HomeMy WebLinkAbout0045 CARLOTTA AVENUE - Health 45 Carlotta Ave
Hyannis '
A=248 -234
I
TOWN OF BARNSTABLE
�
LOCATION �> C�ir<cM�n ! SEWAGE # C
VILLAGE t�19�i(�t� ASSESSOR'S MAP & LOT
II ?ZTALLER'S NAME&PHONE NO. 171VA elOTRE" [QOiKV-9
SEPTIC TANK CAPACITY IS6® j
LEACHING FACIL=: (type) ;2"L52V r (size) 137Q2g0'C Q,
NO.OF BEDROOMS /���,
BUILDER OR OWNER _P14VAW Cc, Cuf
PERMITDATE: �!`�-�(� 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
y� � _
o�
� �
ve
P *�
• �
M
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w = • ,
_..,_ __..__J
5 ( 5
No..aco Fee
♦ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
—!�
PUBLIC HEALTH DIVISION - TOWN OF BARNS TABLE, MASSACHUSETTS
01ppricattou f0'r3Dfgpo!6a1 i§pgtem Con0ruction Verna_
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. 1/5- 6111IV6nI9 Ake— �Owner's Name,Address,and Tel.No. A V '0 ( C6 1
Assessor's Map/Parcel a MYAan / J Cwo� ' � "V/v/S O ��
Installer's Name,Address,and Tel.No. Q l�L'�o//r= Designer's Name,Address and Tel.No. 4��?/.,? Y�y' � ef
144S W6*Y9 "�
Type of Building:
Dwelling No.of Bedrooms Lot Size la �17® o sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 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 Enviro tal C e and not to place the system in operation until a Certificate of
Compliance has been issued by this Boar Healt .
igned Date
Application Approved b Date
Application Disapproved by: Date
for the following reasons
Permit No. !;—),plg CIS Date Issued L
: No.. CI`�'`✓ w FeeJ,
(Jilj
THE COMMONWEALTH OF MASSACHUSET;TS
Entered in computer: `
PUBLIC HEALTH DIVISION - TOWN OF BARN-S"TA-tLE,'MASSACHUSETTS Yes
01ppYicatiddoe i5po5al �bpgtem Cow6tructiou. Permit
i
Application for a Permit to Construct O Repair O Upgrade O Abandon O ❑ Complete System ❑Individual Components
Location Address or Lot No. �I f}G� Owner's Name,Address,and Tel.No. R j � (�GS7Qf
Assessor's Map/parcel
Installer's Name,Address,and Tel.No. Qt`- 7 R�orr� Designer's Name,Address and Tel.No.
6 C! 6-0 Z4W XR 4/ST �55
Type of Building: 2
Dwelling No.of Bedrooms / Lot Size 19 000 sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd :Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
' Size of Septic Tank Type of S.A.S. °""--•n "
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 Environ ental C e and not to place the system in operation until a Certificate of
Compliance has been issued by this Boar Healt . k
igned Date
Application Approved by Date
Application Disapproved by: ! Date
for the following reasons
�r i
Permit No. !74_ 5 5 k Date Issued J
------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance -
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( f/) Upgraded ( )
Abandoned( )by
at OZM 24r. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. ? dated I .) 7
Installer {r70/t( yon-6 Designer e 4-P Q
#bedrooms Approved design flow :�,o => and
The issuance of this permit shall not be construed as a guarantee that the system will uirction�as •esigned.
Date �/{���( � Inspector
L,
—————— —————————---_—————————
No.CXw 15 5 (0 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
Mitpont 6p!5tem Con5truction Permit
Permission is hereby granted to Construct ( ) Repair (4_� Upgrade ( ) Abandon ( )
System located at iQZoph Ave—,
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
F to comply with Title 5 and the following local provisions or special con
kProvided: Constructi n m t be completed within three years of the d to of this p r it
I q n {
Date l ! ) Approved
J 9!16/03
Notice: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only
PERCOLATION TEST AND SOIL.EVALUATION EXEMPTION FORM
I, Pt k r M��^�� ff_ hereby certify that the engineered plan signed b me
� y
dated It 13 ( cr s- }concerning the property located at
a �•a��(1�1� meets g11 of the,
following criteria:
s This fasted system is connected to a residential dwelling only. 'There are no comm.erciat-m --- --
business.uses associated with the dwelling.
® The.soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes '
` per inch. The applicant may use historical data to conclude this fact or may conduct deep
test holes and percolation tests at the site without a health agent present.
