ......--------------.......... -------------------
DesignW Flow----------a_. .....................gallons per personper,day. Total����i�l1' flow.......ROD_-_: _ ..........gallons.
WSeptic Tank—Liquid capacity/, .gallons Length_._._.._.. Widthl� ...... Diameter................ Depth..1;?"---...
x Disposal Trench—No... .............. Width.................... Total Length.........,.......... Total leaching area............ _.sq. ft.
Seepage Pit No...o/✓ ....... Diameter....../ Dept below inlet... ............... Total leaching area. k.Ae..0....sq. ft.
Z Other Distribution box ( ) Dos nk )
Percolation Test Results Performed • ...... .......................................................... Date..7 .,�✓�° ..e-vS._
Test Pit No. 1................minutes pe i Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes p r Depth of Test Pit.................... Depth to ground water........................
a •-----------------------------------------------------------•......------------------.............--------..............-•..---.----------------•------
0 Description of Soil........................................................................................................................................................................
W .....••••....---•............................••..........-•--•••............_..._.....-----------•--.....-----•---------•---------••--•••--••-•-••........---..._...-----••---------•-. £
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 TITLE 5 of the State Sanitary ode— The undersigned further agrees not to pl/thestem
operation until a Certificate of Compliance'h s be i ued the board of health.Si .1.----- -----------------------------------------•--•••-•._....... . ,Y .d...--
s to
Application Approved By.... -.....--�
Date
—� Application Disapproved for the f ollo Ing reasons----------------------------••---...----------------------------------------..................--••••-•----------
•......................•----•-----.........------------------..............--•--•------.......----...------•-••-•-••-•••••••••••...••••••...•••.............-•••-•--••-•••-•-••.....-••-•-••------------
Date
PermitNo......................................................._ Issued.......................................................
Date
•- No....��_�'.�_S �o Fps................... .....
_
THE COMMONWEALTH OF MASSACHUSETTS
BARD OF H_ A TH
, __ ...OF. - ,;✓.,1et.�k M ..................................................
Appliration for Disposal Works Tonstrur#ion Famit
Application is hereby made for a Permit to Construct (L._�or Repair ( ) an Individual Sewage Disposal
Syst
' Location-Address or
•.'c :./ G Lot
. No
:eE":.n.er Address
... ....� ...__ ...... .... ............................................ - ...-^.................-___........-_.....
1!
�"
W
...........
.. j.� .: ................
...--•-•................•----------...
Installer /, Address
UType of Building Size Lot._.'�o..P.5-0..........Sq. feet
Dwelling—No. of Bedrooms..._ r.. ........Expansion Attic 64P Garbage Grinder (�i
aOther—Type of Building ......_ __.____.._. No. of persons............................ Showers ( ) — Cafeteria ( )
Other-fixtures -------•----------•------•---•-•••-•---------•-•-••---.-----•••-•--------------•----------•...._.........
W Design Flow__________ __ __________________________ allons er erson�p da . Total c�ail,y flow..__... ._.:....................gallons.
g g P P Y
WSeptic Tank—Liquid'capacityZR -gallons Lengths.?r.,.--..... Width.._o.......... Diameter................ Depth•_"- ---------
Disposal
Trench—No.,,,.�-_------•-.__.__ Width.................... Total Len h
xgt ..---.y. ._._-----. Total.leaching area_-------__--Ft_.sq. ft.
Seepage Pit No.__�`_�e______- Diameter-----/.� Dept .below inlet... ............... Total leaching area.14 ..sq. ft.
Z Other Distribution box ( ) Do' nk )
Percolation Test Results Performed l_' - --------------------------------------------------------- Date._/.1'`�fr. '�'.____.__..__.
Test Pit No. 1.................minutes p i Depth of Test Pit.................... Depth to ground water........................
G:~ Test Pit No. 2................minutes p n¢1'i Depth of Test Pit.................... Depth to ground water.........................
a .........--•---------•--•---------•-----•-•----.....--•.....................•---....-•--•-••-•-..-----......---•••-•-•-.....--------••-•..._..-••---•.....--
0 Description of Soil......................................................................................................................................................
x
U -•--------•--•----•--•--------•-----•-----------•--••-------------------------------------•-•---------••••------------......._..•---•---•----•--•-------••--...---•.............---..............----•-.
W
----------------------------------------------------------------------------------------------------------•--------------••----•-•-•----------•------------•...............------------•......-•-......
U Nature of Repairs or Alterations—Answer when applicable......................................•__._....................._................•.............
