Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0090 OAKMONT ROAD - Health
Bamst. b le I ............. 1 No. OI 3� Fee I Do. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:—� Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for BIBtJ 5 ' *pstrm (Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.CiQ Old/GN1e h} Ownneerr''g Name,Address,and Tel.No. Assessor's Map/Parcel '3 tC OS Installer's Name,Address,and Tel.No. 4S ffCR— Gc3,37 Designer's Name,Address�21 ,and Tel.No. Ir-4 Axh �x,4 Type of Building: l-f$. S rv,-% 13Wl1 a- ) S Dwelling No.of Bedrooms Lot Size f sq.ft. Garbage Grinder(4,�7 Other Type of Building Xelb No.of Persons Showers( ) Cafeteria( ) Other Fixtures ,tom, Design Flow(min.required) � � gpd, Design flow provided �4* gpd Plan Date P ....e,. Number of sheets • Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hgplth. Signed Date Application Approved by Date (0 Application Disapproved by Date for the following reasons Permit No. gL Date Issued — TOWN OF BARNSTABLE \JD LOCATION TO 01q1<MQ goad SEWAGE# ac ls- 3 S/ Z) VILLAGE bid • 6 I SSESSOR'S MAP&PARCEL _ ` 34 1/ INSTALLERS NAME PHONE NO. Ell J Q a0-hk e,-3 Coh.$'';e. SEPTIC TANK CAPACITY 0®® LEACHING FACILITY:(type) -C'F-fAvc36k!�' (size) / 3 X �, �! NO.OF BEDROOMS IV OWNER Fr ed eA iC lc I . r PERMIT DATE: G 1 1 H f 15 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 r I � D j, `� r C 010I E - J ,. Fee '4 THE.,COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH'DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitation for -M 8aY *pstem Construction Permit Application for a Permit to Construct( ) Repair Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.R 0 ORIc M&V1)- Owner's Name,Address,and Tel.No. SG s- a y.� Cr-,S •` C�V2-- Assessors Map/Parcel 0S Installer's Name,Address,and Tel.No. 4 'c'- 36 x (o a 37 Designer's Name,Address,and Tel.No. L`—�i/S � /LDS 2 3 L=/�TGv� t,/3a ltc� A ,411e 11,4h. 71t--{ , A Type of Building: 1 (4 S• S c„r V t,�, n, ("1 a 9f S9 Dwelling No.of Bedrooms -7` Lot Size 7 e�6S- sq.ft. Garbage Grinder `. Other Type of Building A&e.b No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) U gpd Design flow provided 45110 gpd Plan Date ,P — /. Number of sheets � Revision Date `J� Title ��/ e 4 e 491M dv 14' A-V C C !.! Size of Septic Tank C7c:>- CC Type of S.A.S. p,A C /y %/j:�4�'G 13 it Description of Soil Nature of Repairs or Alterations(Answer when applicable) a/ 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 Certificate of J Compliance has been issued by this Board of He lth. ( Signed t V c _��� p� Date a 1 N Application Approved by Date (0 S Application Disapproved by Date for the following reasons Permit No. ;L Q 1 �j " 315 l Date Issued — L . 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by at 046 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Constry tion Permit No. /dated Installer Designer t #bedrooms�7� 1�l. ;� Approved design flow p gpd The issuance of t'is p�rmit shall not be construed as a guarantee that the systempwindio s designeDate Inspector � S ----------------------------- -- No. d,O � �. � � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS MispoBal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair /(1-1-1/ Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. 's Provided:Construction must be completed within three years of the date of this permit. Date I (] �� 'Approved by C S P . Town of Barnstable �tNE T Regulatory Services Richard V. Scali,Director BARNSTABM r 'Public Health Division 0 3� ►� Thomas McKean Ec Ma+ ,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: I I- S- Zv S Sewage Permit#X I S_ 3�j Assessor's Map/Parcel 34 9-56 Installer& Designer Certification Form Designer: Installer: EEI-U<I � S Address: two l� Z� Address: On was issued.a permit to install a (date) (installer) septic system at '22'�94046rWrA2 "14COW 02637 based on a design drawn by (address) ��n r dated C�-T `), zo t (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. Stripout (if required) was inspected and the soils were found satisfactory. 