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HomeMy WebLinkAbout0060 FERNWOOD AVENUE - Health 60 Fetnwo6a'Aver ueA ;Hyannis 289 097 e i n TOWN OF BARNSTABLE -� LOCATION SEWAGE # VILLAGE d2A�A',-S ASSESSOR'S MAP & LOT ::20ftl—OC INSTALLER'S NAME&PHONE NO SEPTIC TANK CAPACITY 't mV LEACHING FACILITY: (type) (size) e�f'dt Ic( NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: ( - CO LIANCE. DATE: ? 3 V Separation Distance Between the: Maximum 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 ZIA 93 9,3 a 4 No. FEE COMMONWEALTH OF MASSACHUSETTS CC L_�, Board of Health, MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) RepairxUpgrade( ) Abandon( ) - XComplete System ❑Individual Components Location o Owner's Name kN Map/Parcel# Address Lot# 17, Telephone# Installer's Name Designer's Name Address C Address `0 Fc,' "A Telephone# _ \t) Telephone# � �a �o told Type of Building .mil�C✓jla-1 '` Lot Size _sq.ft. Dwelling-No.of Bedrooms i y? CA-) Garbage grinder (N11rr Other-Type of Building G�l� (MCA No.of persons c?) Showers-VCafeteria (6), Other Fixtures �, C�, Design Flow (min.required) ���® gpd Calculated design flow 3� Design flow provided 3 gpd Plan: Date ' ) A: Number of sheets I Revision Date Title 1 SiLAS1, 4enn Op=&. Description of Soils) ` Ab !;;?XC4, Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS Vk Cc). The under ' ed agrees to install a above described Individual Sewage Dis osal System in accordance with the provisions of TITLE 5 and further agr s to not to lace th in o e on until a Certificate o ompli ce been issued by the Board of Health: Signed Date 2 v Inspections K_<�'.i''�.�Fy ^,-�±,,,w+h�,-•+"`'.�'���-.y'�-r+' ,-,.} (n" t+��F.�''.�` +R�„� ,• - �},,.�;R'ir•y"Y`..v^`n^C y+�,rt..-�,-f'�y`'� No. 2Ud A : ��``'.`;. _.. f.; �' ff EE / V Board of Health, Bcx it'*a.� 'NIA. AP PLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair UpgradeOAbandonO - Xcomplete System ❑Individual Components } Location *U f;rtpQOG� `tx any S Owner's Name kgN N e N ey Map/Parcel# O�" AddressAM iC Lot# ­X:'s"Z Telephone# Installer's Name S G , Designer's Name orm amn v r� n Address '�"� CV-� �, TOC OJ�� Address C 0o a (e� C FCeI{YI MA Telephone# GL4 6_J3\t) Telephone# toko Oa53i� Type of Building &A-IA 1C`` Lot Size _3 O sq.ft. Dwelling.-No.of-Bedrooms ,on CA') Garbage grinder Other--Type of Building No.of persons 3 Showers (jiIO"Cafeteria (�Jf Other Fixtures � 4. "-'Design Flow (min.required) gpd Calculated design flow Design flow provided 53,• _ gpd Plan: Date ' S-Q 0 4 Number of sheets ( Revision Date Title �l 7,m pose pin c 5,�1 Herr, t)pp,eMae •t Description of Soils) Alb TLC411 v Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS ORALTERATIONS Fes " ►��C�JC1. The undersigned agrees to install a above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not tto,place the s, t/empin�operation until a Certificate of Compliances has been issued by the Board of Health. { Signed l�f U 1 J`(©( r Date 304, f�J - 2/ u Inspections No. u - S`J C®�'1[[�'l[®l�W III OF MASSACHUSETTS FEE a� Board of Health, r� CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) / Complete System The undersigned herg�y e rMththe Sewage. i�posal System; Constructed ( ),Repaired ( ),Upgraded ,Abandoned ( ) by: at 44 lA has been installed in accordance with the prj visi ns of 310 CMR 15.00 (Title 5) and the approved sign p ans/as-built plans relating to application No.