HomeMy WebLinkAbout0128 CONNEMARA CIRCLE - Health onn`emar'a *,ircle
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- Hyannis
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F TOWN OF BARNSTABLE
LOCATION Aa c ®�"'°'P��� C%?. SEWAGE # oc 1y7
VILLAGE- ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.J">,W '7;;' s"
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) size) / 3 X 9 S`X at
NO. OF BEDROOMS —�
BUILDER OR OWNER 40
PERMITDATE: rP—�®� COMPLIANCE DATE: 0 '—//�o�
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility i Feet
Private Water Supply Well and Leaching Facility (If any wells exist_
on site or within 200 feet of leaching facility) i Feet
Edge of Wetland and Leaching Facility (If any wetlands exist i
within 300 feet of leaching facility) ' ' . "` Feet
Furnished by
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. No. Fee
THE COMMONWEALTH OFiMASSAC Entered in computel
'HUSETTS Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
,Z(Vph.cation for �Diqoal i§p6tem Con.5truction Permit
Application for a Permit to Construct RepairX Upgrade Abandon EI.Complete Systerv�elndividual Components.
Location Address or Lot No. 4:574 4C.140 Owner's Name,Address,and Tel.Nq,
Assessor's Map/Parcel.
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
;7
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder
Other Type of Building 4c�fa No.of Persons Showers Cafeteria
Other Fixtures
Design Flow(min.required) 3.�0 _gpd Design flow provided .7-l'O'47 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank -dg-5e P-7 0TYpe of S.A.S.7W
—vZ
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 Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by P '07 F-4 Date
Application Disapproved by: Date
for the following reasons
Permit No. IDV Date IssuedI-,
——————————- -———— -———————————
Fee Mo .el
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH`DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTSYes
0(ppli.catio n for Zigogal Opgttm Con.5truction Permit
4 � +
Application'for ai Permit to Construct( RepairX Upgrade( ) Abandon( ) ❑.Complete Systerti>VIIndividual Components
r1 d� co,.,.��/lJ4cP� t
Location Address or i�ot No. � Ow er's Name,Address,and Tel.No.
� ivy �o
Assessor's Map/Parcel.2�o ��� ���CO�✓'vcr/J>�QrjQ C/6?� ��
Installer's Name,Address,and Tel.No. Designer's Name,Address and T I.No.
Type of Building:
Dwelling No.of Bedrooms -3 Lot Size sq. ft. Garbage Grinder ( )
Other Type of Building �G�f` No.of Persons 'Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) } �30 gpd Design flow provided • � gpd
Plan Date
7 Z. ` 9 Number of sheets Revision Date
Title
Size of Septic Tank �'N� ✓ " �OOPe` lType of S.A.S.7"M4 "e"4W 3 >C;1 rJC
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
i
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 d of Health.
Signed Date p- ..
Application Approved by Date o J '-`0
Application Disapproved by: Date .
for the following reasons
Permit No h o-I- Date Issued Y-6-0
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded
Abandoned( )by cr ', Gras o�y�
at C cv. ��iY�i'( G SDP, /��/ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. ? Wr-2-Y7 dated -
Installer C:r, W �E'Q�OcF�/f" Designer '4E!:L4y-110 4o
#bedrooms Approved design flow 31po gpd
The issuance of this permit shall GOt be construed as a guarantee that the system wiU.firncYio a d�ign
Date Inspector
_ --._-- .-------- ------•-_--_____.---__--_____.--�------ -- _--_-- -_---_ --
-- _------(f.—.—.-------------_- — �m.m- - - - -- - -
S
No. U() 2 ! 7 Fee /6o
_ -- -. THE COMMONWEALTH OF MASSACHUSETTS -
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
1=igpogar J§pgtem CCon5truction Permit
Permission is hereby granted to Construct ( ) Repair X Upgrade ( ) Abandon ( )
System located at �� G o/�Jli�'Jjl�4�i{ G/!F', by
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: Construction lr�te completed within three years of the date of thil ertn .-D �.