S There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
i The bottom of the proposed leaching facility will be located no less than,five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the
Frimptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
D) G.W. Elevation +adjustment for high G.W.7> 3
DIFFERENCE BETWEEN A and B
SIGIFD : C DATE:
NOTICE
Based upon the above information,a repair permit will be issued for bedrooms
maximum. No additional bedrooms are authorized in the future without engineered septic system
plans,
gASeptiC*rMMW,doc
--
Town of Barnstable
Regulatory Selrvkes
i Tbatnas F.Geller,Director
'0i10L Public Health IDivtsion
Thomas McKean,Director
200 Main Street,Hyannis, MA 02601
Office: 308-862-4644 Fax 508-790-6304
tnatttllSE Pesigner frrtff csd2
Date: II 1 im OS Sewage Permit# � — ' Z`� F ^ Z�y
g Assessor's lVIsplParcel
Designer: Installer:
r s-t,v, t �
Address: �2 �.Gross+;e \c Address: ' -0 Tc _T_0 pr c
I V s, MA-a2
On was issued a permit to install a
(date) (installer)
se tic system at 4 S 6a A&ii" A`rk H y 0.✓t vt,'S based on a design drawn by
W"s (address)
dated
(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.
t 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. Plata revision or
certified as-built by designer to follow.
WIN T.
WINTEE
staller' gnature) QtVtl
M®ows
(Designer's Signature) (Affix Designer's Stamp Here)
c.omrL1A_Nr.L 3'ILL rQl BE ISSUED QTIL B0111 INS I•URM AND ASAMF CAIt9
El'V D BX THE RA1 'l'ABLE P4JSLIc HLALrI$DIVISM, ANx ML
Q.ReWtIVSeptic!Desigter Certification Form 3-26.044m,
No.............14/.. FEE ...........
THE COMMONWEALWAOF-MASSACHUSETTS
BOARD 0 HEALTH
OF....... )r4o- a M_mt.- -----------------------...............Appliration -for 'Uhipaiial Worho Tonstrurtion Prrmit
Application is hereby made for a Permit to Construct ( W<or Repair an Individual Sewage Disposal.
SystenAat:
........ -P------------------------------ _------_--------4-0 .....ITY...... ............. ......... ..........
Location-*z.-
Ito erxA�V...............S-ox......J..�it......................................... ............................
Own Address
................J.1 f
............ ... ................ W.kl---Flo
Installer Address
U Type of Building Size ..Sq. feet
Dwelling—No. of Bedrooms..........*3.. -------------------------Expansion Attic Garbage Grinder
a
Other—Type of Building ............................ No. of persons....................._...... Showers Cafeteria
Otherfixtures ..... ------------------------------------ ------------------------------------------------------------------------
----------*---------------------
Design Flow..............%r ---------------- gallons per person per day. Total daily flow-------15--------1--_ .-.....-.---.-.-gallons.
P4 Septic Tank 4—Liquid capacity&W,gallons Length---------------- Width...._........... Diameter.-.----.-..---- Depth--..----_.......
Disposal Trench—No- ----------------- Width--.-.-------.-------, Total Length..............-_.... Total leaching.area....................sq. ft.
Seepage Pit No--------------------- Diameter-_----_-.---..------ Depth below inlet--_-.---............ Total leaching area------------------sq. ft.
Other Distribution box Dosing tank IOd. /0 eA1 1 7 17
Percolation Test Results Performed by........... ......................................... Date..-.-___-------%----------------------
Test Pit No. 1................minutes per inch Depth of Test Pit...----............. Depth to -round water-------------------------
(14 Test Pit No. 2................minutes per inch Depth of Test Pit----.---............ Depth to ground water--.--.---__..-------.............. ---- ---- ............. .......7
0 ... ------ ------ . ... ......... -- ----- -------
Description I Soil------i -------
. ......... ... -----------------------------------------------------------------------------------------------------------
U ------------- •2-----------
----------------------------------------------------.......................----------------------------------- --------------------------------- ---------------------------------------------------
UNature of Repairs or Alterations��-Answer when applicable.-.----.....:..... -----------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
]&A-------------
the provisions of Article XI of the State Sanitary Code— The undersigije further agrees not to place the system in.
operation until a Certificate of Compliance been i,has .s ed by n e, ,fe bo he
I D S
Signe -------------- --------------------------------
. . . . ........
Date
Application Approved By---- -- --- --- .... 7--------
�Date
Application Disapproved for the following reasons------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.........
i.
=?7ate
Permit No.--..*.................................................... ..
Issued.. .......................... ------
Date
------------------------------------------------------------ --
No........................... Fum...... �" .............
THE COMMONWEALVIIi OF*fAASSACHUSETTS r
BOARD qF HEALTH
Appliratiaan -for Mgpuial lVarkii CITtfttitrnrtion Vani t
Application is hereby*made for a Permit to Construct ( V or Repair ( } an Individual Sewage Disposal
System fat
..........kgt ........................... .................................................................................................
