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HomeMy WebLinkAbout0031 LARCH LANE - Health 31 LARCH LANE Centerville A = 189 - 006 - 007 , 4 �I rs _ — TOWN OF BARNSTABLE LOCATION ?J` LCg-CG L.N SEWAGE# ,aQa- C) - 35L VILLAGE r y� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY � i 5t'l�ti c LEACHING FACILITY: (type) .2 JA',2Cj(J,XM(size) (�, NO.OF BEDROOMS OWNER ..PERMIT DATE: 11( I�y COMPLIANCE DATE: 2 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -(2(- pe(i 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 LACK TT 30 -3 s- � 3 1 � 6q` - `� - 33 Y �f No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliration for Bisposal *pstem Construrtion permit Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address Qr of No.5/l,.e-/G h `� Owner's Name,Address,and Tel.No. c .1ffy- 1il1 Assessor's Map/Parcel k l Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building S1C W C. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3"? gpd Design flow provided 3 % gpd Plan Date ��//�2 Number of sheets Z Revision Date r Title Size of Septic Tank �� �( Type of S.A.S. �� GCrf Gn/ e lxa4. Jj-� Description of Soil Nature of Repairs or►Alterations(Answer when applicable)��„rSfG�� �� !V i-e.9 c)i-"+f 1►J%tlGnl C G,D wo aaZ4_=✓ /N i?.Rs�r2S G✓�°4�S�I //I/G•✓ 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 Health. S' e Date ' ,9-0" Application Approved by Date Application Disapproved by Date for the following reasons Permit NOL �— Date Issued f o� _Z G>- l \ No. *.�V � . � Fee " THE COMMONWEALTKOF MASSACHUSETTS, Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes app Yication for his o'saY.. pstem Construction Permit, Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) ❑Complete S�tem ❑Individual Components , Location Address or Lot No..f 4,, ,h Owner's Name,Address,and Tel.No. allAssesso s Map/Parcel ,g GoKwCV J j Installer's Name,Address,and Tel.No.r Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms __ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building (f°.<,0N�"1c, a No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3- gpd Design flow provided gpd Plan Date �Ah 0520 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S.,2 -S'co Alan! Description of Soil Nature of Repairs or Alterations(Answer when applicable) ,)s�C,j /1 Nd'ca) t 1`a�1 r 1Gn� iCX; c_-4AN r 2 `SC9© %v aNl,R k�s G✓+"��8s 11r°r + e Date last inspected: Agreement: -4 C 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 Health. Signed-, Date d-3),90" Application Approved by Date Application Disapproved by .Date. r for the following reasons '..•:�i.�1. � Permit Now- " j Date Issued -•------------ --------- --- ---- --. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TOO CERTIFY,that the On-site Sewage Disposal system Constructed( •) Repaired(< Upgraded( ) Abandoned( )by <I J,f\% 1 o o jC at 31 L o r rV\ l s l C Pv4 Aru -e has been constructed in accordance t with the provisions of Title 5 and the for Disposal System Construction Permit No.� 3dated % J� Installer NC Designer -c yr c) IV c S r, #bedrooms ' y Approved design flow 3 ',�C) gpd The issuance of this permit shall not be construed as a guarantee that the system will function depigned. Date Inspector (r --_-- -- -- Fee THE COMMONWEALTH OF MASSACHUSETTS { h 'PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS ' Misposar 0stetn Construction Vermit Permission is hereby granted to Construct( ) Repair(s Upgrade( ) Abandon( ) System located at "� / C a�C 41 t e',o�f r 'yt and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following.local provisions or special conditions. / Provided:Construction must be completed within three years of the date of this permit. t hal i Date /,- 1'/ Approved by i1 Town of Barnstable Regulatory Services Thomas F.Geller,Director MAM r Public Health Division *639. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: •Z 2 °Z/ Sewage Permit#e�a 38 Assessor's Map/Parcel j / e0 7 Installer&Designer Certification Form Designer: cD/�0, N4"44/ Installer: '.A 1 E0,4(.zt fN c Address: � �� '� Address: , C) On D�culj � _was issued a pen-nit to install a (date) (installer) septic system at (C, t N '' ( d �1\1P based on a design drawn by (address) .