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HomeMy WebLinkAbout0075 TANBARK ROAD - Health 75 TANBARK`F A= 100031A01 -- --- -- -- - - - -- _ __—_. - _ - --- --- -- h7Cr5To�1S ht, LLS i I i TOWN OF BARNSTABLE 1 ATION ?�S 92ZAIVA /Z/ SEWAGE # 60- 727 LAGE /2l,/?il./ls ASSESSOR'S MAP & LOT/bU -d3/ • I r INSTALLER'S NAME&PHONE NO. `/'77 ,03 Z9 ,9--r- �c �19rr'flS SEPTIC TANK CAPACITY /000 LEACHING FACII.TTY: (type) 2 Spa Gal, dry LU/"A size) _ USX/3 NO.OF BEDROOMS 3 BUILDER OR OWNER PERMIT DATE: 12 -11 O 0 COMPLIANCE DATE: /°1-//-D D Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet J 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 �. ...� r:, �// \�' � "'� . qi� • . s �' .� . • N� � 4. TOWN OF BARNSTABLE ii LOCATION SEWAGE # 60- 72 7 VILLAGE` ASSESSOR'S MAP&LOT 160 -61 INSTALLER'S NAME&PHONE NO. 0 SEPTIC TANK CAPACITY 100-0 LEACHING FACILITY: (type) 2 aO 46&111 51size), 5X./3 NO.OF BEDROOMS 3. BUILDER OR OWNER Q1gfSeY PERMITDATE: /1- COMPI iANCE DATE: 1::2-11-a ip - 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 andLeaching Facility(If any wetlands exist -t 6f'leaching faci thin,3 feet Feet Furnished by • wm 77777� ........... n� �.z D- re a J.: N a Fee �J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprtcation for Mitpool *pgtem Construction Permit Application for a Permit to Construct( impair( . )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. '7S rlf1�`,k gq/ Owner's Name, ddrressss and Tel.No. Assessor's Map/Parcel !9Yl-5 / -s k��p 411/ ! /00 ® Installer's Name,Address and Tel No. 4/`!I—d°Jl�!9 Designer's Name,Address and Tel.No. ✓o,3�p4 O,e /3�Pho s �oS rp4 l7� dot-°�dS , Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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) 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 Certifi- cate of Compliance has been issued by this Board of Health. Sig n gn Date Application Approved by Date Application Disapproved for the following rea Permit No. Date Issued Fee C5 " THE COMMONWEALTH OF MASSACHUSETTS `entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ZIp plication for M*ozal bpgtem Construction Permit Application for a Permit to Construct( impair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 75 reAwl-k i2� Owner's Name,Address and Tel.No. Assessor's Map/Pazcel {�yi,arsrrr�s >�/s fk,� 1?i99s /61 dD Installer's Name,Address and Tel.No. y�y' C.�•14(17 Designs Name,Address and Tel.No. r/ C,4� , 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. DescriptionIs,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 Certifi- cate of Compliance has been issued by this Board of Health. Signed `� Date Application Approved by Date Application Disapproved for the following rea Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( 44-Repaired( )Upgraded( ) Abandoned( )by < 5 at 7 -wH bArka ! has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer, Designer The issuance of this,vernut shall not be construed as a guarantee that the system will function as designed/Y Date . / Inspector Il/�'f� %%'` ( Fee — [// THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS ltgpogar *p.5tem Congtruction Permit - Permission is hereby granted to Construct(G.,)"Kepair( )Upgrade( )Abandon( ) System located at 215 14A 61 fuJ'![' ;L7 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. t Provided:Consuc4n mu t be completed within three years of the date of ' t Date: Approved by L 1/6r99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH .A`+-D .