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HomeMy WebLinkAbout0039 CENTERVILLE AVENUE - Health 39 Centerville Avenue Centerville 246 011 I I !�!! �QECYCIfp !/ll UPC 12543 No.53LOR °osrcoNS°�� HASTINGS. MN No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: v Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppfication for Mi5paal *pftem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(� )Abandon( ) complete System ❑Individual Components Location Address or Lot No. 1 CGgfTEQU aLLC AUG. Owner's Name,Address and Tel.No. Mri Assessor'sMap/Parcel Z ( Lkk Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1Ro\op'A's Se&C '6k+fk1? Eew+ronmQn�o\ S�tCS- YA"y'-'-ykk4. MA C.: Type of Building: Dwelling No.of Bedrooms _ Lot Size -5 Jg(oS sq.ft. Garbage Grinder(wloc�) Other Type of Building JJrx_W_ No.of Persons a Showers(d) Cafeteria( V1 Other Fixtures Lav as:ea_Y. ka-Tc ACea IMTa�lpe1' Design Flow ?1-60 gallons per day. Calculated daily flow gallons. Plan Date to\15,®4 Number of sheets i Revision Date Title ?cps&4 ak 4Ssx +`c t Skern l 9 nc icg6e i Size of Septic Tank Type of S.A.S� X a5' X �a L jwl�\ '4 axn�.^5 L O 4�a\, Description of Soil �o� Am, n>� th Nature of Repairs or Alterations(Answer when applicable) p C -\�o� 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 provisi s of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is ued by is Board th. ``-- Si ed Date & //-7b) Application Approved b Date l7 Application Disapproved for the following reasons Permit No. Date Issued 607 .d �,,+� '` •Fee.. �✓ ; z, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3ppitcatton for Mt5po0al *perm( Conotructton Permit Application for a Permit to Construct( )Repair( )Upgrade O4 Abandon( ) [.Complete System ❑Individual Components Location Address or Lot No. 3q ,e EMTEQv t LLE A U G% Owner's Name,Address and Tel.No. vae'r'A (oO g1 z, ,,. Assessor's Map/Parcel C-"Tm v 2 4(, f ot% 5�a►� Installer's Name,Address,�acndd Tel..No. �f5- s 3ko Designer's Name,Address and Tel.No. tZo�p2��S 5eT c �,)i ce `l �rw�c�clm�� \ SV CS• Y� sCH� MA �. �atcY,cay�t„ Mtn oa53b Type of Building: Dwelling No.of Bedrooms 3 Lot Size .5,G(Q5sq.ft. Garbage Grinder Other Type of Building tQCX-W. No.of Persons Q Showers( ✓) Cafeteria( V5 Other Fixtures L4414F�—,aeY, k-1 rct4 N S1nIk9 LauNo¢t' Design Flow -J© gallons per day. Calculated daily flow 33I-5 gallons. Plan Date \O 4- Number of sheets Revision Date Title ?s-ocn ,u c*-, �e C S u pcc e Size of Septic Tank New t'50c, Q,o\ Acc,l; .,Type of S.A.S. (-I ' X Description of Soil tZcac �bc� S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: ' t � Agreement: The undersigned agrees to ensure'th&construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisi ns of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been�is �sBoard th. — -- /_ Si ed iCJ Date (P Q Application Approved b Date Application Disapproved for the following reasons Permit No. oD0041 ' 0 3 Date Issued /0 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (compliance THIS IS TO C T�F�Y,✓,t at the On-site Sewage Disposal System Constructed ( ) Repaired ( )Upgraded Abandoned( )b ; 0 L at 39 un rw / has been constructed in accordance with the pro isi nsf of Ii�tle/�� ,the�yfo D' posal System Construe ton Permit N .0 00'( `30� dated (o 11 7/U'/ Installer �tXJ (.� LYJ /`c/L Designer The issuance of thisgpermit shall not be construed as a guarantee that the sysfe will fu ction as designed Date "�( I �� Inspector 4- Y N. ��� 3a�---------.