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Home My WebLink About1398 HYANNIS-BARNSTABLE ROAD - Health 1398 HYANNIS-BARNSTA,BLE RD., INSTABLE " 7 a `�.a � .',h"• :M? +, .ter+. �� f y,, �:"� .. r r+},_ t, oh ' � n .xi„x � ti:'�' } x '��` {} �f `�" r •�� a `�''�d v s, n w. a r : G , , -�•' 3 ...� � . +h� ��.{ IL 'CY Nt,ry+ S t{'r�ir: .� -S� ;i4 � J5 `;•. y' Y ��•3' k' f fir:•. - e R+y t a ,. ,.4 '{yt - � ❑ !^'�o ��. • -':� aY - Y - y,. u'" ,.G�' F` 1 �' ;"t. O Y �4; '�F ,�., A.+": '„ ,:. .C+J+ •: .a, 'y.� �.yp.. r -,. ...kt"., .., .,f �<,�"� .� '.:Ga ^-,`-� y q K !x: "• :+. '•" a Jr 1 "� Ya4 �to t7 - '� • tan;a .. w^..'A I'. ... ,s',:.";a, f. ,�.=4 .c ' W " l+f'a. - ,:, a.. ,�♦ 7.. a p f.:"" ., tr. '4 '�'. p -'+N .�; .. 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Jse Gni� FLOOD. %O! t : C' THEISTANCIS NL".I e�UPl4fnwi4_OI �[S N .li lI,) BP trTIF BY AN' fNSTRQM7N'T' SIJF4'—" T1�-Y% f�� ) /'il!'TY 7 Ge: �r�ll�_ T R L4 Y ----- - --- DEED I'.EF: _ 1?G28�i�``J- -- BUYER I't�'I�•�T __ 1�1EkF 'Eli'FL'CM �4 L--- --- DATE: 11:�9%3 -_-- -- - -- F J�:\ RL '' �t �i_ . <�_._ , -- -S_CALE:•1' = 40 ^, i HE tEBY CFrt1IF1` T<� PL`IAI L '1� ;?IO T _11 r,_ 1 ��! 1 Y .. QA Of y � � _ T . T -_AT - _E FtJt DI NC. k _ t'�N:SET StJR�E1 `T i T SHOWNc:��'.HT--PLAN LOCATE ON r^L; ° GDOI ;c+ A Atdt. C;Oi��J�;L'TAlVTS w.HO`vY�T AI`iD THAT ITS �'G� GN DOE; CC;'rf JR t <1OB .(SUITE l) TO THE ZONING, -LAB SETti,A.Cl� PE 'LIRE!vIEN `� (): It : � �,.j� TC51'N OE BA1�'1/SI bI.E' ------------ - ?I`D THAT �4 I STR C�1P IT DGES_!�`_Gl__ LIE WITHIN THE .IP CAL rtnOI? A ,[RD e. �41l+r{S'I'01�5 .M:ILLS, MA �_048 AREA AS SHOWN ON THE 1, U..U vIAP r aT I t � _ ij i9t� _ I TEL� 4'28 0055 C•o _ tln' ��--Ranel 0 ✓005 _ _ ,'__=' 01 -u 1 r' Ti rP'�Al� „> >tiUTYU`rfENT SURVEY, �20 5553 t P L 3 TOWN OF BARNSTABL'E � LOCATION I 1� 1 ��.`� R�V �BEWAGE. # tiLLAGE ASSESSOR'S MAP Sz LOT INSTALLER'S NAME & PHONE`NO.�wml �✓c� 5 �/Q SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) `f (' NO: OF BEDROOMS. / PRIVATE WELL OROf PUBLIC WATE Y . BUILDER OR OW110I DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No, -4- 076 Vv TOWN.OF BARNSTABLE C I LOCATION I 4YAWIVI�: �� EWAGE # ! �' � VILLAGE_ ,W�j 7 TR/7!/IS ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. V" �CJ7C.Yl. SEPTIC TANK CAPACITY a'�77/N d�D / LEACHING FACILITY:(type) (size) X ' .. NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 - __ --------- jran , J h ;�1_ ti I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Migozaf 6pztem Construction 3permit Application fora Permit to Construct( )Repair�k)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �� r Y �+ Owner's < Name,Address and Tel.No.s r � 104 Assessor's Map/Parcel / mo?;io T r. X Installer's Name,Add sss,and Tel No Designer's N Address and Tel.No. �I�t 4LI05 �T '66 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 It 2-- Y Number of sheets Revision Date Title Size of Septic Tank f4�/ g I$TI�G, Type of S.A.S. Description of Soil / 1` f Nature of Repairs or Alterations(Answer when applicable) ZV 5 �/i �'+� 7 7 r 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 de and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of He lth. q Signed l `��/ Date f� Application Approved by Date Application Disapproved for the olio g reasons Permit No. 7 6C) Date Issued Willy . bO Fee '!r 1. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS TippYication for Mizpozal *p.5tem Construction Permit Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I�j Owner's Name,Address and Tel.No, Assessor's Map/Parcel Installer's Name,Address,and Tel.No. �/ l•PF0 Designer's Name,Address and Tel.No. 7,/) Type of Building: /1 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures '/�1 Design Flow `Tr/!J gallons per day. Calculated daily flow gallons. Plan Date 1/412-I j 9 Number of sheets Revision Date Title "Size of Septic Tank 40" Type of S.A.S. Y Description of Soil Nature of Repairs or Alterations(Answer when applicable) /x,,)>77tZ�- 7 ::2 �1( T/ S Date last inspected: Agreement: K 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 de and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of He lth. i q Signed- Date / /I Application Approved by Date -r7,. ry iL Application Disapproved for the llo ' g reasons oX Permit No.�r=' !�� Date Issued -------------- --- `----- ` --------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of'Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( j Upgraded( ) Abandoned( )by 7 at has been constructed in accordance with the provisions of Ti e 5 and the for Disposal System Construction Permit No. P _ 7r r dated Installer Designer The issuance of this permit shall no be strued as a guarantee that th s `ste will function de �e .Date Inspector a PIS ' `"" V �V � t /'" --�y------------------------------_ ------- No. �7 y— l�� Fee 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5polar *pgtem Con5tructton Permit Permission is hereby granted to Construct( )Repair( Y4Upgrade( )Abandon( ) System located at &::v 4741 I �i1 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 within three years of the date of this permit. Date:��'T'? _ g'S� Approved by ,r •.,< ,'�'.-.� � 'µ ➢., Y �i � � f '.— !ice•' � . „ a . �r, p.� � .. ' `tom � {. { a . ' - � •"�f '`-.�..�./'}�/,/,� 5.. " 13 • I IC VU of �` •� 6,• % t � i an_". ��. . (�'y{ '� ' rye _�' ,`# y..,.• � �� vy i d • � �! u `� f✓ ..: � � f J t U LT[ �1"V�� k •��id..FtJ�I� � t .1�.(.1',rf td D ,ti *10 t s VhL -71 a _ , v �r - s' i 1/669 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH A, APPLICATION FORA DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) . I, 4 LPA �� hereby certify that the application for disposal works construction permit signed by me dated . G �� concerning the property located at f"t'�� /� meets all of the following criteria: • The failed system is tonne✓ed to a residential dwelling only. There are no commercial or business t uses associated with the dwelling.- • The sail is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • There are no private wells within 1J0 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be.located less than five feet above the ma.mmum adjusted groundwater table elevadon.,(Adjust the goundwater table using the Frimptor method when applicable) • If the S.A.S. will be located wit'_ 0 fee:of any vegetated wetlands. the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Too of Ground Surface Elevation(using CIS information) B) G.W. Elevation _the M,�Y. Figh G.W. Adjustment D IT cREv GE B E7,WEEN A.and B SIGtiED : Y DATE: (Sketch proposed plan of system on bac:c1. q:5ea1[h Cold=-cat y�f ' sSOR'S MAP N0. ( PARCEL — 4 -y Or CATION SEWAGE PERMIT NO ,VLLLAGE I.NSTA LLER'S NAME b -- , ,ADDRESS Q U I L D E R 0R OWNER E DATE PERMIT ISSUED DATE COMPLIANCE : ISSUED ® a, 2tc%St�hy /000 p4/ F"L. �Y 0 6 �.9 v N L THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Uiip,aial Works Toui3trurtion Vanfit Application is hereby made for a Permit to Construct ( ) or Repair (,/ran Individual Sewage Disposal System at: ............... t ....