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0020 HARVARD STREET - Health
20 Harvard Street 307-140 H i ` Town of Barnstable Health Inspector Office Hours Regulatory Services 8:00—9:30 .J t Thomas F.Geiler,Director 1:00—2:00 • snxxsTnai a Only A ,� Public Health Division rE�Mo�a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE 1. General Information:Address: #AKVAPP !✓N�S Map 3'0 7 Parcel (f I 0 Name: 90Ui4RD P—E-AdC-ff— Phone#:'5-DL3` 77g -0272S 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? YC> If yes, how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? S 2d. Please include a copy of the floor plans for the entire property-showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 6. Is a disposal works construction permit on file? YES or NO 6a .If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public HeaLth Division has no bjectio to bedrooms at this prop rty Signed: Date: , 7 a 3 Inspector(Print): Q,/heal th/wpfiles/amnestyapp 0 fl _ o c� flQ � Z � lJ j� Q a Z � t o C) x _ * cry Lo o go Z �U .�: •- - FRII g VQ........... No. THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF' HEALTH ............L.} �L.�J..04 I?.....OF.... aY.. rips®�.h/c,------------------------------------- Appliratiou for Bhqpuia1 lVorkii Tomitruriiou ramit Application is hereby made for a Permit to Construct ( ) or Repair ( L. an Individual Sewage Disposal System at: ..... o.__�� ..:r�c�r�?....�-r..J=�-................ .................................................................................................. tion-Address e or Lot No. x -...., . e -------------------------------- .......... .._._._____ ------•----...-----------.....--------..._...------ nef ['� ddress a ---------------------- Installer Address QType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type T e of Building ............... No. of ersons__......_............_...___ Showers — Cafeteria t� YP g ----------•-- P ( ) ( ) Q+ Other fixtures -------------------------------- W Design Flow............................................gallons per person,per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons 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 ( , ) ~' Percolation Test Results Performed by.......................................................................... Date---••----•......-•••-•-•••-•--•-------- aTest Pit No. I................minutes per inch Depth of Test Pit...._............... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ® , Description of Soil---------�. •t.d? ?'�_. r �l----------------------------------------- x U ---••-••-------••••••••--•-••-••••.................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable----17&_1140_. �L iIQ .-��--------------------- ......1=1.DQ�__ /'� �?------------- -----------------------------• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT E 5 of the State Sanitary ode—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has Keel issued by the bo rd f health. "7 , Sign '�. �D'te/ Application Approved By........ -- - .. .......... :....... .... 