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HomeMy WebLinkAbout0397 PRINCE HINCKLEY ROAD - Health 397 Prince Hinckley Road Centerville A = 170 169 TOWN OF BARNSTABLE LOCATION3� i�Gl" ��iYc.F /�SEWAGE # V -terLAGE �C Cr�T ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. C.i,,v �7 1'9>Z!�! ' SEPTIC TANK CAPACITY e:'-'��'°'9 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS 3 BUILDER OR OWNER j PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Ma..imum 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 G7i A 4 s"S' ,P®roc D Al, jI I No. V" 1 �.� Fee �® �r.� I THE COMMONWEALTH OF MASSACHUSETTS`. . Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppfication for ]Bigoal *pgtem Construction Vermit Application for a Permit to Construct( . )Repair( Upgrade( kJ'Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No..347~-AC F' ,�'rho Owner's Name,Address and Tel.No. co- �I✓i✓�g �o y� Assessor's Map/Parcel 0— 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 oP41,r No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow '� gallons per day. Calculated daily flow o gallons. Plan Date -5— Number of sheets / Revision Date Title Size of Septic Tank /Qa—3Ke- `X's'T'�"'f Type of S.A.S. 7'02�`�'G 5 X USX y Description of Soil Nature of Repairs or Alterations(Answer when applicable) DESIGNING ENGINEER MUST ISE Date last inspected: INSTALLATION AND CERTIFY IN WRITING Agreement: THE SYSTEM WAS INSTALLED IN STRICT g g ACC9RDMF dT8�s , The undersi ned agrees to ensure the construction and maintenance of the afore described on-si a se 1 stem 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 issu y t ' oard of Health. Sign d Date Application Approved by Date 3 Cv Application Disapproved for the following reasons Permit No. mod`/© Date Issued 51310q Not 0 Qo Y -- t 6 _ �^ Fee 60 /o = HE COMMONWEALTH-OF MASSACHUSETTS,"!,.. ' Entered.in computer: % t!r"_. Yet PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS L Application for Migpo.5a1 ,*pgtem Construction Permit Application for a Permit to Construct( _ )Repair( -,)"Upgrade( Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No..?97 414P,141C C,�ji AG,FC�`/�ift Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.. ��,, �c��BoFG•�' 97 T'40707 64lvA6 4&. P33 eZ 7,7 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 gallons per day. Calculated daily flow 3 gallons. Plan Date `� " S` Number of sheets / Revision Date ~ Title Size of Septic Tank moo o`S,(l. �X�1'Tiw1 Type of S.A.S. 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 Certifi- cate of Compliance has been issu d' y t oard of Health. Sign d —" Date Application Approved by Date S 3 Application Disapproved for the following reasons f, Permit No. /f'�Iy Date Issued U 5 3 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired (of ) Upgraded ( ) Abandoned( )by at _ 3 7 9 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated . Installer ��� '��� ''r Designer ���'�b �•/wit✓'6"'1 • r' The issuance of this p,' tshh�all not be construed as a guarantee that the syste ill unction as designed. Date / W�� Inspector J � No. � — -- ----------------------------Fee ✓� �7O THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwi5po.5ar *pgtem CCon$truction 3permit Permission is hereby granted to Construct( )Repair( Gf Upgrade(Z/)Abandon( ) System located at 3 9 Db� �iyC E" /�✓G�1 ?O 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 con rti-ons Provided:Constructi m t be completed within three years of theate of this p i . Date:_, ��T/ " Approved by i Town of Barnstable Regulatory Services Thomas F.Geiler,Director ' . ' Public Health Division ° . Thomas McKean;l)irector Zoo Main Street,Hyannis,MA.02601 Fax: 508-790-6304 Office: 508-862-4644 ust ler& Designer Certification Form Date: (Designer: Installer: ��00,1 � /�/ �j� Address: G,��.�_ - Address: _ o ' � 4V �;�i,�� was issued a permit to install a (date) (installer) �/s✓�'l jJs�le _ �7 w sed on-a-design drawn by septic system at (address) dated b (designer) to I certify that the septic system referenced above was changes � lled such as 1a►teral relocation accordingstantially the the des1M which may include minor approved distribution box and/or septic c 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-a ere _i } W .