Date Approved by
APPLICANT:,}.
ADDRESS: 4IV2 (J)WW6K� 644L�
DESIGN FLOW: gpd
REVIEWED BY: DATE:
_ N/A OK NO
Legal boundaries denoted 310 CMR 15.220(4)(a)
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u))
Locus Provided 310 CMR 15.2204 t
Plan proper scale?(1"=40' for plot plans, 1"=20'or fewer for
components) 310 CMR 15.220(4)
Easements shown 310 CMR 15.220(4)(b)
System located totally on lot served [310 CMR 15.4050)(a) for
upgrades]- i not, a variance is required 310 CMR 15.412(4)
Location of impervious surfaces (driveways,parking areas etc.)
310 CMR 15.220(4)(d)
Location all buildings existing and proposed 310 CMR
15.220(4)(c)]
Location and dimensions of system components and reserve areas
i [310 CMR 15.220(4)(e)]
System Calculations 310 CMR 15.220(4)(f)
daily flow
septic tank capacity (required andprovided)
soil absorption system (required andprovided)
whether system desi n ed for garbage grindei
North arrow 310 CMR 15.220(4)( )]
Existing and ro osed contours 310 CMR 15.220(4)( )]
Location and log of deep observation holes (existing grade el. on
each test) 310 CMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h)and i
Location and date of percolation tests (performed at proper
elevation?) 310 CMR 15.220(4)(i)
Percolation test results match loading rate? 310 CMR 15.242 ,
Certification st4tement by Soil Evaluator 310 CMR 15.220(4)(')
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n))
Location of every water supply,public and private, [310 CMR
15.220(4) k
Address Sheet 1 of 7
r
within 400'feet of the proposed system location in the case
of surface water supplies and grayel packed public water supply
within 250 feet of the jmioposed system location in the case
within 150 feet of the proposed system location in the case
of private water supply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. 310 CMR 15.220 4 (1
Water lines'and 6thei.'gubsurface"utilities located [310 CMR
15.220 4 m if water line cross see 310 CMR 15.211 1 1 )
Profile of system showing invert elevations of all system 1
components and the bottom of the SAS 310 CMR15.220(4)(o)]
Stain of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 1 5.220 3
Test Holes adequate(two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2)or as
approved for an upgrade under LUA at 310 CMR 15.405 1
Test hole adequate to demonstrate four feet of suitable material?
310 CMR 15.103(4)]
Test Holes adequate to confirm adequate groundwater separation?
310 CMR 15.103 3)
Benchmark within 50-75'of system 310 CMR 15.220(4)(g))
Materials specifications noted? [various sections of 310 CMR
15.000
System components not> 36" deep(unless Local Upgrade
Approval or LUA requested) 310 CMR 15.405 1 b
Address Sheet 2 of 7
VERMIN
IS EM
MM
NOW
Size OK? '[310 CMR 15.223(l)]
Inlet tee located ten inches below flow line 310 CMR 15.227(6)]
Outlet tee 14" or 14"+ 5"per foot for increase ft depth [310 CMR
15.227(6)]
Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)
Separation between inlet and outlet tees (no less than liquid
depth) 310 CMR 15.227(2)]
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR.15.227(5)) or permitted for
upgrades under LUA 310 CMR 15.405 1) k ]
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3) ] ol
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (b 7/07) [310 CMR 15.228(2)
Access to within 6 "'of grade - one port for systems'I 000gpd, /
two for systems>1000 gpd 310 CMR 15.228(2)] Y
All at-grade covers secured to unauthorized access? [310 CMR /
15.228(2)] V
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done 1310 CMR 15.221(8
H-20 Where appropriate? 310 CMR 15.226(3)]
Setbacks from resources 310 CMR 15.211
Required when other,than single-family dwelling or flow>1000
d 3 10 CMR 15.223 1)(b
First compartment 200%daily flow; Second compartment 100%
daily flow 310 CMR 15.224(2) and 3)
"U"pipe through or over baffle, outlet of each compartment with
as baffle or approved filter 310 CMR 15.224(4)]
F� 1 Address Sheet 3 of 7
i f
Located at least ten feet from any water line?[310 CMR
15.222(2)]
Disposal piping at least 18"below water line (when water and
sewer cross, see 310 CMR 15.211 1 1 )
Cleanouts required/provided ? r310 CMR 15.222(8))
Thrust blocks specified in force mains?310 CMR 15.221 c
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
310 CMR 15.222(6))
Proper pitch on all runs?(.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)]
Siphonproblem/ leachfield below pump chamber
Endca s or vent manifoldspecified?