`J_ VV_0• 1"'1� �� dated (designer) certify that the septic system referenced above was installed substantially according to thedesi gn, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils } were found satisfactory. I certify that the.septic system referenced above was installed with major changes (i.e. greater than 10',4ateral relocation of the SAS or any vertical relocation of any component of the septic systein):but in accordance with State &Local u -'motions. Plan revision or certified as-built by.designer to follow. Stripout(if ra acted and the soils were found satisfactory. OF Mg . b may`�1 DAVID � (In al is Signature) M RI 4 C LOCATION SEWAGE PERMIT NO. VILLAGE CAN-N�, cv •�� INSTALLER'S NAME ADDRESS 0 UILDER OR OWN ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED (� t LA C1 oo(a- C)o No � F1.Sa...4�.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH i��`,�- Z. z� ........OF......../ l.Z.� .-5.. �� -. .............. Appliration for Ui ipos al Works Tonstrurtiot ,JJrrmit 3 � Application is hereby made for a Permit to Construct (1-11 or Repair ( ) an Individual Sewage Disposal System at: ) - ........................................................... _..-•--•---...---.. ..-- -------- Location-Address or Lot No. _ C' L�/�s L LQ 4�✓S �f►fir'L L `'lJ ��•-- �»3 1 O t t� f21.» ... 2- /f�f�l>✓.VdS Owner Address W Installer Address Type of Building Size Lot...__.....�____________....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic(--j""' Garbage Grinder Other—Type of Building No. of persons.........4-------------- Showers ( ) — Cafetera-% Q' Other fixtures .......................................... W Design Flow...............................�`w__�..._gallons per person per day. Total daily flow----------- ;ak...................gallons. -­W Septic Tank—Liquid capacity.?!?dgallons Length._R`.�!._.. Width.__`_-.!a.._ Diameter________________ Depth...___.-_...__. x Disposal Trench—No. .................... Width............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------I......... Diameter-----/_.�'.__..... Depth below inlet.... ... Total leaching area.. _0.8..sq. ft. z Other Distribution box ( jo�_ Dosing tank _ aPercolation Test Results , Performed by...L_.. .....:,,Z/l/G.o. Date.......I._y- a Test Pit No. 1.........4....minutes per inch Depth of Test Pit.... .... Depth to ground water-----/_AP.... �✓GCSE Test Pit No. 2....4.Z...minutes per inch Depth of Test pit...Z k.W' Depth to ground water...../.9............ P4 .............................................. •-----•-••---•••---•.---- �- •-+-� N1� Q /}�Description of Soil ... -- ------------------------•-�••----••----••-•-•......•--•._..........•--- V !N� .G ?...y` ? s r c� -I i -- -• --• 77 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 TIT,1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ue y the board of health. Signed-A....... .....---•-•-•------------------••--••••-......•-- Application Approved By.... -•-----•-------- .-•-•-• --------------------------------------- ---•--� ate Application Disapproved for the o owing reasons: ----.... ........... .....................................................--....•-•---•--•---------•-••---•--....--•---•-•---•••••-•---•-••---•••---••-•...................................••.............................. Date PermitNo......................................................... Issued-....................................................... Date No........................ Fss............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77�'�/--V .OF.......� .. -'-1> Appliration for Disposal Works Tons rtiriiun rranit Application is hereby made for a Permit to Construct ("I or Repair ( ) an Individual Sewage Disposal System at: ......... .................................................................. .__............ •--•'•- Location-Address or Lot No. _ .�"L a............�S<..C �.e /✓ ../.� -- 1� ......---J--� Ja:>........... ............. ... Owner Address W Installer Adddreress ss Type of Building Size Lot____---..}.................Sq. feet U. Dwelling-No. of Bedrooms-------------�3..__.- ......•.........__..._Expansion Attie-(--�-- Garbage Grinder-t--j- 04 Other-Type of Building No. of persons........---•-............... Showers ( ) - Cafeteria-+---)- Wp`I Other fixtures --------------------------- --------------------•-----•••---•--••---•--•-•••••-------------------•-••--------••-------••-•••--............