HomeMy WebLinkAbout0161 KETTLEHOLE ROAD - Health 161 Kettlehole Road
W. Barnstable
109 059
TOWN OF BARNSTABLE
J °
LOCATION�GjI n�� �� /)0>OC SEWAGE #
VILLAGE&)eg L �� o� A SESSOR'S MAP & LOT 10 " ns 1
�j
INSTALLER'S NAME PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) !� '�$ �� ) (size) �Qoo 60As,
NO. OF BEDROOMS PRIVATE WELL OR PI BLIC WATER
BUILDER OR O NER
DATE PERMIT ISSUED: / 3D
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No -
LAIC ° �
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4l I��
\. TOWN OF BARNSTABLE !�
i
LOCATION 161 ICc�l U \ko (G "r SEWAGE &O5K
VILLAGE CIS /a-dJ G= ASSESSOR'S MAP & LOT� 6? ' SS9
INSTALLER'S NAME&PHONE NOO. V-6 b c
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) StJO (size)
` NO.OF BEDROOMS
BUILDER OWNER
PERMITDATE: �6—� y COMPLIANCE DATE: yT
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
Sc
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THE COMMONWEALTH OF MASSACHUSETTSEntered in computer: L
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipprication for Zizpaal 6potem Cou!5truction Permit
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System El Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No. 3 6 2—6 7 9 3
16 sorsl�IP cal Hole Rd, W. Barnstable Christopher Sinn
109-59 161 Kettle Hole Rd, W. Barnstable
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4
Wm E Robinson Sr Septic Eco—Tech
PO Box 1089 Centerville 43 Triangle Cir, Sandwich
Type of Building:
Dwelling No.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder(no)
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) Install Title 5 leach system
to plans of Eco—Tech, #ETE-1710.
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 be_. ' ue y thi B d He
Si ned 2M Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued hQ.
,No. Fee 1 0 0.0
0 # THE COMMONWEALTH OF MASSACHUSETTS
�u Entered in wmputer:
!PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS es
f 4
ZIpprication for Mi pogal, *pgtem Con.5truction Permit
Application for a"Permit to Construct( . )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No. 3 6 2—6 7 9 3
161 snWe1 Hole Rd, W. Barnstable "'Christopher Sinn
Assessor's ap arce 161 Kettle Hole Rd, W. Barnslible ,
109-59
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4
Wm E Robinson Sr Septic � 43oTrian le Cir, Sandwich
PO Box 1089, Centerville 9 ,
Type of Building: ,
Dwelling No.of Bedrooms 5, 'Lot Size sq.ft. Garbage Grinder(no)
Other Type of Building) I �n No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title �• f
r
Size of Septic Tank Type of S.A.S.
Description of Soil 4
r
(
j Nature of Repairs or Alterations(Answer when applicable) Install Title 5 leach system
to plans of Eco-Tech, #ETE-1710.
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 bee._ issue y this B d KHe .
Sig Date
Application Approved by Date sRE h 6 q
Application Disapproved for the following reasons
Permit No. 44 / Date Issued G.
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
Sinn �
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( X )Upgraded( )
Abandoned( )by Wm E Robinson Sr Septic Service
at 161 Kettle Hole Road, W. Barnstable has been con-ii-ed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. �Ut)�('`� i dated 1 1,Id L.
Installer Designer
The issuance of this pe t shall not be construed as a guarantee that the system will�function yrs dessigned.
Date O I a�! �J"I Inspector AIA..1
C...�`�� Lr --�-� � ------------------. -------Fe0 e 1 0-Qa _
No. i
Sinn THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS
1=ig;poga1 bpztem Con!6truction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 161 Kettle Hole Road. W. Barnstable
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 conditi(ns
Provided:Construction must be completed within three years of the date of this permit.