Size and orientation of discharge holes specified?(not smaller
than 3/8"not larger than 5/8") [310 CMR 15.251(8)and 310 VZ
CMR 15.252(2)(h))
Materials specified (310 CMR 15.251(5)specifies various pipe
types allowed) "
Stable compacted base [310 CMR 15.22](2)and 310 CMR
15.232(2)(a)
Splash plate or baffle tee required on inlet/provided?(when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323 3 a
Riser if deeper than 9" 310 CMR 15.232(3)(f)]
Inside minimum dimension 12" 310 CMR 15.232(2
Minimum sum 6" 310 CMR15.232(3)
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
310 CMR 15.232(3)(d)]
Capacity(emergency storage above working=design flow)?[310
CMR 231(2
i
Proper setbacks 310 CMR 15.211 same as septic tanks
Watertight 20-in minium access manhole at least 20"MUST BE /
TO GRADE 310 CMR 15.231(5)]
Service components accessible (not too deep,with piping, /
disconnects accessible)
Alarm floats-alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. 310 CMR 15.231(6)and 8
Stable Compacted Base 310 CMR 15.221(2))
[Buoyancy calculations needed ?Provided? 310 CMR 15.221(8
Address Sheet 4 of 7
` y
I
Calculations correct?
4 feet of naturally occurring material demonstrated?[310 CMR
15.240 1
Required separation togroundwater? 310 CMR 15.212).
Aggregate specified as double washed 310 CMR 15.247(2
System Venting required/provided? (system under driveway or
>36" deep) 310 CMR 15.241]
Inspection ports specified and within 3"final grade? [310 CMR
L
0(13)
out requirements met?(No violation of breakout elevation
15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
nce Document]
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. 310 CMR 15.253(6)
Each structure with one inspection manhole (if>2000 gpd must
be to ade) [310 CMR 15.253(2))
Aggregate 1'minimum-4'maximum. 310 CMR 15.253(1)
2'sidewall credit maximum 310 CMR 15.253(l) a ]
In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)]
Width 2'minimum 3'maximum 310 CMR 15.251(1)(b) ,
100 feet-maximum length 310 CMR 15.251 1) a
Minimum separation 2x effective depth or width whichever /
eater 3x if reserve between trenches 310 CMR 251 1 d v
Situated along contours 310 CMR 15.251(2)]
Breakout OK?[310 CMR 15.211(1)[4] and Guidance Document]
minimum 2 distribution lines 310 CMR 15.252 2) a
Maximum separation between lines 6' 310 CM R15.252(2)(d)]
Maximum separation between lines and outside of bed 4' [310 /
CMR 15.252(2)(e)] 1/
Aggregate depth below discharge pipes 6" minimum, 12"
maximum. [310 CMR 15.252(2)(g)]
Separation between-beds 10' minimum. [310 CMR 15.252(2)(f)]
Bottom area used in calculations only 310 CMR 15.252(2)(i)]
Are
Z u-{1 .� ��• Sheet 5 of 7
115,
Pressure Dosed System ? Provided pump and piping
calculations as re wired, 310 CMR 15:220 4 r t/
Pressure dosing required on all systems>2000gpd or alternative
systems undwi medial approval [310 CMR 15.254(2)and I/A
Remedial Use Approvals)
If used in gravelless system - make sure jet is directed as not to
scour soil interface Guidance Document
Inspections once per year(systems<2000 gpd)or quarterly
(>2000 dgood to note on plan 310 CMR 15.254(2)(d)]
Construction in fill -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ? I/
Impervious barrier and/or retaining wall ? Guidance Document
Impervious barrier installation must be supervised by /
designer 310 CMR 15.255(2)(b)) V
Retaining wall must be designed by Registered Professional
En ineer 310 CMR 15.255 2 (a)
Side slope not exceed 3:1 ? r310 CMR 15.255(2)]
Breakout requirements met? [310 CMR 15.252(2)and
Guidance Document
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended)f3l0 CMR 15.255 (2)(e)]
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
t.