••--------- Design Flow................................ v___..gallons per person per day. Total daily flow--- _3__Q____............... ]Ions. 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..C>.6_....sq. ft. Z Other Distribution box (24 Dosin ,to . Percolation Test Results Performed ..................... --------- Date----------------.....---)-........... _ Test Pit No. ]... ._......minutes per inch Depth of Test Pit... Depth to ground water..../_4J_`�....C�?L7�'{/..5>. P P P g Gi, Test Pit No. 2___�__�:__..nunutes per inch Depth of Test Pit..l.�.�_�._ Depth to round water----].%'.' a •-••-•-•--•--------------••--••------••--• ...................................................;,:W - •---'-•---•••-.-----•--- -- O Description of Soil......... � ' I/- - � ''! > '/ G�, j -t-m <r • - ---•---•--- -•-•-•....C...-..........••-T------------•--------•---------------------•------ WW G =7 .S aL =U � ` ................... -- ------•-----•------------------- C 7-- ty": . wItom -, i .,, .._....----••---•-•-----------•---•-----------•......................... .........---•--•••••. .......... 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 until a Certificate of Compliance has been issued by the board of health. Da Application Approved By...- � .---•...................•-•---------- �J- ---- Application Disapproved for the f iJ, wing reasons--------------------------------•------------------------------•--------- ----------- -......-'................. Date PermitNo................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � � .�...OF..... Te/..�-S . -'`.e-: ............. ......................................... .. Trdifiratr of TuntpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (P<or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at.........................�-•------- -•••••. 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.... ......... dated_-ZI-0 P(P________----_-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FU Cf SATISFACTORY. DATE.............. ...................................... Inspecto(4_'�_`_--•----•-------------------------•---.---------•-•----•--•---••-•--•--•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 cl vv"st �-�'�?s f No......................... FEE..... .�. Disposal ]Works T notrudinn rrnti�� Permission is hereby granted ..............•-•-.......•--••-•......•--- to Construct (1--f or Repair ( ) an Individual Sew:�ge Disposal System; , at No... -�7i? C ,-/ t/ "- : �v 1 .0 V'14 L A_ � .:.... ..............•-------••----------------------------------......-------------------------------------- f/ ----------------•-••---- Street y(� J f•.... -�th `.•.� >?v........... ;.. as shown on the application for Disposal Works Construction Permit No.___:t__..._.____ Dated_._----------•------------------------•----�`� / 2. �.�DATE-----•---•-----•-•-----•-•--•--•--•-•------•--------------•---------_.......... a FORM 1255 A. M. SULKIN, INC., BOSTON AsBuilt Page 1 of 2 4 LOCATION HSf,.31 SEWAGE PERMIT NO. VILLAGE ' INSTALLER'S NAME R ADDRESS I U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED fL-C) C3 o.oag e s� c LA http://issgl2/intranet/propdata/prebuilt.aspx?mappar=l 89006007&seq=1 8/22/2017 : v TIT SOI L LOG \ \ DATE: \ ` \ WITNESSED BY: TAM E' S Ca1yL. 0N CArs � s 7 E[. 3 3. o o _H 2 6'C.38,S �' G •• L o AiY, i 3 2.s 5�: o ` t G • 2S.S r L A YLr 1Z 5 Li m �I, " C O V^! T"�J`L ,E L) N C2 .n/ T t - ELEV. TOP OF MANHOLES AND COVER TO BE BUILT W1THlN OF FINISHED GRADE . -- O J; la I✓ ► o. ; , ' FOUNDATION FINISHED GRADE .,,,'� ..' �,,.UlN. 27 SLOPE �._� FfL o e 4 CAST I RO �' Q•... �S •' OR .. '•' • .:.•.... _•• 4 PVC SC . 40 IZ 1ST r \ �yt \ �� 1'� "" PVC SCH. 40 PITCH�t�4 FT. � Z'LEVEI= �, MIN. 2" LAYER \ `f f� 2c ITCH ,,�., �. 1/8et .1I2 PEAST0NE y v n o 2 .04 .a, 1�4�F /, S'•: 30,$ s O 2 3 i Sa �L� �( INVERT INVERT GALLON !NY /. 00 pIST. INVERT � D ;� O. D� ►r ei E SEPTICTANK BOX •.• t q;! 3/4 - i'V2 DTA . INVERT .3a.S0 �y}0� �'. U =D WASHED STONE �,Oj 14� NOtNVE4( 0, ALL AROUND . U !• 1 0 GARBAGE J O!' 74 MIN. 6 R I N D E R ---=a' _ V. BOTTOM T O f .`• . E L E e tut l �! .f + 4' -O Dt A+I'I O F PIT 27. O 2 0� AA 1 N. Ss o•00 �� PROFILE OF GROUND WATER 'TABLE � £>-TkJS7 SAN 1TARY DISPOSAL SYSTEM �\ NOT TO SCAL E D I G N D AT.A _ 3 s • CONSTRUCTION OF SANITARY D15 POSAL BEDAOOMs DESIGN FLOW 330 GAL.1DAY SYSTEM - SHALL CONFORM ,,TO MASS: ENVIRONMENTAL :C'ODE . TITLE SL (REVISED 7-1 - 77) LEACH RATE MIN.