Date: Approved by
Town of Barnstable
Regulatory Services
Thomas F. Geiler, Director
BARNSTABLE,
MAC.039. Public Health Division
ArEO'A°�� Thomas McKean, Director
200 Main Street,Hyannis,NIA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date:
Designer: Eco-Tech Installer: Wm E Robinson Sr
Address: 43 Triangle Cir Address: PO Box 1089
Sandwich Centerville
On Wm E Robinson Sr Sept iwas issued a permit to install a
(date) (installer)
septic system at 161 Kettle Hole Rd, W. Barnstaled on a design drawn by
(address)
Eco-Tech dated 07-28-04
(designer)
I 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.
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-built by designer to follow.
OF
/3 DAVIDMP
yGN
0
sta 's-S•rg tur-e)_- I C0uG4NC
9 r. 1093 c"
P
n s- agNIT AP��
q� (,
(Designer's Signature) (Affix Designer'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.
Q: Health/Septic/Designer Certification Form
TOWN OF BARNSTABLE
LOCATION 161 Ice=#/1 y \Ao SEWAGE kko,% �� I
VILLAGE C/3, ra,C YU cJ 0,dJ 1 C- ASSESSOR'S MAP & LOT i ! g ' S`9
INSTALLER'S NAME&PHONE NO. %ZQ b c u G�•Sc—'P1<'� ��S ' }�`�
SEPTIC TANK CAPACITY. ` Se
LEACHING FACILITY: (type) (size) 3 k 71� Sr
NO.OF BEDROOMS
BUII.DER OWNER S t
PERMTTDATE: `Jd—0 5K COMPLIANCE DATE: a y`
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
3
Y t
1 t
No. _ -... h FEE_.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
rA via ice:
t
k Applirtttion -fur Digpuuttl Works Towstrurtiun 1jrrutit °
Application is hereby made for a Permit to Construct ( ' ) or'Repair (' )'an Individual Sewage Disposal
System at
Location_Address or'Lot No.
VA.104,a
O ne Address
W K » C7 d ..
.] --------•-•. .......... ' _
............. -••--••--...
q Installer �� + f+ .. Address
Q Type of Building / Size Lot.......... .... .i?....Sq. feet
U Dwelling—No.-of Bedrooms.............................. ...........Expansion Attic ( ) Garbage Grinder ( )
per, Other—Type of Building �_��__--_ No. of person -------------- Showers — Cafeteria
- P' ( ) ( )
Q' .Otherrtixtures .
Q -------------------------
W Design Flow..__-_�'''...............•-__-- ......g♦llons per person per day. "Total daily flow.................................; -.-... gallon,.
' Septic T:utk—Liquid capacity.....°���...Mllons Length --------------- Wicltlt._.... . Dirtmeter__--_... .__._ Depths .. . . ..
xDisposal Trench—No- -------------------- Width--------------...... Tootal,Length.............____. . Total leaching area. .-;--.-..------sq. ft
Seepage Pit No.......�''..___.__ Diameter..___._ "�.__.._.._ Depth below inlet_..___..._.__ Total leaching area-_ __ stl. 1t.
z Other Distribution box ( ) Dos• a tank
Percolation Test Results Performed by "'a -9 . �°
Date ----------------
--------------------
TestR;
Pit No. 1--_--.-7�#_._-_minutes per inch Depth of Test Pit.....9-^_a._.__.. Depth to ground water ................
tz;- Test Pit No. 2--------7-...minutes per inch Depth of 'lest Pit_....�1"___.___- Depth to ground water.....
I --- -----•-- -- -
Description of Soil •�_ '`? Ttd �.. Gae�� ca�,ta„aix"� cJt�s t. � wh
......................•----- __-•-•--•-•--------•-__------___._ -----._.....___.._.. ......__.....................
.--.- -----------------------
U_ -•-----•...----••••--•-----••------------•--•••-•-•••-------------••---•-••----••••------•-••-•-----------•---•---••------------•-••---•••------•--•---••----------------•-_-----•-----------------
UW ._......__. ..............................•--' . . -----•---------••-••-------------------._._ .-..-...--_------.._..._-__-------••---__._. ....._'. .. �-•- --_-_
Nature of Repairs or Alterations—Answer when applicable .-----_-- . .. ......._.................. .. ..........::' A��N��.