--------------------- - Fee 50 "` THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mt5pogal *p.5tem Con!gtrurtton Permit Permission is hereby gra t�jd t ons ir ct( ) epa Upgraiio )Ab 'don( ) System located at 7 � � � �� � .C� / 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. ��pe ji�ti Provided: Construction must be completed within three years of the date of this r Date: &h-7le � Approved by e r Q TOWN OF BARNSTABLEL LOCATION c) i I(-e- P*V e-- SEWAGE # VILLAGE C L41 1 ASSESSOR'S MAP & LOT -� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY _ 2 ( t LEACHING FACILITY: (ty )j���I�k 4(�Ll (size) Z� C:l r NO.OF BEDROOMS BUILDER OR OWNER VZ PERMITDATE: CONqLIANCE 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 �P�f Sep - 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304 • sns,ol :NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOL-%TIO.-N TEST AND SOIL EVALUATION EXEMPTION FORM Qtvl V herebycc«if that the engineered is e y me yp n �signed e b, 0 ��tec S concerning the property located at k\e PAX. Cn meets all of the f^L'owmg ::ntehzi� This failed system.is connected to a residential dwelling only. There are no _omm-.r;ia! or business uses associated with the dwelling, T? e soil is ciass;,:ed as.CLASS l and the percolation rate is less than or equa t0 -rt:nutes per The he applicant may use histoncal data to conclude this f3c: or rnav :onduct tests at the site without a health agent present There :s no increase in flow and/or change in use proposed There ;ire no vanances requested or needed. The bottom of the proposed leaching facility will not be located less than fourteen l',j fee: 3onve the maximum adjusted groundwater table elevation. fAdiust the Hunt .pater cable using the Frimptor method when applicablei Please complete the following: •( Ground Surface E!zvation (using CPO GIS informaitan) _ —�_ S; (:.tiV Elevat;on \lb— , -d;us(mcn( for nigh G.W. TT- RE F. E ETWEEI,t and B cJ'►rE D D ATE. _ C C) NOTICE ! 3asec j,on, t,-.e above ir•.formation, a repair pcmzit wil! be issued for oedraorns Tz .lrr.0 r.. :`O iddiu:�nM bedrooms ze authorized to (he future wiaiout en;!neerec =iyste-n plans. �_ --- — 1[:Ilh!f:OU �cicc.lm� Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: Lot No, 1 Owner: �At Acoz Address: Contractor: ^Address: Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date mo h/d /year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OAppropriate index well.................................................... fAI © Water level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... mo h/year STEP 4 Using Table of Water level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 28) determine water-level adjustment 3 STEP 5 Estimate depth to high water, by subtracting the water• level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ............................................... ...;...................................................... I; Figure 13.—Reproducible computation form. 15 10/13/2014 00: 11 FAX 0 002/002 Town of Barnstable Regulatory Services Thomas F. Geiler,Director BARMAN& = NAM Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Desiener Certification Form Date: 7/16/04 Designer: Shay.Environmental Services Installer: Roberts Septic Service Address: 34 Thatchers Lane Address: 5 Trenton. Street East Falmouth, MA 02536 Yarmouth MA On 7/14/04 Roberts Septic Service was issued a permit to install a (date) (installer) septic system at_39 Centerville Avenue, Hyannisport based on a design drawn by (address) Shay Environmental Services dated 6/16/04 (designer) X X 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, I ler's afar �CAR14F S"AY tt<�t8i f - o (Designer's Sign ure) (Affi p,Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT B ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU. ' Q:Health/Septic/Designer Ccrtification Form JIU.