-'�,pPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, ,l s,.,04 Ve-d * 0,5 hereby czrufy that the application for disoosal works construction permit signed by me dated /Q- 8- pd concertina the property located at 1� ��6�s�le ��l/fij,/0//fX meets all of t:he following criteria: di`ne failed system is connec.;ed to a residential dwelling only. i ne:e are no comme:c:al or business uses associated with the dwellinz. 4 Tne soil is classified as CUSS I and the ee:coladon rate is less than or euual to j minutes oe:inch. F/I he:e are no wetlands within 100 fee;of the proposed septic system 6/Zae:e are no private wells within 1:0 fee;of the proposed septic s�sem There is no increase in Clow and/or change in use proposed 4 tt re are ao variances requested or ne`ded Rom of the proposed leaching facility will not be located less than five fez, above the ma.dmum adjusted groundwater table e!evation. [Adjust the goundwate:table using the Frimptor method when applicable] • If the S.A.S. xill be located with 2-50 fee;of any vegetated wetlands, the botzom of the oroposed leaching facility will not be Iccated !ess than oune=i (14) feet above the maximum adjusted g*cundwate:table e!evauon Please complete the following: A) Too of Ground Surace =ievauon(using GIS in.forrrtauon) 8) G.W. E!cr,,aeon 3-5—the:NLA'C -.igh G.W. Adjusaneat D —F-HZE`+'Cc 8 E 7WEEN ?,and 3 SIGNED : /fit`�.P�1�7— D �T-c: /2-g' y lSketc.1 proposed plan of sys;e^i on bac'CI. a::;uth roidcr._.. b ^ '^ ll ld°° lY H L � FY��ST rh 9 O � 12 �1 y Commonwealth of Massachusetts ;r:a�)v Executive Office of Environmental Affairs fE VE® A Department of JuL 9 1996 Environmental ProtectionISO' 1 William F.Weld � Governor Tr �I `f�e Argeo Paul Cellucci I hs U.Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 031 ` PART A _ CERTIFICATION Property Addre—75 Tanbark Rd . ��/� Address of Owner. Same Date of Inspection: 7/1/9 6 (If different) Name of Inspector. Allan Taylor Company Name,Address and Telephone Number. Taylor Associates 75 Governors Way CERTIFICATION STATEMENT Barnstable,Mass . 02630 508-362-3498 I certify that I 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 sewage disposal systems. The system: y Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: "r Date: 7 // 94�_ 1 The System Inspector shall submit a copy of this ins ion report to the Approving Authority 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 the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: , —3E I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES:---- One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair, passes inspection. Indicate yes,no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If"n ot determined", explain why not) The septic tank is metal, 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 Fonforming septic tank as approved by the Board of Health. (revised 11/03/95) I One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-SSW ii Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART A CERTIFICATION (continued) Property Address: Owner- Date of Inspection: B] SYSTEM CONDITIONALLY PASSES (continued) 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 C1 FURTHER EVALUATION 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 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 a 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and 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. 8) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner. Date of Inspection: DJ SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined 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. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 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. 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. 