- - ^"�qs' ,
------- ------------•---....---•----------------------------------- ------- ------- -----------••-. --- ------------•--- D���
Agreement: ' MARTENS
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys e@r in adcince
the provisions of Article \I of the State Sanitary Code— The undersigned f -rther agr s o ice the s y 'tI '
' operation until a.Certificate of Compliance has ben?. s,,ed b the o'a,
-� JALE�
r
Application Approved By.....` .._ ./� - ------ ----------------------------------------
Date
Application Disapproved for the following reasons:...................................................................... .........................................
---------•-•••-•----• •. ----------------------------------------------------------------
r'1i ♦r�tC t:F Date
PermitNo.................. = -------` :: 'A04 'Issued.......................................................-
.�...r„�•.,.�.._ Date
THE COMMONWEALTH OF MASSACHUSETTS'
0 / Q DONALD J `
BOARD O HEALTH f MARTENS
o�-0 9 65 4
.........OF:..:..... ... ....G�.�.. ..'......"... y
�Prtifirnte of fgumpliaure �ss0/sT"G����
* ONALEN�i
T 1 IS 0 RTIFY h « `h _a n '. ual ewa e D• os 1�" stem n ed or Re 1LY-
ed-
e / ...... A...........
at-------
has been installed in accordance with the provisions of : 1I of ie State Sanitar s,de v de,a r•1 ed in the
application for Disposal Works Construction Permit :�o.___. �� G �^ ,:.�.dated"'" �_��....�
THE.ISSUANCE OF THIS. CERTIFICATE SHALL NOT BE CON RUED:AS A GUA►RANZEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.... /.................... .................... .....••--•------------._. Inspector:--------; -------------- `--------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALT OF
7L . ......OF..:.... .......... .......... . . ..................... i ti
No.. ••-•••-1-.._.--v--• �� i o �J€DVS-----',
Bi-spoli ' 11 �utt�t n teIr�ftt 11565
Permission ' ereb ranted -; /,C.
to Constuct or Repair an/Individ.ua} S e s sal tem)�� IfniL
at Noll - ------ ..j....... -- ---......--1 6`. .---1 = "=--_ ...` L ..
Street
as shown on the application for Disposal Works Construction Per o..._._ tkecl_..___....- ___________________
�r
��� . . ,
� LArird of health �
DATE. --•_.._ .....•... ._...... . •--••--------•--- .....•-•--•••-•
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IL.DMFoeaal:b Tb'YMtD RRva'f', t,�bC5 � QJG.4Q,,, � � � �
} 'S'A mtp 0.01cwt clov ma w s o 1% To Cl L'iW A
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A. IlAi OF
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DONALD I d t id •�H, ,7
vA
MARTENS
� e .t-� �:;;�,,,,.«.r.,� Jr'xe''w. ♦a ��tur�. i.J}'.
ti �. ., k�"'L.+.w...l,ir'L,^.�.+• ^"i+,.:.w.�wrdr-4a.;..+ y L►J'.. - •..-.•+.,.���-.-.�-�v''x .2 S ^.w,:+.. ,&N Sri..cw ,�a.o+a:
G a —c —No........���-- Fps....�!�...........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
U(?f��Fnt.............OF.....+lC.�. ..,....................---..........._..........................
Applira#ion for Disposal Works Tongtrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal
System at:
.... ...._- ....-- ..............•-•--•---............... .............................. ..................................................................
BS Locati Add ess or t No.
- --------- ------``-- .�......._. d��o��7 lO�r ...................�°r.��...............
�-•� L.�i..:......
---------
wner Address
r�
4 1;' M- ---- - taller Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms._......................................Expansion Attic ( ) Garbage Grinder
Other—T e of Building .............. No. of ersons............................ Showers
a YP g -------------• ---.P.......- -- ( ) — Cafeteria ( )
dOther fixtures .--•-••--•-•---•----------••------••-•---• ----•--•-....--•----•----•----•--•-'--••-------•----•..................................