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. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the I/A approval letters (if applicable). SN oFn�s�c .g° DAVID 7 o. (Installer's Signature) FtAHER7Y, 7R, y �No. 1211 X TEa� x S esigner's Signa (Affix Desi 'n p 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. gAoffice formsWesignercertification forni.doc Town of Barnstable P# �1tiE _ Departiment of Regulatory Services r+nattar�nstue Public Health Division Vid6 cZ r Mersa : 200 Main Street,Hyannis MA 0260t Date Scheduled '• u� Time c/'t Fee Pd. 0� Foil ui ility Assessment for ,sewage Disposal Performed By:. Witnessed By: e �� LOCATION& GENERAL INFORMATION Address �D 124i/mG- rt Owner's Name CCnJW`I"M'�tl (kv 19 �(li�lJS Address 'vZ15 Assessor's Map/Parcel: WVt+4� S49 �;Qy� 56- GL�Ikt�l��v Engineer's Namcce=-..L NEW CONSTRUCTION REPAIR ` �^ QQ Telephone 8 U Land Use• I]Psk fV42 - ,kc �D� J .�SJY O.C p slopes(96) c3 o Surface Stones Distances fiom: Open Water Body !f-t7U ft Possible Wet Area N . ft Drinking Well Dralhage Way ft Property Line 4-5--Y—ft Other k}Z lZ S SRETCH:'(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands in proximity to holes) A'9D B - ` Parent material(geol gle) . ` Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_IVC)V—< Weeping from Pit Five rvu/Na Estimated Seasonal High Groundwater Method Used: DETERAHNATION FOR SEASONAL-HIGH WATER TA,BLL - Depth Observed standing In obs.hole: ''vl�f Deilth to weeping from side of obs.hole: / in. Deptli to soil mottles: itL bt. Groundwater Ad ustment ti Index Well tr_ Reading Dater Index Well level - -�9 Adj.factor �� A�,Clrcundwuter Level, f/ Observation PERCOLATION TEST bats 9 F3. • ,rtn�b !1 Hole# X��`•9) Time at 911 Depth of Pere / y� Time at G' 11"53 r Start Pre-soak Time @ 1Z Time(9"-61) l��3 ft a End Pre-soak Rate Min./hach ,f,�WG Site Suitability Assessment: Site Pissed -Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back-----= ***If percolation test is to be conducted within 100 of Wetland, must first notify the Barnstable Conservation Division at least one(1) week:prior to beginning. Q:\S EPTIC\PERCPORM.DOC DEEP.OBSERVATION HOLE LOG -Hole#� 9 Depth from Soil Horizon Soil Texture Sdil Color Boll• Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones;Boulders. _ COT181stency.%'Orityen , Z/ &A5"'_c32 /3 an c5'a yl l'U7`2 �b a 2 ''-12r ft F-d 21SY7/�- or DEEP OBSERVATION HOLE LOG Hole# Z X �Q.g Depth from Boll Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, CPA212tency.%Gravell 30 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Boll Other ; Surface(in.) (USDA) (Munsell) Mottling (Structure,Sionci.Boulders. Consistency. ¢ I Flood Insurance Rate Map: Above 500 year f lood boundary No— Yes ._ Within 500 year boundary No Yes ' Within 100 year flood boundary No., Yes-4— Depth of Naturally occurring Pervious Material_ Does at least four feet of naturally occurring pervl s material exist in all areas observed throughout the area proposed for the soil absorption system? �-es If not,what is the depth of haturally occurring ervious material? Certification " I certify that on. Y• �5- (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 tr ex rds an t epee described in 10 CNR 15,017. • 'Signat Date Q:\SEPTIC RRCPORM.DOC THE COMMONWEALTH OF MASSACHUSETTS .BOARD OF HEALTH -D�� - 3..-.....oF..... ► .............................................. Appliration for Di-4pooal Workii Tontrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: i L tion-Address or Lot No................... ....Z < . e�.