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TOWN OF BARNSTABLE
LOCATION] SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S.NAME&PHONE NO. t, -
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
OWNER '(�► .�
PERMIT DATE: Lk,` houL COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
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No. ) t Fee J!,
THE COMMONWEALTH OF MASSACHUSETTS Entered in co uteri
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for Mispo8af *pstem Construction Permit
Application for a Permit to Construct( ) Repair(k) Upgrade( ) Abandon( ) ❑Complete System Mlindividual Components
Location Address or Lot No.`l� C�x��C ` Owner's Name,Address,and Tel.No.50t—LA116 �
vvz., 6RGV_ J %x.-
Assessor's Map/Parcel 0 Oxn �- ks't (>I
Installer's Name,Address,and Tel.No. OCkX-1\ Designer's Name,Address,and Tel.N0 .;—EWA
�o�r.Cc,, E �nee,6
Type of Building:
Dwelling No.of Bedrooms Lot Size Jq.ft. Garbage Grinder( ) t�,A
Other Type of Building fewi(�e_cA\c-\ No.of Persons Showers( ) Cafeteria(
Other Fixtures .jh
Design Flow(min.required)` LA O gpd Design flow provided �-'�t )� gpd a
Plan Date I 1 I I Lt 1-Lo--? \ ` Number of sheets -1— Revision Date r
Title\ -\�- �i ' )\(i�� 1� 0AN&<1
Size of Septic Tank `�1�4d� �(�,\�( Type of S.A.S. 3
Description of Soil ,i0� .�,
Nature of Repairs or Alterations(Answer when applicable) Q-_�e. eY.:Sn - wA 7— C_
A: _3�
Date last inspected:
Agreement: 7)
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.
Signe , Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 2 0 D ? Y i b Date Issued
ro� .`._ ...�TF f ''"`ii4'4'�'r•!wvY ��. 1 r f 4 t 1 " ... _. _
_
No. 2�aa> t o-7 Fee h t/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
k PUBLIC HEALTH DIVISION`- TOWN OF BARNSTABLE, MASSACHUSETTS Yes
4plication for bisposal 6pstettt Construction 3pErmit
Application for a Permit to Construct( ) Repair O) Upgrade-( ) Abandon( ) ❑Complete System dindividual Components
r
Location Address or Lot No. Owner's Name,Address,and Tel.No. ,r� 15
Assessor'sMap/Parcel ICe iSi1E' —10 O
Installer's Name;Address,and Tel.No. Designer's
Designer's Name,Address,and Tel._No.
Quti'l1'c1� Gxra,t' N+G� '3. "l�C � �U C-
a� RiS� rx �. a 1 t "i")�i ' 'Y fi 'i t`C�c� �G.c t . fS7f.Z5
_ Type of Building: _ � �d �`t rrF 1'N�" l H�` S�1 ����+ ' � S `�l'•1 ��Jj �..1 y art F'I�
Dwelling No.Fof Bedrooms " C Lot Size sq.ft. Garbage Grinder(
Other Type of Building fie'j t-\p e,�_No.of Persons 6 Showers( ) Cafeteria(
Other Fixtures
�� tt Y r� ,
Design Flow(min.required) `"t("� gpd Design flow provided gpd ��
Plan Date Z �Lt 2(J"L Number of sheets � Revision Date
NAP 1 ' .[.e 1\! f��t'► t�\r 1' ).e_
Size of Septic Tank Gv,��(aC\ Type of S.A.S. y(�( , C:rC ,r(t� ,p+ar C�',(tiCA c'hc_�n 'S
_
Description of Soil( \\ — '�,� � �� '�-� t.` *�"'" ,ea�«-i"Yf. 11'" `C��(�!"1.