•--... 4 M� .............�4.. .. _12_ ..._......__..._.......__ cat O, w ddress Lot No Lo - -. - � e.r .. Addr ......•..- ...•0. :__________" 1 _.. !................ _.....___._�-'•-••'`•` __. Installer 1 Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_.....................................Expansion Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) G4 Other fixtures •-------•------ --------------- - -- Q W Design Flow........�'�.......................gallons per person per day. Total daily flow---`—_�a.Z........................gallons. WSeptic Tank-L Liquid capacity------------gallons Length................ Width..........:..... Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._-!-------------- Diameter....M.t........ Depth below inlet..... .3.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit---_................ Depth to ground water........................ x .....---•------•---•--- - 0 Description of Soil....................................................................................................................................................................... w U Nature of Repairs or Alterations—Answer when applicable.___,=' �,_._...�_ __. U._�- `�c h_.P!� ` SZ 6 cam. ............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE•5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued b the bo d of health. Signed ----------- � -� -__._. _. _ _ - _. Dare Application Approved BY -------------------V ---------------------------------------- `d-- 2 ` - Dace Application Disapproved for the following reasons- .......................................... ------------------------------ -- -- ------------- ----------------------- ............... ........................................................... ...... ..... .. . ......................................................................................... ..... ................................... Dare PermitNo. ....... ......�------------- -----`----------------------- Issued ...........:�/O... ................. No... �_ � Fn ................. THE COMMONWEALTH OF MASSACHUSETTS , BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( J,,orn- Individual Sewage Disposal System at: Locatio -A,d/d�res -or�Lot No. . Owner f Address a ------------- ±... :� . ..L �`�, �e;------------- ----------------- ,.. ?, �c� .....�;...._./..'.....�1�A;.t.&A- lnstal flddress Y Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.-_._. ____________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers a YP g P ( ) — Cafeteria ( ) Other fixtures -----------------------••--••----------------•-•--_-_- W Design Flow.........-..�.J__5.......................gallons per person per day. Total daily flow.__..... gall ons. WSe tic Tank—Liquid capacity gallons Length Width................ Diameter.... -__...__ Depth-------•---•---- x Disposal TrencIh—No..................... Width.................... Total Length............._...... Total leaching area....................sq. ft. Seepage Pit No........(............ Diameter.......VO_c----- Depth below inlet.......j6.!....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit............_....... Depth to ground water........................ 44 Test .Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..._._..._..•.......___. Q'+ .-•--•-•--•-----------------•--------------------...-----------.....--------•.......---...--•--...---••••-...-----•-----•-•----.... ---------•••-------- ODescription of Soil........................................................................................................................................... ---•------------••- x U ----------•--------•-------------------------•-----.....-----•-•--------••...--•••---------•-••---------•--••-•••......--------....................................................................... W x -----------------------------------•. -•-•--------------------.....-----------•-----------•••••--------------------•------•---••••----------•••---------•---•-••------------------....-•-----••------- U Nature of Repair or Alterations—Answer when applicable_..._ t`C _ 5�._.__l_ -----fA.D_�>____� ram_ __ ,9 -----Q Kr s ��- ------5.. 't (' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ssued by the board of health Signed ....-... .. - "'r�' Date ApplicationApproved PP roved B Y _ ..........................................................------------------------------- -------------- -- --------------------- ...............-........... ...- 4 Date Application Disapproved for the following reasons- --------------------------------_------ ---------------......--------------...----------------------------------------------------- ................................... ............... ....... ---...-----------....------.. ---- ---.---.. ---------------..-............................................................ --------------- ------------------- Date Permit No. 7.. ''.. -�� Issued ............. -- �" .2: t Date THE COMMONWEALTH OF MASSACHUSETTS •1 BOARD OF HEALTH TOWN OF BARNSTABLE Certifi ate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by------------------------------------------------------C A...... ...` ''c` ...5 (— Installer at ............._......................... .�� .h< 5. -f2( S has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .... C'��.--- dated -.-, ls-- - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B'�CONS TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION,SATISFACTORY. ' r DATE............... , . ._ ....... ..............................------.. Inspector. 1 /�L : . i :.... /Y1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HFEALTH TOWN OF,BARNSTABLE No. --• ..•-• FEE.. ...................... Disposal Works CUnnstr on amit Permission is hereby granted �a EEC LKI � 'S '�1 to Constr ct ( or Repair ( an I-dividual Sewage Disposal System atNo..........................�... +vn.-} �.. �=�-�---••---- ------------------------------------- Street as shown on the application for Disposal Works Construction Pe it No�'�_%... ate, .. _ ...... . .. i....... � •-••.•. Board of Health DATE. ..... / FORM 36508 HOBBS&WARREN.INC..PUBLISHERS �'' LOCATION �� < < � � SEWAGE PERMIT C30. VILLAGE �GZO,- INSTA LLER'S NA-dE a ADDRESS 0 UILD R on OM MI I DATE PlRMIT ISSUED DATE COMPLIANCE ISSUED f f' E �VJe I 7 ,:.. ,...a>.a..rs:..ow.two-.:.....r..,.w...n....,....a..,n..,wu�w•....w.r..+�.+_„w,+s.-w,.».w.r+o.,...,..,..,y ..�.w.,..,.w..>W. ..-�. ,:,-<.,rw.......».v....« ___.�,_...._- ,��,,,.,,,,,,.,.„w...yrnr.;r,«.,.....ww..�+..,..::_.:..:. «.