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Home My WebLink About0041 TWICKENHAM CROSSING - Health 1, + ■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ mommommommom ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ �■ ■ , ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ �■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ONE ME No MEN MENNEN NEMESES No MEN MENEM ONE MEN III MEN No MEN No ONE ME No mom ME NONE 0 NOON OMNI MEN No OMNI MENEM no !mqu,1 0 0 0 1 MEMNON MEMO MENNEN El HIIIIIIIIIIIII MENNEN mom MOON EMEMEME Ml MONSOON MONSOON III iii�i 6 �� d ■MENNEN �� ■iiiiii�i■�■i' MONSON ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ P " •_�__- I I � P I I I ! I AV) I I LIP i t4( AIA 4� i ; - I - -- -- P I �� I ! IOil ! a - -. I ._ J- TOWN OF BARNSTABLE ' LOCATION Lf Cn�S SEWAGE - T®" _•- VILLAGE ''�S I�Dt ➢ ASSESSOR'S MAP & LOT *13 7 INSTALLER'S NAME&PHONE NO. a I I is, 43 f&d rs Go tyJ.s 3.G a (pot 3 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) S 6O G s 3 R NO.OF BEDROOMS r� BUILDER OR OWNER PERMIT DATE: I ri l l(j 11�LIANCE DATE: Separation Distance Between the: �� Maximum Adjusted Groundwatel'��e 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 �5� Y i 13 11 . d y- TOWN OF BARNSTABLE LOCATION G!i/ C� F N /[/� 5 SEWAGE# Vf LLAG Lv ' �N ASSESSOR'S MAP&LOT D 3 N lSX c P48 FAtM'S NAME&PHONE NO. I-) (18 SEPTIC TANK CAPACITY S AP 71- c LEACHING FACILITY:(type) (size) NO.OF BEDROOMS BUILDER OR OWNER S L� �7�7 !y PERMIT DATE: C0Nfi41 DATE: 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 "� £�/l , .�$ `' �1 S�� g off ° �� No. � � jl 93 7J W Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pprication for Migpogal *p5tem Con5truc ion permit ��-01 C��.d r�r g App cation fora Permit to ConstrucAepaiggrade O b dP ❑Individual Components �fi ) Complete System p Location Address or Lot No 9=9WROM Owner's Name,Address,and Tel.No. Assessor's Map/parcel � I wdL � p sf. 5to r S Installer's Name,Address,and Tel.No. / R MrY Designer's Name,Address and Tel.No. a 3 IznOr�r/J 3 C-037 1 419,h .-� 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(min.required) %-k f- II to uU ' gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 0UO Type of S.A.S. ih L-et616'+7 C49y/e-1 Description of Soil See SZ41 L-q� u Isk't Sb s' a Nd a„el� Nature of Repairs or Alterations(Answer when applicable) Sep 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 o e of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of Health. Sig J Date Application Approved by _ Date Application Disapproved by: Date for the following reasons Permit No. '' Date Issued No. x / Fee Entered in computer: THE;,COMMONWEALTH OF MASSACHUSETTS p ..PUBL C HEALTH DIVISION„- TOWN OF BARNSTABLE, MASSACHUSETTS Yes 1 too, 'Zip Ytcatcor� for aigozat i§p5tem Cow5truction Permit „ r }r, � ��a Pit to onstc �R A 1 hr' Pgr Obando Complete e System ❑Individual, eair Components Location Address oiNotNo Owner's Name,Address,and Tel.No. Hl t''v (/C 1°17h&r) ��r? Ja/`J t—c �L`I 1 yl(�✓) S, li/� Assessor's Map/parcel 3 r C 7 G tj I T Installer's Name,Address,and Tel.No. I (� f ��J CS�en5~ Designer',Name,Address and Tel.No. � c� 3 1 n h r/�� U r /1(/� }Q�b�oYY- ou ,�vL C9/ram /�' G,r Type of Building: J Dwelling No.of Bedrooms L1 /� /LIdi:Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) _ Other Fixtures Design Flow(min.required) t t 1 �l 6 u uU gpd Design flow provided gpd Plan Date M - 30 �G m Number of sheets Revision Date Title Size of Septic Tank - _� UUf� Type of S.A.S. W LOU cc q L�sCti'9� CG�,/it�f i Description of Soil. Se-e S � d t.cJ - �S c�c O r.,a• /14J. p.clf Nature of Repairs or Alterations(Xnswer when applicable) V F f' H� 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 o tle 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 nn ✓ Date j " 0Z Application Approved by / /!f _ U „�: 0 � 1 Date Application Disapproved by:V ~ . v �� Date for the following reasons i i k `Permit No., ' Date Issued � o- w. 77 ————————-—— ——= '— ——————————————� —— - 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 f3 r-I_�-0cS C. A N at _ 41 TN/j'C/l Ph IA11 e rCS S�L , i.qrn 3dAtY m 5has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated °-, Installer E�/VS Designer � tr�t � l=�t ,.•._„�. , #bedrooms Approved design flow V / ��/. gpd A,171��, / The issuance of his ermi shall t be construed as a guarantee that the system it function as designed. r�Date / � C / � Inspector � � - (/,"r ps --=- i-/ - - -------------------- ---=-�-� No. Fee v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1=igpoat:*p!gtem Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construct ionymu st be corn eted-within three years of the date of this p t. Date ✓✓ �° � / / Approved by me 0 d ��j r fps ,S� r - FROP :d i,in ca}::e engineering inc. FAX NO. :15083629880 Jul. 12 2007 02:08PM F 1 Town of Barnstable Regulatory Services Thomas F. GeUer,Director ' Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA,02601 508-862-4644 Fax: 508-790-6304 Installer& Destener Certificghon Form Sewage Permit# 007— 9,69 Assessor's Map\Parcel M A 3 7 Designer: L L Installer: s :.r .