rn1c
Nature of Repairs or Alterations(Answer when applicable) (—e
Date last inspected: _ \i
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. j
Signed D toj W) ��
Application Approved by /y 1,, . ( Date (1� C"�•) 2
g r J 1
Application Disapproved by Date
for the following reasons
Permit No. d, 3 t1 Date Issued L/
THE COMMONWEALTH OF MASSACHUSETTS v
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(y) Upgraded( )
Abandoned( )by(I_5st'\i\`y Per f V- �r '5 �r4�r \VIC`
at p_ { X ,� C1 r l e has f has been constructed in accordance /J j,
with the provisions of Title 5 and the for Disposal,System Construction Permit No. 0?) -/h'7 dated q[ a.2
Installer Designer
..tom Yh
#bedrooms LA J Approved design flow \'L4 40 3 gpd
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
----- _------- 4 ------------
No. u? 2 o"6)-7 Fee /UU
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair(fir ) Upgrade( ) Abandon( )
System located atw 1(1 k (`1"a((�)CNp 4 , (r'F���,r
:1
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
-Tilde 5 and the following local provisions or special conditions..
*''Provided:Construction must be completed within three years of the date of this permit. n
Date Approved b `(Ar+ 1 _.
Town of Barnstable
Mg
Inspectional Inspectional Services
1 rAR�..
Public Health Division
Thomas McKean,Director
b 200 Main Street,Hyannis,;MA 02601
Office: 5084624644 Fax 508-790-6304
Installer c& Designer Certification Form.
1
Date. - Sewage Permit# ZSJZZ-�Q Assessor's MapTarcel 1
i
{
Designer: Dow) Copz eng.i ft Installer:
Address: 931 R0 vit U:0 Address:
Ar 0VO F0
pn � was issued a permit to install a
(date) (installer)
septic system at }
C)ix ry f? d c� i I( based on a design.drawn by.
(address)
-D t? i''1
C �. P G PLL lated , -� .a l
�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
S
distribution box andlor septic tank. trip out (if required): was inspected and the soils
were found satisfactory.
f 1 certify that the septic system referenced above was installed with major changes (i.e
fi.
greater.than 10' lateral relocation of the SAS or any:vertical relocation of any component
1 ttf the septic system) but in accordance will...t ate &f,ocal RegulA rons. ;Plan revision or
certified asouilt by`designer to follow. Strip out(if required)was inspected and the soils
.
were found sitisfadoryt
t, 1 certify that the system referenced above was:constrocted i ith the to rms of
.the 1\A approval letters(if a lrcable �,
PA pp } !o�r�i �.
3
No 4650,
(Installer's Signature)
seta,
�NAk.
Affix Desi ner's Siam .Here
(Designer s Signature) ( g p )
PLEASE RETURN TQ BARIVSTABLE I't1BLIC•HEALTH DIVISION. CERTIFICATE
OF Ct3MFLIANCE WILL NOT BE ISSUED UNTIL: BOTH THIS. FORM AND AS
BUILT CARD ARE RECEIVED BV:TRE:BARNSTABLE PUBLIC HEALTH DIVISION
THANK YOU.
ilwaldeptslH9A.LTMEWER.connecMEPTIODesigner Ccriification Form Rev&t4 13:DOC
1
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SYSTEM PROFILE MMAARKED WITHCOPNETIC T SHAOR LL BE VENT W/ CHARCOAL FILTER NOTES �
(NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS NAVD 88
ACCESS COVERS TO WITHIN 6' Of FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 2. MUNICIPAL WATER IS EXISTING o Locus
\ TOP FOUND. EL 73.0' FILTER FABRIC OVER STONE
71.5' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 66.5'-71.0'
3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
•fit PaEcasr H-10 WATERTE$1' D'BOX FOR LEVELNESS BLOCKS ORPRECAST RISERS 4. DESIGN LOADING FOR ALL PROPOSED PRECAST e Ponds per Rd
2isERs (tw.) MIN. 2 TSS
HICK SCH40 PVC MORTAR ALL UNITS TO BE AASHO H-1Q (H-20 LEACHING) CO Ox
PIPES LEVEL 1ST 2' FE
4� COMPONENTS INVERT IN 64.0' o c �7g u�tt
•• }' (1Yp.) 4' 5. PIPE JOINTS TO BE MADE WATERTIGHT. • qjura�_NDS SIDES 65.0'
10-.EXISTING �¢" �, eb�swo o�e _ l.(IIG�
0 0 0 0 00000gog c o
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE
FTEE SEPTIC TANK** TEE *69.84't 0 0 0 0'0 6" MIN SUMP >gogo.. ��e�. ® �® B�. �� WITH 310 CMR 15.00O (TITLE 5.) Z °o
,00000000000 �0000o00 0�000�0�
8 ® o a l n o
GAS BAFFLE. ,�0�0�0�0^0� 12" MIN. TNT. DIM. ;oo,g0000 B 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND o oµ t
0 0 0 ®B®®�® ®� ® E� �0�® �® o0000000 ° e� o o00 0 0
00000000 o000000o i
:.
