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HomeMy WebLinkAbout0027 CENTER LANE - Health 27 Center Lane Centerville A= 251 - 062 S M EA® No.2-163LOR UPC 12534 amead.com • Made in USA 4�yc M FMMUSMINrAfPROD=LN SDI �SRPROGRAM 50�RgNGD VJWW.Si1PRbG411AA.ORIi . s No. O Fee THE COMMONWEALTR OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION'- TOWN OF BARNSTABLE,•lVIASSACHUSETTS Yes Application for Mi4po5ar 6p5tem �Con5tructtou hermit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No., ' ce e?r�- /4 1? (� Owner's Name,Address,and Tel.No. �07141 Assessor's Map/Parcel Installer's Name,Address,and Tel.No.�/�,G Designer's Name,Address and Tel.No. ��� /�'� Type of Building: Dwelling No.of Bedrooms Lot Size 4:%�O sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min,required) gpd Design flow provided �7 gpd Plan Date 9 2 4 O 12 jig( Number of sheets Revision Date 0Z �{ Title �1 Size of Septic Tank �� �S(�© w'. Type of S.A.S. 15Z 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 9f Health. ., Signed Date Application Approved by a �P S Date Q Application Disapproved by: Date for the following reasons Permit No. — Z �i Date Issued d� ———————————————————————————————————————————— Al ' .. .. '4 . .. .. .No:2 D D — Z •+ Fee 'THE COMMONWEALTWOF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISIONJ- TOWN OF BARNSTABLE,,-MASSACHUSETTS Yes Z1pplicotiou for �Diqo al 6pgtem Con0truction Permit m Application for a Permit to Construct( ) Repair 4.1 Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. ��� pj Owner's Name,Address,and Tel.No. ✓� � a�/� 'S Assessor's Map/Parcel 7� Installer's Name Address and Tel.No.���.L��// .G:/ 6 Designer's Name,A dress and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size �,/' sq. ft. Garbage Grinder ( ) Other Type of Building �y s No.of Persons Showers( ) Cafeteria( ) Other Fixtures �) Design Flow(min.required) 3Y gpd Design flow provided "-4? gpd Plan Date 1 2 �( � Q� , 12 k# Number of sheets Revision Date 49 7Z y OR Title Size of Septic Tank ,i ���� �� 7XfU� Type of S.A.S. Description of Soil ; a � 9 A.. 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 B and of Health. — i, Signed 2 ` Date Application Approved by � 'S Date Application Disapproved by: / Date 6 for the following reasons (._. Permit No. -a 04 41 s (5 t Date Issued _ - - THE COMMONWEALTH OF MASSACHUSETTS 1 BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (k_ Upgraded ( ) Abandoned( )by /�//�///f�/f at � � (�:i 7e-l— .?e- C`y � has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 24'"9'2 9 7 dated Installer �64F'e' Designer Do" *4 Ca PF_ #bedrooms I Approved de si n flow �1 �+ gpd The issuance of this per mt,h 1 n t e con"strued as a guarantee that the system ill fun i as designed. Date Inspector = "< .n' No. �C�JD l Fee �Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS �Digoal 6p5tem (Cow6 truction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ) A�_andon ( ) System located at Cep f ✓ � � 1r'�!�/�� �j��� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty, to comply with Title Sand-the following local provisions or special conditions. Provided. Construction must be completed within three years of the date of this perm,ii lt Date Approved by ,i I l Town ®f Barnstable Regulatory Services Thomas F. Geiler, Director * BARNSTABLE, MASS. � Publk Health Division s63q. �0 �F039 Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: I Sewage Permit �� �- � Assessor's Map\ParceVII Designer: �Ov� Y) 2 F��/ ►yz,4 Installer: 15► J I JJ �3 /` 4 11 � . Address: r Ad�re�s: xan��my 44 On 4�?