.................•----•..-----••-•--••------•-----------....--------------.......-•-------...----------••---....---•
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the Wstemo•
operation until.a Certificate of Compliance h s b, i sued ; the board of health.
Sig ,. ..... ... -•.._
.--- - ......_.....
• to/;Er
Application Approved I3y_..... ..... .. ..... . ........ ...................................................... 5
Date
Application Disapproved for the f ollo 'ang reasons:-------•------••---••-------------•-------------------.......-----------.....------.._..._..._•-----..........
y,
.................................................. ----------------.....-•------•-----------------------_....
Date
PermitNo......................................................... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
//. BOARD F H 1�....'' ':1...........................O F......... ! % . ..............................................
Tutifiratr of Tontpltanrr _
Tjs IS T le,, Th Individual Sewage Disposal System constructed (�or Repaired ( )
by- :��...�
- -
nstaller
at �y -_.......•.-. .... .._-�-4: y�------'--•---------••-•----•------------•--•----••-
har been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No----_ _.._ dated �f z g
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANT E THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.........................` ''Z_. l. . -`��� .. Inspector........---- ...............................................................
+1 O-Z I +=- .p p
O,�7 — 11 4 Too
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE
�5041...t�. .
... ........................OF..../,�J
No..... ......... FEE .... .-
........
712
wispo n ion rrntit
Permission is hereby granted_ ram..__.. .........
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to Construct ( r ep ) an IIx>iiv1 " �Sewa isposal System
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street
as shown on the application for Disposal Works Construction Permit No...._�. �&ed_.. _._S'.13:.-Jj_?b..........
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DATE_ ...........................G Y Board of Health
FORM 1255 Al. . SULKIN, INC., BOSTON
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?o JACOBI
UPPERCAPE ENGINEERING �a No. 814. ��
P.O. BOX 616
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E. SANDWICH, MA 02537 wEALjN
362-6281
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TOP OF FOUNDATION
" CONCRETE COVER
CONCRETE COVERS
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OR .SCHEDULE 40 MAX. 12"MAX.
P.V.C. PIPE -�`'Z 4 SCHEDULE
t PITCH 1/4"PER.F4. P-FPE - N11N:' Lt ACIi
€' PITCH 1/4"PER.FT IT
-INVERT
,o" PRECAS
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EL,.�aO. . . . . < LEACH.Ir,
,1 a INVERT ca
INVERT SEPTIC TArJI< T DIST• . INVERT �w o: PIT OR
,J EOUIV
10D . . . .. .. GAL . INVERT 4
ELS.��r. INVERT _ w w :i. 3/4°TO 1 I.
R" o ELs-P- �: WAS N E C
.37 —� STONE
r PROFI L-E OF
I` GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
- ss.y
SOIL LOG WITNESSED BY '
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TE ..y-29-e(4... TIME. . . . . . . . . . M,e M�,� �. 80ARD, OF HEALTH
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ST HOLE I TEST HOLE 2
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U10,UP/'CQ/pa ,C4/0/A)66FIAc ENGINEER
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DESIGN DATA
NUMBER OF BEDROOMSTOTAL ,ESTIMATED FLOC'! ,330 , . , GALLONS/DAY
� C30-I-TOM LEACHING AREA /.�.3 , • SQ.FT. /PIT
SIDE LEACHING AREA . ./v`-� SO.FT./ PIT
GARBAGE DISPOSAL ./t/O. , . (50 % AREA INCREASE)
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1U1-AL LEACHING AREA . 4��0 .7 SQ.F'T
PERCOLATION RATE �CeSSJh!A,N .z MIN/INCH
LEACHING AREA PER PERCOLATION
WATER ENCOUNTERED RATE .. . . . .. SQ,FT.
�h NUMDER OF LEACHING PITS
APPROVED . . . . . . -
BOARD OF HEALTH ��?. . .�C6JZ.--. //.�3
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DALE. . . /i CL)CS�/. f�� . . J'cS/�G?•�S J�J l (�/OD
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AGENT OR INSPECTOR
� ' NAL S,gyi� I
BUT S. Z)E—Q6iES 4,gAIZ— JOHN 9v
JACOBI z
I ' UPPERCAPE ENGINEERING N®• 814
. . . . . . P.O. BOX 616 ��°.,
P€r�TIOrJER': , , E. SANDWICH, MA 02537 `yEALV
r<<iR'.�✓fts �- /4. . 362-62E 1 y.