W Design Flow............. -�........................gallons per person per day. Total daily flow................. ®_..............gallons.
Gd Septic Tank--L Liquid capacity.L.3-:—�allons Length................ Width................ Diameter................. Depth................
Disposal Trench—No. ..................%'Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No._-_v�------------ Diameter..?�........... Depth belo 4 inlet........ Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) ,
aPercolation Test Results Performed bY.......................................................................... Date........................................
� T Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water................. __.
ls, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------ ........... .
.-.... •�....... ..Y.................... ..... ....._ .
O Description of Soil..........40.."....�.._ �` 9e�` p�
V ..............•----••-••-•---•-•--------._............•-•------•-•--------•----•----............----•-'•--------•-----........----••--•••---'-•-•---•-••----._....=
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 TIT E 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 the board of health.
Signe •--r ..... ........•--•----------•--•---""•'-'--------...........-•--'---_._. ................................
6_ Date
Application Approved BY ------------------------ ±ff.-�L _��
Date
Application Disapproved for the following reasons:...............................................................................................................
-'..............................................•-•----------•-•----.......------•-'-........-----.....--
Date
PermitNo......................................................... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF', HEALTH
......... ............O F.........�,� ................................
' rrlifir r of Bunt li�anr�e
THT' S TO CERTIFY t the I : ual Sewage Disposal System constructed (�r Repaired ( )
by �17 - .---- -----•---' - - ----- . .... .......... ... .
yInT% c�.. ---- -----•--'---•----------•--
has been installed in accordance with the provisions of T ` of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No...� ._.. _7s.............. dated.__./,-: f, �P __...............
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
�1'- . `- ,. Fes$.. "�'r�� t
No.....•-•.. ............ --•••..-...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ .- 'V..............................................................
. Appliration for B44posal Works Touptrurtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal
System at:
' a� rat ------•--•---_... :..--------•-----•--•----------------------------------•--
s Lo- Add ess or t No
.:_ ._.....:... R...... ' .... [? ' _ _7`. 1................ ± ? 3_______ ..0 ...Al1�"
e_tpwner Address
a xt >a, '�" � :... �`! t:................. -- ____ -------------
•------------------------------------
_----------
_...
I taller y Address
Type of Building Size Lot____________________________Sq. feet
U Dwelling--No. of Bedrooms_____ ________________________ _Expansion Attic ( ) Garbage Grinder (
Other—Type of Building No. of persons____________________________ Showers — Cafeteria
Otherfixtures ----- ==.............................................................................................................
W Design Flow........., , ...........________----gallons per person per day. Total daily flow................_'. ..............gallons.
WSeptic Tank--1 Liquid capacitya.__�_�_cllons Length................ Width................ Diameter.....:,......... Depth................ "
x Disposal Trench=. o...................2'Width.................... Total Length.................... Total leaching'area....................sq. ft.
Seepage Pit No____ ____________ Diameter.__ .-._._..__. Depth below inlet........ '. Total leaching area.._...............sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
a Percolation Test Results Performed by.......................•.............._-------_•-•---------------------..__ Date......................................
,.._-.
,.� Test Pit No. 1................minutes per inch Depth of Test Pit----_............... Depth to ground water-------___________:-__.
f% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0 � f ._ .............................* � -- ...............----------------
Description of Soil------- - ------•-•--------- '`� q� :_...-- "`� /?. -- A ..........
W
c.� --•--•-•------------•-•-------••---•-•--•----------•--•----•------••-•-----------•------------------------------•--------------------------•------------•-----__-________-------------------------------
W
U Nature of Repairs or Alterations—Answer when applicable.....................................
..........................................................
•----------------------------------------••-----...----•--•----------------•--.._..........---------------•--•----•-=---=--------•----------------------=-------------------------------...........----
Agreement:
The undersigned agrees to installolifie aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TILT I E 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 the board of health..
Slgney .. .............•-------••------...__....---------------- __
Date
Application Approved BY 4A'_- ;r ..........
