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Home My WebLink About0329 SANTUIT-NEWTOWN ROAD - Health 329 SANTUIT-NEWT®�VN' 1��}p. j Marstons Mills A = 030 — 122 TOW BOF BsAR NSTABLE W � D� INLOC 5,1� VILLAGE ASSESSOR'S MAP & LOT i INSTALLER'S NAME PHONE NO. -C c, SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL ��OR PUBLIC WATER BUILDER OR OWNER ��_. DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ,,1 Q A 0 r 4-c 1 G-o' � ,� �� TOWN OF BARNSTABLE LOCATION SEWAGE#, VILLAGE MAP&PARCEL INSTALLER'S NAME&PHONE NO. J'c C. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) -el'e-,f (size) NO.OF BEDROOMS OWNER •�Gr.J'��/'J'.1'c�i�v�C PERMIT DATE: 3 COMPLIANCE DATE: Separation Distance Between the: '?1 O A"'Ie'a &, , 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 h')facili Feet / Edge of Wetland and Leaching Facility(If any wetlands exist within. 300 feet of leaching facility) / Feet FURNISHED BY e A 3 A L y ' _ S-1 T�� l � g Town of Barnstable P# Department of Regulatory Services Public Health Di WASS. vision h� 200 Main Street,Hyannis MA 02601 Date Date Scheduled6- Time./ L Fee Pd. Soil Suitability Assessment for Sewa ' Performed By: ge Disposal Witnessed By: LOCATION& G�NERAL FORMATION rNEW n Address .�o �'r��T !?vT � ,Oowner's Name`�`r`Ar,- Address �/{ 's Map/Parcel: O �o� / Engineer's Name&/J�Od,&.��G, �J' CONSTRUC7YON REPAIR &� �� _�� Telephone# 1 Land Use Slopes(%) Surface Stones Distances from: Open Water Body_ft Possible Wet Area -----ft Drinking Water Well __ft Drainage Way--_—____ft Property Une ---_eft .,Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands 1`n proximity to holes) W Parent material(geologic) Depth to Bedrock --------------- Depth to Groundwater. Standing Water in Hole: Weeping from pit Fgce Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: Depth to soil mottles: itl Index Well# Reading Date: Index Well level in, Groundwater Adjustment ft. - ..� Adj,factor Adj.Groundwateriavel PERCOLATION TEST Date . �rFtna Observation Hole# ►1 Time at h Depth of Pero Time at 6" Start Pre-soak Time @ ,=` 6✓ ''' Time(9';60,) End Pre-soak / L — Rate MinJlnch `�i W�� , 1. Site Suitability Assessment. Site passed Si(e Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Comp leted on Back----------- ***If percolation testis to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:SEPTICIPERCFORM.DOC ------------- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. o istency.%,Gravel) COVS a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil. , Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C nsistency.% ray 17 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C nsi to c o Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Co si ten 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 pery o s aterial exist in a areas observed Chroughout the area proposed for the soil a sorption system? If not,what is the dept of aturally occurring pervious material`t Certification {� I certify that on { (date)I have passed the soil evaluator examination approved by the Department of Envir mental Protection and that the above analysis was performed by me consistent with the required training, er' e and rience described in 310 CMR 15A17 Signature Date � �� l� Q:\SSPTIOPERCFORM.DOC No. � � 3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BAjRNSTABLE, MASSACHUSETTS Yes Zipp ration for �Digkb4AW &p5tem Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑ Complete System [ Individual Components 3a2 9 J', i✓ErPw Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel C0 / 5-0 eQ 0 OD 00 P .- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building �T eg -0. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) — 0 gpd Design flow provided `S 9 gpd Plan Date - i' —� Number of sheets 1 Revision Date Title Size of Septic Tank 6 /0.0® "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 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 J Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. � L `-�� Date Issued ————— ——— ——— -- ———-- ———————————— No. Fee _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: j PUBLIC HEALTH DIVISION TOWN aOF BARNSTABLE, MASSACHUSETTS Yes ' 01pprication for.Mi �M *pgtem Construction Permit Application for a Permit to Construct(`) Repair(Upgrade( ), Abandon( ) ❑ Complete System Ieindividual Components Location Address or Lot No. AO Owner's Name,Address,and Tel.No. 67i67Gi.