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions? t/
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a co y of a maintenance
J
Are the variances listed on the plan ? [310 CMR 15.220
4 )
RLS Stamp necessary on plan if a component is within five
feet of Property line 310 CMR 15.412 4
New construction or increased flow proposed- [Refer to 310
CMR 15.414
Address 1Z Gc'7l� GqQ C
��.
Sheet 6 f 07
Is the system in a Designated Nitrogen Sensitive Area (Zone II for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems)
Is the system proposed on the same lot as served by private well ?
310 CMR 15.214(2)
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1 ]
Pum in to septic tank? 310 CMR 15.229
Shared System 310 CMR 15.290
Address IZ°� 1 '� � Sheet 7 of 7
I '
Town of Barnsta.ible
IME,T Regulatory Services
Thomas F.Geiler,Director
aA nt t�V.
9Q a Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office:.508-862-4644 Fax: 508-790-630i
Installer&Designer Certification Form
Date: 1 �^
Designer: '"l�}c`J��`1 Installer:
Address: . YA51 5wr4®wtU4 Address:
On ..6�„� { was issued a permit to install a
(date) ( taller)
septic system a:t:�l Z_ (All
based on a design drawn bY(address)--�-'
--)' h'V I D 13. M06M Y,5 dated
(designer)
certify that-the septic system referenced above was installed substantially according'to
"tic design, which may include minor approved changes such as lateral.relocation of the
diFtribution box and/or septic tank
_ I certify that the septic system referenced above was installed witl '�a3oi.changes.(i,e,
greater tlisAI(Y lateral relocatioa-of the SAS or any vertical".r' looati-on-of any component
of the.septi system.)but in accordance with State&Local;Regulations. Plan revision or
certified as bii*by designer to follow.
3►
tall
er sSignature)
h9ASON R,
No toss
sgN�T�►R�P�
(D er s Signature} er'`s S#ariop Here)
PLEASE RETURN TO F ST-ABP k,PUBLIC HEALT$ DIWIO , C RTM(— TE
OF-COMPUANCE .40 = E IIED- ' .BOT$,-3 �FQRNi
BUZL 'CARD ARE RECEIVED B YTlW.B - STABLIL PDBLI A d DIVISION'
TDAfi YOU.
Q:HealtNSeptiidDesigaer Certification Form
DEEP-OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Sdil Color Soil- Other
Surface(in.) (USDA) (Munsell) ±::--
Mottling (Structure,Stones;Boulders.
Con isle c
- 'U5 �� 2
-- G GS . t
0
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones,Boulders.
Consistency,%Gravel
l
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency'. a Grav 1
i
I
I
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell): Mottling (Structure,Stones,Boulders.
Consistency,%OrnvI
Flood Insurance Rate Man:
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 tenal exist in all areas observed throughout the
area proposed for the soil absorption system? Lf
If not,what is the depth of pat rally occurring pery ous material? �'�
Certification
I certify that on Ct (date)I have passed the soil evaluator examination approved by the
Department of Enviro mental Protection and that the above analysis was perf rm by me consistent with
the required training, xperNse an xp rig ce described in 310 CMR 15.017.