�r u dated /'�j �. Approved Design Flow aad (gpdT 2 61, Mv'+f Installer a Designer: Inspector: / r• Date: : 2 3 Ad The issuance of this permit shall not be construed as a guarantee at the system will function as designed. No. VGUL(`3- ` FEE 00 Board of Health, G ! DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted t}o Construct( ) Repair( ) Upgrade ) Abandon( ) an individual sewage disposal system at 1 l J I i .� J� as described in the application for Disposal System Construction Permit No. 20q' 577, dated � 1/U r Provided: Construction shall be completed within three years of the date o t 's pe nit. All ocal conditions must be met. form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ! /O Board of Health �,/, /�./ j ` TOWN OFBARNSTABLE �- SEWAGE # LOCATION VILLAGE A'f-� ASSESSOR'S MAP & LOT 2P— INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �� � ��,(�lv�Lrt( (size) ��t NO.OF BEDROOMS a BUILDER OR OWNER fCO=A�NCE PERMTTDATE: 1 v ATE: �V Separation Distance Between the: 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) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) i Furnished by a Town of Barnstable ptNE rp� do Regulatory Services Thomas F. Geiler, Director * saxxseasi.e, 9 MAS& Public Health Division i639. .0 �Ee3+0. Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Designer: ���� � Installer: o � �,� Address: .�, p („ y Address: On o _S��C_ was issued a permit to install a (dale) (installer) septic system at�V �� , based on a design drawn by (address) �. dated -9,01a-Y signer) 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. 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. CARMEN' Insta ler's Signature) �� E. ` ,- u SHAY Cn No. 1181 ��Gr.S,TEP�O (Designer's Signature) (Affix mp 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:Health/Septic/Designer Certification Form n ro TION . . FROM�_ .. ALL OURtt .a ' ..,.,. * o r.. :.. 9 40 P.V.C.P- N TE ALL ARE'r0 BE 4 SCHEDULE C ... .. 10 min. from _ fl PIPES _a T,PIPE (M Lsost 24 InCh . tat Y TFM' , oisTRieunoN Box sH�u. 1 vEN : n 0' V F..ADDITION. TO LEA S S , r R Fi�E IE 1r - t Re n � Foundotiorl. to septic •tank _ ,< ( ar � SET u�va.roR�r ueAsr z FT. e Exist house ep _,. ,:. Schedule 40 PVc w/Charcoal Odor-Flit _.., . s W ed .ostar, - 1 1 2 ash mart 3 of 8 C tDh1f Ca'Yer! tM ,. ' SEC r ;;r t / ON 100.00 Assumed. :, •� � TOP OF FOUNDATI ELEV. ( ) r.. 1 ,ri4dn 6 In of finished 9�e 1 1 2 Woh Crushed Stone 3 6'WRE1 . e _ 4 to / , (beds OVM O-•Box 9f,00 ,..., >, .. s. $ .,. ,.... ...., .: Grade over tic'Tank 96.00 ,.. ... ,. . ,. '..<, 'KNOCKOUTS .... qYf/ ..,, ::, ..: •:.: '. ,. ,. .M` sent on < W1LE1 r, s 0.02 3 HOLE H/0 _ -=awns X Ymcknum Cove Tap t ood Elev. DIST. BOX 14' -NEW S-o.Ot a Greater •+5,nb6.yt n.., wry PIPE ,n „,n 1 500 GAL, s- 6.01' foot . 16 5' 4• _ SCH. 40 T w. i 9..gfiK ,-. 