� Y i vA (Desi 's Signature) (Affix Designer's Stomp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OFORM AND AS- F COMPLIANCE E BY.I.HE BARNSTABLE iTBLICffiHEALTH DIVISION. BUILT CARDRF, THANK YOU. Q:Health/SepticMesigner Certification Form I TOWN OF BARNSTABLF, ,3 �► siMG� �l��ei�1� SEWAGE # LOCATION ___ 17C2 C ASSESSOR'S MAP & LOT VILLAGE - INSTAL-LER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /cam LEACHING FACILITY: (type) ��'eiss (size) �X LEA. NO.OF BEDROOMS BUILDER OR OWNER PERMTT DATE: �— COMPLIANCE DATE: x Separation Distance Between they / Feet Maximum Adjusted Groundwater table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility `(If any wells exist Feet on site or within 200 feet of leaching facility) exist S Edge of Wetland and Leaching Facility(If any Feet within 300 feet of leaching facility) low C�� Furnished by A 4S� A ,0 `®��� � A A�' o 4 -7A 8 ,ee /® C o 6?X' �S SKETCH ADDENDUM File No. H0427 r GO Irty Address 397 PRINCE HINCKLEY ^ CEN E oun B S B state M ZipCode 02632 ender/Client HYANNIS MORTGAGE INC Address 259 NORTH STREET HYANNIS MA 02601 - t�Z *cf A.:'tysss�i .c � 1+¢. 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L N CA I � I � � SEYIIA G E P RMIT N0. j v-y VILLAGE 1-76 - 110 INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER DA T E P ERMIT ISSUE D l / 7P DATE COMPLIANCE ISSUED �� r Y r .s �� g����P � � \� .� .. . ti 4 � _ � � O Nok .f...y ' FES........0........... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH t---.....OF................................ ........ ............................ lirtttiuu for Diipuiittl Workii Tunitrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal atem— '4... 1.... ----- ------------ ........ ........---•-••--�.... __------------ tion- ress r 4_'. ............. ..........•--- : : ...... ........_...... r Address oe...... ......._U.. ......................................... •--••-•-•-•-.........---•--........ ........................... Installer Address �, d Type of Building Size Lot-----/�4__,,..lh.jWq. feet Dwelling—No. of Bedroo ...............................................................Expansion Attic ( ) Garbage Grinder (4o)D Other—Type of Building ............................ No. of persons......_..................... Showers ( ) — Cafeteria ( ) aOther fixtures ...................................................... W Design Flow.... ..................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •••••-•-•----••------------••-•-•---••••--...•--•••--•..................•---........_•-•-----•--••••......................................................... 0 Description of Soil...........-.......................................................................................----------------...-----.....................•-•-•••.............--- x U ••-•-------•---•----...•--••--••--••----------------•-•-•-•••••-•.......•-----•-•--•••.•••-••-----••--•-...•••--••-•---•--••--••-•-••••---•----•----••••--•...............•-•---••---.....-•-----•---••. x •------------- ------------•------•-------•----•••---••-•----•-•--••-•--•••--•---•••••-•-••----•-•--•---•••-••••----------------•----•-•----•-•----•---•----•••••-----••••-....._..--•----•---•-•-_.... U Nature of Repairs or Alterations—Answer when applicable..........................................................•.................................... Agreement: ie undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with t p o 'isions of TITLE 5 of the State Sanitary Code—The undersign further agrees not to place the system in pe o nti a ti- e of Compliance has been I u d by the rd Health. Apl a ' n Approved By....... ......•-•-••-•-••••-•••-••-•••--.........••---......-•......................••--- -=:_ _ .. .. .......... Date lication Disapproved f th ollowing reasons:_...---••-----•-••-•----.._..---••-•-----••-•---••--•---••---....-•---•-------•--........_....•--•-•-•--......... ---•-••-•-----•-•-•-•---......-•-•-----------•------••-•...................••----....__......------..............--•----••-----•-•----•-•-----•-•-----••--•-•----••---•-- ............................. Date Permit No.