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HomeMy WebLinkAbout0023 ELLIOTT STREET - Health ' 23 Elliot Street Centerville A = 230-122 i III SMEAD KEEPING YOU ORGANIZED No. 12534 2-153L©R OSUSTAINABLE FORESTRY IBN.RECYCLED INITIATIVE CONTENT 109i CoMad Fib r Sourcing POST-CONSUMER wwwAprogramArg NW11V0 /�p�_��MAADDEnW�UUSAA+MC4A= O�- 4` J No.�--��-�---�---� Fee---------`---------- BOARD OF HEALTH VIA TOWN OF BARNSTABLE Application-*rVell Cootruct ion Permit Ap ' atiog hereby mad�or a pe t to struct Alter ( ), or Repair ( )an individual Well at: r Location - Address Assessors Map and Parcel Address Installer Driller Address Type of Building Dwelling------------------------------------------------------------ Other - Type of Building------------------------------- No. of Persons----------------------------------__________ Type of Well- � ~- ---- ---- Capacity---------------------- - - Purposeof Well----------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private 11 ro tion Regulation - The undersigned further agrees not to place the well in operation I 'fic .o a has been issued by the Board of Health.�71 - - -- - ------- - - - /_�- o Si d -- ------- Pate Application Approved y— --------= ---- --- -- -— --- ---- - date Application Disapproved for the following reasons:----------------------------------------------------------------___----—---- --------------------- -- --- --------- ----------------------------------------------- ------------------------------------ /A date Permit No. - - ©`�-- - - Issued---- V ---------------- date --- - --- - ---- - -- -------------------------------------- - -- - -- ------- -------- BOARD OF HEALTH TOWN OF BARNSTABLE C ertif icate ®f Compliance THIS,�$JO •ERTIFY,Jhat the dividual Well Constructed (4<AItered ( ), or Repaired ( ) --- ---------------------------------------------------------------------- .Installer -- at-QJ� �( !® 7 _------- C�------------------------------------------------------------------------------- ------ ------------- has been installed in accordance with the pro/visions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -----------------------Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- /� --------- — - -- Inspector-------------------------------------------------------------------------- � � oa2- 5 No.-------------------- Fee------------ --.f-------- BOARD OF HEALTH TOWN OF BARNSTABLE f% Applicat ion,forlVell Con5trurtionPermit i AP I' atio ,4s)iereby made or a perm't to struct ( ), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Ma and Parcel — - P ------------------------------------------------------------------------ Ow er Address �Fo ---------------- Installer — Driller Address Type of Building Dwelling--------------------------------------------------------- Other - Type of Building--------------------------- No. of Persons-------------------------- Type of Well Capacity Purpose of Well------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private ell Pro e tion Regulation - The undersigned further agrees not to place the well in operation i r ific a .of o pI' n, has been issued by the Board of Health. y /ate Application Approved -------------------------------------- -— �J //!d f ------------------------ date Application Disapproved for the following reasons:------------------------------------------------------------___________—_________ ---------------------- -- --- -------- ----------------------------------------------------------------------------------------------- -- date Permit No. - C3 a-`�— -- Issued--- -I date -------------------------------------------------------------------------------------------------------' BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate Of (Compliance THIS�IS-TO ERTI Y,,That the dividual Well Constructed (`"), Altered ( ), or Repaired ( ) by o � ------------------------------ ----------------------------------------------------------------------------------------------------- Installer