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DESIGN DATALLJ
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5 .£ DAILY rLOW: ( 3 ) BEDROOMS x I 10 GPD _ 33z:> GPD
PIPE TO BE LAID LEVEL FOR SEPTIC TANK:--13P GPD x 200%m GPD ✓�'(L�
/—2' OUT OF D15TRIBUTION BOX U5E:jpoo GALLON PRECAST SEPTIC TANK GENERAL NOTES `
D15TRIBUTION BOX: N\
41, 5Ch 40 PVC PIPE 2" LAYER OF 3/3" PEA5TONE OVER
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� USE; DB-rr
3/4" - 1 1/2" DOUBLE WASHED STONE
T.o.F. SOIL ABS RPTION SYSTEM: I
EL. 7 3 �' -�G''C 1 . CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION N o ---
a � - ---' U 5 E: _�.,'-g sS X c'3,S ',�( �. �-� �o c��j-.o.c��G-�cGG�e��/_`�,1 N
TOP @ cL. �2,c� y. e,,-- �. ,,,, / OF ALL UTILITIES, ABOVE * UNDERGROUiND, PRIOR TO E
INSTALL GAS.BAFFLr 23 s", M•� BOTTOM @ EL. f5�!, ANY EXCAVATION OR CONSTRUCTION. ;, °
IN OUTLET TEE—f >2,i 2 CAPACITY. "� (n ,
� 51DEWLL AREA: _ �4- '� G. �iz'.S 2. SEPTIC SYSTEM IS TO BE INSTALLED IN (COMPLIANCE W
BOTTOM AREA: _i3 K Zs'X o,�y 4ya, y' WITH 3 I 0 CMR 15.00: TITLE V. /
3. TH15 PLAN 15 NOT TO BE USED FOR PROPERTY LINE
DETERMINATION.
4. ALL DISTURBED AREAS ARE TO BE LOANED * SEEDED.
5EPTC SYSTEM PROFILE
5. CONTRACTOR TO PROVIDE 48 HOUR NOTICE FOR ANY
- - REQUIRED 1NSPECTION5. DEEP 0B5ERVATION IiOLE LOGS
G. THIS 5Y5TEM 15 NOT DESIGNED FOR TH E U5E OF A j
GARBAGE D15POSAL. DATE: ��- c� "rR /r% = '/�?w�/
TE5T BY: �'t�', c '�: u � !,�.✓ c-�y
WITNE55: O,
LCJCG�
P E RC PATE:
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DEL? OBSERVATION HOLE #I EL. &3, c�
DEPTH
s SOIL 501L SOIL COLOR SOIL
HORIZON TEXTURE
f ROM OTHER
S-JRFACE (MUNSELL) MOTTLING
C-�,,z.-/ Z7 ��.7'.. ,:, �.r'��' ) -, ,+r y� �'� mod,✓/ ��
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DELP OBSERVATION HOLE #2 EL. G7,4-
? � DEPTH
501L 501L 501L COLOR 501L
r-ROM HORIZON TEXTURE OTHER �
I41)
SURFACE (MUNSELL) MOTTLING
5• /a yr,>�
S$ I •� 'W- :.e " .t�.aJ Try�., �, ♦oyez s/r� 1
12-5
7 !". .s' ,,�� -__ /✓� �'1/.4?.Elc� G</`vu,/Tcla E.�7 7'O c,,.ti!.E"✓ f z�
DELP OBSERVATION HOLE #3 EL.
. DEPTH ;
501L 501L SOIL COLOR 501L I
To 8�o t�c-ryp i�•v2)z �� _ ,o FROM OTHER
HORIZON TEXTURE
f cURFACE (MUNSELL) MOTTLING I
♦ q9 o- , _y 1
c 3
i '� DE:P OBSERVATION HOLE #4 EL.
,\. DEPTH
i
SOIL SOIL SOIL COLOR SOIL
FROM HORIZON TEXTURE (MUNSELL) MOTTLING OTHER
�� ,
51TE -�- SEWAGE PLAN
F OR
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PREPARED FOR
SCALE: _lee _ DATE: 2- 2 -� -,
- „ DRAWN BY
r}, CTEVEN % " ' t� � iE >. 'o �AN15L E. u;` � JOB NUMBER: REVISION: Sf1EET NUMBER:
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— ,as , �,ST � WELLER ASSOCIATES
2 1 Cs9b1A1
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I G45 FALMOUTH RD. SUITE 4C P.O. BOX 4 17 CENTERVILLE MA 02G-.
�- '7 ' 2 WINDY WAY, #232 NANTUCICET, MA 02554
TEL.: (508) 775-0735 — _ FAX: (506) 775-0754
EMAIL: tr15weller a comcast.net `
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