-----------•-----------------------------------••------- Issued-.----__-•-•---_•-•-• ---•------ Date ^•--•--••---•------- THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA No...............!.S..... F.ES........ ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF......,t4 Appliration for Uhipiial Works Tonstrnrtinn Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ystem at .7 f r� � . .Ald Jhrl •-••-__...: .`.......`.�ff...........t:I_!t:_(::�!•f• .. . .I... `Iyf,-f.r-.o�.�..._.--•.•.--••..-^................._......... { Location Address ! r t No. .....................:_.:..---•-•. ......T. .... L..l.......--•---•. ...................................................f t C.. vfr .............................................. W - i Owner Address __ . fr ' Installer Address Type of Building 7-11 Size Lot..... feet Dwelling—No. of Bedrooms............'r!............................Expansion Attic ( ) Garbage Grinder (//), aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other,fixtures -------•----------------------------------------------.......--------------------------...---.....--------......--•-•----.............__..........---- W Design Flow......... r`:._`:..................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•-•••----••--------•---•----•----•--••------•--•-•-•.............•-......-----.............--•--•--.......................................................•. 0 Description of Soil........................................................................................................................................................................ x rJ ---•- W UNature of Repairs or Alterations—Answer when applicable............................................................................................... .....-•---•---------------•---••-•-•••••••••--•••-•-••••••---••----•---••••••---------••........._•-----_---•- Agreement: e undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the p visions of TITLE 5 of the State Sanitary Code—The undersigned,further agrees not to place the system in per ion ntil a ti a of Compliance has been issued by theboardtof Health. gned_. t'"f,t .....� c . Ze:'_`. ................................. � -- --.}!r ..f_.�f... tel Ap1• at' Approved By....... ... --------•--•.........................•••--•---••-• ---- -- Date lication Disapproved f th ollowing reasons----------------------------•-•--•---------------------••------...........•---------•-•-•-- ---•---•-........_ ---------------------------------------------•--------------•--------------•---------•----•-•---..-.................-------••-----•--------------•--------------....-----•-----••.•--....•-•........_.._. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............I............................OF..................................................................................... Trrtif iratr of TumvIittnrr TTI I O CERTIFY, That th� 'vidual Sewag Disposal System constructed ( or Repaired ( ) by.............�/ ... •_..... - _...... ---------•..................................................................•---------•.. Zi-i aller - . ......•.......----••-------------------•-•••-•-•--•-----•--•-•--•••--...............__......at.......................W../..../Z1. ........has been installed in accordance wivisions T ................ � ..._. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GUARANTEE THAT THE SYSTEM WI FUNCTION SATISFACTORY. DATE.... 3 ._ / ...........................................--• Inspector.- T THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH LI/- �5� ...........................................OF..................................................................................... d No. .... .............. FEE.._�---............. Permission is y granted........._ . to Construct ( ep iV ) a ndividual e Dispo st f�at No. ....................... ........ .... ... ...... ...-----•. .... 1!. = ..------•-------------•---...----------------------•------•-----•- Street as shown on the application for Disposal Works Construction Perm• o.,, '............... Dated.......................................... -------------•- ...... ....................................