�.ol!:I:i•�°:zs: 7_5 Address: 9-3 d , was issued a perniit to install a (date) (installer) e.r pti.;: system at 4 l G-v-0''1 based an a design drawn by (address) 8')rn--5, dated 5/.2a esigner) _ NJ I r ztify that the septic system referenced above was installed substantially according to 7._ 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 ivere found satisfactory. ( certify that the septic system referenced above was installed with major changes (i.e. jM=ter than 11' lateral relocation of the SAS or any vertical relocation of any component 2,f the septic system) but in accordance with State & Local Regulations. Plan revisi6n or (:enified as-built by designer to follow. Stripout(if required) was inspected and the soil:; Were found satisfactory. ��ytH OF A4� 1� - �rr5t3 DANIEL A. � ~ �(:[ aller's Si nature) oJALA -1 CIVIL cn �No.46502es �-7/1 )3 T E S/ONAL.E. 0. er's Signature (Affix Designer's tamp ere)r RETURN TU ARN&F LE E! TH D IS ON CERTIFI ATIL ' X ) WE ISSUED NT BOT>H[ 1'��:f.P 5t � (;gyp EI�E BY THE 14RNST,AB S FORM A S.. `. 1- oNK ou. P� LI ALTH DIVI I Certi.f nation Fann Rev 03-09-06,doe LET TOWN OF BARNSTABL LOCA'I;(-"N� AR SEWAGE# "J/ { VILLAGE ASSkSSOR'S MAP& LOT rAQ INSTALLER'S NAME&PHONE NO. G�� ✓ SEPTIC TANK CAPACITY 57��"'ry GOyT �//'" �� ✓ LEACHING FACILITY: (type),,� 07 5(size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 10 COMPLIANCE DATE: AQ Separation Distance Between the: - 1 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 i . f - i 4 i ! 1 • ar - °Yo Town of Barnstable Public Health Division , "�4 �pPRsr „S& 200 Main Street Hyannis,MA 02601 T _ - 7005 1160 0000 0191 3264.--� wTNE�go, 0 - - .- _ _ . 021A $ 05.21 0004606238 MAY30 2007 MAILED FROM ZIPCODE 02601 r Ut =�._--- Ms Kathryn Silva I 2 P O Box 142 West'Barnstable, MA 026.68 RETURN TO SENDER UNADLE: TO FORWARD T COMPLETE THIS SECTION ON DELIVERY, ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X ❑Agent - a Print your name and address on the reverse ❑Addressee ; so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I Ms-Kathryn Silva = i P 0 Box 142 - { 3. Service Type fstlM Barnstable, A 02668 ❑Certified Mail ❑Express Mau ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ( 7005 1160 0000 0191 3 2 6LJ (Transfer from service fabeo J i =; yi j PS Form 3811,February 2004 Domestic Return Receipt 1 o25ss-o2-M-154o t t+-`-•tT1-rTr1--r-rr-rtrY ttrttm -rr--4`t'-rt#_ T__ . ' IL' �. • . . .• . . . � m ir Imo' OFFICIAL, p c;, . ,j f Postage $ p Certified Fee 66— O p o� ' �5 \ p Return Re Fee Postreark'. (Endorsement Required) a • ��O�Heret C3Rest%d Delivery Fee -0 (Endorsement Required) Total Postage&Fees $ JGj' Lr7 p se To p M5 eat1crf�l -`S,# r/a. - - - - ------------------------------------------- orPOBoxN /'lam City -te,ZIA 4 'n - ..... .� tA :M Certified Mail Provides:o A mailing receipt (esraney)zoo?eun f'008r-OASd o A unique identifier for your mailpieoe a A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mails or Priority l4aile. n Certified Mail is not available for any class of international mail. n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSs postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail ,addressed to APOs and FPOs. Town of Barnstable o Regulatory Services snxtrsrns Thomas F. Geiler,Director _` ••� Public Health Division rED MA'S A ' Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 28, 2007 Ms Kathryn Silva P O Box 142 West Barnstable, MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE.5 The septic system located at 41 Twickenham Crossing, Barnstable,MA was.last inspected on February 21St, 2007,by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of the septic.system showed that the system"Failed"under the guidelines o£.;1995 TITLE 5 ( 310 CMR 15.00) due to the following: t �i F'tYl \1' .TC T , -..rri T,r'^i'}.7 a j Tank& Covers at 20'. Tank full to cover, there is a backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert. Liquid depth in leaching is less.than 6" below invert or available volume is less than %Z day flow. You have 1 year from the date of the system failure to bring'the system into compliance. If there Tare any questions about this reminder,please feel'free to contact the Barnstable Health Department. BARNSTABLE HEALTH DEPARTMENT ,f _b f:].t vt �' .r 4. ._. ,.( ,�e`, 3 L {� tj`Y ,,. ; -t:... YX�..-Cr y `Thomas A1VIcKean,'R.S': YC.H:O { .. _ Y'. r ,. ft: {. 1 aZ,� ,. -U.r�. r.a.. yn Agent of the Board of Health mnf. Town of Barns .. � '°w�'^`��`+�,"'�`G`h �««.w.,,,.�•�.uam.y�` . f ° table "!�u s!' a °-,4 ;`rnR 3 M Public Health Division V' �' � HAMMRM a 200 Main Street Hyannis,MA 02601 s� 70�5 1160 0000 0191 3219 02 1A .. . .- $ 04.640 0004606238 MAY01 2007 MAILED FROM ZIP CODE 02601 N 1XIE. 029 1 02 0.6Y 09,t 07 '0 RETURN TO SENDER ATTEMPTED --. NOT XNOWN UNABLE TO FORWARD GC: 02601400200 'k2922—.15705-0;1-39 x` COMPLETE THIS,SECTION ON..DELIVERY � -�' a Complete items 1,2,.and 3.Also complete A. Signature i item 4 if Restrictedbelivery is desired. ❑Agent e Print your name and address on the reverse X ❑addressee I R so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I a Attach this card to the back of the mailpiece, p or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No I � I I o. a 3. Service Type ,. ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchargise I ❑Insured Mail ❑C.O.D. )� 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service label) 7005 116 0 0000 0191 3 219 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-11540 ; U.S. Postal Se}viceT��' CERTIFIED MAILTN, RECEIPT Pro_vided) (Domestic,Mail,Only;No Insurance�Cov_erage, ff Fd�,delivery,information v sit our web`site aat Fv .usps.com3, � 1 • PS Form_3800-June 2002 See.Reverse_foransiructions Certified Mail Provides:a A mailing receipt an as� aa)ZOOZaunf'008E wio Sd o A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: I o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. . o NO INSURANCE COVERAGE IS PROVIDED with Certified (Nail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted DeUvery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. ,, I Town of Barnstable GF tHE)sue. tiO Regulatory Services MB Thomas F. Geiler,Director BARN16 9 ,0lg Public Health Division Thomas.McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304. April 4, 2007 Ms Kathryn Silva 41 Twickenham Crossing y Barnstable,MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system owned by you located at 41 Twickenham Crossing,Barnstable,MA was last inspected February 21" ,2006,by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system"Failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Tank& covers at 20",Tank full to cover, there is a backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool.. Static liquid level in the distribution box above outlet invert. Liquid'depth in'leachiug-is'less than 6"below invert or available volume is less than % day flow. You have 1 year from the date of the system failure to bring the system into compliance. If there are any.questions-about this,reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALTH DEPARTMENT' ( omaVs A. McKean, R. ., H.O. Ak,, of fhejBoard`of Health �. �'�.�� {�. 4:.� d+, !. yy.• ; �`7 P?.T ' `qft R�,.,TK ,,�- �.:' it :'ii;lir+; �.1�t.pr 'Kx�'c�:5 .-.J ' i� .. _,r_:.r.. �.c-r ,�yT. s. v:�� - ..1. . ,.,c , P_:. .., .. '� t �.�.>•t x ;..i:��S a`.R.a;:lii Y> � V.tt.�t.Y i+.}C;� .. .i �{ l i�l.� t,. Ir� A .. {:•,.) ... { ' �.. `� t-i ._ .... i .. .. .fir, l'.:. �j tr`.l T ... �.. .,i�f_,''� _.{ _�. .. .:^� 2•• i.�. f ,n of Barnstable j is Health Division ges Pos;t� Main Street mis,MA 02601 •. 6 4 gcs RTNEV j 7005 1160 0000 0191 3264_- -. 02 1A $ 03®210 0004606238 MAY30 2007 MAILED FROM ZIPCODE 02601 c Ms Kathryn Silva '� P O Box 142 West Barnstable, MA 02668 NIXIE I RETURN TO SENDER I UNCLAIMED I i UNA LD TO FORWARD I� ®C: 02801400200 *0969-09120-30-39 I i -%�=••-�•y•Jr�� 1I1,,,,►I,I,II„Il,,,,,,ll,I„I1I,,,II,,,,;l;lll,,,li,,,,�l,l,l wn of Barnstable olic Health Division Main Street :�t:;r�..�:;?_ �:.ia� � .,u.: :,�•, :,A�: _�,..�.�, ;.� annis,MA 02601 `_ • - :;Y "��'� 6�..� � ,�.,•"�'"`�... 7005 1160 0000 0191 3219 a 0004606238 $04A 2007 640 • MAILED FROM ZIPCODE 02601 NIXIE 029 1 02 O-SYO9/07 G .. RETURN TO SENDER I ATTEMPTED - NOT KNOWN UNAMLE TO FORWARD � ,� o 1 ' , • i ill,,,; �- CI • ru - m m r a > �Q I E3 ag p Postage $ cJ ,:;�1?i;�`c�t``-..- � p � Postage $ O p � .. r rt:;.. i p Certified Fee %� Postmark 3� g p Certified Fee �� '� p A . 65 j p Return Receipt Fee /� Here , is p Return Receipt Fee streark (EndorsementRequired) V i a r': ;,�llere (Endorsement Required) 07 .4vt• 1 p Restricted Delivery Fee ;� 0 Restricted Delivery Fee -0-R (Endorsement Required) 1 /` -� (Endorsement Required) j r-1 G f}nC, � ppI Total Postage&Fees $ Total Postage t{Fees s p Sent To 0 Sel To L ,.y) p C3 1 at);et-.f G t/GL lti ......... - --- ---- -- - Street Apt. o.• � � ` �` street,Apt ---------/-•--- ----- --------- --- or PO Box No.�l� /p L �/o orP?Box N7 b. o, / l oL- ...... City,State,ZI +4 D /� v / City, fete ZIP+4 - a Complete items 1,2,and 3.Also complete A. Signature j Item 4 if Restricted Delivery is desired. X ❑Agent i a Print your name and address on the reverse ❑Addressee 1 j Iso that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery { I7 Attach this card to the back of the mailpiece, or on the front if space permits. D. is delivery address different from item 1? ❑Yes i 1. Article Addressed to: If YES,enter delivery address below: ❑No , I I j Ms Kathryn Silva P J Box 142 i 3. Service Type West Barnstable,MA 02668 ❑Certified Mall ❑Express Mail j i ❑Registered ❑Return Receipt for Merchandise — ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number I 7005 1160 0000 0191 3 2 6 4 a i (Transfer from service label) PS Form 3811,February 20041! ;I i Domestic Return Receipt, 102595-02-M-1540 �rn Li r4e I i a Complete items 1,2,.and 3.Also complete A Signature item 4 if Restricted'Delivery Is desired. ❑Agent ® Print your name and address on"the