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HomeMy WebLinkAbout0082 HIGH SCHOOL ROAD - Health z 7 HOE,"G-Hi,o! . RD. HYANl\is - - - A =' 300 237 e - r I s s, TOWN OF BARNSTABLE FNO. ATION SEWAGE# AGE O l S ASSESSOR'S MAP&LOT R NAME&PHONE NOr' �O IC TANK CAPACITY 04 HING FACILITY: (type i�7Y�r `� (size) F BEDROOMS BUILDER PERMITDATE: COMPLIANCE DATE: 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) /Y/ Feet Edge of Wetland and Leaching Facility(If any wetlands exist ` within 3000feet of leachin fa ' f �/ Feet Furnished by-- 0 �� / ��� O �. .. '1 °P :�'<`,. � L No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered;ncjoterj: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLAtion for Zisposal 6pstrm Con union Vrrmit Application for a Permit to Construct( ) Repair( ) U grade( ) Abandon( ❑Complete System ❑Individual Components Location Address or.Lot e of No. -7 ® �T� Owner's Name,Address,and Tel.No. Ass lVtJ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. tC(V ,\�C�o'y �GL I�lAl�gira Type of Building: Dwelling No.of Bedrooms Lot Size 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 he Environmental Code and not.to place the system in operation until a Certificate of Compliance has been issued by this Boar f e Ith. gn A, Date Application Approved by ADate -Application Disapproved by C Date for the following reasons r Permit No. Date Issued m i VX ' `l No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in comp�ite — PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASS�AC1iUSETTS Yes ftprication for Misposai Opstem Construction oermit 004 ' Application for a Permit to Construct Repair U ade Abandon pp ( ) p ( ) gr ( ) (V ®Complete System El Individual Components Location Address or Lot No.14 k" ." w. -, ��� Owner's Name,Address,and Tel.No. Asse o4 s Map�arcel Installer's Name,Address,and Tel.No. ' Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedroom-) �''' © Lot Size sq.ft. Garbage Grinder( ) i Other Type of Building -,-,No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)r fix ,.S4 r s gpd�4 Design flow provided ! {,M . , gpd NA 7 Plan Date Number of sheets n ;% Revis aonjDatey,_.l �.t,� Title v O„ Size of Septic Tank Type of S.A.S. Y . f '" Description of Soil Nature of Repairs or Alterations:(Answer when applicable) A Can :;�; F ,. LA,-A Q Date last inspected: Agreement: x The undersigned agrees to ensure the construction and_maint nan a of the afore td scribed-site sewage disposal system in j l accordance with the provisions of Title 5 o(f�the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issuey0s . f A m Date / Application.-Approved by �p / Date tj Application Disapproved by Date f for the following reasons Permit No. Date Issued Cf ------- --- ------ -------- _. . ._ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance t f THIS IS O CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired I; ) Upgraded( ); ' Abandoned(7 ` f 03 v �✓ Ctha.S at 7 �A,,��iti', shas been constj"accace—� with the provisions of Title 5 and the for Disposal System Construction Permit No. at, , )Installer )-\k A Designer U° #bedrooms —i Approved design flow ,�, r / {�- gpd C.The issuance ffof this permit sh i ll tno�t'{be construed as a guarantee that the system will%fimctionNas d,issig/n/e�d. r Date ( i = f`l "( Inspector Iil^- J-/ (/ !b.?/� ------------------- ii y, �_ - t l ------- �j--# ----------�- ' " 9 No. // Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Yee G � Misposal opstem Construction permit Permission is hereby granted o Co struct( kepair( J I x ade( ) YA bando System located at PC �9 Al I . , and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. r Provided:Cons ctn m st be ompleted within three years of the date of this permit. Date J Approved by / AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION + SEWAGE # 26DO— 64 VILLAGE ASSESSOR'S MAP&LOT Z 0� INSTALLER'S NAME&PHONE NO. M'1-Jn MAA SEPTIC TANK CAPACITY LEACHING FACILITY: (type) AS,'YC5 (size) _mac tX . 12.: NO. OF BEDROOMS •.