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0035 LAUREL ROAD - Health
5 I Nathan Road Centerville A= 230-034 S M EAD No.2.153LOR UPC 12534 smead.com • Made to USA w MMUSMNTM9MD=UNB WMMWAWSf' OF11i L9MDGAAlu11� SOURgNO� WWWWSMQOGRMOW TOWN OF BARNSTABLE LOCATION ro 1V'AX AAA/ ni ID, SEWAGE# t� b- VILLAGE_G�it/g'�}��/��/E ASSESSOR'S MAP&PARCEL a 3o s Q INSTALLERS NAME&PHONE NO. 61 Ck Ete G.,O + .SEPTIC TANK CAPACITY cX LEACHING FACILITY:(type) 30 1 e0 7-fi-C&CNS (size) 3 k 2 NO.OF BEDROOMS 'OWNER Oun. LJAI e-aA1c-1nPc7-1oA,1 PERMIT DATE: COMPLIANCE DATE: D —W Separation Distanc 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 r A O Al 3 tiz.- 33 /4 3r 569 ------ q b NO. 6YHE COMMONWEALTH OF USE S FEE MASSA H TT D l C -J� 3_ O A R D OF HEALTH v. O F � AP LICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components 50 Nathan Road �, MV,r� Robert Dunphy 230 3Lpcati me 2 Hersey St. S,Yarmouth,Ma_ Ma Parcel# •�81 -�1 8-0 8 81 Address 39 Adam Ryker `"°t Sweetser Engineering ® � _Installer's Na Desi ner's Name 203 Setucket R . ,S.Dennis,Ma Add CX toAddress 508-385-6900 Telephone# Telephone# Type of Building: Single family home Lot Size9562 S. F Sq.feet Dwelling—No.of Bedrooms r 2 Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow gpd Design flow provided gpd Plan: Date 2/2 3 110 Number of sheets Revision Date Title Propse_ d sei t; r Design 50 Nathan Description of Soil(s) See Plan �' � a e, a. Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and rther ag ace th Sys tem in operation until a Certificate of Compliance has been issued by the Board of Health. Sign - Date /I� FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. �0/0_PJTTHE6COMM(?N WE ACTH O,F'MAS ",)ACHUSETTS FEE / BOARD OF iHEA LT_H a ` APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components 50 Nathan Road C.�ll ��ll Robert Dunphy � cation Owner's Name 230 3 2 Hersey St. S,Yarmouth,Ma Map/Parcel n 7 81-718-0 8 81 Address 39 Adam Ryker fit/"'° -� � Sweetse.r Bngineer ng tal~le-r s Desider,s N am e .S. . 2©3 SetuCke _ R . ,S.Dennis.ra 77y- g AddresAcIcIes64/<o/ 508-385-6900s 4\` Telephone`q Telephone H Type of Building: Singlia family homp- Lot Size9562 S. F Sq.feet y1 Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons 7 Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow gpd Design flow provided gpd Plan: Date 2/2 3/1 0 Number of sheets Revision Date v. Title Proosp-d l-i r, _ems ,� a�a.a haxa Al • , Yy GiZ C31��e,t�I C"� --oo Description of Soil(s) See flan Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation _ "DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 an777-,t es-not'to lace system in operation until a Certificate of Compliance has been issued by the Board of Health. Signd_ A Date W.A.i /00 �f�Igsp.eetiong'[. —Ulr 4r/0 — /1 FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 r - 03 THE COMMONWEALTH OF MASSACHUSETTS FEE OARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) PC mplete System 