: 4' LIQ. LEVEL (ACME OR EQUAL).- 65.42 65. o 0 0 0 62.0 NOT TO BE USED FOR LOT LINE STAKING OR ANY o
.:...,.- . ..:. :::..:,...: OTHER PURPOSE.
.0000000QoeoO00000000000000000Q000Q00000000000 L
0 0 0 0 0„0 0 0 0 0 0 0 0 0�0 0„0 0 0 0 0 0. H-20 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL � o
o,o,o_o_._�_o_'� o 0 0 o o _�. _�_�_o.o 0 3/4"-1-1/2' DOUBLE WASHED STONE 4' MIN. (3) UNITS REQUIRED. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. d
ALL AROUND PRECAST STRUCTURES a
L� 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 33.5' X 12.83' j
COMPACTION. (15.221 [21) U) 9. COMPONENTS NOT TO BE BACKFILLED OR %� o �•
CONCEALED WITHOUT INSPECTION BY BOARD OF Do S
HEALTH AND PERMISSION OBTAINED FROM BOARD oc
( 17 r. SLOPE) (12.5 z SLOPE)H-20 LEACHING OF HEALTH. �• �
A' 1
FOUNDATION- EXIST. SEPTIC TANK 26' D' BOX 12' 56.5' BOTTOM TH-1 10. CONTRACTOR SHALL BE RESPONSIBLE FOR
FACILITY NO GROUNDWATER FOUND CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP
**INSTALLER SHALL CONFIRM MINIMUM VERIFYING THE LOCATION OF ALL UNDERGROUND &
*THE INSTALLER SHALL VERIFY THE SEPTIC TANK SIZE AT 1000 GALLONS OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000't
LOCATIONS OF. ALL UTILITIES AND ALL AND ITS SUITABILITY FOR RE-USE. WORK.
BUILDING SEWER OUTLETS AND REPLACE WITH 1500 GALLON SEPTIC 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 193 PARCEL 115
ELEVATIONS PRIOR TO INSTALLING ANY TANK APPROPRIATE TO SITE BE REMOVED BENEATH AND 5' AROUND THE
PORTION OF SEPTIC SYSTEM CONDITIONS IF NOT SUITABLE 71 PROPOSED LEACHING FACILITY. LOCUS IS WITHIN FEMA FLOOD ZONE X
12. EXISTING LEACHING FACILITY SHALL BE PUMPED (AREA OF MINIMAL FLOOD HAZARD) AS
AND REMOVED OR PUMPED AND FILLED WITH CLEAN SHOWN ON COMMUNITY PANEL #25001C0'.561J
VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY �0 Q) SAND.
BE IMMEDIATELY GRANTED BY THE BOARD OF DATED 7/16/2014
HEALTH AGENT OR BY HEALTH INSPECTOR \
LEGEND SITE IS LOCATED WITHIN THE RESOURCE
�
PAPERWORK. AND HEARING REDUCTION PROPOSALS PROTECTION OVERLAY DISTRICT
APPROVED BY THE BOARD OF HEALTH REVISED
DURING A PUBLIC HEARING HELD ON DEC. 10, 2013
99 - EXISTING CONTOUR SITE IS LOCATED WITHIN THE SALTWATER'
1) ALL SYSTEMS THAT HAVE NO INCREASE IN '� X 99 ESTUARY PROTECTION DISTRICT
FLOW - SEPTIC SYSTEM COMPONENT TO 'y ExIST. SPOT ELEV.