Date
Application Disapproved for the following reasons_________________________________________________________________________________________ ___________________...
.................•--...._....._._....---_.._..__._....-----•-•-----------•.....------•--••••------....-•--------------------------------------------------------------•-------------•---------
Date
PermitNo......................................................... Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........K. .........:..OF......... . -' ........."".................................
Ter#ifir tr of Toutplittnrr
TH , . S TO CERTIFY at. he dual Sewage Disposal System constructed ( ) or Repaired ( )
by - 2 - .._.... ....... - ....................................
e ---
-t Insta ler
has been installed in accordance with the provisions of T ` of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No;_ dated-... R� ,. '
THE.ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEWI` WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector_-..................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OX HEALTH
,� :......OF.......... . � ........ ................................. J-
No.......�75........ FEE..................... .
trr nrkg TI trnrt' Permit
Permission is hereby granted... -- "� . �'l 9 + ` ....---•4-----•...........................................................
to.Con tr ( Repair ( ) a l'I dividual Sew Sy
�� �_at=No.. _ d l l- as , f/fr' �!!'!
Street
ass own on the application for Disposal Work Construction Per No ____ Dated___ 10 _(d --
__.�044r---r---------------------------—
Board of Health
DATE.............
{{ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
VICTOR OLIVEIRA, R.S.,C.H.O. 1498 HIGH S3REET.'r
BRIDGEWATe*R,MASS.02324
OLIVEIRA LABORATORIES
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
CERTIFICATE OF APPROVAL NO.6134
TELEPHONE 697-2650 October
l s. 1978
L.W. Babson Carp,
F.O. Box 753
Sandwi h, Masi., 02563
Source: Well Water - Bored Well with well point
Located on the Babson' Corp. property Kettle dole Road,
West Barnstable, Mass.
Coliform Count
S.P.C./ml. /100 mi. @ 35 C.
@ 35 C. Membrane Filter
5 0
The Standard Plate Count indicated the general bacterial,population of the well at time of collection. very
satisfactory,
Coliform Group Bacteria
The coliform group bacteria includes organisms found in the intestinal tracts of warm blooded animals, birds,
decaying organic matter (hay, leaves, wood, etc.) the top 2 to 3 feet of the soil, lakes, ponds, brooks, rivers,
drainage and types of vegetation. ,
Because the organisms can cause some illness; because the presence of coliform organisms in the water suggests
that other more harmful organisms may be present. Water containing one or more coliform group bacteria per
100 mi. of sample should not be used for drinking or cooking purposes unless boiled for 5 minutes or disinfect-
ed by other means.
On site collection made by Mr Charles Barengo - 1.0/3/78 at 3: 00 P,M.
Sample delivered to ilaboratoxy by Mr. Charles Barengo -- 10/4f78 at
8e 00 A.r,4.
Bacteriologicall t this well water is of a satisfactory sanitary standard
and is suitable for drinking and domestic purposes.
Analyst
1.4`(OuT G=
a 1rW R�AQOON
Aar
ht?*UVA0014 y Avr►t a 0%0 D o 00b P.
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DONALD J.
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t 11365 f` �astLC.� p a jL?� t y :
�'�F
��1�f1At
No.... ~• + 4 r' Fag...........:r..............
/ 2 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TDB Al . . ........ ..O F ... ...`T P1R-�L bT7.M. L. 'r...::..............:...............
! � v
Appliratiun -fur 43hipwiat Workii Tunntrnrtiun Prrniit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
S stem at:
� a
Location•Address or Lot No.
Vv.� 3g $ �4�±[
----- ---- PcM4 .... .C..I....................................................
Address
a ....
Address
Type of Building
Installer O _ ��
Q 1 ai��v«� I Size Lot.-- j- -�o----Sq. feet
U Dwelling—No. of Bedrooms....--4................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Buildin Showers —
a YP g�e.!�!l1�'••------ No. of persons_...-$.-.. ( � Cafeteria ( )
QOther fixtures ...................................................-------------------- ------- .................................. ..................................