at-O-) %o__ --------- kisi—ons � �------------------------------------------------------- has been installed in accordance with the pr of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------------------Dated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE----`-'-/( -------------------------- ---- Inspector------------------------------------------------------------------------ ---------------------------------- -_-------------------------------------ems:.,-__P_ BOARD OF HEALTH TOWN OF BARNSTABLE Vell Congtruction Permit No. - --- --------- Fee--- -- ----------- - yy Permission is hereby granted f----- �2- - - -------- - -- --- ---------------------------------------------------------------- to Construct ( 1 r.( or Rep it ( ) an I ividual Well at: Street as shown on the application for a Well Construction Permit No. -------- O c' --- -- --------- - Dated---- -------------- ---- ----------------------------------- Board of Health DATE— -- c--- ,JI -0---- -- — -- No... 0� 6.3 !� s'Q, L9 Fee i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PYes BLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS pphrattou for Migozal *p5temc Cori.5tructton Vermtt pplic n for a Permit fo Construct t( ) Repair()Q Upgrade( ) Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. Owner's Name,Ad ress,and Tel. o. W ill-ox A f,& Assessor's Map/parcel S '?�( �,� llL7 Carte rv��e,s 1401 ,� Installer's Name,Ad essnd Tel Igo nSQQ9�� d✓v Designer Name,Address and Tel.No. 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) S gpd Design flow provided _5400 gpd Plan Date ` c7/ j � Number of sheets Revision Date Title Size of Septic Tank 11JID Q Type of S.A.S. 4_600St.,' qrS ►yLZ. Description of Soil Nature of Repairs or Alterations(Answer when applicable) O p j p� !al, Lmak 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 ealt S' e `' Date Application Approved b _ Date j I 7 Application Disapproved by: Date for the following reasons Permit No. 6, 3 Date Issued 101/5 No. . 005 5 6 3 v Fee 1. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: { Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zca pplication for �igoga[ *pgtem Construction Permit A pion.for a Permit to Conte strruuctO Repair( j, Upgrade O Abandon O ❑ Complete System ❑Individual Components y Location Address or Lot No. Owner's Name,Address,and Tel.No. / C QX� rv�t Wj r 1 l Adwtlzr5o>'1 Assessor's Map/Parcel CIS p_ c a a3 S h T(J�>)1 �5-3338 s h Installer's Name,Add ess�,,Xa'nd Tel.N <s�)9 Desig erg �u 3:y� Name,Address and Tel.No. ` �.. V, 51 toyer Pt1J=4_..Mo Type of Building: Dwelling No.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( : ), Cafeteria( ) Other Fixtures Design Flow(min.required) 5 Q gpd Design flow provided 5 G O gpd Plan Date 10 1 1 7 /9,00-6 Number of sheets Revision Date Title Size of Septic Tank 16 0 Type of S.A.S. 4`�0051 • (�C�11Le CYUwltk}+P.r'S 14,s6r'ie, ! Description of Soil i Nature of Repairs or Alterations(Answer when applicable)`,Ol�2 'U,6c 00�� Lf) l6op c51. t_�47 T 0,` tom '.GA C t'Ws . C.r l U AX'"5 J 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 ealt . x Si ed , �` Date Application Approved by Date / Jig t 8 Application Disapproved by: Date for the following reasons Permit No. 2,-)00 5 5 3 Date Issued ———————————————————————————————————— ceon+ (0l THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (k) Upgraded,( ) Abandoned( )by JQ, I'LQl C 0M,6-V 0 11A Rio a _ at t.o �,� . COftlltx V 101. has been constructed in accordance with the provisions of Title 5 and -the for Disposal System z � `�J Construction Permit No. J 6 3 dated 1 Installer R�UC�?Cf 6 L; I Designer r,r] D A, cg #bedrooms 5 Approved design flow gpd The issuance of this permit s all be construed as a guarantee that the system will function as designed. Date Inspector No. 0�0c) 5 O� Fee _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1=t2;po5a1 ,pgtem Congtruction Permit Permission is hereby granted to Construct Rep ) Upgrade ( ) Abandon ( ) System located at as �.