�.o.r.:.....,..... 1 ttI11S 1 i r� I! L O 7` .3 / W 0 1 ~ (4 TA K fox Fury,er !U /O FT D/i9 a: ` ,p17-= 1 i 1 1 ` 1 t1N Of g RICHARD s� R SD JAME `G O'HEARN }} o v O'HEARN -+ He. 27111 " No. 40 694 'Q to f �t3' 0r8?�� j SANITAP,1i`� SUR LEGEND _. EXISTING SPOT ELEVATIONS O,A •�; �'� ' EXISTING CONTOUR — — — O FINISHED SPOT ELEVATIONS 0.0 FINISHL-D CONTOUR; 0 PROPOSED PLOT PLAN APPROV'EDt BOARD OF HEALTH �A,�r�✓sT�.�,� , MASS. _ DATE AGENT OT I CERTIFY THAT THE PROPOSED R. d O�HEARN, INC... RLS, RS ?UILLiNG SHOWN ON THIS PLAN 1348 ROUTE 134 CONFORPOS TO THE ZONING LAWS EAST DENNIS , MASS. OF MASS. DATE 1L_ 8'�% 8 __ SCALE; Z-. �O � — �� ' /41 ; C - �0ts NO I. IEr�T�L- ^' ifs �_,_,�� I. t. 1 c l s, ATE --rEGISTE RED LAND „URVE�Y0R 3`f ,r._ L t^ T f,: , ,_. .-� .. ,r:,.. ., a .w: .: ...•. .: , .f. -.,::: a u,: .. " 4 , t , . . :: IN�E�T ; EVAl'IO�IS _ .. + of • .: .� ..� ,- -TES,_ - : .� .. ...:•.:.- x.. ,. .. .:,•t A'-• ,. k ,. - j . .. .. '. ... -.. -. ..:.'..m ...::. .: ....: ... .'., :. ..:::.:: , ,:. a 'z, '�'. \•� .� ��\ z, r�, WARKMANSAl:P ArNO MATE ALS.�:g:. . . . T AT .BU1 D1 F.T.. DATE F S I T T INNER L NG SH ... ;,> D E 0 O.L .. ., ES ,. . . 7 ,,, T:Ot <t).:E.Q.E`;. TIT ' �. 'SH;4f1:: OONFORM i .. , LE 5 " .. . INLET,, SEPTIC;:: . TAtdK z FT. s WITNESSED,.;6Y AND :;THE TO,W N JpF •g �,;sry1 _R LES OUTLET SEPTlG; TANK FT.. ' PERCOLATION .RATE R: . . NS 0..,, . Sl1SURFACE ,._ moo. AND : •REGULATI'D,f. ;: . t. r "-INLET , DiSTFt,l9 ;lJTiON BOX.,,. FT DIS RY . :. . M OBSERVATLON- HOLE, . OBSER�/ATION.,.: H0 E. .2 PosAL.; oF: sANiT,� E :.: „ t.. .. U:TLET,, .D�STRIBUTlAN: BQX<, cyo..3: FT..> - , ' . 0, Y/v , u. ELE1/AT:ICIV.._ :.1 ELEVATIONIL, L) c7 ^: s' ,,.INLET:'' LEACH_iNG. . PIT 98 PT.: 77 :,•. .: , '° � BOTTOM- LEACHIN:G PIT y .. . : . - . . . . � , .. . : , � . SiGfV -ALCULATit�NS NUMBER Of= BEDf200`fu1S �3 ... . 7 - - _ . ,,.• :.. " _ ,. ;GARBAGE . DISPO`SAL ,UNIT.: 2 : � :30 - TOTAL, .ESTIMATED_' FLOlNn (,�U 'GAL x_ BR:) tiGAL/DAY,, , ,F IRED SEPTIC ,TANK' ,CAPACITY G At GAL ACTUAL SIZE' 0'F SEPTIC :.;TAN'K, TO ;BE .fNSTA'L' LED a e ` 5(1 LE A-G ARE'A-_'R:EQUIR;EME,'V'TS L, N. 2:� , ID`E, WALL AREA GAL'./S..F.. _J � F` : . BOTTOM' AREAL_:GAL:/�. ., . - GAL s .... r Y„ BOTTOM,+SIDEWALL Yx TE_ �o , w.4r. /P.� LEACHING CAP;ACIT )( ly x 4 X r �S r. RESERVE LEACHING CAPACITY. . .. ,.. : TOP OF 'FOUND :, , D f CFI 40 :_ / 4 S �. : _ _ CONCRETE.., _ GLEAN` SAND , rz. �LE.V. ,> � . ' <. p : EFZ PVC f 1 E C0 V S . - .. CONGR'ETE MI FITC ., f r . N� I/8 PE.R, ,FT. a OVER• r — \ ;a ` �,. 2 /o'MlN PITCH �-k: r , f�. MAX. , Uf N 2, LAYER .OF FLOW LINE _. �o 274>,. (- STONE' r fit` �� /r� �'� 4. ,:CAST .IRON - - o , w „ :. WA NE r frt , PIPE - MIN. .PITCH /} =, D: PR CAST .LEACHING „ �•. 4. ':P-ER. FT. ,.,.. z. , •, I:iT- o -, � H: E P f p D, . BOX BASIN :OR EQUIV.; ,. �. LL - o :GAL," ��- ,r,��, �-�:�r.��.- SASS. n wT' -r � r . , ,. SEPTIC TANK.. :+ R. J. O r�EAR-� F- 'I, ROTE" 41 - r: - •. - . � � 1>: A- T DENS PROFILE OF: _> GROUN;D .. WATE'R TABLE' `. ' E S ' P r, r� JOB NO. _? . G-.�� Y'STE M. SEWAGE . ,DISPOSAL'. S NOT TO SCALD _E T 0 Z S.H t. / - THE COMMONWEALTH OF MASSACHUSETTS ` 39� BOAR® OF HEALTH D.l�/....?V.........O F....... /�1 nl..STi9.Tj 4.�T.......................... Appliration for Uiipnial Works Tomitrurtion ramit . Application is hereby made for a Permit to Construct (>C) or Repair ( ) an Individual Sewage Disposal System at: 7;4.... Cre -----•--•- ............ .........•...••---------...-------•-._...-----...._.......------•---------- ...........--- Location-Address or Lot No. .L .L�l. .S ` o. /30 FORD /�__L.... Owner Address --._._ ........._ .•-•-• ----•--_-- ........ ............. Installer Address S Type of Building Size Lot. __ ��_.._._ q. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p`1, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----••----•-------------------- FnQad�� Septic Tank—Liquid ca se per day. Total daily flow................ ..........................gallons. Design Flow........ ...............................gallons per.ptx 04 allons Len h.. ... . Width..'�.�-/4'Diameter................ Depth....�_=_. pacityj000 g � -��- -- W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No-------/........... Diameter../ �Fr... Depth below inlet-j.!cr..... Total leaching area....Z96.Zsq. ft. Z Other Distribution box (,i(') Dosing tank ( ) Percolation Test Results Performed by..2Z..O'/Y............I�.._.^:........................... Date_._ ------ a L Test Pit No. 1-__ . ...minutes per inch Depth of Test Pit..../ `�.... Depth to ground water.._._..._--........_.. Test Pit No. 2__ .z....minutes per inch Depth of Test Pit... Depth to ground water------------------------ ;; --------------•--•---------•-----------------------•--.----- O Description of Soil... r---- 3�'- �`fz 1�`- C n f.0---s ......-•------- � 2....--o` �f` ,, psoc c........ UY3sa. ------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... •-•---------------------------------------------•-•---------------......._......_..............................---------------------------------------•-------------------------...---•--....-----•-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI'M 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been by boar healt • P Signe .-- ----- -----....... <--------- /.................. Date Application Approved BY •--- s � Date Application Disapproved for the following reasons:.............................................................................................................. ---------------------•------......-••----•--•----------------•••••--.........._..............-----------------------------------•.------------------------------------------------------------..._..••- ----.. Issued----... ............................................ 9 ate PermitNo.............................•------------------•- Date F �,,s THE COMMONWEALTH40F MASSACHUSETTS BOARD OF HEALTH ..........�r�-W_ _l.......OF......... ..............:...... Ap,pliration for Bispos al Works Ton,itrurtion "motif Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: . .................................�r� D .............----------Lam............................................................. Location,Add r sr Lot No. 1.41��11_ -. .ff�4R.c:��--------------------------------•-- l3d ,��t-ao ... ---•=---•--- ... .--.:- � D Y Owner Address .G. /?�`E f � �.!YvY!J �-1, , c.. a .._. Installer Address Type of Building Size Lot.. . ,....V.b..Sq. feet Dwelling—No. of Bedrooms............................................................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria dOther fixtures --------------- -----------------3-�ti�.f --- w Design Flow_._.....��..........................gallons per-�srsen per day. Total daily flow.............. gallons. WSeptic Tank—Liquid*capacity?