Signat Date G. b 200q
Q:1S EPTIC\PERCFORM.DOC
i
oF�
Town of Barnstable P#
Department of Regulatory Services
Public Health Division Date
MARS.
t63A �� 200 Main Street,Hyannis MA 02601
Date Scheduled Time Fee Pd. . U o
Soil Suitability Assessment for Sew ge , isposal
Performed•By: Witnessed By: vl /P d
PC
LOCATION& GENERAL INFORMATION
Location Address /,T C � C/GP. Owner's Name
Address Go vira'/l1, .d G/w. N�
Assessor's Map/Parcel:
Engineer's Name&4v/o e ,4Vrv._'I�P`r
NEW CONSTRUCTION 3"
R.�EP,AIIt x Telephone# 0� �3 3
Land Use GC7 Yl Slopes(90) / Surface Stones
Distances from: Open Water Body ft Pos:ib:e Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line I ft Other / ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&.pere tests,locate wetlands in proximity to holes)
Parent material(geologic) 0V3 AZjLj
Depth t0 Bedrock l
Depth to Groundwater. Standing Water in Hole: / Weeping from Pit Ppce
Estimated Seasonal,High Groundwater -
DETERIVIINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: In. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: In, Groundwater AtlJustment ft.
index Well# Reading Date: index Well.lewCl, _ Adj,factor ,e 4 A .C)ro dw
Observation nter vel
PERCOLATION TEST Dated C
I '
Hole# Time at 9"
Depth of Pere -1
Time at G"
Start Pre-soak Time @ 2 Time(9"-6")
End Pre-soak
Rate Min.flnch
Site Suitability Assessment: Site Passed Sih Fmiled: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation*test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conservation Division at least one (1) week prior to beginning.
Q:\S EPTICIPERCFORM.DOC'
No...... d'--.., F$$..��...-.....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH._,,,
.:................OF............ ... �s
, ppliration for Ditipmal Marks Tonotrudion Vrkmit
Application is hereby made for a Permit to Const uct or Repair ( ) an Individual Sewage Disposal
a .S y�s/t,e�m o:r►h eb42f ................ �
� .��
— 1
/
.�
r
L..... . .O &-- ------ - - ---------.........---................
LN Locationdrss or ot o s
.. ...............................t.Owner Address
................................. ........... -- -----------.-.--------------------------------------------------------
taller Address
d Type of Building�,� Size Lot............................Sq. feet
Dwelling-No. of Bedrooms__.___. Expansion Attic ( ) Garbage Grinder ( )
......_
p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Pa Other fixtures .........................................
W Design Flow.. .................... .....,rr-y.....,_gallons per person per day. Total daily flow...... .. ...............gallons.
WSeptic Tankt-Liquid capacity/�-- 70allons Length--------_...... Width............. . Diameter................ Depth................
x Disposal Trench—No. .................... Width..............#,e_-pFthV0jw
n�th}...... _Total leaching area....................sq. ft.
Seepage Pit No ........... Diameter./ ._ �inl"e�f..............�..i..'. 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........................
pC ..-•-------------------
O Description of Soil--------- ........................ ... ....� �-. ...... ,9 re -
U •--------------•--••---......--•-........................------......................---.....--------------------tom--•-----•-•----------------•------•-•---•--------••-•---•---------•-•••----•--•----
W
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 XI 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
� s health.
h
Signedi.. ...... , - Date
_. /APPlication Approved - � !t. .
Date
Application Disapproved for the following reasons:-----••-------•---•-•------ ------ -----••-•-------------------•-----------.....---•-----••......--•-------_....
...................••-•---------•---........................------------..................----------------•-•••-----•--••---••••-•---•-•---••----••---•--. ••-------- --- ---- .......