reverse X ❑Addressee so that we can return the card to you. ® Attach this card to the back of the mailpiece, B Name) C. Date of Delivery Received by(Printed or on the front if space permits. i 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes I If YES,enter delivery address below: ❑No o• Rai /90-- ; h/,4 ae /� 3. Service Type i 6 ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merch Ise ❑Insured Mail . ❑C.O.D. )� 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7005 1160 0000 0191 3 219 PS Form 3811,February 2004 Domestic Return Receipt 102595 o2-M-1 sao LLj �I qo - J ` OR (u3tc-X f lr Lu l t yu T-7� . r-6' r o� Barnstable Assessing Search Results Page 1 of 2 i �A s r Home: Departments:Assessors Division: Property Assessment Search Results New Search T New Interactive Maps >> Owner: 06 Assessed m Values: SILVA, KATHRYN A 41 TWICKENHAM CROSSING Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 166,600 $ 166,600 237 /061/ Extra Features: $2,700 $2,700 Outbuildings: $24,400 $24,400 Mailing Address Land Value: $216,300 $216,300 SILVA, KATHRYN A Totals $410,00 4 41 TWICKENHAM CROSSING 4"*- '564, W BARNSTABLE, MA. 02668 V 2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $58.66 Fire District Rates Town Barnstable- Residential $1.90 $6.31 Barnstable-Commercial $2.51 Commei Barnstable FD Tax(Residential) $779 C.O.M.M. -All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Persona Town Tax(Residential) $ 1,955.47 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other R; W Barnstable-Residential $1.60 Commur arnstable-Commercial $2.46 Total: $2,793.13 poo al "I Construction Details Building Property Sketch Legend Building value $ 166,600 Interior Floors Carpet t4� Style Cape Cod Interior Walls Drywall Model Residential Heat Fuel Electric Grade Average Heat Type Typical 9 Yp () Stories 1 1/2 Stories AC Type None 0f e Exterior Walls Wood Shingle Bedrooms 4 Bedrooms Roof Structure Gable/Hip Bathrooms 1 Full + 1 H http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparbac... 1/31/2007 Barnstable Assessing Search Results ; Page 2 of 2 Roof Cover Asph/F GIs/Cmp living area 1960 Replacement Cost $185097 Year Built 1985 Depreciation 10 Total Rooms 7 Rooms s 1=13 Land , a t CODE 1010 Lot Size(Acres) 2.26 r / S Appraised Value $216,300 Assessed Value $216,300 Interactive Ma s > Sales History: Owner: Sale Date Book/Page: Sale Price: SILVA, KATHRYN A May 5 2000 12:OOAM 12991/254 $310,000 NOLAN, SCOTT M& MARIA K Jul 15 1993 12:OOAM 8668/114 $ 165,000 HURLEY, ROBERT A Aug 15 1984 12:OOAM 4233/277 $0 HURLEY, ROBERT A Aug 15 1983 12:OOAM 3838/081 $ 15,500 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BRN3 Barn 1 Sty/Lt 1080 $24,000 $24,000 FPL2 Fireplace 1 $2,700 $2,700 SHED Shed 64 $400 $400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS UST Utility Area (Unfinished) Second Story Living Area ) (Finished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO6map.asp?mapparbac... 1/31/2007 Barnstable Assessing Search Results Page 1 of 2 yy g D%ly b Home: Departments:Assessors Division: Property Assessment Search Results New Search New Interactive Maps >> Owner: 2006 Assessed Values: SILVA, KATHRYN A 41 TWICKENHAM CROSSING Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 166,600 $ 166,600 237 /061/ Extra Features: $2,700 $2,700 Outbuildings: $24,400 $24,400 Mailing Address Land Value: $216,300 $216,300 SILVA, KATHRYN A Totals $410,000 $410,000 41 TWICKENHAM CROSSING W BARNSTABLE, MA. 02668 2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $58.66 Fire District Rates Town Barnstable-Residential $1.90 $6.31 Barnstable-Commercial $2.51 Commei Barnstable FD Tax(Residential) $779 C.O.M.M. -All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Persona Town Tax(Residential) $ 1,955.47 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other R, W Barnstable- Residential $1.60 Commur W Barnstable-Commercial $2.46 Total: $2,793.13 Construction Details Building Property Sketch Legend Building value $ 166,600 Interior Floors Carpet Style Cape Cod Interior Walls Drywall Model Residential Heat Fuel Electric Grade Average Heat Type Typical Stories 1 1/2 Stories AC Type None Exterior Walls Wood Shingle Bedrooms 4 Bedrooms Roof Structure Gable/Hip Bathrooms 1 Full+ 1 H http://www.town.bamstable.ma.us/assessing/assessO6/displayparcelO6map.asp?mapparbac... 