�?gallons Length.?=..6 Width.4.--/_4 �biameter..:............. Depth..t..'¢. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./......... Diameter./e ...F1.... Depth below inlet..6...EK._. Total leaching area...Z4.7...sq. ft. Z Other Distribution box Dosing tank ( ) Percolation Test Results Performed by... '.Cf ... ..... .:...................... Date-.��0�?.�...... Test Pit No. 1.�.z-.._._minutes per inch Depth of Test Pit..../�.�1..... Depth to ground water........................ L=, Test Pit No. 2.....Z...minutes per inch Depth of Test Pit--- Depth to ground water........................ •-•----•--------••••................•----------•------------.....................-------••••-•-•......................................................... O Description of Soil..!`-----6.---. O..Q..P_c_o� --1. ........ate.. ` . . y----Su f3 sG� , `36. . ...... VCc "� t I�.--....re�.p. ------- .. . - -`� - 7 9P_ ai.c.. ..5!/d :rf! ......... -------------------•----------------------------••------------.......--------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITT12 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issped by t e ljgjrd of healt .. r . �— Signe ....----- ...... .... Date Application Approved By... ...... `Date Application Disapproved for the following reasons:.................---............................................................................................ ....................••-------....--•-------•-----------------...-•------------- ._..... -------•-•--•------•-•-----------------------------------•--••------•-•.......-- +-- Date Permit No.................. .......... .. Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD O HEALT........O F.......... ..... ...... .......... Tntif ira of Toutpli atta T IS IS 0 CE TIFY,"That the Individual Sewage Disposal System constructed �r Repaired ( ) by d {�' �" - ---- -...=-- . --•- �✓! In ler has been installed in accordance with the provisions of T _ r of The State Sanitary Code as describe in the application for Disposal Works Construction Permit No. .......1��-�V...._....... dated.... <Z:...-�4......_.7 ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................................:......--•-•----•••--•-----........._. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF1 EAL.TH f ......... ...'.OF..... .. .-.:.. ....................... N FEE..... ................... �i��azs�al or � on�tri�rtuan anti# ,: Permissions Whb..here granted...... . l ! ' to Corstru ( ai ( ) a nd' idual Sew ;posal Sat No.. ? •�w x.. �} i�r:. ......-•-----------------......--------- r- r ••..a .1.. - S et - as shown on the application for Disposal Works Construction Per No...... .:. .. .. ted...J.. �,5' �......... •..... .... - ..................► � JtBoar of e 1. alth DATE.. ._.. ll.....�-�--•---•-•-•----- .. FORM 1255 HOBBS'& WARREN, INC., PUBLISHERS e: Town of iarnstable ru� Department of health,Safely,and Gnvir-onniental Services �T Public Health Division Date 367 Main Street,I lyannis MA 02601 HARN9TARI4 MASI r63a79. �� _ '°�tn►na+" Dale Scheduled w " lime�� I Fee Pd. t Soil Suitability Assessment fl r'Sewage'Disposal r Performed By: Witnessed By: ,JC1L3,LY& tow.