'The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: — O U� at r�f(/1 !n-1 has been installed in accordance wi"thetovisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated,. Approved Design Flow (gpd) Installer t� ) � Designer: Inspector ,1/ �- Date T b® The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM-5/96 t THE COMMONWEALTH OF MASSACHUSETTS FEE .rkCsOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT, Permission is here y granteAd�to onstryu�ct ( epaq t j pgrade ( ) Abandon ( ) an individual sewage disposal system at a /�� 7� 1/�.1/ Al I .! as described" in the application for Disposal System Construction Permit No. JLdated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health F , FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARREN TM PUBLISHERS- BOSTON fJ" ���a��a �f� �0/00 o 11�� � l� cep l-9 L/ - - _ . _ _ - w -r - - _ . ® ® a� tv ® ®r _ - _ — f—. —. _.. -_ — -- — — -- — T :l a 4„,'I.�-�(,:J•. , .���. 1_.i'11'.,_ ..r.; >. 1y:__:-�>r.�1t� — - .. ... -. .. _.. R LLLJ - REAR ELEVATION J _ ®urrJ f7 1I' r t T..r ,:R, r Y,`;: r L_1 r,-` r _ar -;, T "?T W.`•r..'�rl�-R" _ r._ - z LEFT ELEVATION RIGHT ELEVATION ..4 GENERAL NOTES: —OR EQUI-ENT ON ROOF AND S—W—S. 2.BASEMENT UTILITY WINDOWS TO PROVE GLAZING i0 MEET STATE REGULATIONS. B.GUTTERS ARE DOWNSPOUTS TO BE PLOW DED WHERE REQUIRED. PROVIDE BASHING ABOVE ILL WINDOWS AND DOORS. DOUBLE JOISTS BELOW ILL—TION WKLS. TD MEET STATE LOGE REOUIRExEnTS. Kl CONCRETE TO RE A NINIMUM OF 25W PSI STRENGTH AT.DAYS. NTI—TOR SHALLASSUME ALL RESMISIBILRv FOA CONSTRUCTION AND CONFORMANCE WITH ILL STATE AND LOCAL RULES AND REGULATIOHB. INSULATION NOTE: ELEVATIONS aQQRSABDY HEKITEOANBELMVIEAT=_DBPAL -WR-BFIBERGAssINBIILATIDNORBETTER. GREMNG DESIGN EMRIOABO HEATED IGHALDWUNHEA3 ID'R-1E ISERJB FISERC STIONOR BETTER OR BETTER AW N E%1ERIOR WALLS ABUTTING HEATED SCALE-stR'R-tSFIBERGLASS INSuuNON OR BETTER. 131 QUAKER MEETINGHOUSE ROAD,EAST SANDWICH.MA 02537 �uLC R Ic m��"W''1Ommv YAVW.91BYWIDB.com(508)BEE-OBBS Ow,O Gxw.inB DMpr^SBBBBBJLgBB xon rm A1u, s-s" s•s• i t BEDROOM#3 4' 3•-7" 4 5" 3'•2" O 51• 2'-4" T-6• II a q A I I O CZ I I II s II BATH - II II II O � II II O II II II II II ti UNFINISHED ATTIC 51-11• 2-4 A BEDROOM#2 � II II � II II II � -- — z,, -- ------------------- F SHELF ' 2•-6' 1•-10" 1'-10" 5•-8" T-6" 1•-10" 1676• 33'-6" Town of Barnstable °pTHE rok Regulatory Services ti Thomas F:Geiler, Director * BARNSTABLE, Public Health Division y MASS. o �p 039• '°TFOMA�a Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 0 W Sewage Permit# �G/D Assessor's Map/Parcel - O 3 Installer &Designer Certification Form Designer: Installer: l V� 76 Address: � U C — _ Address: Aak ���/V 11� S y�r✓Mc��l-� , M� o�GG�� 7711-8 36.6 y®1 On I d g 0 was issued a permit to install a dat (installer) septic system at e 4 J?— WAased on a design drawn by (address) �. - (design 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. 