— 216-2004 FRI 11:36AM ID: PACE:2 TOWN OF BARNSTABLE LOCATION c) 6 �e�T� ✓V i f t f SEWAGE # ;W/_36' VILLAGE - CkFwvm V ►MSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I 1Db - e j c dW 04 ((j t l l LEACHING FACILITY: (ty ������1� (size) NO.OFBEDROOMS BUILDER OR OWNER V PERMTTDATE: -CoNqLIANCE DATE: 0 V, 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 t go, I l �IwsD ntit�.rtr a 0 -A. . i ACTION A , ALL OUTLET PMfRau n1e „u 1 � u .. *NOTE: PIPES ARE TO BE 4 SCHEDULE 40 P.V.C.:' , TE E Do�aeunal sox s►tAtL ee 10 min. fromPROFILE PIED OF LSACXINC SYSTEM 12^' house to septic tank ser u va FOR AT LEAST fr. t�RcxEtE covERk', " i t 1'snk Ex sung Foundation ,,_, .• ,� d` Septic tank covers must be r^. + " 3 6^OU1lE1 a i +rtd e Rhin 6,in, of rxNehed grade r b t / . - K►1oC OUTS - } ... .. Grade over is Tenk -98,0o tirade over o-Sox- ss.00xzl ove.SAS'-- ELEv-MOD /Z. ..Ma cr.ws erw.. v fir �/s ..�Iw w.. . , - ss . 1r MaET Dunn Mill s 0.02 3 HOLE H-10 !f 0.10 DIST. BOX 3`M OXI num Cawr top oR SAS-Etov.�5.75 t5 NEW GREATER S•, 0.010 x foot O 1b5^ ' P O 4 _ c .0 1,500 GAL ; 1 SCH. 40 T SEPTIC TANK o 0 C6 PLAN SECTION R p - � 20 �.cw.o.vtn 2 Lhlts a as, . 17, � QSSS .SECTION rn H 10 01 C3 o r g N > ...rr. rn ,: nlll fOUWMTpN-� O 5 ar 3. --5 3.5 M 3 HOLE H 10 DISTRIBUTION BOX a_ �, , 6mac3/4*-1 1 m > i s SYSTEM .PROFILE.. . /2 Effec•rf�e';'Length NOT m scA1.E x , > compacted stone d m 12� p Not to Stole c Effective Width ,M� ?hltMh,sY® T r u - � SOIt ABSORPTION SYSTEM (SAS) a i 500 - C H--20 LEACHING UNITS / WIGGINS PRECAST GENERAL. ' NOTES compacted stone m Not to Scale NOTE: ALL COMPONENTS MUST HAVE RISERS TO WTHIN 6" BELOW GRADE Bottomor Test 1. Contractor is responsible for Digsofe notification s t Hole Dee. 1 El and protection of oil-underground utilities and pipes. Obs. Groundwater Test Hole 1 Elev. NONE OBSERVED 2: The septic tank an distri ution box shall be set level on 6" of 3/4�--1 1/2" stone. 3� Bockfill should be clean'Sand or gravel with no stones over 3" in size. PERCOLATION TEST 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc, 5. The contractor shall install this system in accordance Date of Percolation Test: MAY 28, 2004 with Title V of the Massachusetts state code, the approved plan Test Performed By. CARMEN E. SHAY, R.S., C.S.E. and Local Regulations. Results Witnessed By WAIVER (per BARNSTABLE B.O.H_) LOT #19 6. If, during installation the contractor encounters any - Excavated By, SHAY ENVIRONMENTAL SERVICES, INC. soil conditions or site conditions that are different Percolation Rate: Less Than <2 MPI from those shown on the soil log or in our design installation must halt & immediate notification be LOT #4 made to Carmen E. Shay Environmental Services, Inc. 7. No vehicle or,heavy machinery shall :drive over the Test Hole septic system unless noted as H-20 septic components. No. %1 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. DEPTH SOILS ELEV. 9. All Distribution'Lines shall be 4"',diameter, Schedule 40 NSF PVC pipes. -- 0 98,50 10. All solid piping, tees & fittings shall be 4" diameter LOT # 8 Loamy �O s � - Schedule 40 NSF PVC pipes with water tight joints. Sant6 rR a/2 �� 11. Municipal Water is Connected to The Residence and Abutting Ae 98.00 �r9� Properties Within 150 Feet. LoamSandy' 10� 5/e • it^- 38^ Bess.25 LOT #12" THE PROPERTY LINES ARE APPROXIMATE AND p� COMPILED FROM THE.SURVEY PLAN GENERATED BY Medium .