W
Design Flow......575..............................gallons per person per day. Total daily flow........-`'�.�-------------------------gallons.
WSeptic T;,nk—Liquid capacity..1160-gallons Length................ Width------------.--- Diameter................ Depth.............. .
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No....... --------- Diameter--------$........ Depth below inlet....6............ Total leaching area---_0.�-----sq. ft.
z Other Distribution box ( ) Dosing tank ( ) x '� /
aPercolation Test Results Performed by D!�1�c4rQ..,�..MtiAr '4 N � ht............... Date. C�\,.�Z�S._..........
Test Pit No. i......le----minutes per inch Depth of Test Pit.....\'l.._........ Depth to ground water----Upwkt.......
�14 Test Pit No. 2........:3.v�...minutes per inch Depth of Test Pit......k1e....... Depth to ground water......K.Q%IF---
I -----------------------•--------.-............-..-------......-.-..-....----------------------------••-------.......-•---.-...---------------..-..----------
Descriptionof Soi13S` .AcX. .T.QP.Sq„__� o�y -Aoa�ASt�... ..�r4 !►N,-i��4N.�. r ----------------
x
Ili U g ------ -------------------
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.........----------------------------------------------- `SH OF
V Nature f P.epalrs or Alterations—Answer when applicable------------------------------.-.._--------- !. . ................. 9E;
---•---••------•.......................................•-----....... :�Q1 DONALD J. - -
g iVIFl}7T EN$ yr :---------
rn
Agreement: I v 11565
The undersigned agrees to install the aforedescribed Individual Sewage Dispo tem in ad ce with
the provisions of Article XI of the State Sanitary Code—The undersigned further agr�sQ ystem in
operation until a Certificate of Compliance h h S N��
p C p e as been ' d b t o h th
S' ned- `
Date
........................APPlication Approved BY•--•- - . --l=
f 7f-'-------------
Date
Application Disapproved for the following reasons:----••-------------•-----------•------•-----•--•--------•-•----•-•-•-------------.-.....---................----•-
......... •--•...........................•-------------------•-------.-•.•••-
Date
PermitNo......................................................... Issued---------------------- ---------------------••-.......--
Date
t
DATE OF TEST: JULY 14. 20104
SOIL TEST LOG IT C OUG H DESIGN " CALCULATIONS
WITNESS REQUI EMENT WAIVED. SOUGHT
NO GROUNDWATER ENCOUNTERED DESIGN FLOW: 5 BEDROOMS X 110 GPD - 550 GPD
TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH
PERC AT 78 in : 2 MIN/INCH IN Cl SOILS SEPTIC TANK: 550 GPD X 2 DAYS - 1100 GALLONS
ELEVATION - 95.23 �-
USE EXISTING 1500 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL
DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER CONDITION. IF NOT INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED)
(INCHES) HORIZON TEXTURE (MUNSELU MOTTLING
DISTRIBUTION BOX: USE 3 OUTLET D-BOX.