1/31/2007 LOW & WELLER, INC. "Fiddler's Green Plaza" 714 Main Street, P.O. Box 119 Yarmouth Pbrt, Massachusetts 02675 362-6868 362-8131 Registered: George Low, Jr., R.L.S. Land Surveyors A. Paul Simard, P.E. Professional Engineers William G. Weller, Consultant October 8, 1985 BOARD OF HEALTH Town of Barnstable Town Hall Hyannis , MA 02601 RE: Lot 2 - Coleman Lane, W. Barnstable Gentlemen: Please be advised that we have supervised and in- spected the installation and construction of the new sew- age system for the above referenced location. We find the system has been installed and completed in accordance with the revised plan. If you have any questions, please do not hesitate to contact us. Very my yours, A. ul Simard, PE APS:dlw cc Barnstable Assessing Search Results Page 2 of 2 Roof Cover Asph/F GIs/Cmp living area 1960 Replacement Cost $185097 Year Built 1985 Depreciation 10 Total Rooms 7 Rooms Land ��'� � �.:. CODE 1010 ' Lot Size(Acres) 2.26 Appraised Value $216,300 Assessed Value $216,300 View Interactive Maps > Sales History: Owner: Sale Date Book/Page: Sale Price: SILVA, KATHRYN A May 5 2000 12:OOAM 12991/254 $310,000 NOLAN, SCOTT M& MARIA K Jul 15 1993 12:OOAM 8668/114 $ 165,000 HURLEY, ROBERT A Aug 15 1984 12:OOAM 4233/277 $0 HURLEY, ROBERT A Aug 15 1983 12:OOAM 3838/081 $ 15,500 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BRN3 Barn 1 Sty/Lt 1080 $24,000 $24,000 FPL2 Fireplace 1 $2,700 $2,700 SHED Shed 64 $400 $400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assessO6/displayparcelO6map.asp?mapparbac... 1/31/2007 TOWN OF BARNSTABLE LOCATION SEWAGE# .VILLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: 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 O.J �3 No Fee ram' ETT, Entered in computer: MMONWEALTH OF MASSACHUS Yes_ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,MASSACHUSETTS 0[ppfication for " P001 *PMCM Cougtruction Permit Application for a.Permit to Construct( epair( )Upgrade( )Abandon( ) 0 Complete System ❑Individual Components Location Address or Lot N �+ Owner's Name,Address and Tel.No. Assessor's Map/Parcel t. S� V n, 7 r Installer's:Name,Address,and Tel.No. Designer's Name,Ad ress and Tel.No. � r xv �? r2 Type of Building: e ��b� o �e /rs oy�(f �4D'11�L Dwelling No.of Bedrooms Lot Size .ft, Garbage Gttind r( 3� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design plow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date . Title Size of Septic Tank t1U ��^ Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) N 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 iss b this Board f Health. Signed Date __ Application Approved by Date Application Disapproved for t following reasons Permit No. )0,0,r=_0 Date Issued U . THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS .certificate of_Comptiance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded.( ) Abandoned( )by c= at l e- �.•1•�'- Ss t`t has been constru ted ' accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. u.S -��3 dated / � 0 Installer do,.rj n t Designer , The issuance of this pe 't shall not be construed as a guarantee that the system will function as designed. Date Inspector No. U U Fee . I THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION = BARNSTABLE, MASSACHUSETTS 12151400of .-item con5tructiOff Permit P Y g Permission is hereby ranted to Construct( v)Repair( )Upgrade( )Abandon( ) System located at LZ 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. i Provided:ConstructiPn must be completed within three years of the date of Dater' I �o.S Approved by V TOWN OF BARNSTABLF��r�6'� I LCk"A'pFf N :� ��'f �� SEWAGE # VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type),<7 '(size) L , NO.OF BEDROOMS BUILDER OR OWNER /�/ .S�ti PERMITDATE: 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 rr -.t r _� � .. • �R :,. �. J.i. � �O r �\� �G�, .. �\.......- i V\ / . 1 1 { \ �' �. V � i 1 ..� � r !;.�'� � � �. e..r g. � a SO Fee / THE COMMONWEALTH OF MASSACHUSETTS ._jEntered in computer: ✓ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for niooml 6pgtem Construction Permit Application for a Permit to Construct( )Repair()()Upgrade( )Abandon( ) ❑Complete System ElIndividual Components Location Address or Lot No.y �5rc�1 pl 4Z37-0&` ( �x�f Owner;�me/�ddress and Tel.N�U Assessor's Map/P tz InsptaAller,' arne,Add ss,and Two,,. ) Designer's Name,Address and Tel.No. Type of Building: dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 4Y—Z- ZO.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Re rijrsorAlteraliaw ns er 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$,lace the system in operation until a Certifi- cate of Compliance has been issued by t�s Bog f Health Signed Date Application Approved by Date Application Disapproved for t following reasons Ice Permit No. Date Issued Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ - Yes _ P B HBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Application for Migooaf *pgtem Construction Permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Z 3 7—O(9 f , Owner's Name, ddress and Tel.No�._4—illift .r Assessor's MapN?; el Installer's ame,Add ess,and Te o. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ® To.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. .`- ,.Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. =a. Description of Soil ! Nature of Re irs or Alterat' s SAns er when applicable Date last inspected: 3 Agreement: _ 1 . 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 operation until a Certifi- cate of Compliance has been i su d by hti�ijss 0 f Health,, Signed �/` Date Application Approved by. Date Application Disapproved for t fonowing sons Y t Permit No. L4 L4 — Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewa Dis sal System Constructed( Repaired Upgraded Y ) P ( ) ( ) ' Abandoned( )by at 1 1 r17 4P N&�, ,v h s a onstructed in accordance Y; with the provisions of Title'5 and a for Disposal System Construction Permit No. -" dated Installer - Designer ,S A The issuance of this permit..