� 5,665 Square Feet + BEARSE & KELLOGG .OF BARNSTABLE, MA ENTITLED Sand ,' r- LOT #17 102 "CRAIGVILLE BEACH ESTATES, HYANNISPORT, MA"-PLAN BOOK 100 PAGE 031 10 rR 7/+ ; I 1-____- --�pZ DATED MARCH 2. 1949. IT SHOULD BE USED FOR NO PURPOSE I 38- 132 C, 100 OTHER THAN THE SEPTIC ,SYSTEM INSTALLATION. I-,10 EXISTING CESSPOOL TO BL.PUMPED`DRY & 98 REMOVED IF FOUND TO BE ,NECESSARY TO INSTALL NEW SEPTIC TANK. .25r _ - r, - NOTE: ANY STRIPPED 0 SOIL -�,�.,-•- .,1 OUT CONTAINING L.EACHATE :a z FROM THE'EXISTING P TEST HOLE 1 EX G CESSPOOL TO BE DISPQSED i 0 - OF AS PER BOARD OF H T S 0 - HEAL H SPECIFICATIONS.' LOT 11# •�. .. .2 NOTE: ' N►,;. ,� 0 WETLANDS ARE PRESENT.WITHIN'200 FEET OF PROPERTY. ASSESSORS MAP 246, ...PARCEL 011 - t D Box E-- Pert i1E1 : PROJECT BENCH MARK Depth to Perc:_38" to 56" 4 >_I, Perc,Rate- 2 `MPI (assumed) , .' --�- TOP OF FOUNDATION LEGEND � �2 4.5 ELEV. - 100.00 Assumed ' Groundwater .Not Observed - DENOTES PROPOSED No Observed ESHWT 104X 1 ADJUSTED H2O`Elev. s None 0 0 �2' SPOT GRADE NEW 15M gal: CO DENOTES EXISTING � septic Tar* LOT B X 104.46 SPOT GRADE Failed Cesspool PL PROPERTY LINE EXISTING PROPOSED CONTOUR S:BEDR00�1! p o _ — _ �: -�97 EXISTING CONTOUR HDVS� o ,-ass o DEEP TEST HOLE & 3-2,C aAlL ACCESS MANHOLES PERCOLATION TEST LOCATION 1 6 FOOT STOCKADE FENCE +- • _.:..,`•=dam-..a- ';ram..-.,.:.'-� :_..:. c1; I F I 2" 1 > REV : 17 04 -` Soil r : - #? � "----_____ � . , > 1 / / Log pe I�OH ti,LeT 1 8in 1 42.12 1 PLOT , - ,... L A N --__ , , _,. a. THE ACCESS COVERS FOR THE.SEPTIC TANK... -._ �� ,..:.... .-- asrnlBunoH e x AND 0 LEACHING COMPONENT . . ._ T. OF PROPOSEDEPTlC SYST M SHALL BE RAISED TO WITHIN 6" OF ) w`. E UPGRADE FINISHED GRAD .. STEEL REINFORCED PRECAST CONCRETE ,, E PREP R INSTALL TUF»TITE GAS BAFFLES E A ED FOR .. ..,:. .:.PLAN .VIEW OR EQUALS ON ALL' OUTLET.TEE ENDS; - `, ;, . ' , U-E72V T V `R ILL E' A V lid Z. ., �2.'REYOVA�.E COVERS DWA_ E RD UIGLEY 40 FONT RIGHT =0F WAY AT fnh dearanae ,: r,' _ 39 C ENTE_R�/ILLE AV NU n ItUet to eanet HYANNI POR �1 • , Desl n Calculations ' b Number of Bedrooms. H a _ 3 -£ ulvalent 'to �330 GaL` a � _a P EPA RED `BY. 33 mtnkrtum ' er.Title x Gander. Na , w-• ,. , Leac?tin ;Ca stet Proposed: 330.Ga1. Mtnl utn Mtn. Per Title V �YV �f �T .,.. 9 Capacity P hY m ( V} 4 ��� �a ��,C1 l O tic Tan -- :,,k . 2 x 3 Gal. a 60 U 3p 6 SE NEW:1,500-GAL Septic Tank. , IR NIfL�'NTAL SE,l7VIC �. of _ Fs'Sr INC. 5 L ABSORPTION AREA, to ROSS SET END. ::SECTION E us percale ...rate of.<2 men: inch _. o 20 40 _ � sa _ Bottom'Area. or al s .. _ � - _ . t.,. . • .: . ., . , ft_,..)c 300s . ft. , _.222.00 ollons � tl_ .,x p � P.O.O - BOX 27 � ` Side oI I,Area., fl.74 0l. ,, ,, t� ,_. ,_ ,. W s . ft.. x 148 s . ft. 109.50 '"allons 9 / q q 9 I TE S EAST FALMOUT A ffi H, .M 02536 Providing. 1 S a, TYP:ICAL`. 1500 GALLON -SEPTIC:.._:. ..: _ _ � 331.50 al art$.... . .; TANK 9 9 qro, a�R w, , �. , ,,, ` L 1 AX . .508 5�8 0 _ F -756 . se. PRECAST U 2 P E AST.500 C UNITS'.HAVING A 2 EFFEC VE , NOT TO SCALE O TI DEPTH, 'r . ..:r t ..... 0 D, _ „. != 1M 5 0 .WASHEQ TONE ON l}1 SID AN � SCALE:, f 20 ' N 10 LOADiN .. S E Es o SCALE..- 1 , ZO DRAWN BY. :CES. DATE.,,.,JUNE 15 2004 I 4 OF.WASH , EO STONE ON THE ENDS. _ R J- P, 0 ECT SD586 FILENAME. , D586F' WG - # P p ..._.. ...SHEET 1 OF 1