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. 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. El LARGE SYSTEM FAILS: 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: 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 II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 75 Tanbark Rd . Owner. Brad Campbell Date of Inspection: 7/1/9 6 Check if the following have been done: _y_Pumping information was requested of the owner, occupant, and Board of Health. ,X_None of the system components have been pumped for at least two weeks and 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. X The facility or dwelling was inspected for signs of sewage back-up. g The system does not receive non-sanitary or industrial waste flow X The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. including soil absorption system %V' Lt (Xu a V ?cr _XThe 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 or approximated by non-intrusive methods. The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. e (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner. Date of Inspection: FLOW CONDITIONS RESIDENTIAL• Design flow:_ gallons Number of bedrooms: 3 Number of current residents:_ Garbage grinder(yes or no):�p Laundry connected to system.(yes or no):yp s Seasonal use(yes or no):ne Water meter readings, if available: 1 Q Q ri— 16 ,n f)f1 rf a 1 1 r n s/ 1994 -371 000 gallons Last date of occupancy: COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow:_gallons/day 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 PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)_yp If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM x _ Septic tank/distribution box/soil absorption system e Single cesspool Overflow cesspool Privy Shared system-(yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed(if known) and source of information: c p V p n years Beard f HEALTH COMPLIANCE Sewage odors detected when arriving at the site: (yes or no) n0 (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Tanbark R d . Owner. Brad Campbell Date of Inspection: 7/1/96 SEPTIC TANK: (locate on site plan) Depth below grade:1 w i th n ew r i s e r s Material of construction:Xconcrete it metal_FRP_other(explain) Dimensions: Sludge depth: Distance from the of sludge to bottom of outlet tee or baffler A-1 Q" Scum thickness: Distance from to; of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baffle: 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.) System is in very gnod Chap, mml)i na wa G =rPfnrmL-d Game GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction:_concrete_metal_FRP other(expkdn) 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: 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 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner. Date of Inspection: TIGHT OR HOLDING TANK_ (locate on site plan) Depth below grade: Material of construction: _concrete_metal_FRP_other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert: ppi Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box, etc.) P Be* is in- very geed shape , He sign ef selid earrever- er- leakaffep l eye-1 i s fine PUMP CHAMBER:_ (locate on site plan) ;. Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) F , (revised 11/03/95) 7 0.. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 75 Tanbark RD. ,Marstons Mills ,Mass . Owner. Rr Date of InspA7����/d Campbell SOIL ABS013PTION SYSTEM (SAS): (locate on site plan, if possible;excavation not required, but may be approximated by non-intrusive methods) located in very good shape If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) xv xxa varcx Cvv CESSPOOLS:_ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth 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 11/03/95) g SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Tanbark Rd . ,Marstons Mills ,Mass . Owner. Brad Campbell Date of Inspection: 7/1/96 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' Rtse7j�:01 �z"Dower 'Tv4�a�t., LA a, L)K\ Z%Z% i3Su1 t� G2Fr4-`1r O po C—R DEPTH TO GROUNDWATER Depth'to groundwater: JT f— feet method of determination or approximation: — OIA� T€S� f rD2ll g' (revised 11/03/95) 9 7-�'TOWN OF BARNS'rABLE �L"CATION A+�� dQ.X SEWAGE VILLAGE ArS+,NO5 i �IS ASSESSOR'S MAP & LOTA :: � I. INSTALLER'S NAME & PHONE 2NO.,..I.���Z�i�j'�'�I� �I"I I -�S�O� ©SEPTIC TANK CAPACITY kjo0 LEACHING FACILITY:(type)� (size) 1 NO. OF BEDROOMS_PRIVATE WELL OAR UBLIC WATE BUILDER OR OWNERiL+rs't ) DATE PERMIT ISSUED:. y.. DATE COUPLIA.NCE ISSUED: VARIANCE GRANTED: Yes No �► of �I 3^ I `ti, No.---- .... FEB;....26.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD--�OF HEATH o ,f l AkAI:5 ah ( C •----..-.. ....................................OF.................................................... ...... ApplirFation for Biopoii al igor Towitrurtion tirrutit Applicatio is herehy made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .�F?s .., � /�/ �,o,✓BAA��t Zan-- l�c_5 -------------------------------- -- ;t F r3 iz f tin dress , rLoddrzP - Fd;c 5-1(0 �o ------------ ------------•------- -------- Owner Address W ✓ , f. )/r t S C...... 511ti •-•-------•----•--•....................•--- Installer Address Type of Building Size Lou-f......................Sq. feet U Dwelling—No. of Bedrooms__________________3_______________________Expansion Attic ( y) Garbage Grinder (A) W04 Other—T e of Building No. of ersons____________________________ Showers YP g -•-••-•-•--------•---------• P ( ) — Cafeteria ( ) dOther fixtures ----------•-------------------------------------------••-••---------------••••---.._...-..••••-•--••••••------•••------------•-•-••••----•----------- wDesign Flow.............._-`_.-_S.....................:_gallons per person per day. Total daily flow.........3_3()..................._....gallons. 1:4 Septic Tank—Liquid capacitylQ.06_gallons Length................ Width................ Diameter________________ Depth................ xDisposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area..........._........sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin tank (/) // '-' Percolation Test Results Performed b LEY_ G!�.6At�lr:c_!_w-�!� __._._____ Date__.__'_f _30 a Y 1 r f minutes per inch Depth of Test Pit____ _ `} Depth to ground wate ................. Test Pit No. i a`� a - N fXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-_____________________- 9 •-•••--•••••------•---------••---••-••--- -•------ ------------------•---......................................................... O Description of Soil.___� _"� ___________�_ ^' _.__._�!`y �JFg�� x w VNature of Repairs or Alterations—Answer when applicable............................................................................................... ------ ••-------- ••------------------------------------- ------------------------------------------------- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T' ; , p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issued b he o rd of health. Signed. ( `'. ����•�•-_�------------------- �/ � ce•t Application Approved By............... --- ..-•---• e Date Application Disapproved for the following reasons----------------•----------------•----------------------•-----------------------•----•-•-•-••••-•--•-•••-------•- .....