�al��Yfqred as a guarantee that the syst n ' unc io}��as signed/! Date /T�'z, Inspector ------------- _TQ_—_ No. ,77 if Fee THE COMMONWEALTH OF MA_SSACHUSETTS PUBLIC HEALTH DIVISION -.BARN"STABLEi MASSACHUSETTS Mi-gpogar *pgtem on5truction Permit —Pe missio*t is hereby_granted to Construct( , )Repair,( UpgFade( )Abandon ) A System located at //fig 1 C /� 1�f/r j r 1 V C , UJF Y V 1-J7'/ r 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:Construe must c eted within three years of the date of p t). �f 0- Date: --Approved by `t 116199 NOTICE. This Form Is To Be Used For the Repair p Of Failed Septic Systems Only. - 1' CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, ,l//rL�/tN� / ereby certify that the application for disposal works construction permit signed by me dated concerning the property located at I' I mom�ee�>ZsXalllol'f the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil 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 150 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.�dmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(l t) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation —0+the�IAX.High G.W. Adjustment�W = Q DIFFERENCE BETWEEN A and B o SIGNED : DATE.- (Sketch proposed plan of system on back]. q:health folder.cat TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE � ' 4 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. AIIX/Ah • Z21,16 �. ^ SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ,//�/�/L�fLTG�5'(size) Ael� NO.OF BEDROOMS BUII DER OR OWNER PERMUDATE: 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 y • . y - 1; r e, �Z �._� / L0 TI9NI SEWAGE PERMIT NO. v r E I N S T A LLER'S NAME Z ADDRESS B U I L D E R OR OWNER DATE PERMIT ISSUED DAJE COMPLIANCE ISSUED 10 3 -a5 a 1 Cl e o-cti e- F� A APPLICATION P'OR PEliCOLATION TEST AND OBSERVATION PITS CATION Lo 7- Z 7-1-Jic jc��14iq M LLAGE ,3A P-AJsTi4,0[-E _ DATE// -j - g¢ PLICANT 2045EiLT- H Ue LE FEE 30 eb DRESS /D G LOCvsT_ LA-•� LSItle J -7 q13 LGELEPHONE NO.,57(= ? - 68 A Non-refundable) GINEER 'Ga k) _ :` NC- _TELEPHONE NO.3(,2-- TE SCHCDULED b�"� /�} !y8�f -� // A ti �_• �3 f G,� """' (Applicant' s signature) • • • • • o e e a 009 • o.• a o o o a • w o a D • • e • o • o o o • •-• •.• • e'• •r a • • • • •.•.• • • • • • • • • • • • e • e • • • Del . o . • • . • . SOIL LOG. B-DIVISION NAME DATE 1z TIMEJ/ 7. ANSIbN AREA: YES KNO _ GOw I.JEL-C.E2 . /�G ENGINEER ' N WATER�_PRI VATS WELL ,� , G!l=/=d/z D BOARD OF HEALTH G 'C-00 Gpe—j tiJ /AJ C EXCAVATOR _TCH: (Street name, etc. ,dimensions of lot, . exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES: Z15': 4=5 Zo o. fe zo;07' -'. -' f - - 45 4511 dam. '� 99 • 8. Zo5 .94:' 7:46 COLAT I ON .RAM e M�,v /,c 'T�,HOLE ENO: LEVATION: TEST HOLE NO.: ELEVITION: ' 2 � 1 Go�M 2 3 3 6 �\ 6 -- 7 - 7 g 9 9 f 10 _ F/N E 10 11 _ 11 12 _ 12 - •13 13 Y 14 14 15 fi/,JE 5 Rio 16 / 16 ; TABLE FOR SUB-SURFACE- SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES UITABLE FOR SUB-SURFACE SEWAGE. REA4ONS. E: ENGINEE'11ING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION G INAL: . COI.IPLP,` PI) T IJ ENTIRETY BY P. E . AND RETURNED TO BOARD OF HEALTH P.P 1� t f r � • t � G No......... . a Fizz....d....'..................... THE COMMONWEALTH OF MASSACHUSETTS ' BOAR® OF HEALTH •................................. ------..OF..........................._........... A%t Appliration for 0iipnsFal Works Towitrurtiun rrutit plication is hereby made for a Permit to Construct ( ') or Repair ( ) an Individual Sewage Disposal .. lear_AIO. ....7.. --------------g�..... _..-----------------------.... . ------------.. --a-._• dd L ress o lryr W Address Installer Address Q Type of Building Size Lot......... .................Sq. feet Dwelling—No. of Bedrooms...5.......................................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building &...... .No. of persons.......... --------- Showers (`Z.) — Cafeteria ( ) Ga Other fixtures ........................................................ w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity_Jgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 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........................ ----- O Description of Soil �� ¢`Id/ ----- ' °�'1'_._....-•---. •-------� .........._. .....-- -----------• -•---•--.------ x c, 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 TITLE 5 of the State Sanitary Rde—The undersigned further agrees not to place the system in operation until a Certificate of Co p a ss d b t e b a d of health. /®� � �`'� Date Application Approved By.............. t.._ ............................. Date Application Disapproved for the following reasons.-----•--------------•------••--•-----------------------•---•--------------------•------..