-Le, 0-.apt .O erR*44i J'X444�Jr Assessor's Map/Parcel O 3 C /,12 1 3,0 CP 100.0 OD 00 9 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 77 f O'07 �p v�,b �. /�'3 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building a er No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) O gpd Design flow_provided -3y9 gpd Plan Date mom. Jr--1 Number of sheets 1 tl/' Revision Date Title _ Size of Septic Tank GrX'�J'T��✓� �00'PS.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) X Date last inspected: j Agreement: j 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 i Application Disapproved by: Date for the following reasons Permit No. C' of ;3 —0 5 Date Issued wy 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 T/iW .G e`A!V4741P f//r . Q`6,>1"'i,-_ J 4'Ot A, -C ' at 3'.2 9 s-A/-Tyi7" /Y cc'Ly/"�o LvN' JZ l> has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. _0 7� dated Installer (%,.Oy -e Aep�d G•�f' Designer ,GTiQ�// 2Q,/�►/�il�o A— �'•l' #bedrooms Approved design flow 3 gpd The issuance of this permit.$ all t be c strued as a guarantee that the system illill f Die, . Date Q111r Inspector No. ��C` ) � Fee -------,---- __.. _.._ .,-'--- Fee --,�r;0 ---, - --- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION;- BARNSTABLE, MASSACHUSETTS Th6po5al �&pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( A11 Upgrade ( ) Abandon ( ) System located at .3�9 !4 h'�`�/�'' /L�"ltiT 4 by �✓ /�1j 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 condition Provided: Construction must be completed within three years of the date�this permit. Date 5 1 3 Approved by i Town of Barnstable 'WE ° Regulatory Services °s Thomas F. Geiler,Director B,tMASS. Public Health Division 1639. v�ArfD Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508 621644 Fax: 508-790-6304 Date: ?✓' O _7 f j Sewage Permit �`7/0'1�Assessor's Map/Parcel Installer &Designer Certification Form Designer: 4 Installer:64 Address: Address: V On /s was issued a permit to install a , ( ate) (installer septic system at based on a design drawn by - 4,(address) dated ( esigner) 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 >7 `-Lions. Plan revision or certified as-built by designer to follow. Stripout (if rP- acted and the soils were found satisfactory. N p�F - .,4 o DAVID y\a B. MASON �((Insstaller'sture) _;+6 ,9 No.1066 o c� A /STD ff e ' ature) PLEASE RETURN TO BARNSTABLE PUBL.; _ fE OF COMPLIANCE WILL NOT BE ISSUED UN i iL isu i n i tin fORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAofce formMesignercertification form.doc No.... --•- F�>�Y. .:.o. ........ THE COMMONWEALTH OF MASSACHUSETTS 2 BOAR® OF HEALTH � -Apli ira.tilin for 1iapo,ia1 orkii Tomitrurtiun rrmit Application is hereby ma for I?,ermit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �j JG.n' �T" �j -•i• r:...f ........................................................................ ............'`........ .:: ... ....��s�✓ ...............,, Location•Address or Lot No ......... 'U l ..... ....... .. ...x...... ... .....3........:f 1 %.........l .0................... Owner Address ............ .. . . . —� Address ...... ................ ............................................ .................................-•----.... ns l UType of Buildin Size Lot... `..Q>r4`'Sq. feet Dwelling—No. of Bedrooms............................................. Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type e of Building No. of persons............................ Showers a YP g ...............•.-•.-•.-..•. p ( ) — Cafeteria ( ) P4Other fixtures ---------------------------------------•--•--•-•......d -------------------- ------- W Design Flow.......5�'G?...::......................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity&j�a.gailons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No........ ....:.�... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___�[1_dl1_____ iamete '�............. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.--..---_-_-__.-__--_--- (L, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--__-______---_--.---_-. P4 ----.-•-- ----------------------•------••-----........---------------•------------..------..