PermitNo......................................................... Issued........ ... ..--. a
Date
No......�e ... FEE. ....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT.—H,
wo
------------------
OF............
.. � ....
Appliration for Ropouttl 19orho Tonitrurtion Frrutif
Application is hereby made for a Permit to Construct (),") or Repair ( ) an Iwivid a S�ewag�D p sal
Systema� • � (''JJ �
i. � . .... !.... .. '" - •. ..................... - -----------------------------------
1 -- Locatiotr�Addss •-••-----•----•-•---•--..__.....or Lot No. .-
;� ................................. ......... •--..........------.......----....................----
Owner —Address
........ .._t.-:`"?!_ ............................... .................... ...........--------•--..•...........--••--.
s. ' Installer`s Address
UType of Buildirk �e Size Lot............................Sq. feet
Dwelling=No. of Bedrooms......_-.�`............................Expansion Attic ( ) Garbage Grinder ( )
p-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures •........................ . ior __
W DesignFlow................... allons er erson er da Total dail flow..__.. 4+ ...............gallons.
W Septic Tank--Liquid capacity/gallons Length................ Width____.__._..potal
Diameter................ Depth.............._
Disposal Trench—No..................... Width_._.._.- ---- -- 0 1 Ise h----- - - leaching area....................sq. ft.
Seepage Pit No ........... Diameter. .. ............. epth e+low role ............_....... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY.......................................................................... Date........................................
Test 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........................
W .....................••• ••. . ....... 0. ---- ............... ._.
O Description of Soil........
....""''.......................
x �..... •--------- -
V ------------
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-------------------------------------------------------------
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W
UNature 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 undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed... = :._..._ 15�.._ :.... -----------•• -----------•--------------------
................. Date ............
Application Approved By.... _-r��.•� J!. ... ....
Date
Application Disapproved for the following reasons-------------••. ... ......................................... --•-..............
......................•--•---••------•-•••--••-•••-•••••••-----.........•t----•--••-.......-•-•---------•.-•---------......--•-•----•••......--••----••••--- ---•- ......... ........---•--•--
PermitNo.......................................................... Issued......... .
D
� - -•---ate.. ..... ......-, -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF
?HEALTH
OF.........., „)....:......................................................
Ter#ifirate of Toutphatta
T S IS/TO CERTIFY, T the Individual Sewage Disposal System constructed � ) or Repaired ( )
bY-•.._--•�.....4-t- '�1. +v",�,."...................... -2talt
-----................ .............
V n�ailer�
at--" ?. ..._ � ,4 ;f1 r .cL:Ce„ --•-. - a�` ....................
has been installed in accordance with the provisions of Article of he Sanitary Cod as de cribed in the
application for Disposal Works Construction Permit No......._.__��......................... dated_._-�.7/7----•-•-_-----.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE
SYSTEM WIL TION S/-'--
FACTORY.
DATE5 Inspector ..... ............. .. •---
3. - 7---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
� ........E .. . ........ --
No........ ..........oF , .. ...........
FEE... -...........
Disposal Ttks Tons#r rtion Plerutit
Permission is hereby granted..:n---•- -,� ...- ->!.r� !..... _ ------------------------------------------•----------•-•-•-----•---
to Constru-t ( Re air (�) an Individual Sewage D iosal Sy em
Street �
as shown on the application for Disposal Works Construction P7 ..it No ,................ Dated_.._/,.., _ .�L............
Board of lth
DATE................................................................................ —'
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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r 1. DATUM Is egg r ! I-�..II% f � `�•Y.° � �I/'r//'` t,��-[
2. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO
BE USED FOR LOT LINE STAKING OR ANY OTHER _(`,'-.-�
PURPOSE. '. \,.• 1,% r_'_f 1;•',:1
3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING ' ! ! r74i �� l� �'•`'' L
DIGSAFE (1-888-344-7233) AND VERIFYING THE L. i-.