0-2 0 WOOD LOAM 10 YR 3/2 NONE FRIABLE
2-73 A LOAMY SAND 10 YR 4/4 NONE FRIABLE SOIL -ABSORBTION SYSTEM: A 41.5 f t x 13 f t x 2 f t LEACHING GALLERY CAN LEACH
7-36 B LOAMY SAND 10 YR 5/6 NONE FRIABLE A 6 o t - ( 41.5 x 13 ) - 539.5 s f
36-116 CI MEDIUM SAND 10 YR 6/4 NONE LOOSE A s d w - ( 41.5 + 41.5 ; 13 13 ) x 2 - 218 s f
116-02 C 2 SILT CLAY 10 YR -5/1 NONE FFH A t o t - 757.5 .5 f
LOAM Vt 0.74 x 757.5 - 560.55 GPD
�� a3 USE A 4115 ft x 13 ft x 2 ft GALLERY. Vt - 560.55 GPD > 550 GPD REQUIRED
NO GROUNDWATER ENCOUNTERED
TEST PIT 3 2AR MIN/INCH NCH IN MATERIAL:
CA SOIL OGLACIAL OUTWASH
ELEVATION - 93.55 �-
(INCPHES) HOR
IZON ZON TEXTURE USDA SO
L SOIL COLOR SOIL M NSELL) MOTTLING OTHER GROUNDWATER LEACHING GALLERY
�3,3 0-6 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE ADJUSTMENT CONSTRUCTION DETAIL
��. 6-34 B LOAMY SAND 10 YR 4/4 NONE FRIABLE EXISTING GROUNDWATER LEVEL
BASED ON BARNSTABLE GIS —H-20 DRYWELL UNIT STONE
34-120 CI MEDIUM SAND 10 YR 6/3 NONE FRIABLE DEPARTMENT RECORDS a'-a'x 4'-10'X 2'-9'
2 fi EFF. DEPTH
INDICATED GW: 20.0 41.5 ft
$3,55 INDEX WELL: SDW-252
ZONE: B
READING: JUNE. 2004 '
LEVEL: 47.3
ADJUSTMENT: 2.1 ft
ADJUSTED GW: 22.1
NOTES - Ll 1 1 -
1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 4 fr 8.5' ,4 fr , 8.5 4 fr , 8.5' ,4 fr ,
2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 415 ft SNOT TO
SCALE
3) ALL. COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS
OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15)
4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES
BEFORE EXCAVATING FOR SYSTEM.
5) EXISTING LEACH PITS TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED
6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE
7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0' BEFORE PITCHING DOWN L SEWAGE DISPOSAL SYSTEM PLAN
8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE+;-INS'T;ALLATION OF LOW FLOW FIXTURES -TO SERVE EXISTING DWELLING
AND APPLIANCES. AND BIANNUAL PUMPING�"OF�TFHE ,'SEPTIC TANK
9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LkOADIN(3. DO NOT CHISTOPHER & TRUDY SINN
PARK OR DRIVE VEHICLES OVER SEPTICtSYSTEM. tv",
3 �,:._- MA
10) INSTALLER TO OBTAIN DISPOSAL WORKS'I'PERMIT BEFORE STARTING WORK. 161 KETTLE HOLE ROAD WEST BARNSTABLE.
S` i' E
11) SEPTIC TANKS SHALL BE INSTALLED LEVELiANDtTRUE' TO GRADE ON A LEVEL ECO-TECH ENVIRONMENTAL
STABLE BASE THAT HAS BEEN MECHANI'CALLYY COMPACTED AND ON TO WHICH
SIX INCHES OF CRUSHED STONE HAS BEEN-,PLED TO MINIMIZE UNEVEN SETTLING
12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED 43 TRIANGLE CIRCLE SANDWICH MA 02563
FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS . BAFFLE.
- ETE-1710 I JULY 28. 2004 2/2
o PLAN REFERENCELL cc CONTOURS ♦�
a PLAN BOOK 301 PAGE 99 EXISTING - - - - - - - 90 N h 3
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11 �o�� -�� SEWAGE DISPOSAL SYSTEM PLAN
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0 0 -1 "� v) � U ` -TO SERVE EXISTING DWELLING
I,, � x O WELL
o ;� wow _ CHISTOPHER & TRUDY SINK
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161 KETTLE HOLE ROAD WEST BARNSTABLE. MA
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O J W X SCAL��: 1 in - 30 ft � 9� s ° 508 364-0894
H o w W NO WFLLS WITHIN 150 FEET `� �'�a TAO% ETE-1710 I JULY 28. 2004 I/2
�OF PROPOSED.LEACI-IING GALLERY 2S THIS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT
BEARS THE STAW AND SIGNATURE OF THE DESIGN ENGINEER .
�- ��q- ORIGINAL PLANS INTENDED FOR SyBMITTAL TO THE BOARD
OF HEALTH WILL BE SIGNED IN
BLUE AND STAtfED N RED.
E.