-------•-----------------•-------------------------•------------ .0 Description of Soil.........X...= .y ! �..-..LL? ----=----------------------------------------------------------------------------------------------------- U .-----------•-------------•-•---•••-•--•----•-•-----•••••------••••-----•••---•--•--------•••--••--------.._.._......•--•--•--------•••-----•-•---••-•••-•--•-•-••---••-•---•--••-----•............---••- W x •--••-••••••-----------•---•-------•----•-•---------••-••------------------••-.....•--•--•-••••--------•----•-••-----------...--•--•--•--------•-----•••-•••-•--•--•-•--•-•--•......-•••.............•-- 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 Article XI of the State Sanitary Code—The undersigned further pgrees not to place the system in operation until a Certificate of Compliance has been i d by the board of iealth. Signed -. ..... .... :. ........... ................. .......... Da ApplicationApproved By................................................... ..................................... '1 - - Application Disapproved for the following reasons:...........................................................................................Date•••-----...... --.....-•--------•-...........•--•---•-•-• . ----......--•-•-------•--------------------•----------•-----•---------•--•---- ....................................... ••--------------------- r� ate Permit No.---- � - ..............................;... Issued......f J /........ ...:..... Date ------------ -- ------------------------------------ No.........�' � Fus ". :�:...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for 41i�i vsa1 lVarko Cnonstrurtion Vrrnfit Application is hereby made for a Permit to,Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...... . 1,!' .. '! _....... Ze itr:YA.__......:t z-........ ....e i iv:/...,7F.,. 3:: �' ..: ................................ Location•Address or Lot.No. r ........ ..... .......... .'..l.,. cm,,:• .e:*•• e1•�-,j- <;; ..... ., . �. :•c'.....,......m:w tg, _ '.r.:. syt,�,................. Owner .Address � .......... „ • Installer .,,. a .,...� .. .... .............. ............. ........Address...,...._ ................................ U Type of Building ¢ ` ° " Size Lot.... J... „ aq. feet -� Dwelling—No. of Bedrooms.......,:.............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a d Other fixtures ---------•------------------------------ --- ------------------------------------------------------------------------------------------------------- Design Flow.........r ra.............. ._..gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity_ !�.lgallons Lefrgth�,' ........... Width................ Diameter................ Depth................ x Disposal Trench-No. ....:............... Width...........: ......_ Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No._•._,A..,r, &a''meter �O_.......... Depth below inlet-................... Total leaching area,.................sq. ft. Z Other Distribution box ( - Dosing tank ( ) Percolation Test Results Performed by---------�;;••---•--•-.........--••-:+ ........................... Date........................................ rest Pit No. 1................ininutes per inch .Depth of Test Pit.................... Depth to ground water___.___.__-_-_..___.__-. 114 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water.......................... P4 ...------•-•----••••---••----••---•-•-•--•---•-•-•--•-----•--•---•-•-•----••...-•••--------•-_•---•--••--•---•---••-......._•......................•--_-•--- Description of Soil r. YL----46,- to----•----------------------------- 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issqed by the board of health. _', Signed a Application Approved By..........................................................� _....... .... .. ••�� Q Date Application Disapproved for the following r easolas:......--•------------_-----------••••------•-----•----------••--.....-•------•••---•••--•----•---•-•--•_..... .............•-------•----••-•----•••--------....----------......._.._...••••--...--••-••••= ----.-------------••=--•--------•-------•-----------------•-•••......-----........ „ Date Permit No.- t .' *., Issued .................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '� t • .. ii.f•:.. s..............OF........ �" `- .'