FOUNDATION SETBACK (NO MORE THAN 50% O�
69 PROPOSED CONTOUR
REDUCTION IN REQUIRED SEPARATION DISTANCE) � � �
198-41 PROPOSED SPOT EL SYSTEM DESIGN.
TH1
2) SYSTEM COMPONENT INSTALLATIONS PROPOSED >
MORE THAN THREE FEET BELOW GRADE WITH TEST HOLE GARBAGE DISPOSER IS NOT ALLOWED
PROPER VENTING (PIPED TO ATMOSPHERE) AND \'p� Zy
SLOPE OF GROUND EXISTING 4 BR DWELLING
WITH H-20 LOADING, BUT IN NO CASE SHALL
THE SAS BE LOCATED MORE THAN SIX FEET T DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440 GPD
BELOW GRADE. 0T z �, U1i�ITY POLE _
C) 15,2 6t S F. \ m �Cyc FIRE HYDRANT USE A 440 GPD DESIGN FLOW
cp � N07E: NOT ALL SYA180LS MAY APPEAR IN DRAIMNG
III -� ELE SEPTIC TANK: 440 GPD (2) = 880
TEST HOLE LOGS 6, I \ EXISTING METER ' **RE-USE EXISTING 1000 GAL. SEPTIC TANK
CRAIG J. FERRAR►, SE 13871 DWELLING LEACHING:
ENGINEER: # TOF = 73.0' 72 SIDES: 2 (33.5 + 12.8) 2 (.74) = 137 GPD
WITNESS: DAVE STANTON ��SVED A BOTTOM 33.5 x 12.8 (.74) = 317 GPD
DATE: 12/13/21
PERC. RATE _ < 2 MIN/INCH c DRI TOTAL: 614 S.F. 454 GPD
S° O USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
CLASS I SOILS p# 21 -310 � '?pg 71> 71 WITH 4' STONE ALL AROUND
ELEV. ELEV.
65
,. 69.0' ,. 68.0' �g N 1 ,c
0 0 6 � � \
6)
FILL FILL MA
APPROVED DATE BOARD OF HEALTH
65 �7, T EE LI E
"18" 1 6
A A ' 1z -)1- )TITLE 5 SITE PLAN
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8 SC EE ( L CE N B ��D DANIEL f F
410 G �+ ° .� < CF �,� A
22 10YR 3/1 7 17' 24" 10YR 3/1 66.0' � �: C TR c R +M OM o ER ;' �s, .��,!.,a
�d CO sU TA ONE r , �� ;< 70 OXNER RD
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B B ° �, R_ o � ��� f ,� ,�� J /Z CENTERVILLE, MA
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PREPARED FOR
BENCHMARK: ��,A� �;l��
36 10YR 5/8 " 10YR 5/8 65.0' HYD. TAG BOLT �H of rrtis c �1N of r�gSsq y\�
. S 2 JENNIFER PORT
66.0 36 =67.8 NAVD88 o DANIEL DANIEL,1 .
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A. OJALA
OJALA �� CIVIL U j DATE: DECEMBER 14, 2021
C C No.40980 No.46502
PERC
°�ess ° nF °jsr R o�, off 508-362-4541
M/CS M/CS �q y° ' s N " fax 508-362-9880
�V1)SURJ- NAL �. I
2.5Y 8/4 2.5Y 8/4 downcape.com
clown cope engifieerieg, ;J?c.
144" 57.0' 138" 1 156.5' l C� 9
civil engineers
Scale: 1"= 20' �* 11_21 -� f land surveyors
NO GROUNDWATER ENCOUNTERED / 939 Main Street ( Rte 6A)
DCE #2 -436 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
21-436 PORT.DWG