1�✓ .............. --�-�--�'�---'�_--•7-�_•-_=- Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------• ..................... .............•-----•------••-•••------•••-••-••......•-•----•----••-•••••-•••-•-•••-••-•---•••••----•-•--'---••-•••-••----•-•-•---•••------•-•-----•--••••••••-•--••----•-••--•••-••----••-•-•--•--•----- Date PermitNo......................................................... Issued....................................................... Date } No...... ....... FBB .::f -THE COMMONWEALTH OF MASSACHUSETTS �. . ;.4 BOARD OF HEALTH ApplirFatiuu for Elh4p ti al Workii Tomitrurtiou Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( s,..) an Individual Sewage Disposal System at: -•---•--------•- .......--••- ...-••-•-••-•----••------- ----•................•----•----------•--•- '�y y." Location•Address E or Lot No. Owner _}`.4I Address ........ I Installer Address UType of Building Size Lot____________________ _____Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria.( al Other fixtures __________________________________ W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons 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 ( ) '3 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....................... --••--------••••-----------------------•--------------------------•--._...._._....•---•---•••-_-----......................................................... n�_sl:�°_. _ � �: -----••----•-•--------------•----------•••--••-•-•••-••••••••- O Description of Soil `•� -°`:� =-------•-•- x UNature of Repairs or Alterations—Answer when applicable }`1� �' �` aV �..4...................... ........_. `"��"� fir .c'� � ' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ei issued by the b ar lof health. Sign j _.°`` d'�� �= - �"�......•'4- --------•--•--•-•--- =-, �_. 7 / Date Application Approved By....... u*' 0--•-•-•••-••. vfi"'- �.r-. � '•• Date Application Disapproved for the following reasons_____________________________•__-______________________________-_____________-_______•...__. _-______..._..____ 'Date PermitNo------------------------.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �..�r?............oF... :y : :. `. ...._.. '. .--••-... T rrtifirat.e of Toutpliiitta'--{aF:; TLLIS-IS TO CERTIFY, That the Individual,_Sewage Disposal System constructed ( ) or Repaired ( "'j" by �.�f �e f:tFs "r r' �+ °` ---- ------------------•-----•..._....--- ;... .._...... .--------- .� a t S Installer ,t has been installed in acrdance with the provisions_of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit Noi � da.ted_..._ �,Z_,2'..? --------------- THE ISSUANCE OF.T1 IS..CERTJFICATE SHALL NOT BE CONSTRUE® AS A G,U1 ANTES ZHAT THE SYSTEM WILL FUNCTION SATISFACTORY. Z� ���� DATE ..__ . l y� I � n fector __ + ..;,,t ru`.. '�'•' °'-f 3..., hr ,,,.• -: r y* '' R'a'a:.,>Q.y m,.f- Jy'! F -_ tt f' �� M`�'�'1 e �".. ;r T ! '� �,�a�.'w... .�:. -_^V r`K.,: °� ...�-+�.x•,wi't�eP`in�`. '�� �� � .'Jh. � `g�F4'ok"i��� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..yp t 'l( ........OF.- .mot �t��..i.:�:"a�!`�..�.a.�`'.�!�; .......................:............ Permission is hereby granted:`^ . _ 4Y` • to Construct (; or Repair (P-1 an Individual Sewage Disposal System at,IVo._f �_:_ �` �' rz, y �'' --------------------------------------------- Street g� .... --• '. s �' Street n-Jg.... as shown on the application for Disposal Works Construction Psi it N :__' __._, _:___ Dated::__,f'-....2-..!7!_c.......... f ------..._--•--•••••. DATE � !l '] 2_ 7 � Board of Health •-••--••-•-•-••••---___---• .......................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - 9 3t� SEWAGE PERMIT NO. WATER TABLE LOCATION NO. STREET l l I NSTALLERS NAME & ADDRESS /L D ATE PERMIT ISSUED DATE OF INSTALLATION DRAWING OF INSTALLATION ON BACK i .. a P S _ � �6 ,_ v- � 1 z (ADDITION) PILASTER 6'-a, EXIST, EXIST. �"'� <C N a CCD C 245-2 WI C� ANDERSEN PILASTER rtC �'''-- � E7$COMBO \: ���-, �t"' N rX3 11 ANDERSEN `v 11 00 <=f t l CX i 45 ! - � rIFR CH Q � < X t+ Da R CENTER NEW PILASTER I i SUNROOM DN. EXIST. r _ _ ANDERSEN LIVING t SHAFTED 1 ET 8 COMBO 0 ----- ( SKYLIGHT I b }- ABOVE LAND.RV 2938 D,tV A A CENTER PILASTER r Z8"x 6'8" AN11 DERSEN i t FRENCH DOR CX 145 1 t UP I j EXIST. y I (ADDITION) STUDY I I I ANDERSEN 5 C 245-20 C' ET 8 COMBO PILASTER EXIST. EXIST. EXIST. EXIST, � EXIST. PILASTER r New 10"DIa 12^DooRS cv HALF COLUMN ;1 2 x 3 ON FLAT ^ WALLS Wl AZEK b 1'-3. 4'-G '-7 SHEATHING V 1 P RTICOa— —b t 6-CY' 6'-Cr I POSTS&TOP RAIL FOR CABLE-RAIL SYSTEM TO NEW 19'DIA 11 ;URPOUND SK{LIGHT g COLUMN 1 I 2'8"x 61y, (SEE'M1FR'S.SPECIFICATIONS A t t 15 LITE SKYLIGHT TO HAVE TEMPERED GLASS 112'-8 7._O. 12.-4' EXIST. 4'Z' DN. EXIST. 32'-a' 12-d' BEDROOM (EXISTING) (ADDITION) NEW O W n ROOF W FIRST FLOL/`"1► DECK C) ,^-SEEDErAfL#4 �.{ LEGEND: A II 15LIT 6' C A2 �i EXISTING WALLS - CONSTRUCTION TO BE REMOVED Q NEW CONSTRUCTION .� EXIST. , BEDROOM EXIST. CLOS. EXIST, N EXIST. EXIST. EXIST. b 6'-(Y. 6=0" NOTES: PORTICO scALE :: ,_ ROOF 72,, . 1/4 1 O 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS (ADDITION) & DIMENSIONS IN THE FIELD REVISED: 12/8/2006 DATE : 2.) CONTRACTOR TO VERIFY ALL INTERIOR & EXTERIOR MATERIALS, g THE DESIGNER SHALL BE NOTIFIED IF ANY 1 1/ 10/2006 ERRORS OR OMISSIONS ARE FOUND ON DETAILS, & 'FINISHES IN THE FIELD WITH OWNER THESE DRAWINGS PRIOR TO START OF CONSTRUCTION.THE BUILDING CONTRACTOR 3.) VERIFY ALL INTERIOR DOORS HEIGHTS BEFORE WILL BE RESPONSIBLE FOR THE CONTENT DRAWING NO. : PLACING ORDERS FOR NEW DOORS 12'- T-a' 12'-4" IN THESE DRAWINGS IF CONSTRUCTION COMMENCES WITHOUT NOTIFYING THE 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS 32,E DESIGNER OF ANY ERRORS OR OMISSIONS, THESE DRAWINGS ARE SOLELY FOR THE USE STATE BUILDING CODE ON THE PROPERTY NOTED.ANY OTHER USE OF ECOND FLOOR PL E" AN THESE DRAWINGS REQUIRES THE N 5.) CONTRACTOR TO REMOVE EXISTING DOORS,WINDOWS, CONSENT OF THE DESIGNER.THESEE DRAWINGS WINGS WALLS, & ROOFING AS REQUIRED FOR NEW CONSTRUCTION. ARE PROTECTED UNDER THE ARCHITECTURAL COPYRIGHT PROTECTION ACT OF 1990. NEW ROOF DECK e. ti.23' 'Z '�' 1 x 10 ci #8013 CROWN Q NEW 2x 10's 514x7 *�., 877 t�� #8016 BED MOULD #8016 BED MOULD BROSCO CE 278V RAIL ' 1M BROSCO 2.25"SQ.BALUSTER #8575 NOSING M b ZD (5 00 n �------P.T.6 x 6 POST W! -�-----5/4 x 