Location-Address or t No
W Owner Address _ +
., Installer p Address
Q Type of Building Size Lot.... F t:1.? d°" g: ._Sq. feet '
Dwelling—No. of Bedrooms..-_.--.-_�"----------------------------Expansion Attic ( ) Garbage Grinder (NO
Other—Type of Building --------------------------•- No. of persons.--------------------------- Showers ( ) — Cafeteria ( )
p'I Other fixtures ------------------------------- - -
W Design Flow-----__._--' Mons per person per day. Total daily flow......... --._ ------_-_--_--.__.. Mons.
.
Ix Septic Tank ., Liquid capacity__P_._____.g.,llons 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 ( ) dl4A i, IV e AJ" ' "
aPercolation Test Results Performed -by:-----.. .'_ wx.:a�•�............................................ Date_-_ . _-------.--.-_----.----------.
w,. .•round water .
Test Pit No. 1_.:...`___.:__minutes per inch Depth of "Pest Pit----------------•--. Depth to a
!. w` Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water.---------------
------------------- _._. .
kol
O Descriptiornq of Soil- --- -- =......6---------�---- � � � .�. ,t �' f ---------------------
------------- "� d Fa pyp a ....... h .................
_ ...... � _.;ice
�3p� y ��,� .vim ---
W ___________________________ -_--•-------.-..--.-_-..--------- ---.--_-----_- ..
FT+I r Y,
U Nature of Repairs or Alterations-Answer when applicable............ ..... ..._----.---. _.---.--_----.-----.--_.---.--- _-..--_---
-----•------------------------------------------------------•-------------------•---•-•-------------------=-----------------------------------------•--------•----------------------------------•------
Agreement: ivichia,
t:.
The. undersigned agrees to install the aforedescribed In l Sewage.Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The under signedfurther agrees not to place the system in*"
operation until a Certificate of Compliance has been issued by the board®`f health
Signeram... y •• �- -• .....................
1 Date
Application Approved By...... �'� r ` ' �"t " - 444 ........... --------
Date
Application Disapproved for the following reasons---------------------------------#-----------•--------•--=--•--•--.---•----------------------•-----------------
--••-••••••------•----------•--------------------------------••-----------------------•---•--------------------•---------------•--•------=---------------•--•-•----------------------------------------
Date
PermitNo........................................--............... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. .........oF...............
;............:..............................
Tlaertifirate of T'Ipmjilianrr
THI L� TO CERTIFY, �Ct
the Individual Sewage Disposal System constructed ( 4e, or Repaired ( )
by_ ' f.a r g= "�`"�' --- -------- ------------------------------------------------------ ------
e
has been installed in accordance with the provisions ofr XI'of �J ate State Sanitary C de as described in the
application for Disposal Works Construction Permit �10_,,;;��---_-_ ___.' _ ....... dated.._ _'_. '............................
THE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM VILL FUNCTION SATISFACTORY. >
DATE-----i"' a, -
-----------------•-------- Inspector---- •-•--•--•--•-----•-•- •-• --•-AW•-•-----=---•-------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFF HEALTH "7r
� ' >• � ............OF.... .. .._ ....:p.... ............................. �"
K
No........ --• -
FEE
F
Vi-sVi a at Way -lai Mrurtion tarrmft
Permission Is.hereby 'granted------ _� _.._"`.............................•-•-•------....-•-----...._..---•---
to Construct''( ) or Repair..( , ) an Individual Sewage Disposal Stem
at,No.-- ••------- -•-•-••-••--•---- •=•-•--•--•-••-•-----•••--•--•----•-•------ --• ----- ------------------------
Street
as shown on the application for Disposal Works Construction Peit No ______ o --___.:Dated__."..
1�0 ,
----- - -- - .................
. t 'Board of Health
i DATE.
C�
FORM .IZ55 HOBBS'.& WARREN: INC.. PUBLISHERS
/oo. 0 0
/0Q7,_ i/-TUG
Al EXIDAN S/ON-
0 � o
LOT 83 \9 O LoT .:F
EX/STJ JG' �U 0
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Of 44s �Z1{
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OF cP So
R;CHARD
JAMES RICHARD. G�
(� O'HEARN JAMES
No. 27871. O'HEARN —'
P�. �Q �B U No. 696
c/STEa �p FG15��F� CERTIFIED Pd'-07q I�^LAN //V
O SURN � SANITA��P� 3f�L?/J STArLE MASS.
S CERTIFY TYAT TNE PlCI-IARD c/ OWFARM, R.L.S., R. S.