�t>�n 1� l yl D,- 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: Constructi n mu�t be completed within three years of the date of this pe Date Approvetlby f Town of Barnstable Fstio Regulatory Services Thomas F. Geiler,Director snxNsensIX 9� HAM ,�� Public Health Division Ar fp 5�°i Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 ' F Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Designer: - Installer:'`"' _ Address: f \i Ab Address:1MA - - v 'l On Ycan I was issued a permit to install a ( ate) (installer) septic system at 3 E In I S f rc e based on a design drawn by (address) �SSoCj. datedA 9 �� dS (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. 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 Re ulations. Plan revision or certified as-built by designer to follow. VN of AMS, EDWARD L. yGN. PESCE !^, f(Ins / 0CIVIL GO al er's Signature) No.32001 9 O Q . A GISi�O,P � E�� �� 1 ner s Si e) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLI&H'EALTH 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. Q:Health/Septic/Designer Certification Form } TOWN OF BARNSTABLE LOCATION ELL/ O 7'1 S 7' SEWAGE # VILLAGE C e Al rC S V/_.L ems^ ASSESSOR'S MAP & LOT 2 3® � %2.Z INSTALLER'S NAME&PHONE NO. J /-p,M A C o M Fe S o N SEPTIC'TANK CAPACITY l S-D O LEACHING FACILITY: (type) al? t o eLL S (size) �'2- NO. OF BEDROOMS I BUILDER OR OWNER A AIZ2 f Rs O 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 w 7 a \ � � � 1 � � � v►� a �- �, � - , �o r 5 ,ems •�. �w ` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSE'TTS Certificate of C ompliante THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( } Repaired (K ) Upgraded ( } Abandoned( )by at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Constriction Permit No. e)W 5 5 b_3 dated � Installer IbC7¢X" �.tEt'1.4 Designer C A ?p 6 C ,F #bedrooms Approved design flow gpd The issuance of this permit sha not b nstrued as a guarantee that the system n ed. DateT Inspecto ` �, — t EolT i "J G 01 © 0 56064 a - f { McKean, Thomas From: McKean, Thomas Sent: Friday, June 10, 2005 9:50 AM To: Dillen, Elizabeth Subject: 23 Elliott Street Centerville/William Anderson The applicant submitted a septic questionnaire for four bedrooms. However, the submitted floor plan shows potentially seven (7) bedrooms in the dwelling. This application cannot be approviced as submitted. Please submit neatly drawn floor plans showing room dimensions, doorway dimensions, door locations, and window locations. I McKean, Thomas From: McKean, Thomas Sent: Wednesday, May 04, 2005 5:36 PM To: Dillen, Elizabeth Subject: Amnesty Applications/Septic Questionnaires 79 Suffolk Avenue/ Andrews The septic system shall be upgraded to accommodate four bedrooms. The application can be conditionally approved with the understanding that the system shall be upgraded prior to occupancy of the amnesty unit. 8 Curlew Way Cotuit/ Villa The septic system was approved for three bedrooms in 1990. Therefore the application is approved. QUESTION: Are there any windows provided within the basement bedrooms? If the answer is yes, are they properly sized for emergency egress? 23 Elliott Street, Centerville/ Anderson PROBLEM: The existing septic system was designed for four bedrooms. However, there were six or seven potential bedrooms counted when the submitted floor plans were reviewed. The submitted floor plans do not show doorway dimensions, door locations, room dimensions . Please have the applicant provide neatly drawn floor plans showing doorway locations, doorway widths, door locations, room dimensions, and window locations. i I 2 117 7 No.... 5-_0.0.......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH. .......................T own---......O F.............Barn stable---------------•-----------------.........---..... ApplirFatilan for Dhipaii al Works Tomitrut.rtion rrrutit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at:SZ �� FylliDtt.,�?d.