� . as issued a permit to install a (date) �- (mstal er septic system at 7 ao�� L - based on a design drawn by / (address) dated / (designer) ' V 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. 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. OF MgSs9cy DANIELA. nstaller's Signature) 0 O IAi 4 No.46502 �GISTEM ASS/ONAL ECG (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DMSION. CERTII+'ICATE OF COIULIAI,TCE WML NOT BE ISSUED UNTIL BOTH 1IDS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC IJEALTII DMSION-. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc . i t Town of Barnstabk �TRE Department of Regulatory Services uAnNrrrAeM p Public Health Division Date MASS. 200 Main Street,Hyannis MA 02601 t4. Date Scheduled \ y I0 —1 Time 10 A,r�� Fee Pd.— Soil Suitabildy Assessment for Sewage Disposal Performed By: Wr C k-e-l'��t1n 1 - Wlhtessed By: LOCATION & GENEERA]L INT+ORNIATION Location Address L, owner's Name �Oht ra. ty 2 d D Address Assessor's Map/Parcel: L tl /�i Engineer's Nang , NEW CONSTRUCTION REPAIR Telephone It Land Use. �5� _ 4 _— Slopes(%) � `�� u Surface Stones rk c,KC- Distances from: Open Water Body 7 S(�,� R Possible Wet Area -7 300 ft Drinking Water Well 7 2 o ft Drainage Way 7 30 D ft Property Line 35 f[ Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Cb L1/000 SF+I- \I.% v �00•00 - Parent material(geologic) p-u.'Tt,.hPlrl.IJ, Depth tQ Bedrock, 3 fe 1 Depth to Groundwater: Standing Water in Hole: P4 I Weeping fl'on1 Pit ftitce — t Estimated Seasonal High Groundwater I DETERAIIIVATION FOR SEASONAL 111011 WAFER TABLE Method Used: Depth Observed standing in obs.hole: In, Depth to soil nlrJlt-0: Depth to weeping from side of obs.holc: III, Groundwater Adjustment _ _ I`t• Index Well II Reading Dale: Index Well level _ _ Arlj,fLICthY AeIJ,CIYi7UlidwateY lxVel PERCOI.,ATION 'I'I+ST Dille 2 Q� TIM10 1 d A M Observation I HDIc# Time lit 9" _ Depth of Perc � Time at G" Slart Pre-soak Time @ oi-�,-V0 _ N Time(9"-G") End Pre-soak I' 1' '� ? e �� r,, Rate Min./lncli Site Suitability Assessment: Sile Passe,a° Sits-Failed: `�. Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Colnpleted on Back----------- ***If percolation test is to I)e conducted witilti11 1001 of wetland, you Iuust first notify tile. Barnstable Conservation Division at least 011C (I) week prior t0 beginning. Q:\S EPTIC\PERC FORM.DOC ON HOLE, LOG Depth from Soil Horizon Hole# Surface(in.) Soil Texture Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,stones;Boulders. Co istenc %u ravel � _ LS 10. t23/3 S . A (rW E D-RE D OPSERVATTON H LE'LOG Depth from Soil HorizonSoil Texture ` ' r Hole# Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consis ency,% ravel DEEP OBSERVATION HOLE LOG # _ Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil(USDA) (Munsell) MottlingOther (Structure,Stones,Boulders. Co sistelicy, Gravel) DEEP OBSERVATION HOU, LOG Depth from Soil Horizon Soil Texture Hole# Surface(in.) Soil Color Soil --' (USDA) (Munsell) Other ( I I) Moltling (Structure,Stones;Boulders, Consi ten a l I Flood Insurance Rate Map.