SHOWN ON ThIIS PLAN /S LOCATED /-9/ MAIN ST. (RTE. 2 8)
ON THE GROUND AS INDICATED AND VVES T DEIVNI S , MASS .
.
C'OMFORMIS TO 7fYE HOB M/C LA Wa
OF 'i;��i ��r AMASS. DAT /a; ? SCALE., ;"- o
l,lO 10 /CVO
®F
DATE REG. ~LAND SURVEYOR DR. $Y:�`�•G'/� SHEET /
/O FT. /✓//N. p Cl EAN SAAID
/d9/M. PITCH- �}
CONCRETE a C®NCRETE
t . -
COVER S- I3 "-Eq FT. COVER
u QUID 2 N LAYER
LEVEL yg' 31
+CA,T IRON WASHED STOVE
Allm. 14 d
Pi'7"CH %PER FT. SEPTIC D/SY o o o 3+,�p/12"
TANK Box k (, K C WAS14ED STONE
goo W W , o PRECAST SEEPAGE
o k Q o PIT OR Hqu/►-
o � o
� U
6FT .U/A•
G'ROUAID WATER TABLE ��tH GE)yqs/�
�� RICHARD.
SECT/O/�/ OF s
SEWAGEAMES
DISPOSAL SY57 E� O'HEAR� HEAR c�.� N ti
NO T TO SCAL E ,A No' av .
/'DIVERT ELEVATIOAIS FclS7�f�
INVERT /4T 811/LD/l1/G ET.
N1TA?\\
INLET SEPTIC TAA11< FT. SOIL LOG f,
OUTLET SEPTIC TANK FT. �
INLET D/STF?IEUT/ON BOX FT. DATE OF SOIL TEST/ ����Z4iG`y�4 .,
/' /, v r .�' 'Ya
OUTLET' 'DISTRIBUTION ,;SOX FT WITNESSED
BY I t�
IAIL ET SEEPAGE PIT FT. PERCOLATION LAMES RATE c � M/N.`/NCH RI G +
ME$
i� O'HEARN?
ELEVATION W. 2us» ;, f
01STf-
DEE"SIGAI CR TER'1 A
AA114SE IR OF SE DR OOM S -� —� „ S'U R j
GARBAGE DISPOSAL UNIT
TOTAL ESTIMATED FL.C)w 3 00 Gci-IDAY - — 24 "
NU/!�BE'R OF SEEPAGE PITS l L 07— - 091
SIDE LEACHING AREA 1145-1 SQ. FT.
BOTTOM LEACHING AREA -S-0 SQ. FT
TOTAL LEACHING AREA 301 SQ. FT. RIC14ARD J. OWE'ARNIPR.L.S) R.S.
RESERVE LEACHING AREA 301 SQ.Fr. /91 MAIN ST.
WEST DE/VN/S e MASS .
jOB No. 06 CL/E/JT: 9 1-7-0
r 2 O F Z
L-O•CATION SEWAGE PERMIT . NO.
VPL,LAGE
INSTALLER'S NAME & ADDRESS
BUILDER OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
_ _
�1 � �i
A2`
�y\
I
i
RF
1
Fv�a/ice
�x/�..u->�e.�
r r
`.'.
t
Id
N o.........;L..?.S— `4 F ............................
.... ... ..... inc
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
1'7_0_-G"__v -0F.......... D,c ,.................................................---..
Appliration -for Bitymial Works Totuarnrtion Punift
Application is hereby made for a Permit to Construct �r Repair an Individual Sewage Disposal
System at:
00
Lou-o ...Ae----------------------- . .........
Location-Addr4ft %A— Lot N
r.... . ......... . ......... .. ........ . .......... .......... ---- .........0....................................
caner
.. ... .... ..*.................... ................. 7—-----------
Installer Address
Type of Building Size Lot_.___ -------Sq..-feet,
U
Dwelling—No. of Bedrooms______ ____________________________________Expansion Attic Garbage"Grinder W)D
a4 Other—Type of Building ___________________________ No. of pet-soils............................ Showers Cafeteria
Other fixtures ----------------------------
------------------------------------------------------------------------------
Design Flow.__.....Nk.0--------- lions per person per day. Total daily flow.._...._..IV ---------------------gallons.'---'--- 4
I —Liquidcapac -----�4 Septic Tank capacity allons Length................ Width_.___-._-_.--- Diameter___.:.-..-.__--.
Depth------
Disposal Trench No. ..................../ Width--------------P_'jTotal Length------------_------ Total leaching area--_____ ____-.-__-__sq. f t.