... -..................... d,r VTrrtif!rate of TialujifiFaaarr THIS IS TO CERTIFY, That the Individual Sewage Disposal Systern constructed (.,<) or Repaired ( ) by........---a'' �-"'<.` .................. I �" ,. _ '�j...... ... t\ r er .. at. rr-.1_.� -. `� - -`--��--¢ .'- .............................................. has been installed in.-ac 6 cc with the provisions of Article XI of The State Sanitarv•Code as described in the application for Dispo$,.tl`W ., 's.Construction Permit No-..... �,��s .°__;._ _::°__.� dated ��. ::;�x:Q.__ �---------- _.__.. . R r THE ISSUANCE OF THIS CERTIFICATE.SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY: DATE ---------------------------------------- Inspector.................................................................................... T,HE COMMONWEALTH OF MASSACHUSETTS r. BOARD , OF HEALTH f�; ..:: ........O F � a fit.' J , ¢' ,,,... ............................. No................... FEE S ................ , Permission is hereby granted----- f x�>:,, --= .,: � 6f et_/40 :)......................... to Construct O or Repair ( ) an Individual Sewage Disposal S em at No..... ......a,.e:......r�,h`+,..._. .............................. Street as shown on the application for.Disposal Work Permit Dated !e.. ---------- --•--•---------- ---=----- ------ -----------------------------------•-•• ........:..... r• Board of Health DATE----. ---------- ..................... FORM 1255 HOBBS & WARREN, !NC., PUBI.lSHFR$ lit" yf<' fp ASSESSORS MAP : -EST NUIZS: .. 1 E S T HOLE LOGS PARCEL /2 Z FLOOD ZONE: aT 1 'I'lie install, shall comply with'1'itle V and 'Town of WBoard of A� 6 t _ I G/ _ - _ SOIL EVALUATOR: �U 1 ) ` ' REFERENCE: c -._ ro 1 l WITNESS : Dom; t � (Iealth Regulations. �_ _ _ 2) The installer shall verify the location of utilities sewer inverts and septic _.T.... - - DATE -_' a� 3 PERCOLAT 101J` f1ATE• 1 �/yJl I components prior to installation and setting base elevations. � �� , 3) All gravity septic piping to be 4 inch Sch 41) PVC at 1/8"per luul. The first two feet out of the d-box to the leaching shall be level. Q� TIL- I TN-2 4) 1'his plan is not to be utilized for properly line determination nor any other purpose other than the proposed system installation. 5) All septic components must meet'1•itle V specifications. G) Parking shall not be constructed over I t 10 septic components. �!o S 7) The property is bounded by property corners and property lines. L:OCAT I ON Iv1AP � 'xr� �Z 8) The property owner shall.review design considerations to approve of total \` design flow and number of bedrooms to be considered for design. Receipt a of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. 9) '1'lie existing leaching or cesspools shall be pumped and filled with material per'Title V abaudoiunet�it procedures. '17iose within the proposed SAS shall be removed along w'itli cont urinated soil and replaced with clean sand per Title V specs. NZ7 p 10)System components to be 10 feet Isom water line. Sewer lines crossing the water line shall be sleeved with 4 inch SCI 140 PVC with ends grouted if ------ - applicable. The proposed SAS is being installed below the water service flue. 71'he line is to be sleeved as afrementicmed and maintained in place. / SEPTIC SYSTEM DESIGN 11) if a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. f � i FLOW. ESTIMATE � 12)'fhe installer is to take caution in excavation around the gas line if such exists. BEDROOMS AT //0GAL/DAi'/4EDROOIA —5N�AL/DAY 13)'Flie installer sliall,verify the location, quantity and elevation of tliosewer d / lines exiting the dwelling prior to the installation. SEPTIC TANK 14)'I•his plan is representative only that a system can fit on a property meeting V Title V requirements. 5,_'Z GAL/DAY x 2 DAYS -C= GAL AV � USEI060 �677W*GALLON SEPTIC TANK C L ABSO(tPT 1014 SYSTEM to '- SIDE AREA: Zx (7 �X �17 - ' I ► �� BOTTOM AREA: 7— JC I.Z, O 1-1 EFT IC SYS7-EM SECTION 10 co n W ill. b1r I - Z� I (a�►�� Z�ldo ,L �o0 D-BU' \n GAL Sz,00 • -- �. g1, I SEPTIC TANK IfGtt�.11 ? ;� j uU Ic r �mf "V 0� L11� Oft o , �-�J? ► K � p S I fE AND SEWAGE PLAN O LOCATION : 4wl W� P 11 E PA 11 E D F 0 R : SCALE : 1 a W � DAV I D B . MA3014K5 DATE: �32of z DBC ENV I RONMEN�AL DES I GIJS I W (:AS"I' SAI4DW I CH . MA DATE FIEALTN AGENT ( 508 ) 633- 2177 I t I _ _