-•---------...---------••-...........----•- 4 (� Board of Health DATE...... .. ///-... FORM 1255 A. M. SULKIN, INC., BOSTON �a►NG► FAM►LY+ �CORooM �O G 7 . J " ',. : DAILY F►.ow 4 .. Ito Y. 3 = 330G.P0. ►/ 1� ; `. 5F-PT1G TA►JK = 330915o% .4956.R U _ I loon GAL. Di5po5nL P►T " v4fc`" to GAL.. j _ ,-1 15Q. s.F X: �.•5 �z 3?5 6,Pp r 5OT TOM , A2E.A o S.F. N 1 O G P 0,- . Sp s.F x I� o• A. 5 1GN * 25 G.PD' -TC-TA%- DA1►-Y .F1•-oV•( - 3306.PD• Mt PE2GoLA•TION RATE] P►T ; OFSN M / r w %{ ALAN %n�1� t-OtJNDAf I caht . Y' i. RICHARD ti W.A. BAXTER 1oNcs ..., . No,24048Q H of ��� SU�y a•�vv.:,•bv"• �Gb.,v� TOP Vie' ' •, ^�: F N W,�y INV. 1000 : Sd�rtO1V 0�� IN7J. 56GT�� •� i TANK I Ai� �Eacu: r INV. INY YL 4 �I y. V4ASK6p 6TvN6 , LL- M I SAW C.I=IZT I I°I G D p 1-wr P I_A W AL ��, N o. 5 CA%L L- S cA L.E �N� rp �P•T E (-�2. . R E P S 1ze N CE II 1 csMTVGY. •THAT THE I"nuIJ�A'fi1D�1 5>1oµ(N NER.oN C.oM?%.45 WITH"CHE 1 a> 5s:iT5Ac\< f�6R�►R.�M6N'f� QF "T41� I OWN OF TA(3L3 ANC 1S Nam- �Pd► • 2p . II t.OGp.TED WITH u µE GLoaD Pl.A1N Z DATE I-Iy 'o 8A-ATE2e IJ`{E INC. ' REG I SZ G?-6U'U\N D 5 u MY EYES ?uIs NO1' 4n5c c c►d AN os-►-E2VILIZ • µp.SS. 1N.5-T-R••uM6NT 5v2V1!�-Y J .-TNE 0►-FSETS 6u0UL3) APPLICA►.4T No-t_DE V9EOTo 0E`TE�^1►,l� �.oT �-INE.S ._ AL.M �- REVISIONS ZONE REV DESCRIPTION DATE APPROVED i 1 3� 1 I i s k r1 I O 1 Pighf elevollon Dove K'Iqhl flcvallon SIZE FSCM NO. DRAWN BY: Gary P S1u66in5 REV SCALE 3/167 7 SHEEP Drawings are for olimentiona purposes on yl REVISIONS Any structural analysis rust . be approved by ZONE REV DESCRIPTION DATE APPROVED licensed structural engineer , 28' 4„ 18'-10" 17,_9„ 2,_6„ 8 24'x 34' double hung window Ll 24'z 34'double hung window 3'0'x6'8'door 5'cased opening 211 2'8'z6''door 2 5'cased opening A. one step up Existing Garage !�U 3'-11 J5' blfold doors 2'8'x6'8' door 2'-4„ o® one step up Wet bar with side cabinets 6'French doors O 0 18'x24'double hung window 24'x 34'double hung window Existing House Cove -door plan SIZE I FSCM NO. DRAWN BY: REV Gary R Stubbins SCALE 1/4"-1' SHEET r ASSESSORS MAP _.__. L TEST HOLE LAGS -- �- � PARCEL : ,t - --_--- FLOOD ZONE: vw/t>7 qP �-� l SO I L EVALUATOR :7 l; ,WITNESS : 61- � NOTES: a REFERENCE:- ✓ f� � DATE: 1 tv1� PERCOL,AT 3 ON RATE;JA 1t1 I � v�►L 1 The installation shall comply with Title V and Town of Barnstable Board of � ) PY 1� i ---- Health Regulations. TH- i TH-2 2) The installer shall verify the location of utilities, sewer inverts and septic r�0 r components prior to installation. 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. 4) This plan is not to be utilized for property line determination nor any other \ � 701 q _ purpose other than the proposed system installation. LOCATION MA (� p7j 1 5) All septic components must meet Title V specifications. , 6 � �( 6) Parking shall not be constructed over H10 septic components. 7) The property is bounded by property corners and property lines as depicted. 8) The property owner shall review design considerations to approve of total number of bedrooms to be considered for design. Receipt of payment for the plan and installation based on the plan shall be deemed approval of the number of bedrooms. 9) The existing leach pit shall be pumped and backfilled per Title V Abandonment Procedures. 10)Proposed leaching is to be within 36 inches of grade or provide venting or cut grade as permitted by the Board of Health. t r SEPTIC SYSTEM DESIGN 11)System components to be 10 feet from water line. � 1 FLOW ESTIMATE BEDROOMS AT11 GAL/DAY/BEDROOM - �'3 AL/DAY r f SEPTIC TANK — — — — — -- -�-- —--- p - 9 5GAL/DAY x 2 DAYS -65&�GAL ,I ( ► �"t USE It GALLON SEPTIC TALK IV — S I L ABSORPTION S ' I q '"� tC!' Lam`, !,�;1�GI--! �l`Y�- G�-'� �7� ��''` �' ��,��� � �r�a� `•�"``�M i1�+ f i w NJ iao I S I DE AREA: 1,7Y. N U V c SS r BOTTOM AREA: , - SEPTIC SYSTEM SECTION q+�t►�. 5_02 / ? GAL ( ,� WA _ W .. e 1 f SEPT I C TA. G , Le VA ub SITE AND SEWAGE PLAN LOCATION : � � ` oi�,, o HIWCk Y_1� I�Ni?_ PREPARED FOR : ! , mot SCALE: i DAVID B . MASON IZ� r DATE: rJ DBC ENVIRONMENTAL DESIGNS DATE HEALTH AGENT EAST SANDWICH . MA t ( 5C38 ) 833- 2 I 77 L i