-•--•-•------------------------------••-•----•-••••-•---------•-------••-••-------•----------••--------•-•••-•--••-----••••-•-•------------•-•••-••-•-•----•-------••-----•-•------•---•-••-------- ,Q Date PermitNo.-------U - 7--------------------------- Issued....................................................... No....ill'., :_-71— Fss.....2 _a............_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1 ..... ........ oF..............................:.......................................................... Appliration for Disvviial Wor 6 Tontitrnrtinn Ilrrmtit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 1 , / t? t' Location- ddress -� or No. Owner Address Installer Address UType of Building Size Lot&2' 0?A1....._..___Sq. feet .-1 Dwelling—No. of Bedrooms............................................Expansion Attic (Y) Garbage Grinder (�) Other—Type of Building No. of ersons............................ Showers a YP g --------•----------•-------- P ( ) — Cafeteria ( ) d Other fixtures .---••-....--•• ------•--•-•-•--••------. w ... .......................gallons per perso n Design Flow.............. n per day. Total daily flow.......... . Q------ .-----•--------....gallons. fYi Septic Tank—Liquid capacityl ObO..gallons Length................ Width................ Diameter................ Depth....._.......... Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area___--__----_------sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box-( ') Dosing tank `-' Percolation Test Results Performed .................................................. Date..... ............ minutes per inch Depth of Test Pit _ Depth to ground water_ _______________ Test Pit No. I........... _ /d__ 4 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water-_.--_______---__.-___-. Description of Soil---•-I... ...........f --•-----------------------------------------•----- x U w ----------------------------------------------------------.............................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --••----•••••-••--••-••--•-••••--•-•----•••-•••--•--•-••-••-•-•-••-•----•---••-----------------•-•-•------•-•--•••---•---•-----••----••••-••--------•-•-...•------•---••---•-••------•••----•...._.-- Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with T�•l-•-� the provisions of �!•1 T:L� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by he board of health. , r w Signed ` try "°` __ J .3f tl ....-----•---••---- �F `� . • Jg -..... °Date A lication Approved B ..s =, = . PP PP Y ---------------- Us" `t Date Application Disapproved for the following reasons----- ------------•---------------------------------- ........................................................... ........----•-•------•---...----•-•---••.............••-----...---•-•-•--------•------......•-----..................••-•--•-••-••-----•-•------•---•-•-•••--•--•----••---••••-••--•----••-•-•--•--•------ Date PermitNo........ ---------= 5------------------------------ Issued-------------------------------------------------------- DS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........A..u. ..................OF........ ......rS�.... C Trrfifiratr of Gautplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } b ........... c )C a.t t = •..................•--•--••--......---._ ...=.............------------------------------...............--------------..................----------------------------- t Installer at---------- �.