- LOCATION OF ALL UNDERGROUND h OVERHEAD UTILITIES
`a:os,-J.Eimr.
' PRIOR TO COMMENCEMENT OF WORK. /'--' r I L Scn.\,
s\ -,
4. EXISTING SEPTIC LOCATION PER TIE-CARD ON FILE ,•\4 N?%
WITH TOWN. 3 tM tac9i r�
J' LOCUS MAP
SCALE 1"=2000't
2t. t ASSESSORS MAP 290 PARCEL 148
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— ROP' ''� '• ��-'' ` OSED ` ZONING SUMMARY
Nj5.42 r� �,.'� _ GARAGE
Zp 58 n: PAS �'" ADDITION ZONING DISTRICT: RB DISTRICT
!;1 `-DRIVE
MIN. LOT SIZE 43,560 S.F.
MIN. LOT FRONTAGE 20'
MIN. LOT WIDTH 100'
`� MIN. FRONT SETBACK 20'
I r f 7?Jy MIN. SIDE SETBACK 10'
?. MIN. REt.R SETBACK 10'
EXISTING .�\ vy,3 MAX. BUILDING HEIGHT 30'
DWFI LING
SITE IS LOCATED WITHIN THE
PATIO GROUNDWATER PROTECTION OVERLAY
( DISTRICT
1. a' .c,1" 1• \�\ ;�`\-- ,' PATIO•; r
rn
1 LOT 8-1
,15,213 S.F.t
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- - SITE PLAN
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#128 CONNEMARA CIRCLE
- HYANNIS, MA
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+; PREPARED FOR
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yd G is Nh 01. l 0 L� _ KENNEY BUILDERS 1 � ..
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DATE: AUGUST 12, 2019
m -
_T CC^ oll SOB-362-4541
o _ fax 508-362-9880
downcoPe.com p
� _ �-% � down cope engineering,inc.
civil engineers
o K t Scole:I"=20' .� _`-- -- `) t `- -�, land surveyors
•( 1 9J9 IAoin Street ( Rte 6A)
DICE #1 9—1 S8 -'- " DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTNPORT MA 02675
n_I�
6-
c ASSESSORS MAP :_ 0Z90 -. ,.__._ ..-.._.___. TEST HOLF- LOGS NOTES:
PARCEL : —,--,-, --� /1716 _ r� I rN� W Gam,!
FLOOD ZONE: I/d/- - .9 5,L� SO I L EVALUATOR : y
c� _���Z 4 _-... _ _ _ 1) The installation shall comply with Title V and Town of Barnstable Board of
WITNESS : \/( ;) ►�Mtn 45
Healthl;egulations.REFERENCE: DATE:' �7
r y�,tc PERCOLATION RAT G w a/, / 2) The installer shall verify the location of utilities, sewer inverts and septic
components prior to installation and setting base elevations.
�
� �fYj 8( �UQV Cot�,lcSU(,`Tigc,t7 � l" �-1--- j ' s 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per,foot. The first
_ TH- I TH-2 two feet out of the d-box to the leaching shall be level.
t1 UL _ 7 . ._. _ _.. k}�+,t 4) This plan is not to be utilized for property line determination nor any other
�b Q'1 '✓ A purpose other than the proposed system installation
J
Lv4M 64,-149 g �j ,� 5) All septic components must meet Title V specifications.
3 16 2G �, 00 a lat Q6 E, 6) Parking shall not be constructed over H10 septic components.
Z� 1 7) The property is bounded by property corners and property lines.
LOCATION MAP G vCaw�& SAD I wj0 8) The property owner shall review design considerations to approve of total
1 f 1 4/11
m al 4 design flow and number of bedrooms to be considered for design. Receipt
�6 G;-� of payment for the plan and installation based on the plan shall be deemed
t ICO, p i l� , "AAA' approval of the design flow by the owner.