Seepage Pit No. Diameter/dW. .......We th'bel ow onlet Total leacln ..........sq. ft.-------------- -- e ...'.Other J-
Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by-----------------4- _A.____-------------------.--
....... Date.__........_.-_.__-_--_---_.............
Test Pit No. I................minutes per inch Depth of Test Pit.._......._......._. Depth to ground water------------------_----
1:14 Test Pit No. 2................minutes per inch Depth of Test Pit_................... Depth to ground water__._...________._____...
------sue--- sr-------- -- .. --- ---• - �----
O �.n Of Soil "
0----$Pao%--
�4 /.i - - ----------
I------------------------ ------------ ..... ------------------------------------------------- ---------------------
U
--------------------- ---------- ------ ...................................................................................................................................... --------------------------
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 Article XI of the State Sanitary Code— The undersign further agrees not to place'the system in
operation until a Certificate of Compliance has b issue by',.-fge b o
Signed ... ....... .......... - - --------------------------------- ................................
Date
Application Approved By--------- . . ...... . . . ..................4fWAV
----------
Date
.he State Sanitary Code The undersign further agrees Compliance
'ance has by e bo
SigneS /.. ...... .........
d ....................... . . ..... . . . . ................. . .........
Application Disapproved for the following reasons:----------------------------------------------------------------- ..............................................
................................................... ---------------------------------------------------------------------------------------------------------------------- ---------------------------
Date
,W g g
PermitNo......................................................... Issued....0--------- ---v W .........
Date
—------------------ ------
�.1 f
r
bAle
�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ,OF HEALTH
4 .OF......... .��. »r ... ............................................
Apli iratiun -fur Eli,gpuitti Works Tunutrurtiun Prrnlit
Application is hereby made for a Permit to Construct ( L) ^6r Repair ( ) an Individual Sewage Disposal
System at• aka""'
----•-. -• _. ....�.... .. A ...... __ ------------------------ ------------------- �� ��� --------------
nn r Location Addre sj "1 or Lot No.
Owner Address
- " ._...-- .............
Wr _ •_ gar . ._ _
Installer. Address
UType of Building Size Lot----------------------------Sq. feet
F-I Dwelling—No. of Bedrooms--------:._____-------------------------------Expansion'Attic ( ) Garbage Grinder ( V)0
p I Other—Type of Building ____________________________ No. of persons.--------------------------- Showers ( ) — Cafeteria ( )
QI Other fixtures
---------------- --- ----- -- --------- --- --------
W Design Flow--------: ..........................___._p1lons per person per day. Total daily flow___.__. ? ..":_..__.---.gallons.
USeptic Tank f-Liquid capacitv _�rll"fallons Len-th................ Width................ Diameter.........------- Depth----______--....
xDisposal Trench—No ............ :.___ Width otal Length-------------------- Total leaching area....................sq. ft.
Seepage Pit No-___.:_ ______sr ft.
3 -__. ...Diameter _______________` below:inlet .___ __ Total tre�t._ _ 1.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by __, _ __ 1&_________ Date_......... . ....... --------------
Test Pit No. L_______________minutes per inch Depth of Test Pit.................... Depth to ground water._.----------------
.__..
f14 Test Pit No. 2_______________minutes per inch Depth of Test Pit-------------------- Depth to'ground water------------------------
-------
O Descri tion of Soil - ..- :"-- - ;- Y S C : r "A-- --------------------
`'� rs.+ =! . ,�!' - ra �s---•-••---------------•------._...._..--------•- .....--•----•------ .
W
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 Article'\I of the State Sanitary Code The undersign -further agrees not to place the system in
operation until a Certificate of Compliance has been��issue bystt e boar "`f-h It
Signed,, b` �� °�' t ' r Date
Application Approved BY---------V__'�'------+ ---:--- .......--............. .... --------- D to
Application Disapproved for, the following reasons:...................
r
,.; ---------•-••--------
Date
Permit No. ---------------;. Issued.
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH.
:. ...............:�r. .....................OF........oxe . �.�i�"��'s ..........................................
rrfifirate uf-.f�nnt l nrr
- THIS IS O CERV Y, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
y er
f { - Install �y y
at "� .. h.- � 3 ------------- ----
has been installed in accordance with the provisions of Artl e XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No._t:� - ___ ' _. "_. dated------- - `�_n ."_±t`..i ........
k�. r N
THE,ISSUANCE OF THI.,,S CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
DATE
SYSTEM
--YJILr
FJJNCTION,flATISFAC RY. ...
.. o es Inspector.......
rF-- -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD QF HEALTH
jP
h d r
r �� ►
......
...........
Di-r ul t� urkq � mitrurtion Prrmit
Permission isis�hereby granted
' to'Con r�uct („ ) or Repair ' nidividual�$SewagA Disp sal ystem
at
- �. � eet-
7.
as shown on the application for Disposal Vorks Construction 'mit No- -------- :_._ Dated__. ' ,C 6
V,
DATE....