�...0 ente�ville .---.02C-2.............. ..........•------- ,r .....-•-- Location-Address 3S or Lot No. W.ilI is EL.A nderzon.................•------------•---...----•-------•----._.... E17.1Qt1.. 02632....------.... Owner / Address A..&...B..CessgQol__S.e=iQ-e............................................. 12 .. i hop .. errace.,..HYAAniq.._MA 02601 Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......................... ...............Expansion Attic ( ) Garbage Grinder ( ) k Other—Type of Building ............................ No. of persons.............q............ Showers ( ) — Cafeteria ( ) Q' Other fixtures .............................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons 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........................................ aTest Pit No. 1................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........................ P4 --------------- -------------...-----...-----................._--------•---..........---......................................................... 0 Description of Soil.......Sanq........................................................................................................................................................ U --•...-••-•-•----------••-•----------•-------•-------•-•-••-•-••-----------------•------••---•------------•---------------•----•--•---------._...-•-------•--------•----------------.....-------••-••-- ---------- • . ....--- . . • - ------------------------•------•--•--------•---. -------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable__installation of a 1,00....gal�on,...pre..cast, stone Packed leach pit (overflow) . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITHE 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 bo rd of lth. Signed--- . --- •---y $/B2._.. Application Approved By.............. i// .. 6/ � 2 Date Application Disapproved for the following reasons----------- ------------...................------------------•-------------•---•-----------•---•---...----•-. -•----•-----•-•......................................•---------------------------•---........------------I--•---••-----•--------•--•----•---------------•--••-----------•---•-•--------------•••...._..._ 82- 6/ 8/82 Date PermitNo......................................................... Issued..................................................... Date No..•I?-..A-1 Fims.............�d.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ----------Tom.........OF............. as:table-------------------------------------------------- Alijiliraatiaan for Uiipaaaal Marks Tnnitratrthin "a mit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at:Sr E119.att ,- Ge�ateacscille,..*°A. .Q?.b32.............. ......--•---••-•-•-•----•-•---------......•-•---.............---•------- Location.Address Sj or Lot No. 'r.Ci:L1ia>r.Anclsr Qn..----•-----••------------------••--•-•-----•.............. ..r:A.....!2632•----......... Owner Address �y-annis:... -A 02601 Installer Address d Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms...........................:...............Expansion Attic ( ) Garbage Grinder ( ) p.I Other—Type of Building ............................ No. of persons-------------4............ Showers ( ) — Cafeteria ( ) 0.' Other fixtures ......-•---•-•-•-•-------•-••-• • • W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons 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 ( ) aPercolation 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 ••.......-•••••---•---•---••••.....................••......•---•---•----•.......---•••••-•--•..............--••---•-......-•-----••-----..........•..•--•-- 0 Description of Soil••••• sand ------------------------------------------------••----•-----------•---------------....---------------...-•-•--------------............--•---------.... x W •-•••••••••••-------------------•-•--•-••---------••••-•••••-•-•----••-•--•••---•---•••-•--•......