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Home My WebLink About1585 SERVICE ROAD - Health Ir FA= Service Road, W. Barnstable 174-part of 006 Lot#1 I U1VN Ul~ BAkNl ,I ABLE / o LOCATION!./ 5-5�5eTyiLe/ell SEWAGE # VILLAGE ly l�a��yt�d/� ASSE,�S/SOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �DrlrLe/�� Cori/` 7 7/-Q3Y ip SEPTIC TANK CAPACITY / ` LEACHING FACILITY: (type)C�-sad ��D �S rJ 6�C/I C(size� NO.OF BEDROOMS BUILDER OR cEi Abvofell PERMIT DATE: 1�( - ?�_COMPLIANCE DATE: — 7 7 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 and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet !Furnished by �o�� Shs�ygl •.10-r _ i c1 i TOWN ON BARNSTABLE V LOCATION6-sri�,5eru/e,8 lee, SEWAGE # ?b/-r'314' VILLAGE ASSESSOR'S MAP & LOT�4f- 224 /T2 INSTALLER'S NAME&PHONE NO. �/®� C046� 7?/-Q3,4?0 oep SEPTIC TANK CAPACITY LEACHING FACILITY: (type)y Sma �r� ��c� C(sizze3 NO.OF BEDROOMS BUILDER OR(!� N PERMIT DATE: COMPLIANCE DATE: 7 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 and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I-con� of IkouSe I oar 3 7-0� 3 ► G� � . v �z�eG:, r64�.bvs o30� i to' 2 No. �'�? � FARCa /NoP°"`� a04 Fee Entered in computer: f_�l THE COMMONWEALTH OF MASSACHUSETTS p Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pprfcation for 30igpo-gar *vZtem Congtruction Vermtt Application for a Permit to Co strict(/)Repair( )Upgrade( )Abandon( ) El Complete System 0 Individual Components Location Address or Lot No. i Owner's Name,Address and Tel.No. Assessor's Map/Parcel /J Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �dif o /046 • 'own Cart -7--7/r 93 9f{ Jr 2—N4-YI Type of Building: Dwelling No.of Bedrooms N Lot Size y3, s sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow yryd gallons. Plan Date Number of sheets Revision Date 'Title Size of Septic Tank Type of S.A.S. Description of Soil ,4s Ile r 4�k 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 Pis Board ealth, t� Signed ° 2__ Date /6�t yllG Application Approved by Date ®o2 Application Disapproved for the fo owing reasons Permit No. s3 Date Issued !G" C/ sF-,/ l"'.��-..-.++r-^1,+s,,,...-1.. - ,...�.. . •�� —T '`s-w`�i,i�f+ti'rc'}+��r.�'�•�rb. Ta..-,..�-`'`r Y t"`� y.., ''�' -• �.,�' . ...��y:,.,,.r _ 5-3 / s �a 1 O0/ Fee No. � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0(pprication•for Di.5pooar *pztel m Con!5tructton Permit -' Application for a Permit to Construct Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. / der. :C e K e R CI f` Owner's Name,kddress and Tel.No. {�� iydn5t(i .4I / 4a%1�j'{nf; x� �+fPr� ^� y6i-ri.� t Assessor's Map/Parcel /' Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.Now 13 9 S Type of Building: Dwelling No.of Bedrooms 'y Lot Size y3 5 d sq.ft. Garbage Grinder( ) r Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow .416 gallons per day. Calculated,daily flow' Yyd gallons. Plan Date Number of sheets r° Revision Date Tile Size of Septic Tank Type of S.A.S. Descnption of Soil Dr Nature of Repairs or Alterations(Answer when applicable) a Date last inspected: ? Agreement: r -� 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 t is Board of ealth,� Signed a f• Date Application Approved by /LIkg5e Date A0 Application Disapproved for the f wing reasons Permit No. (� - S�� Date Issued q --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed Repaired ( )Upgraded( ) Abar_doned( )by c!