�. ............................... . .......... ....................... n R Address a ............ VVZ y �.e- )��h u....................... ............................... Installer Address Type of Building J Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........�-J................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons--.......................... Showers ( ) — Cafeteria ( ) Other fixtures ................................... �.p ..:..... .................. W Design Flow.........._1-...._.. .. gallons per person per day. Total daily flow..--..... =>�.....................gallons. WSeptic Tank—Liquid capacity..l.*100...gallons Length................ Width................ Diameter.........--..... Depth................ x 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 by-------------------------------------------------------------------------- Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--. Test Pit No. 2................minutes per inch Depth of Test Pit.--................. Depth to ground water.---.................... ----------------------------------------------•---------•--...•.....................----•---•----•-•......................................................... 0 Description of Soil..........................................................--•-----•-------••------------------------....-----•------...---....-----------•-•-••-•--•••-•-•••--......-•-- W U •----------------------•--•------------------.........---------...-•-•----•------•---------•---•------------------------.....----•---------•---......---........-•-----•---.................---....---•- •-------------------------------•-•-•• •--•-••---•----••--••------••---•-•-•-••••... ---•-------•-----------------=.......................................... - ------ U Nature of Repairs or, Alterations—Answ whenpll O c� t ----- lf ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Systemin accordance with the provisions of iITLi: 5 of the State Sanitary Code— The un ersi further agrees n to place the system in operation until a Certificate of Compliance h be issued by th oar f iealth. Signed..... ....... '- _.. ... ...•...........•--......, ........... Date Application Approved BY.....--------. . ...... = -'.�`..� ......------ -•------•--•. -� Date Application Disapproved for the following reasons:.............................................................................................................._ ......................•-•----•--••-----------•-••-------•.....----......---•---••----------------•--•-•--I-•----•••..........--------•-••-••-•-•....••-•--......--•----•----•-•---••----•-•-•--....-•-•-- Date PermitNo.............�. �.. ..� -------•--' Issued........................................................ Date No..T. ....:.�.�. Fss......... .. THE COMMONWEALTH OF MASSACHUSETTS ABOARD OF HEALTH ................ .........OF....., . YNS IRr1..� -------....................................... :F{y Appliratiun for Disposal Works Tonstrurtion rrrntit I Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal system at , I� .r..�.... _. ... z'!'1 - > <�� v, .........--'...---•....................... ••--......_.............•---•-•---...... 1� i'• Location-Address or Lot No. ....................-........_ ccner ..... --....-•— •' .....—Address i. Installer •- Address � Type of Building Size Lot.................... ....Sq. feet Dwelling—No. of Bedrooms......41.................:....................Expansion Attic ( Garbage Grinder .............. No. of ersons._.._..._...._.............. Showers — Cafeteria Other—Type of Building p ( ) ( ) -a Other fixtures .-•--....-•------- ---------------•••••---•------ --. - _ Design Flow........Al.`.�_... gallons per person per day. Total daily flow......... . 8� P P P Y Y ...................•..gallons. f Septic Tank—Liquid capacity/.