__.....-----•••-•--•--- --•-•••-•....._••---•--•••-•--••-•----••-•--••--•-...._..-•----•-••--•-•--•----•-••--...••-••••-........--••--•-•--•--•---•••••--•-•--••-••--•--...•--•••-•••••-•••--•-•----•••...•••-••-•--••••-••-•--- Date PermitNo......................................................... Issued....................................................... Date No.......s�r Z:'1=.�f.`..� Fizz i..... .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -•----....................................O F......................--•---•---......1-.-----•-----•-------......................----•• Applira#inn for Disposal Works Tonstrurtion Frrutit pplication is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal g� ,OWn at: I ` .. - l--� ......... --. -----•--------------------•------•---- .............................................. r Lot�NOL c ion Address .. Q �rc w?ne '.. ....................................................Add ress Installer Address PO I Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms___..-_.....................................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building J.9 &._..... No. of persons...._....7........... Showers (L) — Cafeteria ( ) aIOther fixtures -•----•---------------•----=-------•-------•--•-----•..••----••••-•-•-•-------•-•-•-•-----------••--•--•---------•-------•---•......----•--••-----•-•- d WDesign Flow............................................gallons per person per day. Total daily flow____--_--.•_---;............................gallons. WSeptic Tank—Liquid capacity_/.o9(Ogallons Length................ Width................ Diameter..:............. Depth....._.......:-. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area......._.......^...sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--_•_•-______-__-_-____. Li, Test Pit No. 2 ..............minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------j-- -- O Description of Soil �r� t 4/ t 5� ............ --/`--- ` - - --- 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation untillaa Ce t,1 sate of >a be sued b the b�-d of health. Sign e- 17 " ---------------------- � � � 7 � Date Application Approved By................�...� �..e.• %,: .� Date Application Disapproved for the following reasons.__ _ ____________________________________________________________________________________••---_---- -•-•----•-•--••------•-----------------------------------------------------------------------------------.--•-------------•-------------•------------•------------------••------•-•-••--------•-•---•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF' MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... ° Tn#ifirab of f omplinnrr THIS IS TO CERTIFY, That-h Individual Sewage Disposal System constructed ( ). or Repaired ( ) by-------------------------- .::_s:1.....''a t-------------------------.....--........-----------------------------...------...---.............------------ Install has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._. M „-------•_. dated-............................................... • _.._�-___�'�.._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. . DATE...........................{0/* a ............................... Inspector........---1.. -----------------•-•--•-......--•---....----•-----•-•-•-•-••-- THE COMMONWEALTH OF' MASSACHUSETTS BOARD OF HEALTH ...........................................0 F..............--..............................._............._....._................. No. 9.. Fes......................... Disposal Works Tnng#rnr#inn rnmit Permission is ereby granted-----------."... . J.r....... e to Construct ( 21 or,Repair ( ) an Individual Sewage Disposal System atNo........... y' �----•-_- .:�- =.� .�- 1 --4-•------_.----- ................•----•-•--••. •---•----•- • ............. Street �_ as shown on the application for Disposal Works Construction Permit Nam.____ _-._..Z._.. Dated.-___-------��!c%................. '- ••--•--- Board of Health DATE............... -- --J. = ............... ' FORM 1255 A. M. SULKIN, INC.• BOSTON Al'i'LlCt\fi0U 4 FOR PERWi,�,4i1W TEST AND ObS'E kV,�Tj.UN PITS LOCATION ��,�° f03 '� NO. "•I VILLAGEDATE �_13 APPLICANT FEE 2- 3 (Non-refundable) .ADDRESS TELEPHONE NO. ENGINEER TELEPHONE NO. DATE SCHEDULED Y (Applicant' s signature) • • • e • • . o 0 0 0 0 0• o •o e oe e • • • • • • •e o o •o 0 • • • • . • • o • •• • . . . e • • • •:e • • • • • • • ••••o • • • • • o • • • • • • . • • ?,CArJ DG ./A.,.� iN SOIL LOG SUB-DIVISION NAME,3ArrjS? jF_ (� F. DATE oeoer / TIME EXPANSION. ARE "::' YES NO A�/ 2. v , ..- I _ � ENGINEER ' -::. ,. TOWN WATER `� PRIVATE WELL Y L BOARD OF HEALTH EXCAVATOR - SKETCH: (Street name,etc. ,dimensions or lot, exact location of test holes and percolation tests, locate wetlands in proximity to test hol s ) NOTES: y 30' Z.A/ i • a � o PERCOLATION RATE: � ' TEST .HOLE NO: ELEVAT ON: TEST HOLE NO: /EVATION:' 1 ° �a Ate^ 1 Tago L �►-� 2 .2 3 3 5 AC T•� �� 5 �i 6 Cory 6 8 8 9 9 10 10 RZ,Yoe 12 12 1�3 13 14 14 15 15 16 16 / SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS V LEACHING TRENCHES- a UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS:' NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PVCT T APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E. AND RETURNED D OF HEALTH COPY: , RETAINED BY APPLICANT 4 _ t . - I I , J I ! f . .. �" , ' ° r to X R + r e i, i . Ali 44, .17 14A- -. �.