•c2 at t E r i sue. r o R� w • IT a rR ca tiL' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9& - S-?f dated /U •,2 V ::Ie� Installer ill to /0a Designer 40'.., The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date' 7 Inspector- -—————————————————————————————— -7 No. Fee—f�= THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 1=igoogaf*patent Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at 4 r I sue, •r P i?aa 4 Ives.( 3 a-A c 6 S 4 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed withinthree years of the`date of this permit— Date: 1 1 Appfovidte by r_� �� 1 SOIL EVALUATOR& PERCOLATION TEST FORMS ( � Pagel of 4 Town of Barnstable 1(8aar+TrA9LX F Department of MOM, Safety, and Environmental Services Public Health Division 367 Main Street,Hyannis MA 02601 Olriu•: 509-790 6265 '7 FAX: 508-775-3344 J Soil Sultabl ll AssessinenoI Ser�ua e Dls �osal So lT' t f � ASSESSORS MAP NU' 1-7 q PARCa� NO. T�'r` f7 9� Date: �1 Date: Performed By: Witnessed By: I.oca ion Addres i� - Owner's Name �� 719? Lot q: r Address,and Assessor's Map/Parcel: Telephone k NEW CONSTRUCTION REPAIR Office Review Published Soil Survey Available: No Yes ` 'Zy aL' Soil map unit Year Published �_ Publication Scale I! Drainage Drainage Class Soil Limitations Surficial Geological Report Available: No Yes Year Published _ Publication Scale Geologic Material(Map Unit) Landform �' N tjE Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Wetland Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range: Above Normal Normal Below Normal Other References Reviewed: DEP APPROVED FORM-12/07/95 r FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot 140. L�1 '5ary\(- T On-site Reiriew �o ��GDeep Hole Number � ` Date:. . :- .-. Time: .(Z,1�7 p'^ Weather 6;, � Location (identify on site plan) Land Use V/-..At-;T Slope (°io) Surface Stones Vegetation c,Z&C>DED Landform ^AO(\yt-A\f JC Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well Uo feet Other DEEP OBSERVATION HOLE _OG' Depth from Soil Horizon Soil Terrture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, 9b Gravel) d - \ 0 �� r 15- r 5A+� t Patent Material (geologic) DepihtoBediock: DepthtoGroundwater- StandingWaterintheHole: Weeping from Pit face: Estimated Seasonal High Ground Water: DLP AFPRo%,LP rok►i-I2rov63 N 1 ✓ � I I � N ' FOP-M I - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot (Jo. On-site Revieu Deep Hole Number 1-1—rL Date:. k!?IY yt' Time: -.t2• lL Weather Location (identify on site plan) e7v-C-T'--16 �--v . Land Use V/ Z-/+,-j Slope M Surface Stones Vegetation Landform A^r3rgLk,")C Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE -OG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Mansell) Mottling (Structure.Stones.Boulders,Consistency. 9i • Gravel) �j6 "�`� \ d�•-d 2.�i;�/� '-fie `lG c�.`bb� 5 ILTS kiQUIRiDYc nil Parent Material (geologic) DepthtoSedrock: peethloGroundwater: StandingWaterintheHole: Weeping from Pit Face: Estimated Seasonal High Gtound Water: IMP AFPROM)FOK11-12FD763 •t FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole........... . inches ❑ Depth weeping from side of observation hole . inches ❑ Depth to soil mottles inches ❑ Ground water adjustment ................... feet Index Well Number ................. Reading Date ................. Index well level ..... .. Adjustment factor ................... Adjusted ground water level ..