�'.V'_._.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 bY.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••---••-------------------•-------......-•••--•-•-••---••-•••--......•....... ........................................................................... ODescription of Soil........................................................................................................................................................................ U .................................... .. -----------------------------------------------------------------------------•-------.......-----------........-•----------------------------------•••-•.••--• ----....... U Nature of Repairs or Alterations—Ans)=;when applicab e.......: �,.... k.�,9.... `._Ole � Czs�V......... I�Cl/•`^c-� "`........_:� _.:.f 1�1=,. - ?.gin:=� -------a: .... ------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TITLE 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. Signed.............------•----------------------------------------------------------------• ......................-----••- Date Application Approved By...........r ^L . �..... ------•----•---.---•---•-------------•------ _._...__. Date Application Disapproved for the following reasons:............................................................................................................ ....................................................................................................................................................................................................... Date PermitNo.---........�.....-- . I 1 ..._....... Issued......................................................- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... .........................OF..................................................................................... At Trrtifiratr of Tnntplianrr THIS-1; E T �'�T�a&tl� Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............q.� `f�� ..... -�{ ✓V✓V Win - :_...�CG1 l� at..................ii•-•---.....----...............-----•-•--•-------•-••-••--••••--•-.....-•-•_---� �...•---•-•--....-•••-•--•---•-••-•............................ ------•---••-•---_.. has been installed in accordance with the provisions of TIT 5 ofiThe,State Sanitary Cod%�/ ed 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-• ----•--•---•---=---- .... _ -------------••-----._ •.................. � THE COMMONWEALTH OF MASSACHUSETTS BOARD✓ �OF HEALTH _ /.0 WV ..OF.....I N u•J No . ���.....:a F>tt>�=..�-�.............. Disposes arks Tonstrurtion Prrmit Permission is herebyanted................^ _ 1��... - 5..� •--------•-•--•-----...-• ........__... to Construct ( ) or Rep r ( ) an Individual Sewage Disposal System at No......�.( ......... ---.-�...- '� �' -�1 -�-v=m v: v��.......... ................. ................. Street, _1 1 / ,� as shown on the application for Disposal Works Construction Permit Na......_.....�...--.... Dated.___ .�.._ ....................... Board of Health ------------------------------------------------- DATE....... ..... FORM 1255 A. M. SULKIN, INC., BOSTON 9® } L0CAT10N SEWAGE PERMIT NO.' VILLAGE INSTA LLER'S �fMF R A NESS i IEUILDEN OR OWNER DATE PERMIT IS It0 DAT E COMPLIANCE ISSUED j � L6-7- 1 , µ __. fir.�.1 __.. :p.: 7 <I- l'• - _ _.„ L� _ _ _ No• Fes$. 3... ...... . .... ................ „ THE COMMONWEALTH bF'MASSACHUSETTS BOARD GK HEALTI / Via} 5 �. D oF Appiiration for DhipooFal lark C� $� r#inn r nti i Application is hereby made fora Permit,to ConstLuct°•(K) of Repair ( ) an Individual Sewage Disposal System at: /�, M. f' j� ' �"�% �) ............. ».:...X. /tea .._....!'.�ae. w�.. _._K' z.. ..._Y v........ .:...d_....._ (✓. ...._......._.._..............._...__ ._. Location-Address or Lot No. t N •. ------------------ •--------------•--..