10 PILASTER ® 1 x 7/1 x 8 CASING 1V® AZEK SHEET SIDING � Q� ,� ?G BROSCO CE 278 V RAIL 1/2"PLYWOOD (� :].W 2 x 6 WALLS DETAIL #1 DETA I L #2 SCALE: 1/2" = T-O" SCALE: 1/2" 1'-O" --- lf7 "--514 x 10 PILASTER AZEK SHEET SIDING 1t2"PLYWOOD © 2 x 6 WALLS /4"T&G PLYWOOD SUBFLOOR, ",,.,—#8465 SHINGLE/PANEL MOULD TOP OF PLATE Z'RIGID INSULATION(R=10) GLUED&NAILED _ 2 LAYERS HELD BY P.T. 1 x 6 PILASTER BASE 2 x 2 BALUSTER STOCK 5/4 STOCK x 2.75'LG.W1 BEVELED EDGE —CROWN PEDIMENT P.T.2 x 1O's @ 16'o.c. #8016 BED MOULD AZEK 1 x 8 / / ♦ 3-P.T.2 x 17s NEW W.C.SHINGLE NEW DUROCK W/6 MIL SIDING rn VAPOR BARRIER ON GRADE ETAI INSTALL TWO VENTS AZEK SHEET SIDING SCALE: 1/2" = 1'-0" TOP OF SLA9.1 ANDERSEN RV 2838 SKYLIGHT W/INCLINE CURB FLASHING,SEE MFR'S.SPECIFICATIONS PANELS(VERIFY MATERIAL 5/4 x 10 PILASTER(SEE DETAILS) IN THE FIELD Wt OWNER FRONT ELEVATION POSTS&TOP RAIL FOR CABLERAIL SYSTEM TO SURROUND GHT BUILD CRICKET SEE MFR'S.SPECIFICATIONS F ATIONS . . (ADDITION) (ADDITION) BEHIND SKYLIGHT SKYLIGHT TO HAVE TEMPERED GLASS is N N 2•P.T.2 x i0's EXIST. MULTI LVL BEAM l CHIMNEY I SHAFTED SKYLIGHT O E-� p D ETAI L #4 / SCALE: 1/.2" = 1'41 3/4"AZEK SHEET W/ o RUBBER MEMBRANE 'y N ¢ x 75 1l2"PLYWOOD a 2 x 1 #8013 CROWN c l \ 2 s 16"o.c.@ .�.1 x 12 ZAX F toA Ak #8171 ASTRAGAL A y A �- A2 2x 8's 0 1G'o.c. ^ 11 x 8 F�+�I C l r x 2-2 x e'$ SCALE to BEAD BOARD ON 1/ 1' r-0„ ` 1 x 3 STRAPPING I \, 10"DIA.COLUMN DATE b.. MULTI LVL BEAM 2-P.T.2x 1O's 1 1/ 10" 200"'`R/ 28"DIA."BIGFOOT'FOOTING PORCH 4'0"DIA.EEPONOTUBES AT DRAWING NO. : i(ADDITION) (ADDITION) O' D ETAI L #5. (ADDITION) SCALE: 1/2" = 1'-Q" ISO DEO% K FRAMINGPLAN- FOUNDATION PLAN- REVISED: 1 2/8/2006 C.� C) N N Z w N LC� w 00 ED C) 51 < rVFU TOP OF PLATE Ft H ❑ LJ z MINIMUM \ t \ t co AZEK SHEET _ r SIDING TOP OF SL r EXIST. — AB U� ATTIC LEFT SIDE ELEVATION PANELS(VERIFY MATERIAL !N THE FIELD W/OWNER . TYP. ROOF DECK bow 1.314"PLYWOOD 2,RUBBER MEMBRANE ROOFING 3.2 x 4 SLEEPERS G 16'o.c. 4. 1 x 4 MAHOGANY OR CEDAR DECKING VERIFY PANEL SIZE IN THE FIELD z 5.9"BATT.INSULATION(R=30) EXIST. SEE DETAIL#1 EXISTING ROOF LINE 4-1 C BEDROOM W to to SEE DETAIL#2 l 2 x 12's®.16"o1. . . SE DETAIL#5 NEW 2 x 10's @ 16"o.c. TOP OF PLATE 2 x 8's 16"o.c. 2-2 x 8's """'� MULTI LVL BEAM ■.... M"""( �"/ VERIFY CEILING MAIL BEAD BOARD CEILING W/OWNER IN FIELD in NEW WALL CONST. 10"DIA.HB&G PERMACAST F7 -2 x 6 STUDS @ 16"o.c. �+ TAPERED COLUMN WJ TUSCAN CAP&BASE ' EXIST. NEW -uz"PLYw00D SHEATHING EXIST. t -6"BATT INSULATION(R=19) ` LIVING SUNROOM � -1rr GYP.BD. � LIVING RTICO I -AZEK SHEET SIDING ull -r'm/EK! INSTALL FLASHING i t° AT HOUSE "" PLYWOOD SUBFLO R, SEE DETAIL#3 GRANITE GLUED&NAILED TOP OF SLAB + P.T.2 x 10's Q 16'o.c. 4 �/ + TOP OF PLATE _ EXIST. Z'RIGID INSULATION(R=10) 2 LAYERS HELD BY P.T. w N ' BASEMENT 2 x 2 BALUSTER STOCK 2$ DIA, SIGFOOT"FOOTING y a SCALE : , ,T UNDER 12 DIA.SONOTUSESAT EXIST. PORCH4'0'DEEP BASEMENT l/4 = 1 —� t \ t \ t DATE : (� c EXIST.FOUND. \\ '� \♦ t t 0/2005 WALL r ♦ t ♦ t \ t \ t BUILDING SECTION NEW SUNROOM BUILDING SECTION NEW PORTICO? - DRAWING NO. : A C? � � A A i'OP OF SLAB RIGHT SIDE ELEVATION_ REVISED: 12/8/2005