9ovMQm Dr .ri. ''. r ;: ' m FROM EXISTroiiNnAr10N ,y N SEPTIC TANK g 10, a"EMectNs Depth t.rs 1110 s.La,Its e b.zs sa PLAN SECTION CROSS SECTION .., �x•: a n k' _ x 1x 1 H-10 3 3 CONCRETE ruu FouNw o a v rn ri 0:83' (10 inches) 31.25` >su I aL rn m $ 3 H LE H--1 O DISTRIBUTION BOX ,.,.rE., SYSTEM PROFILE 6 In.of 3/4-1 1/z' > p 37.25 _� ,1r ;;, c cannpocted stune y o 0 o m Effective Length - NOT TO SCALE r ° Not to scale c o o M rt Rme is kry i sw,er y tQ Nerprkn i` T > # 4 SOIL ABSORPTION SYSTEM (SAS) > c c � 2.5 > - � to` INFIL ATROR HIGH 4 CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN GENERAL NOTES 6 In.of 3/4•-1 1/2' compocted stone Effective Width (OR EQUIVALENT) Not to Scale IM T HAVE RISERS TO WITHIN 6' BELOW GRADE 0 1. Contractor Is responsible for Digsafe notification NOTE. ALL COMPONENTS US VE ER o Bottom'af Test Halo 1 Dev.-86.00 m NOT-- OVERALL HEIGHT OF INFILTRATOR IS 18' CTIVE HEIGHT IS to- and protection of,all underground utilities and pipes. No Groundwater observed O 132• � P g P P - ------- 2. The septic tank on j distri ulion box shall be set level on 6 of 3/4 -1 1/2 stone. 3.'Backfill should be clean sand or gravel with no stones over 3 in size. 4. This system is subject to inspection during installotion by Carmen E. Shay - Environmental Services,' Inc. 5. The contractor shall install this system in accordance LOT 36 with Title V of the Massachusetts state code, the approved plan PERCOLATION TEST LOT #30 # and Local Regulations. Co 6. If, during installation the contractor encounters any Date of Percolation Test- JULY 7, 2004 , t soil conditions or site conditions that are different Test Performed By, CARMEN E. SHAY, R.S., C.S.E. I r • Results Witnessed B . .WAIVER per Barnstable B.O.H. r from those shown on .the soil log or in our.design Y ( P ) r 190.00 installation must bait & immediate notification be SHAY ENVIRONMENTAL SERVICES, INC. i made to Carmen,E. Shay - Environmental Services, Inc. Percolation Rate: Less Than`2 MPI 0 42 7. No vehicle or heavy machinery shall'drive over the 8 septic`system unless noted 'as H-20 septic components. r ��'---- 8. 'Install Tuf-rite`gas baffles or equals on `all outlet tee ends. 9 9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes. Test Hole t ��-- 10. All solid piping, tees`& fittings shall be 4 diameter No. 1 I LOT #37 &32 rr P'P g j Schedule 40 NSF PVC pipe with water tight joints. DEPTH SOILS ELEV. i i 11. Municipal Water is Connected to ALL OF The Residence and Abutting % ,23,940 Square Feet +/ � i a 97.a0 I r � , Properties Within 150 Feet. i Sandy I r THE PROPERTY LINES ARE APPROXIMATE AND Loom I I -----`--,_ COMPILED FROM THE SURVEY PLAN GENERATED BY 0'-12' A 96.E i �i EXISTING GEORGE CLEMENTS OF HYANNIS, MA soRay LOT #31 &32i i DECK -'- GARAGE LOT #38 ENTITLED -,SUBDIVISION PLAN OF LAND IN HYANNISPORT, MA r ------ --__- DATED AUGUST, 1928, & PLAN BOOK 38, PAGE 91 and The Loam r r , ' --- DEED DESCRIPTION ( BOOK 10135 PG 202) io Ytt s/b. i � �� t2'- 42 Be ' 93-5o rr 1 /� 96 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN Med, r r I THE 'SEPTIC SYSTEM INSTALLATION. Sand i EXISTING