•.....----•-•-------------•---------------------..........._.----- .. . . Address i Address aU Type of Building n 'Size Lot-----47• -k Z Sq. e Dwelling—No: of Bedrooms............'.:..............................Expansion Attic ( ) Garbage Grinder Other—TYRe, of-Building --___----• No. of persons............................. Showers Cafeteria. Q Other fixtures -------- .� �..__.... ------------------------ Design Flow............. _:..............__:.gallons per person per` day. Total daily flow.._..._..___......._._........... gal W - -- � -----•----- Ions. WSeptic Tank—Liquid capacity./POL.gallons Length.....t...... Width_._.... ... Diameter................ Depth... ......... x Disposal Trench—No..................... Width.......'............ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_________ __ ______ Diameter__Z0_e:S_ Depth'below inlet.........___........ Total leaching area.-_4;?,__7. .�•�a D. Z Other Distribution box ( Dosing tank (. ) "" Percolation'Test Results Performed by.__G0 ._k_.__W 'L....e J.A.J._._ Date-Le ..I0 &..i............. a Test Pit No. 1.......4, -minutes per inch Depth of Test Pit.-.�4_... . Depth to groundwater.�J.Q.r....=N Test Pit No. 2....... ¢_...minutes per inch Depth of Test Pit...1._2-a._.`__ Depth to ground water4:�.:.OV6�72W_C 0 O Description of Soil..........!S-� ....--• ........ L ..............=------- --- ----------------- --------------- x W ...............-.......................................................................................................... -------------------------- -- .............................................. V , 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 iITLL4 .5 of,the Stafe 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. ed 1;,,. --------------- Application Approved �; Application Dis ro for a following reasons-.......................----------------------------------------------------------------------------------------- _........................... •.-•••-•_... •-•.....---••-••••••••-•-•-•--•-------•-•••--•--••-•--•.---- Date PermitNo......................................................... Issued........................................................ Date 10......... _....... FEs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF` HEALTH .(..1. ..........OF...........���/�1:2!v�S . �. :ter................... ApplirFation for D44pnaa1 Vorkg Tomitrurtiun firrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: �1`362 ation-Address or Lot No. AIM-----.- --------------•-•----_----_--------- •------------.--------•---•----.---.---------- Owner Address W Installer Address Pa " Type of Building Size Lot...........7_Z-G-— Dwelling—No. of Bedrooms-__---_--__ &.....:..................Expansion Attic ( ) Garbage Grinder Other—T e of Building No. of persons............................ Showers — Cafeteria QI Other fixtures ----------------------------------------------•--- Design Flow............. .................gallons per person per day. Total daily flow............... ._...........gallons. W W Septic Tank—Liquid capacity.../.9. allons Length............ Width....... ..... Diameter________________ Depth.....4........ x Disposal Trench—No..................... Width................................ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------:_f._-__-- Diameter--__/0_x_5�.' Depth below inlet..........4...... Total leaching area...461,2sc}: . Z Other Distribution box ( A Dosing tank'( , ) a Percolation Test Results Performed by.....,Go.kL.At..... .G. E ......IA). ..:.. Date_�_Zater... 1._�l�__1:....._._.. Test Pit No. I..........�_-__minutes per inch Depth of Test Pit-----/4 4_. Depth to ground (14 Test Pit No. 2_______________minutes per inch Depth`of Test Pit-----/.Z_L._" Depth to ground water.w a •---•---•-••-----------•-••-----•-...