Board of Health
Y P"
FORM 1255. -HoeSS & WARREN, INC.. PUBLISHERS
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PEA OF
4Vj"OF 1jf4 q
RICHARD Cti 1�9C
o JAN,ES m'. O R!CHAKD, yG
,y O'hEARN + p 1 JAh1E5
�1oQ/sT of �71sTE A CERTIFIED PLOT PLAN IN
SANITARI'�� T.9I3/L�jE As
s.
1
I- CERTIF X' 7-14AT THE n TioA )9JC14APD U. OWEAPiJ9 R.L.S., p. 5.
FWOWAI OIL TYIS PI AN IS LOCATED 'I91 MAIM ST. (RTE. 2£)
ON THE GROUND AS INDICATED AND . V✓EST DENS,I S , MASS .
N CO/VFORMS TO THE ZO/V//VC LAWS
DATE: !i� �� SCALE: % "-- ELL '
JOB No. 61419 CL I,�M T• _ r,:, r-;..
12
PEG.- LAND SURV.SYOR � � DR. BY: SHEET / 0F `-'
20 Fr /1-
/O F r M,1 n1. 4"pvc Pi.pE CL EAA1 SAND
Ao9>A1. /Tcea- Co"CRETE
CONCRETE '/B" PEF? I=T
_ COVERS COVER
LIQUID 2" LAYER
►', 4 LEVEL OF ye" 3 g
'`¢ CAST 0//RON A514ED 5TOAIE
PIPE- A-11,v o o � o 0
o r
PITCH SEPTIC . DIST 314f -/�?"
Y PER FT. TAIVH Box
00 ►� o GNASHED STONE
o , 1414
, b PRECAST SEEPAGE_
, O o 0 PIT OR EQU/V.
O o
(FT O/A• 7T
rr
.� 7- / 1,7 . �i7ln
GROUAID WATER TABLE `P�H
SECTION OF RICHARD
SEWAGE DISPOSAL SYSTEMJAanEs
O T TO . SCAL E o.694 i
N N y
No. 694 x)
INVERT ELEVATIONS
INVE A T AT BUILDING FT.
/IA/LET .SEPTIC TAAIX FT. SOIL LOG
OUTLET SEPTIC TAiJK _ FT. ��P�tN
INLET DISTRIBUTION BOX � FT. DATE' OF SOIL TEST � sq�
OUTLET 'DISTRIBUTION PDX FT WITNESSED BY �.�"I R,CHARD
INLET SEEPAGE PIT FT. PERCOLAT/ON RATE /V1/N./INCH O HE JAMERN
No. 27871 O
ELEVATION C
)VUA4 ER OF BEDROOMS _� v_l�OGi)LDAh�
3- SllFd�GARBAGE DISPOSAL MIT LOB,%F -r320wn/
TOT-gL ESTIMATED FLOW GAi-IDAv �ui3 soic
/VUMBER OF SEEPAGE PITS L l y
SIDE LEACHING AREA /.5/ SQ. FT Mao To
BOTTOM L EACIdIA/G AREA SO SQ. FT.
ooA�s E
TOTAL LEACH/NG AREA 301 SQ. FT. RICHARD J. O'HEARN,R.L.S:, R.S.
RE SERVE LEACHING AREA .3o i SQ.FT /9/ MAIN ST.
WEST DENIM S , MfA S S .
— /44"
,106 No. CLIENT: TiCGTT
A/C SA/V E71VC 611V7EeFZ)
SHEET' OF Z
LEGEND
C
r wESr Mai y� sJ
• CART TA - .. _ AVENUE. 99 PROPOSED CONTOUR a N Sr
L a �a Street
991PROPOSED SPOT GRADE ' Pine
EXISTING CONTOUR
98,89 98,91 99,31 Edge pavement/berm 101,09 —110----�
98,78 110 EXISTING SPOT GRADE
99,50 �� `�a o Carlotta A
'N \\ N 87 52'30" E 99.97 TEST PIT a` LOCUS
��
\ 101,45'
99,39 UP/3H o �00,00, Pk het CB/DH/FND —pHw — EXISTING OVERHEAD WIRES =. old Tows a
O \
CB/DH/FND 99,03'� Paved LOT 84 \\ `� W EXISTING WATER SERVICE a
CL drive MaPot248 EXISTING GAS SERVICE
Parcel 234
98,58 99,38 x �9,56 ro I 40 1
EXISTING TREE LOCUS MAP N.T.S.