------ ... `r A'J •-------------------------------------------------------------------- has been installed in accordance with the provisions of TIT<E- 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......... .. ................ dated___..-----................_..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................... ............................. Inspector........7 =- - THE COMMONWEALTH OF MASSACHUSETTS BOARD�yOF HEALTH f ....OF..---.!•:••.'.'r rr> C. .' ................ ` FEE---•, Aj nr`�� �nn��ruan rrmi� Permission t ereby granted :: __....._. - .. C to Construct (`: ) "or Repair ( ) an Individual Sewage Disposal System at No. t c+r a!j bra�✓rs t< R 0/3O) A4'rs& .1.0fv 1 14.41 t t j ....................---....................-• -•-----• •••-----•-•-•-•-•-........----•-••--•-••-••-•---••--•••--•----•............. Street as shown on the application for Disposal Works Construction Permit No ��:----rj--_--•-_ Dated__________________________________________ -•--•-------------••------------- ' _Z ............................................ Board of Health DATE.. ->� FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS SNEET 7A OF 7 •L R O•ll rrnommea PLm - -_ N1 11L 1O'A•7 rr 3 ANr r�O ••r1 r wr •a i olretr MARSTONS MILLS ;�qa ® s ri I A 1 ® DE9fi1 CALCULATIONS: MUM Or tmloels is ls>��iw p11H R f t0►U P•t t'R L00AOON MAP �� ra 111a 1/►1w rt �om i11s0i 1�ti rt t b 81�10 WR xeMlan�) sit�o .ter�r r tA111• AC*14 UK or um Mat ■m UACN M AURA NEOLMO30M ML =ARA j_b.OR/ir. r-T tdOM awAaTy(< n,m .w m--N. ow !! M �KIA1M0010(CAPAW" � y SOX : ® _ I. ALL 000OM01!00 OL10MLf OWL 001/OW TO#t6L 1111E 0 AM•K 101.1 OF ►M+ MAO AM IlollAwole FM•R YOOAOt ellOWL Or MUL 1000 GALLON SEPTIC TANK L r I r I r I 3 O�ilw� ar 01Ax OWL N w0101i 10 Inc sYSTFIL PROFILF w I ` am swL i1u1►A uiu¢TO mw a w saw • AtL 001OOIIONI!OI•Q smu"sma OWL R cowu Am w emu BOTTOM Of TEST HOLE 01 t•IstAMemo N-m IOtONO 10rtL•0•[r AR usa a OM m R.Or 0t010 01 Praoa ANA& 116-29 1161111111111111111111111111 LEAOINO PIT eANNe w aao boat w tfw11 m rc or or#=a A MOt1Q1MAL AM IOtX:At OONOOL=LEW.Oe�R j e MOO Ptv 11010o0X AtlZAMO PLAN 1316-10 t LOT N0. ELEVATIONS LEGEND: Pow,ww t131.im m aEV. 106 107 108 109 110 111 112 1131I14�i115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 z ` 3 OCA RAM PIT p .O.FOUND. 40 A 76•5 It's 71.0 i.o 1b•0 71p 76.9 1&@ 740�I7s•s 7r.o 77.P 1r.f 6e.e ¢ !!.7 fL• qo �I,f p• - D6o ql,• ?*.f ".0 74•f 7f.f 7fo 74.a IurAo�eMlor�rt �1 Xi.1 74,T 71.e 7yo 71.o IS.o 76.5 y�•f 7f•o 7.60 73.0 7R0 71,5 79. p A ANo ow Oaa01v0•TN evil 8 7b•s its N° 641 K•1 00.0 dJ 716 ?t.oi 7e9 73e 74f 7.•0 -p,s 71;s 77S 1" 10.1 I64 X.0 - '76.o 76o IOU f ll.i 714 7ii Ief 7o.f Ise 76.f 1A4 170.6.741 7i1 7l.1 WA 7i4 &4A ii,s t�s t1.o 14.o 9 11 C Ib.1 I., 03 rf# Iltf i27 &4.1, 7L3 �a., 7r.7 7t,,j 74•2 7!J 71.i 7> "A- ws no 71.0 %'s. - T7.7 77.7 7f.i 14 -TL3 I It.i Ihs 70"u 7P.t 767 7f.1< 7;.c If.i 74 1 6 7fi 1l.Y I 7s.1 71.1 61.1 1 601 oft &f•7 '1►•7 C D 70.0 He cos eu if.lr 1Lf i4o 7Le 1114 TI0.S 7T•.f 74•0 Ie.f 1&# 17,9 77.0 -4.0 "e • 7o.e 70.o 71f 7o 4 is, D7i A71 . Y . E i!•1 c6.6 0.5 110.4 66A 05 &&* ho !713 73s 79.3 7&9 I1.3 If•6 R.6 11.6 7f1 77.s 7f3 Ts.# - 7L1.) 77.3 Af A 1 7s.I bA 7&% 7e.1 61.6 b,4,f 1 11.4 n.# 7f, 14.1 74.s 7f.S 7t.1 11.6 },♦ 60.0 if.6 64.0 Y1•) An E F Ht1 60.6 cf.1 13.1. cfs iat 14.6 7•.c y7Ll 7t.1 7•.I. 7l,1 7f.1, 7L.1, 7hr 7117 771 77.1 T<L+ - 77.1 711 In _14& 7i.1, 10.1 71.1 10.1 c4.i 6" 71.E 7t.i 73.1 T4.7 74.1 . 7i.1 4/, a, K.6 6" 99.1 7bi F G 14.5 i6.f 1f.0 MO if,1 c7.I i/•f •1N.Sp ITtJ +t•o 7f•S 7f.e 7f,f 7as 71.'J 7ES 7Z0 77.0' 71.• 7f.f - I7•o 746 7i.f 7•f st.o 7o.s i1•S H.S ll.o .0 mis 7,4• 7s.• 7•A 11.0 1e•0 ►6,s 6s. 7t.f H.5 1f o 7.0 G H 1f.f i=,S 01•0 67.e 91•0 1110 14•9 640� 1• Ii"m 16,0 17.5 No 14.9 7••f 70. 