•-••...•-••....-•-•-..........•------------•---•......•..•-•_............................................................ 0 Description of Soil-----------5 r.....-- r- C! .�.:, •-••--. .. -------------------•-----------------------------------•-••------•----- x ----------------------•--------------------•-••------- W -----•-----•--------------------------•-------------•-•••--•--------•--•--•----•-----•--•-•---•-------••-•-••••--------•••----------•••-•---•----------•--•-----•---•-•---------•-•----•--•---•-_---•-- 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 TITL%. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate o 1 Compliance has been issued by the board of health. gned•-•---•.......••-•--••---•-------•-•-•-•---••••••••-•-•--•----•--....-•--------------- Application Appro d Date Application Di ved the following reasons:-------•--------••-•-----•-•-----------------------•---•---•-----••---•---------•------•----•••-••-••-•-----.._ -•-•----....-•-------•----------•--•-•..............•-----•-•--•----------•------•--•••••---•------------...••••--••••-••---••--•---•---••••-•---•-•------------•---•---•---•••--...••------••••--------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MAS ACHUSETTS BOA - TH .........................................OF.................................................................................... Trrtifiratr Lit Toutphaurr T , ERTIFY, at the dividual Sewage Disposal System constructed ( ) or Repaired ( ) - b -- ---- •----•--•=--•••-----------------------`•-----_-_---------•---=--------- ....... ..................... _. y Installer at --•---------•-----•-••--•-.---•-••-••----•--•-•-•---•-••--------•---••--.._..---- °�' -------------- has been installed in accordance with the provisions of T1 State Sanitary � disscribed in the application for Disposal Works Construction Permit No.............--------------------------- dated_.............................................. THE ISSUANCE,,OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE A GUARANTEE THAT THE SYSTEM WIL F TION SATISFACTORY: DATE.......B./ ................................................. Inspector------... --- ...... ,THE COMMONWEALTH OF MASSA USETTS BOAR No......................... FEE........................ ttotr ion pautit Perm' o hereby granted.. = to Cons ��" IR p it (% > 1—Seirage Disposal System atNo. �� .............•--•--•--••.-•---•----.....-•-- Stre,; as shown on the application.for Disposal Works Construction P&n1i Uo;`rr'_ Z;, .. Dated.......................................... ............ = ............... .......................................................... %9 �.� 7Board of Health DATE.._... `./ .........................•-•----....---- r FORM 1255 HOBBS &-W4 EN. INC.. PUBLISHERS � � r III .�f.�,.. �� ...� �K -�.,.. _ _�- -, �' I ._ tl h ti a t � ,� � • `��. ��` M TOWN OI BARNSTABLE LOCA'TION_�_�} Qgx tVA IAw SEWAGE # VILLAGE G u M irl 14 ASSESSOR'S MAP Sz LOT -fr INSTALLER'S NAME & PHONE NO. Z`ti5(-W 77 SEPTIC TANK CAPACITY_ '--Lr 0 LEACHING FACILITYAtype) Z j—eot G�l ` ' S (size)f.WO �-t t(c*%5 NO. OF BEDROOMS t-1 PRIVATE WELL OR PUBLIC WATER ._ BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_�_� � — c�'_ Vol VARIANCE GRANTED: Yes No t q-0 tom`�,� 3y= 39' LOCUS DATA .CURRENT OWNER SHIRLEY .A. ENZ N' 3 PROPOSED y, FREDERICK C. ENZ 13' x 33.5' \ 150.0• PLAN REFERENCE 235-149 D Locus o . LEACHING cHAMeERs ECTRIC N N EASEMENT , DEED REFERENCE 3411-231 oAKMONT RD Dkp Z \Z o. m PUMP, CRUSH AND �o ZONING DISTRICT RF-1 AABANDON EXISTING o LOCUS MAP LEACHING PITS IN 3 ACCORDANCE WITH F FLOOD .ZONE rrX, . NOT,TO SCALE: TITLE 5.`" 50 . 15- O'0 ASSESSORS I MAP'- - 012 349 ' 8 oo. PARCEL 056 EXISTING SEPTIC 100.8 \ *' TANK To REMAIN DISTRICT - NOT A ZONE II' . `100 L O /T ,20 47,265f'" S.F. L 65f S.F. i 47'2, LOT AREA u R \ DHT-1 � 98 \ SITE 8c SEWAGE ,4X 96.9 ' - j o DTH.