{ GZ 2 9) The existing leaching or cesspools shall be pumped and filled with material
216j�14 f per Title V abandonment procedures. Those within the proposed SAS shall
` t✓ ,l ;✓ be removed along with contaminated soil and replaced with clean sand per
l
lib �.W�, 'Ir.��r�(.� � p ��� . �.�w^��`7..� � Title V specs.
-�_ --_ ---- - 4 --
10)System components to be 10 feet from water line. Sewer lines crossing the
water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if
/ ( �EM DES I G N applicable. The proposed SAS is being installed below the water service
SEPTICSYS
line. The line is to be sleeved as aforementioned and maintained in place.
11) If a garbage grinder exists it is to be removed and is the responsibility of the
v '� FLOW ESTIMATE owner to ensure such.
a Z i�v 1 2 0�' 12)The installer is to take caution in excavation around the gas line if such
75 25 BEDROOMS AT IID GAL/DAY/BEDROOM - ?�DGAL/DAY exists.
13)The installer shall verify the location, quantity and elevation of the sewer
j \ SEPTIC TANK lines exiting the dwelling prior to the installation.
v�Z� �GkL/DAY x 2 DAYS - / GAL
�
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USE 100L) GALLON SEPTIC TANK
N L ?"Ugc- 4'Q'Ma DV1' b l+ST -
d SOIL ABSORPTION SYSTEM
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- _ V,
SITE AND SEWAGE PLAN
LOCAT ION : I2 CZ NEM A 2A
PREPARED FOR : ��OJ-
SCALE: I �=
w DAV I D B . MASON F� DATE: 3a ?oa f
Z DBC ENVIRONMEN AL DESIGNS
EAST SANDWICH . MA
3 DATE HEALTH AGENT ( 508 ) 833- 2177
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NOTES Ro„to 28
�o
1. DATUM IS NAVD88 s
o
2. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO
BE USED FOR LOT LINE STAKING OR ANY OTHER a
PURPOSE. q°
1 a
3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING
DIGSAFE (1-888-344-7233) AND VERIFYING THE
LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES Hyo. E t{ et
PRIOR TO COMMENCEMENT OF WORK. Locus Elem. Sch.
4. EXISTING SEPTIC LOCATION PER TIE—CARD ON FILE T, �teJens Igor St.
WITH TOWN. t
m y
a � ion
m Moin
West Moin St. St.
e
P�e
J v LOCUS MAP
SCALE 1"=2000'f
ASSESSORS MAP 290 PARCEL 148
A
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cROPOSED ZONING SUMMARY
GE
20.5a `9 DR
V ED tK ADDITION ZONING DISTRICT: RB DISTRICT
MIN. LOT SIZE 43,560 S.F.
34 2� MIN. LOT FRONTAGE 20'
MIN. LOT WIDTH 100'
MIN. FRONT SETBACK 20'
g, �s ,g- MIN. SIDE SETBACK 10'
24 _ �'EXISTING MIN. REAR SETBACK 10'
•AR, s--
DWELLING MAX. BUILDING HEIGHT 30'
TOF = 35.1
SITE IS LOCATED WITHIN THE
PATIO GROUNDWATER PROTECTION OVERLAY
DISTRICT
0 PATIO
N 0 32
cP —� 0
O 33
LOT 81 �2
15,213 S.F.f
SNE
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SITE PLAN
OF
33
#128 CONNEMARA CIRCLE
HYANNIS, MA
PREPARED FOR
KENNEY BUILDERS
or� SSq DATE: JULY 8, 2019
v� c \SNOFA,�gSS
i� D AN I EL yGm ��v 9cy
t . A DANIELA.
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�0 WAI-A o WALLA fax 508-362-9880
No.40980 " CIVIL I downcope.com
No.46502
°Fs�'° �o �� �° down cape engineering, inc.
9,yp Su yd F /ONAI- G��
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civil engineers
Scale: 1"- 20' - < land surveyors
939 Main Street ( Rte 6A)
DCE > 9- 188
0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
#
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