�INCH AND THE TOWN : OF f3AT/u37lf) ,�3L PROPOSED LEACH CAPACITY - 0 �7T14) HEALTH : REGULATIONS. • SEPTIC TANK, DISTRIBUTION BOX AND LEACHING PITTO BE OF. REINFORCED CONCRETE : . `� 3 GAL/DAY MIN. CONCRETE STRENGTH 3000 PSI ., o MIN. STEEL STRENGTH 2O,O OOP SI H iO DESIGN LOADING • DRIVEWAYS N OT:TO BE :LOC ATE D OVER SYSTE M SUNLESS H- 20 DESIGN LOADING IS USED. • ALL PIPES AND PITTINGSTO BE WATERTtGHTAND TO BE OF CAST, IRON OR SC'HED j40 PV. C'. SITE PLAN SHOWING : PROPOSED CONSTRUCTION SH.IOF SHS LEGEND L d:CAT1 ON: -- T3 .9�wsr•� ' (c -,� ✓/ L FOR : L LUEL - s©LGoyys, -,pE-VEL , Cdl'zP' APPROVED Ig SCALE: "= 3c ' DATE: ,/�. 9 � � �~ BOARD OF HE A LTH BUILDING SETBACK REGULATIONS PER -7 009z .Sh� aW^/ /r✓EXIST 1 N G CONTOUR --—t 6--.-- t? E F E R E N C�E� Z3 �"!n/ G, L.,, d ?' BUILDING INSPECTOR OR BUILDf-NG �' etc 44 1� � • 38 COMMISSIONER . :2 ©/1/�" : T� C , PROPOSED CONTOUR ( 6 DATE AGENT - MIN. FRONT SETBACK 2 O' EX I STI NG' SPOT ELEVATION 17. 6 . PROPOSED WATER SERVICE L�F MIN. SIDE SETBACK �� W TEST HOLE LOCATION o� CRAIG . 1 /� MIN. REAR SETBACK r `+ SHZF o T M IN . L 0 7- S/ Z �' /�" 0 C7 0 S 7� IL v 83 C . R . S;HO RT, tn1C . E4������ a isE .: SSIONAL ENG� PROFESSIONAL :LAND SURVEYORS b ENGINEERS 586 ,MA1 N St T T.E.:CA :EAST .DEIVN I S M A S S.•v 02641 2 N. a n ti e • .. .. .:. Y ., :. .. a .. z• : r a „L , H. M M— ONM Y T HOL P02�2&b7EI 1) The installation shall comply with the State Environmental Cade Title V and Town ofi _ --4- . - ,,, ,r-� Velfd of Health iZLBilt3t1Qi1S. '�LG � — - !/`�'�lt� 2) *ire septic system as proposed an this plan shall not be installed until a Iiterised town Installer .M. ! - - .-•- , - . receives approval and an installationpermit#rom h applicabl e town.Prior to installation,the Installer sia verify the foca#ion of utilities,se�jjr inverts,sewer lines3} ! 4 \VLfand existing septic components prior to installation. $) All gravity surer piping is to be 4 inch schedule 46 PVC at 1/8"per fool. The first 2 feet out of the distribution box shall be level. All piping connections to be glued. 03 S) sills s is design plan,is not to 6a utilized for property line determina ion or for any other v'1 �� ► �, to fj purpose other tlt4n the proposed septic system installation. l Ali Title V components are to meet Title V speditcaMns. � �i Parking shag be prohibited aver'iitl+�V components ante3s c^mpotten are H34 loaded. LOCATI ON L�.l 9) The existing leaching or cesspools shall be pumped and(died with m Hal per T"stle V tt 6A abandonment procedures. .Leaching and cesspools)and contaminate soils within the proposed SAS shall be removed and replaced with dean sand per Titie specifications. 9) Septic components are to be 10'franc►_a aster service one.Se%w Imes rossing,a water Bite Sha tl be sleeved with an approprzatel�,r sized schede 40 PVC with ends gig ted. The water ser►vic+:� d15� line or tilt-septic line cars he sleeved vAth the sleeve being a distaom 14' on botb sides r4 A Grp-/ . __. ., .. �, W' 110 D Z ' crossing the lute. �9 a -�r�_ �^ - VMJ if a garbage grinder exists In the structure,it is to be removed if the se tic system is not ` �.tL designed to accommodate a garbage grimier. 111.The Installer is responsible for care of excavation around ail utilities on the property and. PT( r J protecting the structural Integrity ct all Structures during the irrstallati r process of the septic system. 12;This plan only represents that a septic system can be Instals t1 on the p apenY meeting Title e� 1`1 [j�f requirements. 14 The property avmer shall review desggt;criteria to apprmie dre total n ber of bedrooms and din flow.lnstaWon of the septic system as proposed and receipt payment for the design. . - - shall be deemed approval of the design criteria by the property yawner r agent of. K-0 Tire validity of this plan st--ali expire with the expiration of the toWn iris llation permit Issued for t this plan or the validity;of this plan shall expire on the expiration of theCertificate of Compliance issued for i�allai-��r�of the proposed sysretr en:his plan. , � .� L i • (z !-��D C� � G kW S10 It.100 � secr WAX. qZ0 NWEA Z.. ` y'C4t OF �JU�I�I/� dC �T ��j V". ZZ,5 lop MASON 1n! �• G I�WTf.2�,/j 1Z. � 1C.. I� r. A TF_ ' r w;.- .v 12 � �