}2 REPAIR PLAN 93 \ .�` 4 I SHED' •OA KMOIV T ROAD LOWER ,i j wLEVEL 99.6`` ' - \. ` / GARAGE:.. CUM_.MAQUID MASS POOL T 1 \ FINISHED DATE: OC 9- 20 5 i PLAYROOM . : _>�a"• � PROPOSED \ / �9 ASEMENT ,�D" BOX OWNER APPLICANT: / / �r BATH 99.3 Da-3 92.3 / / FINISHE Mr: FREDERICK ENZ TORAGE P.0 BOX 215 ► �� /—�-� I ti9 D• BATH' 90 OAKMONT.. ROAD t MASTER !HALL BENCHMARK CU M M AQUI D, MA 02637 O �o� W I \ CONCRETEFWALK ,�g BEDROOM STAIRS s SHEET . 1 OF '2 �� \ \\ ELEV. 94.00 _ �. o ` o \ \ t ��,�of ass PREPARED •B`Y: I \ G moo? ED100 wARfl �s� sEcoNo FLOOR \ A . 'EAS SURVEY, INC. �\ _ o°N o N P. 0. B 0 X 1729 - �o �. - `98 2 BH DIN. KIT B.FAS FAMIL 9g Q 30 4.5 60. °N ���� HALL SANDWICH , MA- - 02563 _ BED 91.3 3 ST L CELL (508) 527=3600 `�f' . IVINCRooM PH. 508 - 888-3619 ' GRAPHIC SCALE: BED#4 EAS:SURVEY@YAH00'.COM 1 INCH 30 FEET FIRST FLOOR REMOVE CONCRETE PATIO SYSTEM DESIGN OVER SEPTIC TANK i RAISE COVERS T0.WITHIN 6" OF FINISH GRADE CENTER CHAMBER RISER RAISE TO WITHIN 6" DESIGN' FLOW SILL = 102.36 FINISH GRADE GROUND ELEVATION 94.4 - FINISH GRADE OF FINISH GRADE 4 BEDROOMS AT 110 GPB/D 149L GPD F.G. ELEV..99.9 ELEV. 93.5 'ELEV. 94:0 i �� //ate /.mow °D REQUIRED SEPTIC TANK N 3' MAX. COVER N " TOP ELEV 91.56 ✓ 440 x 2 _ 880 GAL. 20'®S=0.015 2" MIN 1/8"-1/4" -- 4" PVC SCH 40: 10'®5=0.01 00000. o 0 000'0 o DOUBLE WASHED SEPTIC TANK PROVIDED _1500 -GA . SCH 40 INV.= MIS T L . INV.= O O V o o O O O I PEA STONEINV.= EXISTING 91.30 10"TEE 14"TEE 0 O O O i� SIZE OF LEACHING FACILITY REQUIRED 91.13 ` " 00000o 0 00000600 3/4" DOUBLE 5'-7" WASHED STONE _ GAS BAFFLE 5 OUTLET DESIGN PERC RATE _ 4 _____MIN./INCH 4'-61/" THREE H-20 5'-0"x8'-6"x3'-O" CHAMBERS AND OR f� 2 4'-1" LIQUID LEVEL D-BOX / LONG TERM APPL. RATE_�•74_GPD/S.F. 4'-4 INV.=90.83 S.A.S. (13.0' x 33.50') o d FILTER FABRIC INV.=90.66 m SIZE OF LEACHING SYSTEM PROVIDED: ' .r: 1 / 88.56 IN 90.56 o b 440 + 0.74 SF/GPD _595 S.F:' MIN. REQ. BOT. o % 0 o ui TEST PIT #1 EXISTING SEPTIC TANK TO REMAIN USING 3 H-20 CHAMBERS WITH 4' STONE . , : CONSTRUCTION NOTES: ELEV 83.6 ADJUSTED G. WATER ALL AROUND -• I CERTIFY THAT I AM CURRENTLY APPROVED BY THE 1. CONTRACTORS /•INSTALLERS SHALL VERIFY GRADES AND SIDEWALL = 2(13'+33.5') x 2 = .186:0 S.F. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT . ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING BOTTOM = 13' x 33.5' = 435.5 S.F.- 15-0128 -SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL WORK ON THE SITE. TOTAL LEACHING AREA 621.5 S:F. -2 NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE EVALUATION ARE ACCURATE AND IN ACCORDANCE WITH 310 621 S.F x 0.74. = 460 GPD WITH DEEDED OR ZONING REGULATIONS: OWNER / APPLICANT SITE & SEWAGE - 'CMR 15 T OU IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 460 GPD PROV 440 GPD REQ. ='20 GPD RES.' v _ -- ------------------ 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING. • R E P'A I R. PLAN' EDWARD A. STONE, CERTIFIED SOIL EVALUATOR �; MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION .,BOX AND" NO (GARBAGE DISPOSAL / GRINDER .ALLOWED) S.A.S. AREA IS PROHIBITED j GENERAL NOTES: R OAKMOW ROAD 1. ALL WORKMANSHIP AND MATERIALS- CONFORM``TO `D.E.P.' DATUM: D.T.H.•#1 > D.T.H. �#2 TITLE V AND THE TOWN OF BARNSTABLE_RULES AND REGULATIONS _ _ _ _ VERTICAL DATUM: BA D 0 5 RO • 0 FOR SUBSURFACE .DISPOSAL.OF SEWERAGE. DATE: 9 8 -2 1 '-,DATE:E 8 2 15 �N+ RN: GIS MSLf " � GROUND ELEV. 96:9 :GROUND-ELEV. 94.9 • •. 2. AT LEAST ONE ACCESS POINT'OVER TANK TEES SHALL BE NO GROUNDWATER NO GROUNDWATER C U M M A,Q U[D,�°• M ASS ` . ACCESSIBLE WITHIN 6" OF `FINISH GRADE,- WITH ANY REMAINING. BENCH MARK USED:-CORNER OF:CONCRETE ACCESS PORTS,BROUGHT TO WITHIN 12". OF FINISH GRADE. WALK. ELEVATION 94.00 _ 3. 