&*Jb I,OCATION:Bc G1� RAL INFOIRMATION Location Address s Owner's Name q Address Assessor's Map/Parcel: Engineer's Name 4—Arve,6%-5 /C NEW CONSTRl1CTION REPAIR telephone N 3 CQu� �� Land Use I Slopes(%) 3—F—.) Surface Stones" �b ve4 1 Distances from: (pen Water Body 50 Il Possible Wcl Arca n Drinking Water Well f�llwn i I Drainage Way Il Property Line Il Other n SKETCI1: (Street name,dimensions of lot,exact locations oftes(holes&Pere tests,locate wetlands in proximity to holes) 14 ' I'arcnl material(geologic)' .�� Depth to fledrock �.� Depth to Groundwater: Standing Water in Ilole: wing from Pit lace ne- s Estimated Seasonal I ligh Groundwater DETEIZMINATION rOR'SI ASONAI IIIGII WATER IAI3LE Method Used: " Depth Observed slanding in obs:hole: in. Depth to soil mottles: A in. Depth to weeping from side of obs.hole: p3 A in. Groundwater Adjustment Il. Index Weil I! _ ,- Reading Date: _ Index Well Iev 1 Ad.j.factor-_ Adj.Groundwater Level TE RCOLATION;�I EST. irate b Time 1D3D Observation lole ll Time at 9" Dcpth of Perc 50 Time at 6" Star(Pre-soak Time a Lk Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passe) Site Failed: Additional"testing NecdeJ(1'M) Original: Public Ileauh Division Observation hole Dala To Be Completed on Back j Copy: Applicant DEFT.013SERVA`['10N:IIO,LE:LOG Hole # Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mollling (Slructurc,Stones,nouldcres. Consistency. Travel) e G 2 �I �2bp1 4 — p V-0. p90GS ,R a 1)EL1 nI3SERVAT[ON 1IOLE LOG IIole # Dcplh from Soil I lorizon Soil Texturc Soil Color Soil 011cr Surface(in.). (CISDA) (relunscll) Mollling. (Structure,S;oncs, Ifoulderes. Cons islcncy,%(iravcl) DEEP O13SEIZVXF1ON HOLE LOCI . II61C # 0cplh from Soil I lurizon Soil Tcxlurc Soil Color Soil 01her Surface(in.) (USDA) (Monsell) Molding (Slructurc,Stones,Bouldcles. bn5ims t cecy, ravel 1)EEI' OBSERVATION 11OLE LOG Iiulc # Depth Irons Soil I lorizon Soil Tcxlurc Soil Color Soil Dlher Surface(in.) (USDA) (Mullscll) Nlolfling (Slructurc,Stones, Ilouldcles. Coils islclicy 10(iravcl) 1 I I Flood Insurance R, t2 a MaI Abovc 500),car Ilood boundary No--- Ycs Wilhin 500 year boundary No_ Yes_— Wilhin 100 year flood boundary No_ Yes Depth of Naturally Occurrita Pervious Material Docs at leas( four feet of naturally occurring pervious material exist in all areas obscived (ill ollglou( the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? r t Certification I certify that oil (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 will the required training, expertise and experience described in 310 CMR-15.017. Signature_ _ Date , �T--'— —'-- 7-- -- ;---- --- —L I --— L I— I 1 I I , I : - - i------ I - -may , . � I 17- RB DEC 22 PM l: 49 t _ • I . Q _ - � r f 4 I I I i - I .—r—- -- I t f � I' . : - I °i :. 1 �; � i f :: i ..' , 1 I L I r ' -- •— I _ I y r! I I : �7 t r I I ri t _.1 I I ! 'I , 1 1 t r( +{ , ( : ?: I -, i , i ( U � j I I j - J „i ! ♦I _ I I I I 1 --i—-i---' — —--- -- — --- --t-- I I ' M _�---•--�- r—r--�---- � -�� .. .I � I �: o-..-:.:� I i 1 - 1 r I i _ � j }, fJ -.I.. _. I - 1, i , f t 4 I �- i- 'I�. ' � L•� -I� I—�.._ i-•— �� 1 �I. -T-1 _ I t f 1 - 1 j : I I � !• , , : ' I j [ ,• .. , � -�I ; a -6 l � ;. I �.. I , 's_.I ..t s.is I' ___..__. ! _ , , --�--'� . ----1--- : � I' , � � , � �i sY. f�. L. _ i i •�•i j L�:' 1�� I i is r I i i ��r J : ' i f : ! I I ' . . I _.::. i .' , i- I I i . I{ I j \, -=t-- I �— t '� I - —�--- �,- �--- i— -- 9l-�� }- • I I -- , I � j f ' I I I' ------ ---,--;�---'--- I ! I I r � I } - : :7 •_' �. ! � ft e �I �° ,.� i. L. !- .�. I I ,4: t I �. 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