71.f 'N•0 -x.o 64•5 - 71.0 71.0 of.f (+•f trA•f K.o e10 1,s.4 1,3f is,. e1•5 cao i6.f N.o 7.e r.•.o if.i o4.5 Ys•f 54f JiJi K.o 1.4o H IJ I APPROVED: BOARD OF HEALTH J s1f ff•s fs•o 00.0 1�o f+0 "A 1,#!PP i(d.o, ►z.e Me Y!•S es.• ef.5 15.0 66.0 675 c7o ei• e4s - c7a K•5 iLs cl.f 60.0 Aa.• a•s sf•r f4S ih0 1t.6 a#• o4f 14.0 1.3e Yl.o W ! io•s fbf 444 1.0 vo.0 I co.o K 7t6 %6 7r.o coo µo 7i.o •/1•0 71.31 7S•Y� 'A 0 If.1 I1•o 77.f 14.0 74•S 49 M.• eo #•.• 7q.5 • 711,61144 •.,t AO11 - Sao !� .f 76.3 7#f 74•a 76.e 7s.0 7#! If•b 7f.• 7i.11 I 7ti.i 77.0 10:b 74.6 ?A3 733 11-01m.0 1b.0 7!.• 1M.9 K. L 714 71-s 1qo Ise f•f N•e 70.1 76•I #il,7" 7te 7b.f 77.0 76.9 7Me 74.0 740 M 74.1. 71.0 - Its 71.6 71.• R,r 76.9 71 f 7f! h b 7f•e T!f 7L7 0 7se x• 7f.S 7Af 74o 76.e 1be 7e.o 7tf 7f.f L M 7e.0 71•o i7 Up 5 Me 7 , 1. 71. If. 6f 10 $r .0 7 ss 71.f l.f1f 740 79•9 7}0 74.f NAL7 o t 7f•1 744ZLE76•0 71P, o4•f Ito 12.5 M N 1l.0 7Le i7.r 1fA. N.e )D,o lie 7ja l 7f J 74 3[149 If.e 7e b 71.g Top 76 0 74 4 714- �•e 7Eo _ 769 770 71.0 71.0 7y.0 7l.S 79-f I" 7r•f 74.E 16.0 A..f '►s•S 743 75.e 7;.0 7wfP o4eN.o 7bS 1t.s N 1 12 INITIAL ISSUE UCT NO.I DATE I DESCRIPTION I BY PERC TEST 1 PERC TEST 2 PERC LEST 3 PiRC TEST 4 PERC TEST S A D SEPTIC SYSTEM DESIGN LOT lie LOT 125 LOT 131 LOT 149 LOT 146 MARSTONS MILLS WOODLANDS •AWALi Oa•.anaL •A1t.��•.r Aug nr •r �_�q r .. Me NABMP•1.4'O r M1t AAA•is 1• •tt 1•Ir lMi w loomrAANI er w+1n• •iIOL Orf BARNSTABLE, MASSACHUSETTS :e a t111t a e# �•Al•r+.1�` 1100DLANDS ASSOCIATES REALTY TRUST t11e•pis 11•P N.•e0 w•t•1 111A�YO w+mi r•�V•n•1•f IMAM an MO waa rl r1e�N t� a1e wt•rl 11+t•1�a •� M SCALE 1 s0e a 40' JOB N0. 133e� INEA1r a or yi,� r•aM rs rO rp r� 'o+�t PAUC MO^®01'+-� MOfI®a+'JT� RA1 ROr n 1m °Aw 6��iv La wII s OW tOT�O 0 �0 0O ^' t :•�0 ,� PaoOLA•OM MTL S�1OL/•1CM POm01A1NM aATt St-IN/MON PQ10o<A7f01 AATL AA--WL Ma PDIo0AlI0N OAA f1�rL�01 rgORA/f011ryMA SLIOL/a01 •X •�f PERCOLATION SOIL TESTS LM MOM a 1i4GlI0t ASS012ib INC. sea TILST Mm 3Txw ca"mtvwz I" os�z i ots rrrol,l,l�. SHEET 7 OF 7 i MARSTONS MILLS LOT 130 i LOT 129 mum s LOCATION MAP ono f \ 7►.6 „ '� L�::t .� � v LOT 31 �� \ as>1 ►— lOT 137 1< Mw s'�� .'' 14o, 4 p ♦ tan"s LOT 12 b 4� LOT 106 ' 11 b h `` w� ! bob , — �ti` /- �_, l ♦ j �`M �' rM .o°d s> 1 I \`�� LOT 126 ` L01V2S L07 123`� I r�i I h ' �� /1. kr ( / �h R L_ � we w 4.4 ,A 1 i I �' LOT 13 d j �� IAA ) faar \ -'\100/o s i - \ � LOT 149 w */ " i LOT 136 !o•46 4 _; LOT 134/ Tsai 1 1 y. -1 �� �- I LOT 12z 1 I 4 I&M t LLa Y j - \� J LOT 121 t►� .. I ly '•� M w' \tad° 1400 LOT 107 LOT ? i' ab M \ - - d>a` f&OT 147'/ tl \\ ♦o�� o: . '! �4,4 -� 'LOT 141 \\ '�\� ,ram pA�•� +aaao s " �S. SS 1 > 4.OT}lbl •+ 'T A, LOT 120 LOT 117 LOT '�, `` X tia rofae sr "+� ` „ao � o LOt 44' \ 'LI "�' �'' 9t• ��%'� brio ad �r P 4 ►o1s ' `� �.. 1.'b" 60"T 7A oc7 rolC so,1- ✓try ANo '- LOT 115 •ia -N�RLv1•IIT.1.1 -moo. RCSJa°7c. ►�l9�i45 '`� ` �`'+i 10.00 V o $ 4 s.isf .ogfte T 7A or 7 hit Ra/i RAW / 1 I LOT 146 - AOAa of 1- •76• 1 LOT 106 a A' 1uS�pr' -!/ 6 Y�%• \.6 t' o.# \ 1a 1 i 1 I LOT 116 \ TA \. '� tom' LOT 11b 10 �,,. �`.a waae ar 101 LOT 11 tda �{- LOk 114 '�• LOT 11i loam w i .. laaee aR 11, a :� _ la s •a o,r..+.e -4 Rskc E xaM1lo.�s �p 1tiA 1 1 3 11 29 88 FlNAL BLDG. AND SEFnC LOCATIONSPAL _ ,I.o f� \\ RQ oP p•o ' 2 ELK N0. 10DATE 8 DESIPn a1 BUILDING LOCATION PLAN tiws 11Vei '' I MARSTONS MILLS WOODLANDS LOT 110 BARNSTABLE,' MASS CHUSETTS �\ LOT 109 11,M0 v I IWOODLANDS ASSOCIATES US `\\ SCALE: 1 : 50' JOB NO. 1338 o° o ao 100 `'^U% ` IBVY, EID=1 TAGNO 00CIA INC Lmmmm � Loom aso writ Jim gTJ=r CZ"=V= MA On32