•----••--•-••••---- ------• x — installation of--a .1 000 ••�aTSon, pre-cast, U Nature of Repairs or Alteration Answer when applicable............................................................................................... stone packed leach pit �overf low). --------••------------------------------------•-•-•----------------•------------------......--•-••-----•----•-•--------------------•--•---•--------------------------•--------------------••---•••..._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:ITF:u'. 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 bo rd of lth. Signed__ �� � �1. . ... a R2 Application Approved By................ . 6/ ' '2 Date Application Disapproved for the following reasons-............................................................................................................... .....•.•..................•--•--•-----•••-•----•--•---•---•-•--•---•---••-•...•-•----•----•--•-•---•...•.-•----•-----••----••••--•--••---•••------•-••••••••--••••-••----•-------••-••••--••--•••------- �/ �/GJJ02 Date 82- PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................`?.own....OF....�'stable.................................................... CTrrtifirtt#r of ToutpliFanrr TIIS CTesfo6i Ietv3Ce,tvi���iaops 1.1erDC�os Hyayrins,cotrucOt4(1 ) or Repaired (X ) by S ------------------------------- -------•--• ---•••• • --------- ---- ---- Elliott , Centerville, fi"A 02632 �nsk�'i�`. Anderson at...................... %•.•• ••_...• • ... ..................•• -•-••••-•----•-•-•-•••••--•---•-•-•-••-•--•---••••••----••--•---•....•••••••••••-........................-•- has been installed in accordance with the provisions of TI 5f The State Sanitary,C0 /afdescribed in the application for Disposal Works Construction Permit No.......... ........_�.tl�........., dated.`'./_._._'..__-___--__--_:- .................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM VII41� kTION SATISFACTORY. j DATE............................ .................................................. Inspector..................�.A.k.-1................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town arnst ble 5.00. ....................OF...................................................................................... No .'.._ . '. FEE..............•---...... 11hip sal 10orks Taanotrnduaat rani# A ?- Cesspool Service Permission is hereby granted.............................................------------... -•--•--••---•••••...........••--••--••-••........-•--•-••..................--- x to Cons Re tr l Indiva u e D' sal stem gti tt : . , den ez'tr1e, l �` - r'1SIr�. An arson atNo. .........••••• - -•-------•---------- -- •- -- ------------ -----------------•----•----------------------------------------.--•-•--•-- �/ � - Street as shown on the application for Disposal Works Construction Permit No.._..w2....._...... Dated................. ......� ......... DATE. 6l 8182 Board o£ Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ffa a951 LO CAT ION SEWAGE PERMIT NO. o VILLAGE i I NgT,A LL �'S NA NIX i ADDRESS 6UILDEIII OR q"w ER tu i f Lim �ivSo� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED A_ J?e4l /oeo �p �. 1 BUILDING SKETCH ADDENDUM Borrower/Client Property Address 23 ELLIOT STREET city CE=VILLE county BARNSTABLE State MA Zip Code 02632 Lender WILLIAM ANDERSON BUILDING SKETCH . . . ; ....;. ;.....:. ......: .. .. . .: . . .. o ..... .. .. . :.i. ..... .... . : . ............ ............ ............<............. ....................;............:...... .. .. .. .. .. ..:... ... h .......... ...... .......... ... .. � � � � .. .... ......: : .. .. .. . _.. .... ........................ ....:.....: ... .. .. ..:. ;. .... , . ...... . ... ... ....... .. . ....... ..... ...... t ..._ ....... ..- .. •...�. ...... ... .. AA .. .. .. ............... ............ ...... ....... .... ... .... ............ .... .................... .... ... .. . .......... ......... ....... . ... .. .. .. .. .. ..E) .. .. .. .. I_. t _. j. _; .. .. .. .. .. .. .. .. .. ...... ............. .... ...... ...... .............. ..... ...... ...... . ........... ... ......... . ........... ....... .... ......... ............ ...... ............. i ...L. • ?�., d ..... .. .. .... . . .... .. .. .. ....;. .. .... . :....... .. . z . .. CaE st ;......:...... ...:... . ........... .. ..;... ......:... ................:: ;. i.; . ................. ............: .`.......':....._....................;.......... ..;..........._............ ......... ............. ;7) :............::.....:............. ...:............ .. .. .. ..;.......:..............:......; .....:......,...........:.... .. . ... . ......:..... .......... .......... .................... ....... ............. ....... ..;....[ ... ..........:...... ;. .............. . ............ ......... .......... ........ ...... . ............ ...... ..... . ...... ...... ........ .. . . .. . ....... ... .................... .......... ...... ... ... ........... ...... .................... ........... . .. . .. ....... .............. ..... 'TOTAL"appraisal software by a la mode,inc. 1 (800)328.6825 '_____� 10 BUILDING SKETCH ADDENDUM 11 11 Borrower/Client Property Address 23 ELLIOIT STREET cfty CENIERVILLE GountV BARNS'IABLE State MA zip Code 02632 Lander WILLIAM ANDERSW , BUILDING SKETCH .. `.. : .............,....--.-....-.,.... ............ .. .. .. .. ; . -...--- ..- ...:.. ..... ...... ..:.. .; . . .:.......:..............:...... ....... - : .............. ......... .. .. .- .. .. - .. ..:... .: . : . .... .. :. : .... • . .. .. ;... ; .. .. . . . . .. .. :. .. ::: . .. . . ... v Q �ft I .... ................: . .. -- .- .. .. ,... ..... ..... .. ;.. :..................... .. <. . . ..:......:..............:.............:............. ................. ..111 .. -.. . <; .. .. .. ....;..............;1.. -..........:-............;-....-.... ---;---- .. - ... ....:............ .. .. .. .. .. .. ..�,, . .. "TOTAL"appraisal software by a la mode,inc. .1(800)328.8825 A Town of Barnstable Health Inspector of rqs, Office Hours o Regulatory Services 8:30—9:30 - t t Thomas F. Geiler,Director 1:00—2:00 sasxsrnsr.E, Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-63 04 AMNESTY PROGRAM APPLICANT— SEPTIC QUESTIONNAIRE 1. General Information: Size-of Property: �. f �,/)GC-- Address: T �M ( Ma .Parcel Name: Phone #: 775 - iL 2a: How many bedrooms exist at your property now? J 5 P 2b. Are you planning to add any bedrooms? lid If yes,how many? U 2c. How many bedrooms total are proposed at this property y(including the amnes� unit)? �-- 2d. Please include a copy of the floor plans for the entire property-showing the existing rooms in the home plus the.proposed amnesty apartment and/or addition. Please label . each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO �' T£'the�dwe33ingis�connectedxo� ib�c sewer,skip�,queshons�#4 tlrrongh�#9xbelflw � s 4. Location of dwelling is INSIDE or .OUTSIDE a Zone of Contribution to public supply wells?�� a 5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO .8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9: Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property._ he s Special Conditions: c .M ­'s�l► 61� ee'M r1° L 4-0 `cram�Pu`te 'ma`s "� YY1ii7$Sh' U !Zi�(�, O.&Ia, Yu( (fin`5 CS�OJiC Jit Signed: IYt Date: fla s O;/health/wpfiles/amnestyapp c 29 �j` AO C A T ION — SEW G E PE RMIT M0. VILLAGE. l/6 — j IN TA LL 'S N/AN i ADDRESS l ��U/C� iUIL.DER OR q" R DA T E PERMIT ISSU ED D A T E OMPLIANCE : ISSUED i o i i b a� ► 00, 065 f 1 ue.Li loom 4p �. 9 a Y Ulad � F Z� U'po(-T -Tctvl CENTER VILLE A i A V �� • J A.M 230 PAR. 123 ,y cg/nH TOP OF BULKHEAD FOUNDATION EL=50 e7' Y LOCUS (GIS DATUM) W 44 2 '� � 8 ROUTE O ! ♦,,,,2.2 j �ci�iis A.M 230 PAR. 124o .............., s•..,.,•, • LOCUS MAP OF A16- .,., , EDWARD L.9oyG PLAN REF. 400/71 p \ , PESCE m DEED REF- 19764158 .