EXISTING z s Y 7/4 r 2 BEDRO011[ I I ✓ EXISTING LEACH PIT/CESSPOOLS TO BE PUMPED OUT AND 42'-132' C, 86.00 r GARAGE 1 i � ' REMOVED TO FACILITATE NEW SEPTIC- SYSTEM INSTALLATION o F ROUSE (ASPHALT i NOTE: ANY STRIPPED OUT SOILCONTAINING LEACHATE w #60 DRIVEWAY( i FROM THE 'EXISTING LEACH PIT/CESSPOOLS TO BE DISPOSED . __- i� p OF AS PER BOARD OF HEALTH SPECIFICATIONS. - I; / t --- ---- NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY i ` e '6NEW CV r I I 00 gal. ASSESSORS MAP 289, PARCEL 097 ank , I , %( PROJECT BENCH MARK LEGEND �-- 2 1 _ I r % TOP, OF FOUNDATION I i ELEV. 100.00 (Assumed), Perc #1 � � i Failed D-Box 1 j � I Depth to Perc: 42 to 60 t I I Cesspools 104X 1 DENOTES PROPOSED Perc Rate- Less Tha 2 MPI ;?• `� - "'1A t1 % SPOT GRADE ASPHALT I ;. +� tI % Groundwater Not Observed DRIVEWAY s _ a: - =s�. - % No Observed ESHWT �� ► l t =; r� . DENOTES: EXISTING R \ I i bf. '"``4 i % ► X 104.46 ADJUSTED H2O Elev. ffi None �� I ' f t SPOT GRADE ;, t 14 PVC %` PL I I TEST HOLE 1 %VENT % 190.00 PROPERTY LINE ��y t ELEV.= 97.00,:. 1 ni In 96J PROPOSED CONTOUR _------ I � L-------- ------- - - - - ----97 EXISTING CONTOUR f f `-- -- - DEEP TEST H LE & 3-sa•Mlit A�MkfiaFs PERCOLATION `TST LOCATION FE_H.ZV WO 0 D A� VENUE 6 FOOT' STOCKADE FENCE " r (40 FOOT, RIGHT, OF WAY) tau 1 1 04 , OUT P LOT FLAB {: THE ACCESS COVERS FOR THE SEPTIC TANK .!a .w�...�j, -•Z•••.-rr-- DISTRIBUTION,BOX AND LEACHING COMPONENT OF r PROPOSED SEPTIC SYSTEM UPGRADE sHAIL, BE RAISED TO WITHIN 6' OF STEEL''REINFORCED PRECAST CONCRETE FINISHED:GRADE _ PREPARED FOR INSTALL T1TE GAS BAFFLES OR EQUALS PLAN `VIEW `"x ON ALL"OUTLET TEE ENDS 3--24•REWVABLE 001ER5 MR . K E N N ETH HENRY „ AT �,,dom . a + FERNWOOD AVENUE poplin Y Mr, N.it to eatlrt W1LET - H YANNIS MA E 4-0`mks. 1� 'rt,r �.,, Design Calculations •. .: r , .. � e.err _ ,` ; u¢rd°dM� BY: • *. ,. PREPARED r ent to 20 at. Da 330 Goi. Da Min.', e t ., .. .�,,. . Number of Bedrooms: '2,,,Etlalval 2 G / Y_ ( / Y P � ,. , Garbage"Grinder. No . •., a . 3. �. R E i rL►ll Yll LeachingCapacityProposed: 330 Gal. a Minimum (Min. Per Title ,. _ A Septic,Tan _ 60 USE :NEW 1 500 GAL k, o END S C'ION Septic Tank . ; 2 x 330 Gal. ay: +; E eP ENVIRONMENTAL SERVICES INC. CROSS SECTION � f 01 ABSORPTION sin ercolation rote of � min. inch S L A A. Using p / ., , . i31 .,. Bottom :Area.,.. 0.74 al ft. x, 370 s ; .ft. 273.8 allons P.O. BOX .'627 -` 9 /sq , 4 9 < 0 74 al, s ft. x 78 s ft. 58 'gallons idewau Area: 9 -/ q q 9 A MOUTH MA:<02536 ,, , , � t: :EAST..�" L , TANK' . -, rsTE TYPICAL `3 50Q _GALLON SEPTIC A , . Providln 331.80 allons , ♦ 9 9 S , � TEL FAX 508 548 0796 _ , Nbr To GALE SCALE. 1 _ 20 f _ , , .,, , ; S EFFECTIVE PTH Use; 5 < INFILTRATOR HIGH CAPAGTY.H 20 1JNI1S HAVING A 0.83 10 INCHES) EF E D. _ ) ( ) r . _ _ � .^. • . 1 20 � _DRAWN BY:, CES DATE. DULY ,16 20 -1 A NG WASHED NE FI O LO DI T WITH 4.0 WASHED TONE, THE SIDE AND 3.5 of S ED STONE . , `` ., 0 BE l)SED O!` S .-oN S, W . : _. >. -::: M � S 603PP` WG `-" '. ,::.SHEET `1 OF >1 , , TONE'UNDER . .. , -. _, , PROD CT Sfl503 FILENA E. D .D . . ON THE ENDS. NO 5 .;, E , :. , v , a +.p jy r ,