G 99.32 1 1
3 � 1 POLY LINER
Cov, 99,3E 1 A 40 MIL POL Y LINER SHALL BE
I I PLACED 5 FEET OUTSIDE THE S.A.S,
porch I AND SET BETWEEN EL. 94,0 - 91,5
99,30 99 U
i
98.9� EXISTING DWELLING 11 0rq
i GENERAL NOTES:
(HOUSE #45) 1 0l o 1 E
O 00 TOF=100.51 ` W �1 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
V o (Assumed) I O N BOARD OF HEALTH AND THE DESIGN ENGINEER.
W O GARAGE I a 1 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
O Sewer cutlet 11 l OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
a Inv'_97.25t 99104V LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
� 100,5 Benchmark -310 CMR 15.405(1)(b):
Right Bulkhead Corner 1) A 5' variance, S.A.S. to cellar wall, fora 15' setback.
Deck en B /RC-BH -E(, 99,42 (Assumed) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
_ -
1 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
I 98.62 ---- TP-I 10 DESIGN ENGINEER.
98.32I� 1, 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
98.22 - FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
-PROP. O I W , ENGINEER BEFORE CONSTRUCTION CONTINUES.
ro `-SEPTIC
8,1� TANK I �\ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
_
---.96 X I�TP=2' " 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
9 0997.9
SE / � ` THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
2
.Y 9 2) �9 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
loo��� 0 61 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
97,61 97,94 97, 8 8. THERE ARE NO ABUTTING PRIVATE WELLS WITHIN 100' OF THE S.A.S.
S 87°S2'3O" W 97.05 Fence 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
97,50 �--- Stocka e TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
EXISTING S.A,S, THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
TO BE PUMPED AND EXISTING SEPTIC TANK CONSTRUCTION.
FILLED WITH SAND TO BE REMOVED & REPLACED 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
WITH NEW 15DO GALLON TANK IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S.
GARAGE ? AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3).
HjjuSE ki• 12, THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
BACK Df , IS NOT TO BE .CONSIDERED A PROPERTY LINE SURVEY.
✓� � �,�� �F Mq f f9
c 3I,S, S3,g 2~ 9 G o�P PETER T. PROPOSED SEPTIC SYSTEM UPGRADE
MCIVIL N 45 CARLOTTA AVE, HYANNIS, MA
No. 35109
iv I �FPSTE ��� Prepared for: Richard Ousterhout, 45 Carlotta Ave., Hyannis, MA 02601
jPROP, S.A,S,-j 1 oFFs L Engineering by: Surveying by: SCALE DRAWN JOB. NO.
Engineering Works Terry A. Warner P.L.S. 1"=20' P.T.M. 215-05
�— 23 —� 23 Deer Hollow Road 22 Long Road
S.A.S. LAYOUT /� Q� DATE CHECKED SHEET NO.
Forestdale, MA 02644 Harwich, MA 02645
�' �t` (508) 477-5313 (508) 432-8309 1 1/3/05 P.T.M. 1 of 2
K0
4
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
T.O.F .=100.51 }} F.G. EL: 97.3t FOR A DSTFINISH DANCEHOF 5'ALL AROUND THE O
(EXISTING) EXISTING F.G. EL:, 97.5±(EXISTING) F.G. EL: 97.3t PERIMETER OF THE S.A.S.
MAINTAIN 2% MIN'SLOPE OVER S.A.S.
INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO 2-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER CHAMBER/S
" I SERIES I STONE ALL
SHOWN ON PLAN AND SET COVER/S
WITHIN 6 OF FINISH GRADE
E
a
L =18, TO WITHIN 6" OF FINISH GRADE WITHIN 6 OF FINISH GRADE
L =2' '
4" SCH 40 PVC 4" SCH 40 PVC 4" SCH L=10 PVC
2' LAYER OF 1/8' TO 1/2'
to7, 7
(MIN.) 6' @ S= 1% (MIN.) IMBED®$®®�
DOUBLE WASHED STONE
d ®®®
ae u0u1D 2' EFF, DEPTH e®®�
LEVELNV. ELEV.=95.17 INV. ELEV.=95.003/4'-1 1/2'
GAS 4' 5.2' 4' DOUBLE WASHED
INV.EL: 95.50 BAFFLE PR❑POSED D-BOX
FFECTIVE WIDTH = 13,2' STONE
INV.EL: 95.25
t 'll
PR❑PASED i500 GALL❑ SEP
TIC PTIC TANK INV. ELEV.=93.50 PROPOSED S,&S.