�• ?ro, aviL ZONING. RD-1 30-10-10 ASSESSORS MAP 230-122 TEP ZONE OF CONTRIBUTION R PUMP & ° ""` ° FSs� NAL GROUNDWATER PROTECTION "GP" ""` / FLOOD ZONE. "C" REMOVE / ................ �........... q Vv/ � /��._: •••••(SLAB),...•APARTMENT... � -' � Q L ......,......................... ti �' / l� / ; SEPTIC REPAIR PLAN / ' / TP� ~ ' LOCATED AT- ,� 09 / s /l \ s #23 ELLIOTT STREET 0 Ike" ° CENTERVILLE,, MA. NN � PREPARED FOR.• r� WILLIAM & A UDREY A.M. 230 PAR. 122 4 O AREA=24,965f S.F. ANDERSON SCALE: 1 "=30' A.M 230 PAR. 154 - y OCTOBER 17, 2005 N - __---- --� REV REV 1� ,�• � OO' LAND SURVEYED BY: REV cBjnH % YANKEE SURVEY PESCE ENGINEERING & ASSOCIATES. (' ) % CONSULTANTS 451 RAYMOND ROAD �A M. 230 PAR. 121 /� ' 40 (SUITE 1) PLYM OU TH, MA 02360 INDUSTRY ROAD EPESCE@ADELPHIA.NET MARSTONS MILLS, MA. 02648\ PH. 508 743-9206 TEL 428-0055 s f 1 FAX 420-5553 SHEET 1 J, 53915 GM TOP OF FVUNDATION EL =50.87(G.l S.f) I-- 10' MIN. _._.. X 4" SCHEDULE 40 P V.C. Y /B_YE/R of EL= 52.3' MW. PnW 1/8 PER FT. 9f4' Tt'! 1-1 2' WASHED STtTNE WwASflED NE . , / EL= 52.0 / / / / / / / / / / / / / / / / / / 4" SCH 40 PVC PIPE _ INVERT (OR EQUAL MWIMUM PITCH 1/4 PER FT EL =l 8' LEVEZ L.�7.50' CLEAN SAND FILL 9» 4 DL4 SCB \ flVR 2' --- MDV FLOW LINE 40 PIr PIPE o EXISTING U110" °7.0i INVERT �! 14" ., o° 0 0 0 p p O O O O 0 O om EL.=_4B.79'— LyyERT DVVE,RT, Ly T 24 0 p o O O 0 I—I v O O O O m o EL.= 48.z--- EL.= 47_95' NEW EL.= 4 7_6' EL.= 45.5' ° °°o° EL._ 5' DISTRIBUTION 4 ° 8.5' 4.o BOX ( )H-10 (T 42.0' PROPOSED 1,500 GAL 4-500 GAL. DRY WELLS `O SEPTIC TANK (H-10) (H-10) OBSERVATION HOLE 1 ELEV.= 51.82 EI— 51.82 DEPTH ORIZ TEXTURE COLOR HOTT. OTHER BOTTOM OF TEST HOLE ELEV.= 39_85' EL--51.40 0-5" A LOAMY SAND EL-- 49. 74 5"-25" B LOAMY SAND 10YR 518 � EL-- 46.82 25"-60" Cl MEDIUM SAND 1oYR 6/6 PROFILE OF EL-- 41.82 160"-120' CO .ffDffM SAND 2.5Y 7/4 I SEWAGE DISPOSAL SYSTEM NO GROUNDWATER ENCOUNTERED NOT TO SCALE OBSERVATION HOLE 2 ELEV.= 50 85 �1�� PERCOLATION RATE __ MIN./ INCH AT _ 4B INCHES 3WASHED STCJNE" 1/e" -1" YER WASHED STONE EL-- 50.85 DEPTH ORIZTEXTURE COLOR MOTT. OTHER EL-- 50.02 0-10" A SANDY LOAM I EL-- 48.85 10- 24 B LOAMY SAND 10YR 518 $��g8 EL-- 45.52 24"64 Cl MED SAND & GRAVEL oYR s/e ' PERC `b�8$ o o w7x8 r GENERAL NOTES EL-- 39.85 4--1.321 C2 AMOH M SAND 2.5Y 7/6 ' 4' 4.8' 1 4' 12.8' 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. PERCO TEST PERFORMEDN0 GROUNDWATER 48"EDEPTH RED DRY WELL TITLE 5 AND THE TOWN OF BARNSTABLE__ RULES AND END VIEW REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC --TANK SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE, OTHERS 0ITHIN-12" 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF BARNSTABLE I'ERC TEST # P10,033 WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DATE OF SOIL TEST 0710712005 DESIGN CALCULATIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. WITNESSED BY: DON DESMARAIS — B.0.H. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL NUMBER of BEDROOMS . . . . . . . 5 BE MORTERED IN PLACE. SOIL TEST DONE BY EDWARD PESCE, RE GARBAGE DISPOSAL . . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH ( 110 GMlAAT127R ID Y s 5 BR) 550 GAL/DAY DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO USE NEW 1500 GAL SEP77C TANK 1500 GAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR INSTALL' 4— 500 GAL DRY WELLS ( WITH 4' CRUSHED STONE) IS TO CALL "DIG— SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS SOIL CLASSIFICATION . . . . . . . . I PRIOR TO COMMENCING WORK ON SITE. } DESIGN PERCOLAT70N RATE . . . . . s 5 HIN/IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . . . . . . •74 GALIDAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. TOTAL LEACHING CAPACITY 5so.03 GAL/DAY 8) PARCEL IS IN FLOOD ZONE __"C" _ SMEWALL: (42' + 12.8) X 2' X 2 SIDES)(74)=182.21 GA41DAY 9) LOT IS SHOWN ON ASSESSORS MAP _233 AS PARCEL _122 B02-MM• (42' X 12.8)(74)=39782 CA41DAY 10) NO WATER SUPPLY WELL EXISTS WITHIN 150' OF SAS ( SHEET 2 OF 2 JOB NUMBER__ --- ---_—