'ALL COMPONENTS,OF THE, SANITARY SYSTEM SHALL BE ` A/E A/E DATE:. OCT. ' 9,, 2015 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS.THEY ARE LOAMY SAND LOAMY SAND :UNDER OR WITHIN 10' OF DRIVES OR,PARKING AREAS THEY, 10YR 5/1 . 10YR 5/1 MUST WITHSTAND H-20 LOADING. INDICATES DEEP B, 10" B 12" OWNER/APPLICANT: •4. THE EXCAVATION CONTRACTOR SHALL'VERIFY THE LOCATION DTH #1 TEST-HOLE LOAMY.'SAND LOAMY SAND OF ALL UTILITIES PRIOR TO ANY EXCAVATION. 10YR 6/6 10YR 6/6 ` Mr.. FREDERICK ENZ '. 5. ANY MASONRY UNITS USED •TO BRING COVERS TO GRADE " p OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. ELEV =94.2 . 32, ELEV =92.4 30" f.O. BOX 215 6 FOOT ,O GRADE ER SHALL H AND DISTRIBUAVE A TION BO OF X. FEET PER INDICATES ° - .. • 9 O, O A K M O N T ROAD 7. SEPTIC TANK SANITARY TEES'SHALL BE CONSTRUCTED OF P-1 48" PERC TEST C ;C` SCHEDULE 40 PVC AND SHALL EXTEND A.MINIMUM OF 6" ABOVE FINE SAND 48" FINE SAND C U M M A Q U I D, , M A 02637� THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND N0 MOTTLING 2:5Y 7/6 2.5Y 7/6 LOCATED'DIRECTLY UNDER THE CLEAN OUT MANHOLES, NO WEEPING a SHEET 2 OF 2 8. THE INLET,PIPE INVERT ELEVATION SHALL BE NO LESS THAN ZHOF 2 INCHES NOR MORE THAN 3 INCHES -ABOVE THE INVERT mossy ELEVATION OF'THE OUTLET PIPE. o�' DAV y� - NO G. WATER PREPARED BY: 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF'9 INCHES �� 4 NO G. WATER 120" 136" 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED.WITH A GAS o ELEV =86.9 ELEV =83.6, E A S SURVEY, INC. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC " No.1 21 R B.O.H. -7 11. ALL PIPES SHALL BE SCHEDULE 40 PVC. SEWER PIPE AND DAVE STANTON P. O: -BOX 1 -/ 2 9 SHALL BE SLOPED 1/4 INCH PER FOOT MIN. 'EXCEPT FOR THE �c�c�STER�� SOIL EVALUATOR FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL sgNITAR�P� ED. -STONE SANDWICH MA 02563 BE LEVEL SOIL EV, LIC. APRIL, 1995 12. CHANGES OR,REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 1 BACKHOE OPERATOR. CELL (508) 527-3600 TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW ` � 1 j� KHOE PER , AND APPROVAL. PH. (508) 888-3619 13. MAGNETIC TAPE OVER ALL COMPONENTS. PERC RATE: <4 MIN. PER INCH EAS.SURVEY©YAH00;COM LOADING RATE: 0_74 GAL/SF/MIN T '-/o � � NOTE . 2EM0 v� �9N 5i /M F'E.2(/ a✓S 2 cOutiJ—ED F.2O�+ /AJ !9 /G ' e,,g4D/ c�� 94 -4- i 81.75 2 ` _ /Ocr©bfo.� "» C �o x G /E a.c t Pi so !I-gin, 0 f le-CL r/-7 , . 86.^0 �; f C ei 80_00 - - ----- e x1.5 r)'� around prof, ; e ppse � pi S oA- / —o — o 7- C ,9LE O' SC/aED 4o PVC FC- o1../ ED( HL 7T) SEvr/c rr�cnir»c�rn 7 kor o?c Ye �2 cl�asf��vd 1 f {ot�f� . ... -� L !n! -� _ i 1 /nJ _ gnu rlrrrr t3 D/57-S�BOX � G din P 0 washed stnne� aT Zo I A S ,-� L cl a LoZAI E LVELLE 'k- , /Ne. C. 3 �� r a• F E C fi'F� 7-E `� �r �v1i,v C N ' f`/ G/ F f o D a. e n _ q % n f: Low es�7F_ 30 ._ GALS v�vY' Bar/lsfa6le Bd• of Hec'L/f�j 7/ , TEST HOLE / TEST t- 0LE- 2 I �/ S`'• F, �f- q3 Got Zoo Ci S E /O O O_ GAL. TFi A/AC - 9 7.4 y/ P/ 7 _ II ,- �aLpOu11 l .� rD 7-H r.0 �> u� 5oi� Sv6s o S/DEwr9LL = /g7•7s F { Z o j - 45. 8 `?�2.�� I� 5 \� 1� 98•g t' e 1 B 07 7-OM : BCo.Co 5 F (O•s 7 a F �� 101.0 _ S0-/-�7 d / GL r-r c7 gR�i6o ,d q4 C i o' 3 , /44 /-7 0 (iJ a f e r- r7 Cc o_U n to r e o//f ^ / 0 / C E AE'7-/F Y 7 /-l A 7- `r-H'E B(J/L. n/ti/C=, -- -- � � �� � � C- � ( _ �� / �/ ---- --- _ - 05 Z7 ow THE- G�c>c_�/vt; fI., �- 5 / T E "_ - - -- s ^,J -7 f r"s f=•I/- /C?&/ r-)C-)F / 0 7- Z o /4 -1 GONFO,eM 7-O 7NE f3U/L. 7>/A/G -7-- 7- Tow �eA/STFIBLE G 'J ��I�✓> /9C� U / G � re? /955 • -:",e� ,9,2 1 o� of ate`% S9�y sc � 4 E aS SNow' �/ IDS-TE� c-JU /� Jp / FYERErr H / v / / / / / - EVEREf t G !� ! NINi KLE.Y �/ C l/�/ o H. r" o o. 17 V HIN�c!� ti i � � o I NJLi SO � ��� �• ��F`t ON Coo proposed ei0Lat o� A;2C �/`�I� ti/TS /'X-) f� S S. �rOn� -o -o �roPosed confoUrS S dP - /5 4?0V'E D . HEALTH _ T6E.3L�-_ j �8/ - z75