• Above 500 year flood boundary No_ yes Within 500 year boundary No Yes Within 100 year food boundary No—JI—C Yes . Depth o:t'Nmtural Qcentrren pervious tVlaterial Does at least four feet of ntiturally occurring pel•vious material exist in all areas observed throughout the area proposed for the soil absorption system? L �5 If not, what is the depth l h of naturally y occurring pery ous matorlal7 Cen•t1fB�atloua ^ / �G 1 certify that on /v 0 V I (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 train' , expertise an&experience described in CIO CMR 15.017. Signature ✓`-� , Date K Z6 01 Q:\SBP'T'1C\PERCF0RM.D0C TOWN OF BARNSTABLE LOCATION � �//�'- '� /(/�; SEWAGE# per® VILLAGE_/Y�-_(AVUE ASSESSOR'S MAP&PARCE INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ,lWW J_-t)OD LEACHING FACILITY: (type)S,90 (size) NO.OF BEDROOMS OWNER AD PERMIT DATE: O `7 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 leachin ci'ry Feet FURNISHED BY y ,�3 T "• Notes: I '1.All work to be performed in accordance with Massachusetts State Building Code u 780 CMR,seventh Edition,or as directed by authorities having local jurisdiction. wr 2.Contractor to secure all permits,and to arrange for all required inspections on 3 site. !I G • 3.All debris to be disposed of legally off site.Completed work to be in usable and clean condition. LOCATION MAP NTS i 4.Patch and repair all areas of the existing building where affected by new work. ASSESSORS MAP 251 PARCEL 62 Replace all components where temporarily removed during work.Refinish areas as ASSUMED DATUM required to,patch existing. \ 5.Contractor to coordinate his work with utility companies and other third parties \ which may need to become involved in the completion of the work. 6.Cost of all permits and utility tympany back charges to be by the Owner,unless a\ J tij otherwise specified in the Owner-Contractor agreement. lQ f 4 5 d].5 47. / 4] \4xa 47.] PAVED SL_ 4).] G \�4 LOT AREA \ , 00 21,000* SO. FT. D EXIST. 47 G - CO=E -47.8 EXIST.DWELL. 1 e .B y. 47 +46.6 l 47.8\ se + .4 r +45,8 +46.1 O .. BENCH MARK-ON Y6 CpiC.PM EL-47.8 - +453 +4516 +47.1 es � , + +4&5 44 44.0 SITE PLAN " - - SHOWING PROPOSED GARAGE ADDITION b AT J�O 43.9 00 27 CENTER LANE +43.3 CENTER V ILLE List of Drawings: PREPARED FOR fl 506 362-4-1 +oc I ra,sae-36 Al 2-9sao _ JOHN LOPES Site 1_ Site Plan aoX.neape.com® .eo''HDr First Floor Plan ♦ +43.6 down cspe engmeerkf,me. OANIEL JULY 30, 2010 A2 - Second Floor Plan civil engineers A = land.surveyors aAIA A3 Elevations Nu.40980 Scale:1"=20' 939 Mom Sfreet (Rte 6A) 4, ,+ A4 Elevations YARMOUTHPORT MA 02675 � 0 10 20 50 60 50 FEET �_� to AS Sections and Details - DATE DANIEL A.OJALA, P.E..P.L.S. A6 - Foundation Plan A7 - Framing Plans 04-227 A8 - Framing Plans I Andreis R. Stfikls Archltecl . fiS River Vlew tape,—cenlervOta h4.e.4.chiuetti Plb3:. •Telephone(508r Site Plan 1+p - _ Addition to 27 Center Lane S 1 l.t+ Centerville.MA 02632 I 9 ILWSP 18 117-tO f , • A I I I - I P I aM . I o N O 3 } aL - - - � i Eli 12 s low t -- I II I i !•-1 Z I i � �i b s y E 6B .m w�—'♦' — .Z jN Io a P i r. w s t � IIIIti � D' A�O P L. { U m�q• r � z m o. Z c 17' � � • inn b ;a`m I j f :FR€D-6tCYC1tNtf -1£t4 — I CL j 1 �.I g_p It-4• .. v 5-o c•o. \ I � DFDRDOM NO.3 m o, / 3.N.i—13�=7_�LTe7C&-oet 0 I . 15'$" •N -- --PLAYS O.4 LA 17=g" I •� ' I / erreeAite,v. lzooll � m I I I •w I w Andrejs R. Strikis Architect 85 River View lane, Centerville,Menaehusetts OM2 •Telephone(5W)7WOM Second Floor Plan Addition to 27 Center Lane /,�2 Centerville,MA 02632 l 1 I I I I Y I I If M7-vim I ----------- - — ---- - I I nn ID 4 M4B-- -_R¢D'D �41��_REIN:E-_taES:N: N lau��ty krnN -.J I I I I I I I 5.f4_Ew .vOrE:,=tea I to \�7 I �• I --- i ——— — —— _-- --- L_U EXI$LIA -BIItLRIN.G....- I Tro21 39=0� 'L;4" 9�ti ILL 9�0•, 2�" _�lfLSS �I:D.OR_i`2k•MING PLAN. ----:zr'a=::- . - - � - NEW F6UNt7AfION PlA�1--._ __._ Andrejs R. SUMS Architect 85 River View lane, Centerville,MFssuhuxua M632 •tlkphone(5"99D4M I Foundation Plan Addition to 27 Center Lane A6 Centerville,MA 02632 ' 1RTho 8-17-10. AQS