(UIr4...... . ....N� Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? yk If not, what is the depth of naturally occurring pervious material? `-- Certification I certify that on /yQV 11ti (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. e Signature I Date [0 V7 - DEP APPROVED FORM-12107/95 FORM 12 - PERCOLATION TEST Location Address or lot No. �— e5;>rY TiA COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test* Time:Date: tp G `�� t2 :th �,� Observation Hole # TR. I Z Depth of Perc G) Start Pre-soak End' Pre-soak Time at 12" Time at 9" Time at 6" Time (9%6") Rate Min./Inch Minimum of 1 percolation test m►10 he nerfDrmed in teeth the p►unary aree AND reserve area. Site Passed Site Failed ❑ ..............................................................................................:......................................_......_......_ Performed By: 4N ( y�E- Witnessed By: et> (3 o f� 1 Comments: DEP APPROVED FORM-MCl/% u 4,� ,... - is .a _ - j4`,Fy)2* .TIA"� 3• �' }�t� 3 �fOt }'�.,y§�'F' SEPTIC PROFILE TEST HOLE LOGS _ -1T.O.F. AT Et (NCTr TO SCALE) ACCESS COVER TO WITHIN ir OF FIN. GRADE AccEss COVER (wArEKncHT) TO ENGINEER: /tf - wtT►* Ir OF FIN. GRADE x � � � I -� j x y MINIMUM .75' OF COVER OVER PRECAST 2X SLOPE. REQUIRED OVER SYSTEM - =�_ fi `l; - ' A - —_ WITNESS: --C �' ' -- -- o c: : -�'c;`'- _ L._ RUN PIPE LEVELiLi —_ /{a - _ (Do--) FOR FIRST 2' DATE: ..._.. _........ .—_,_, .. r ... I PROPOSED �> • C �� ,,1� /'A/C GALLON PERC. RAT17 E - �`� a r CLASS . SOILS P# -x SLOPS CRUSHED STONE OR MECHANICAL �o � DEPTH OF FLOW COMPACTION. (15.221 [2]) TEE SIZES: `' x SLOPE) -x SLOP0 j -Cr 116 • '��7. t Y� _�INLET DEPTH m ounFT DEPTH 1/6 !_ _ l/y 3 LOCATLEAION MAP 1' y ASSESSORS MAP PARCEL =� FOUNDATION— SEPTIC TANK �r' - D' BOX FACILITY `HING ' C y i FLOOD ZONE {a i BUILDING ZONE _ SETBACKS: FRONT - �� SIDE y� REAR -f -- � PLAN REFERENCE k" c a ! l i• J T4,. YT ♦ / IS 1. DAT UM � 2,,�/, / MUNICIPAL WATER IS � 1 •,,,.--' SEPTIC DESIGN:- (GARaw.F rnsPasa Is _ ) ...__. . . rk ..� 1 1 CnT Lam. ,S. MINIMUM N I P t P '((:N 'v C)E I j t3` r'F K DESIGN FLOW: C BEDROOMS ( L -, GPD) - GPD - ! 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H__ USE A GPD DESIGN FLOW 5. PIPE JOINTS TO BE MADE WATERTIGHT. SEPTIC TANK: ` ' GPD (_ } - GALLONS 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. USE A r GALLON SEPTIC TANK ENVIRONMENTAL CODE TITLE V. 7 WORK ONLY AND NOT TO E ' LEACHIN . THIS PLAN IS FOR PROPOSED L- "'`�.- 7- USED FOR LOT LINE STAKING. SIDES: 1 - /7 ?` L -' _ l6:4+` _+^- _._..�. (,._} - GPD 8, -PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. .. �.. BOTTOM.__ o (=-'--) GPD 9. COMPONENTS N T T BE E RCONCEALEDITHO T 0 � BACK LLD 0 WITHOUT TOTAL = a' S.F, 7%� GPO INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED ' } FROM BOARD OF HEALTH. J ` SITE AND SEWAGE PLAN OF I 4 r THE IN TOWN OF: BOARD Tt• G OF HEALTH / ✓ �.,_ _ v �>� - - PREPARED FOR: € APPROVED DATE ` '. ._ �f"c ~^ �, " Foot SCALE: ��f ?'/ DATE: �l down cape engineering, inc. OF Ef (7 AM*H. ARNE 1, CIVIL ENGINEERS dwcA , LAND SURVEYORSI � avk j' ' , 1 PHONE 508-362-454 i ma FAX 508-362-9880 F*F 939 main st. armouth ma H.OJA - _ JOB Y .' a. OJA B' + . .s. DATE # 'l..'C - �.. r- �' -