�°' � 7�' e" "'!�Cl_� =. 4 �„� �' .� `-�,r _ ti3 f �• #"'��^,, ..i- �+ �. ..., .._ �"' ""`:--ram y � f t ram, �c },yySy:,t „.7;_ �i M .w•' t M�/�.. . „i �... , Q f ` ry � �� f"''''4►�.. -�: -'° .rah t i Y ;� SYSTEM PROFILE MOTES oe LEGEND TOP FNDN. AT EL. 71.5' ACCESS COVER TO WITHIN 6" OF FIN. GRADE ACCESS COVER TO WITHIN 3" OF FIN. GRADE 1. DATUM IS APPROXIMATE NGVD 100.0 PROPOSED SPOT ELEVATION `• /F=7-1. AccESs cavER (WAT'ERTIGHT) TO WITHIN 6" OF FIN. GRADE 2. MUNICIPAL WATER IS EXISTING 0' MINIMUM .75' OF COVER OVER PRECAST /� 2% SLOPE REQUIRED OVER SYSTEM 70.0' o 10OXG EXISTING SPOT ELEVATION R M. RUN PIPE LEVEL 2 DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. {ergo{e r a o 100 *EXISTING �* FOR FIRST 2' OR GEOITJ(TILE FABRIC �/ Q a � PROPOSED CONTOUR 3 MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO **EXISTING 1000 100 EXISTING CONTOUR 67.6' H- 10 ., *EX TIN GALLON SEPTIC TANK GAS "'r 67.43' � .: _. 6.78' S. PIPE JOINTS TO BE MADE WATERTIGHT. Cape Cod a BAFFLE66.95 ppE3p 0 _pppp7b p LOCUS o Community Q fi6.63 ppp0 M pOpCl DEPTH OF FLOW = 4' 6" CRUSHED STONE OR MECHANICAL p p p p p p p p p 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH Col%ge COMPACTION. (15.221 [21) 64.63 MASS. ENVIRONMENTAL CODE TITLE V. z TEE SIZES: 2' p !� p p p p p o p ' -1 ROute 6 INLET DEPTH 1 Q" 3/4" TO 1 1/2" DOUBLE WASHED STONE 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO OUTLET DEPTH 14" BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE. I Exit ( 1 % SLOPE) ( 1 % SLOPE) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. #6 FOUNDATION EXISTING SEPTIC TANK 65' D' BOX 17' LEACHING 6.83' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED FACILITY WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. *THE INSTALLER SHALL VERIFY THE **THE INSTALLER SHALL CONFIRM MIN. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCUS MAP LOCATIONS' OF ALL UTILITIES AND ALL SEPTIC TANK SIZE AT 1000 GALLONS AND BOTTOM TH-2 EL. 57.8' DIGSAFE (1-888-344--7233) AND VERIFYING THE LOCATION BUILDING SEWER OUTLETS AND ELEVATIONS ITS SUITABILITY FOR RE-USE OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO SCALE: 1" = 2,000'f PRIOR TO INSTALLING ANY PORTION OF COMMENCEMENT OF WORK. SEPTIC SYSTEM ASSESSORS MAP-237,PARCEL -61 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. soh LOCUS IS WITHIN AID OVERLAY DISTRICT 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. N TEST HOLE LOGS ENGINEER: LISA LYONS, R.S. ENGINEER: DAVID FLAHERTY, R.S. WITNESS: DAVID STANTON, R.S. WITNESS: DONNA MIORANDI, R.S. DATE: SEPTEMBER 17, 2004 DATE: MAY 22, 2007 PERC. RATE _ < 2 MIN/INCH PERC. RATE = 8 MIN/INCH CLASS I SOILS P# 10804- CLASS I SOILS P# 11758 c0 ELEV: ELEV. ELEV. co N 0" 69.3 0" 4 66.5' 0" 4 68.8' A A A EXISTING �'� LS LS LS BARN / �,/�' �. _ TWICKENHAM �2" 1OYR :4/2 67.8' CROSSING 7" 10YR 4/4 68.7' 9" 10YR 4/2 65.T B ' � B LS ` �� '�' B LS 30" 1 OYR 5/6 66.3' N 'f, ` '/, � LS 22" 10YR 5/6 64.7' PERC C1 1OYR 4/6 , - MS 29 66.9 C 1 52 1 OYR 7/4 64.5 GRAVEL � /' FLS REMOVE EXISTING LEACHING �' PARKING ,� �o `" �� ,� 70". T 0`�F 7/4 -_60.7`- FACILITY AND REPLACE WIITH . c, PROPOSED SAS �� C1 FLS 81" 10YR 5/6 62.0' � PERC FS/LS C2 TH-1 o 2.5Y 7/3 86" 162.1' SANDY LOAM C3 5' REMOVAL OF UNSUITABLE SOIL / 90" 10YR 5/6 59.0' FS REQUIRED AROUND PERIMETER OF C2 108" 10YR_5/6 59.8' � / LEACHING FACILITY, DOWN TO M SUITABLE SOIL LAYER. REPLACE !' I` ,�2 LS/SL C3 FLS C4 WITH CLEAN MEDIUM SAND. TH-A TH-2 1OYR 5/6 FLS VW 136" 58.0' 144;" 54.5 132" 10YR 5/6 57.8' NO GROUNDWATER ENCOUNTERED BENCHMARK SYSTEM DESIGN: NAIL IN 14" PINE ELEV = 74.1' .� ! PAVED PARK/DRIVE �� GARBAGE DISPOSER IS NOT ALLOWED 11 s o t \�� W Or) DESIGN FLOW: 4 BEDROOMS 0 110 GPD = 440 GPD -�- N USE A 440 GPD DESIGN FLOW TITLE SITE PLAN 71 i GAS ,�" SEPTIC TANK: 440 GPD 2 = 880 o t METE ( ) OF 0 of **RE-USE EXISTING 1000 GAL. SEPTIC TANK �'-- EXISTING 4 BR DWELLING TOP OF LEACHfNG: 41 TWICKENHAM CROSSING FNDN=71.5' SIDES: 2 (38 + 12.83) 2 (.66) = 134 GPD o BOTTOM 38 x 12.83 (.66) = 321 GPD BARNSTABLE, A �2 a DECK TOTAL: 689 S.F. 455 GPD PREPARED FOR �2 USE (4) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) N �_ EDGE OF WITH 4' STONE AT SIDES AND 2' AT ENDS KATHRYN SILVA 73 LAWN DATE: MAY 30, 2007 -7 ,3� , MA APPROVED DATE BOARD OF HEALTH Scale:l"= 20' 74� 0 10 20 30 40 50 FEET n LOT 2 rn 2.26 ACRES± off 508-362-4541 OF P�gss9c "�4H OF Mi fax 508 362-9880 ARNE H ARNE y�N 118.05' o OJALA H. CIVIL OJALA down cape en gin eerin g, in c. 3 .47' o. 307920 �No,2 348 CIVIL ENGINEERS o LAND SURVEYORS v p 939 Main-Str'ee t - YARA IOU TNPOR T, MASS. s� DATE ARNE H. OJALA, P.E., P.L.S. DCE -23 04-232 SILVA_SP_SEPTJC.DWG DDFj