GAS BAFFLE TO BE INSTSALLED ON
OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV.=94.3 —BREAKOUT ELEV.=94.0
TUF-TITE, ZABEL, OR EQUAL
INV. ELEV.=93.50 ®®®®®
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING MCREM13131 In®®�� �Hamm®
TIE IN TO 4" SEWER PIPE INVERTS PRIOR TO CONSTRUCTION. BOTTOM ELEV.=91.50
OUTLET OUTSIDE HOUSE 2) SEPTIC TANK AND D-BOX SHALL BE SET LEVEL 1 3' 2 x 8.5' = 17,0' 3'
AND TRUE TO GRADE ON A MECHANICALLY COMPACTED 5' MIN, ABOVE BOTTOM OF EFFECTIVE LENGTH = 23.0'
INV.EL: 97.25t SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN T,P, EXCAVATION OR G.W.
310 CMR 15.221(2). S.A.S. SECTION �� Qf MAJ j•
3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO GROUNDWATER, EL.=86.5 ����� 9CyG
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL.' q PETER T.
" NTEE
N❑TE+ SET INVERT AT OR BELOW "C HORIZON. IF BELOW o McE H
(3) 5" DIA.OUTLETS ELEVATI❑N 94A, S❑IL C❑NSISTENCY AND ABSENCE ❑F CIVIL
1s5' ,.� 2• SEPTIC SYSTEM PROFILE GROUNDWATER TO A DEPTH OF 5 FT, BELOW BOTTOM
No, 35109
�"I OF S.A,S, SHALL BE VERIFIED. IE`��O
N.T.S. FSS ECG
1
15.5' ��` e DESIGN CRITERIA Q�
6 4" 4" Din. Outlets
• � •,�: ., ....` 4" Din. Inlets /'�
P {�
2' S�ILwTsLOC' NUMBER OF BEDROOMS: 3 BEDROOMS
H-10 LOADING O SOIL TYPE: CLASS I
D•—BOX DATE: SEPTEMBER 20, 2E, DESIGN PERCOLATION RATE: 2 MIN./IN,
SOIL EVALUATOR: PETER McENTEE PE, CSE
Krs, 5'-8" 3" ;'T DAILY FLOW: 330 G.P.D.
4'-10'; 48" Liquid Level 4'-7" WITNESS: NOT WITNESSED—CLASS 1 SOILS DESIGN FLOW: 330 G.P.D
4„ GARBAGE GRINDER: NO
Elev. TP-1 pe�th Elev. TP-2 Depth LEACHING AREA REQUIRED: (330) = 445.9 S.F.
99.0 A 0" 97.5 0"
S C ON SANDY LOAM A LOAMY SAND '74
®®®® ® E3®®III -�-CTIO 10YR 3/3 10YR 3/3 PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY
®®®®®®I�®®I8) 33" 98.7 4" 94.7 33"
#E3
®®®®®®E3®®®® Bw SANDY LOAM 8w LOAMY SAND
®�®�®®®®®®I 10YR 4/4 7.5YR 4/4 USE 2-500 GALLON LEACHING- CHAMBERS IN SERIES
10'-6" 95.3 42 93.8
C' c1 48" ( 3.2 + .0
48" )
SIDEWALL AREA: 2 1 ' 23 ' X 2 = 144,8 S.F.
102" 3 - 24" Din. Covers PERC
MED. SAND PERC M-C SAND BOTTOM AREA: 13.2' x 23,0' = 303,6 S.F.
2.5Y 5/4 60" 10YR 3/4 60" TOTAL AREA: 448.4 S.F.
4' KNOCKOUT I DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D.
20' DtA. COVER 0092.0 84" 88.5 108"
4" KNOCKOUT O//4" KNOCKOUT 62„ C2 C2
M-F SAND i MED. SAND FP'—',p"",d,
ROPOSED SEPTIC SYSTEM UPGRADE
4" KNOCKOUT 3-4" Dio. Inlets DEAN 3-4" Dio. Outlets 2.5Y 6/4 � 10YR 4/6
45 CARLOTTA AVE, HYANNIS, MA
500 GALLON CAPACITY, H-10 LOADING 1500 GALLON CAPACITY (H-10) 88.0 132" 86.5 132" for: Richard Ousterhout, 45 Carlotta Ave., Hyannis, MA 02601
PERC RATE: <2 MIN/IN PERC RATE: <2 MIN/IN Engineering by: Surveying by: SCALE DRAWN JOB. NO.
CHAMBERS SEPTIC TANK t Engineering Worla Terry A. Warner PLS NTS P.T.M. 215-05
N.r.s NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road 22 Long Road
N.T.S. DATE CHECKED SHEET N0.
Forestdole, MA 02644 Harwich, MA 02645
(508) 477-5313 (508) 432-8309 11/3/05 P.T.M. 2 of 2
j-