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' 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. Stripout (if required) was inspected and the soils were found satisfactory. 'IA OF 4148"y TERENCE M. (Ti-istaller's re 0 HAYES No. 9l9 9�GISTEp'�� ✓®��/1�1 S�NITAR\h� (Designer's Signatu ) (Affix Design"fi tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH 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:\office forms\designercertification form.doc Town .of Barnstable r# 1.2•117 Department of Health,Safety,and Environmental Services IN Public Health Division Date % O aL' OF Main Street,Hyannis MA 02601 II a►waan►ew 0 rEo act" Date Scheduled I/S //V Time l A M Fee Pd. Soil Suitability Assessment for Sewage Disp�'osal Performed By: /'^ . /�-�O Witnessed By:�/. i J�, Location Address / ��� /I 1�,/o /,� �J Owner's Name �� hd��-- ( �t� T[/f �CCy Address /<',.5� IQOS2/S�`F w]4 ��1�Y111 (GcC..,;l"�Ql�(.`l(rT�a� Assessor's Map/Parcel: q 7Ur 13� Engineer's Name slt.)2P.�f NEW CONSTRUCTION REPAIR Telephone# 5ff-3 05 6 q o6 Land Use Slopes(%) G Z' Surface Stones Distances from: Open Water Body�ft Possible Wet Area 7�D ft Drinking Water Well 7Z4V ft' Drainage Way /" A ft Property Line /0 ^^**'ft Other ft SKETCH:(Street name,dimensions of lot,exact I tions of test holes&perc tests,locate wetlands in proximity to holes) �4�r �. 9 k o� Parent material(geologic) `"�� Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face ~ _ Estimated Seasonal High Groundwater 0(( , ::»>::»:::z:i>::»::i::>::>::i::.......................................................................:.......;:::.;..:.; ...:...;.;.:..;.;::........;...;.....;:...:...;.,.;........:..:>::.....:.;.:...::...:....:.::.::.::.::.::.::.;:.;:.;:.;:.;:.;:.... »> »>::;:<::;: MethodUsed:::::.................................................................................. ....................................................................... Depth Observed standing in obs.hole: L' G� in. Depth to soil mottles: d—v-vim- —in. Depth to weeping from side of obs.hole: N'0 in. Groundwater Adjustment Index Well#_ .Reading Date:__.•._._ Index Well level.,.-.--- Adj.factor___ Adj.Groundwater Level �/r. ::::>::: ...:..:.......::'I`E T.:.:.:::::::.:na ... ... . ...:: Observation Hole# 1 Time,at 9" Depth of Perc J ( Time at 6" Start Pre-soak Time @ 0=� �'� Time(9"-6") End Pre-soak Rate Min./Inch 4 Z L 2` Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back---� Copy: Applicant :..:.:�..;.h..y.y.�y..�.......y.y.�..!.:�...1............... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. rnncietpngy,° Gravel) /v /ZwTr 33-r� c olS z,sy �Gw Depth 9611 Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell} Mottling (Structure,Stones,Boulderes. onqistency.° r ».....:..... ::::>::: .......(3 ( . .. f� .....::. ale.. .:::::::::.::::::....... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n istenc ° Gravel) 9 Z�lPM S Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. to c °°Gravel) Flood Insurance Rate Maw Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? � If not,what is the depth of naturally occurring pervious.material? Certification qq I certify that on f (date)I have passed the soil evaluator examination approved by the Department of Environmental P otection and that the'OoV y analysis was performed by me consistent with the required trainin xpe ' e and e�riencc e i e ' 310 C 1520/ Signature Date � 4 gIMP30N A SHEAR PANEL £ A° :E SEC ON PROVIDE 519"FIR CODE_GYPSUM ggVINBXe ON CEILING AND WALLS.WHERE -------------------- GARAGE ABUTS DWELLING tp IEENED PORCH I wEAT 12X12 P.T. SCR h t: UNHEATED 0 O D 1 CAR GARAGE Q0 I 3 112"Xp 114"LVL bA3EMENT HEADER eUL HEAD ACCE33 SIMPIi1 " SHEAR PANEL R ®BVyi'8X8 -- — f a''z" 3'=4" 71.1 p" " 1'-g 8 C 12=8" II x in :. 2 II o KITCHEN tv FAMILY ROOM SATH i i WAIL.K-1'N I N i I SET BATH CATHEDRAL CEILING o n I O C I I� s0 1f s � I a+' o o , A I O "HEAT-N.GL 6"MODEL 8000 OAS FIREPLACE I ) 4'-4" _ ADJUST FRAME FOR MODEL USED) ADJUST VENT OUTLET TO AVOID g'-b" In;. OUTDOOR z r • MASTER BEDROOM t A 4e LIVING/DINING ROOM Iva f zn 6 FT COVERED PORCH 4 " UI- •' W d' 1 5,_g" K J ,,, -11 I'b. � 11 � -`_7__11�777 . � , ", -., - I - Iil- _111.111- , 7�� ��,,� ... . 1�, 17 7' * - 111� - �" , � - , � I �,o.' I 1� �I -_7_ 7-�_�- � _' �!0�_7"�,:v� 7%��*,�r��%�,,�i" --,�l I I"17,10�-1-1�'!"",,.-'-iy---�w�-,--!-.-%,--.rz,7�7-�-7 r7G17V�.7�� 7" . -� . . - �l t ,, ." -�7_-_111_ " - 7 I�- , � �r: .,�, - � . A � - ,,, . I , - 11 � - � ,,� T,.,.T, I, .� 7� , ,11,I I, �,e , , -,,�, It I. 1p , .�l - - � � I I I � I I ,. . �, . -, 1�, ,.,v, I,1� , �l, I7 I . -,:" .- -�, -- ,-, " , , - , I "I � � I I-, - ", ,� � I I - � , i".I T' � -,�-I,I: I I I I I I I I I .1 , . , . I- I ,. � I I . . I -, .I I-. . �� ,� :t, %, I � I * � . . -* ; o, .,� , ': �. , , .A. , , " ��,,:� ,",:q,�� , ` , ,�-"zk,-��,_ 1�, I �! . " ,_� 1 , , I I ...:�._, ,.- � - t�_� " , I. � ,3�� �i �.'� �,�, x, I �l I ,�� -,, I �� � I I i , , * " .e ;. 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I � 11 -THE INSTALLER Ip. .TO 'GIVE THE,ENGINEER A � TOTAL LESTIMATED'FLOW : �", I� Yr ,,",�� �:_ ;�*,- �] I � I , I 11 . � . .: 1 � -1 . ,� -r I -,r ��' ' . . I ,��, , . . j, ""I r "OF,48 HOURS%'14 .1, .-, ,el .,��, .' . , , , ,,r,, ., .j, � I I- �l ' ' ' " � - `� I I .� .r �l I , ., I " , , . t 1, . I I I'll r . r r - � � ,.-'. � � r I I." , -_� G _/6A �I I ,'� : _1'1�1 ", '1'11'�'. �. I_. , I . - - I . I � �,r f,�_ I I . �� ,r,r, - . ,I . � 1, '*'- ,, . , . I 1. (2 WORKING.DAJ) 'NOTICE FOR THE FINAL� INSPECTION (NUMBE �_�� . �r -_ -.7 '( 110 GAL/BR.AAY X �L� BA)'' , �' �� AL _, ,�,% , ,_ _ - �,� I � . I I � . - I " - 11 � ,r � . � "I r � 7 ;� � - , r . I � � . . .MINIMUM I I I I .: � - - - � �, � . - '.�r� 1. � o -' -1 I .- � . � I - 1'�'.. ��', 1, , 1, :��,,!� I ,� � �� o, �;, , � I � 1 ,. ��,%�,_ , r �1� �"�, , " -, -, - L . � - I I I I . . . I . I I '. r � � -� 11 ,_: " I�,� . . � .- I R BELOW), I ; - "'. 'i .'' I "- . .r I I r 11 ,�� . - -::,. 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