� BUILDER OR OWNERl�- PERMIT DATE: /0—31^;tea COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Fee' Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feel Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of I c fa 'lity) Feel Furnished by r� ,1 on Y-4-4 • 42.1 43 off'' ���� Al coo O O 0 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=306237&seq=1 6/23/2011 TOWN OF BARNSTABLE LOCATION + SEWAGE # 2 VII,LAGE t-5 QDM `- ' ' ASSESSOR'S MAP & LOT Z 3 n INSTALLER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY � rf�l LEACHING FACILITY: (type) PP(O F[U12X u (size) NO.OF BEDROOMS —3 t BUILDER OR OWNERPERMIT DATE: COMPLIANCE DATE: 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 o within 300 feet of lc ng fa 'lity) Feet Furnished by ���� � � � � O � a`�� ��i � N � �' e ` .. "! � tom' � � ®�®' ,, .� � 1 � ® �_ 2 4 A. 1 ))� � ��W � �- i � V. � �� � � � -� 1_ � � e b � �.'. �� n l/�� ,. i ` \l� 4=: l _. __ V y No. � THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD,, OF HEALTH / ! ! O F 0APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (' ) Repair ( ) Upgrade (� Abandon �'omplete System ❑Individual Components V17, A4- ;lUtVw� Loca,ion Owncr's Name Map/Parcel ff Address Designer's Name Adcrcss Telephone R Telephone 9 Type of Building: Lot Size 1-T3 Sq.feet Dwelling—No.of Bedrooms Q Garbage Grinder ( ) Other—Type of Building No.of persons& Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 5 gpd Calculated design flow 440 gpd Design flow provided -�igpd Plan: ate - Number of heets _ Revisio. Date Title Description of Soil(s) °- 2, (0AA1, 12"-Zq Soil Evaluator Form No. Name of Soil Evaluator -S ,i r1lA Date of Evaluation_ DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a es not to place ystem'n operation until a Certificate of Compliance has been issued by the Board of Health. Signed � Date r ih FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 y" t N0 � THI`COMMONWEA T-W,;OF MASSACHUSETTS-1--' FEE u t: BOARD OF HEALTH APPLICATION FOR.,DISPOSAL SYSTEM`vCON'STRUCTION PERMIT Application for a Permit to Construct (' ) Repair ( ) Upgrade (� Abandon ( ) - VComplctc System ❑Individual Components - Location Owner's Name �l y a I C', �o �G� 3 Map/parcel 41 Address 1 hers NN nic �✓ Designerti Name I i I Address # Address r � Telephone 9 Telephone k { „,,,Type of Building: Lot Size Y)3 Sq.feet t \ ' .Dwelling—No.of Bedrooms Garbage Grinder ( ) ° Other—Type of Building ,•." - No.of persons& Showers ( ), Cafeteria ( ) - .Other fixtures t Design Flow(min.required) ���7 gpd a.'s Calculated design flow gpd Design flow provided n`�Z_gpd Plan: ,Date ,q-60 Number of sheets Revisio Date Title IA V Q kAVX Description of,Oi1,(s)o X, lOG1M► 11"o t w� " V► ( n I" cl Soil Evaluator Form No. ' Name of Soil Evaluator -& ' Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS ,f The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further ag ees not to place k"ysl 'n operation until a Certificate of Compliance has been issued by the Board of Health., Signed V t L DateAF �- p FORM 1.- APPLICATION FOR DSCP DEP APPROVED FORM 5/96 f ,t No.WW-67 THE COMMONWEALTH OF MASSACHUSETTS FEE 1 GtihfrJs BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) 4111CSomplete System nI The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) at 7 -� G�oO� ACLAM k c 4 has been installed in accordance with t e provisions of 310 C 15.00 (Title 5) and the approved design lans/as-built plans relating to applicati<'nN dated,' O 3 U-00 Approved Design Flow (gpd) Installer Al �/� / Designer: Inspector ,� .,. Date ellZ1 6 The issuance of this certificate shall not be construed as.a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE: DEP APPROVED FORM 5/96 No THE COMMONWEALTH OF MASSACHUSETTS FEE '' ' 6 y hGC BOARD OF HEALTH . r DISPOSAL SYSTEIM ONSTRUCTION PERMIT Permission is hereby gra tedC to11 Construct.(►►//) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. 7 dated U �� Provided: Construc ion shall be completed within three years of the date of this pull local c•nditio s mu be met. Date ` Board of Health ' fA FORM 2 - DSCP DEP APPROVED FORM 5/96 ` FORM 1255 (REV 5/96) H&W HOBBSB WARREN TM PUBLISHERS- BOSTON Town of Barnstable P# Oki q0 Department of Health,Safety,and Environmental Services _. °`"'E'b'►� Public Health Division Date F �� H 367 Main Street,Ilyannis MA 02601 aeaxareet.r~ NAM Date Scheduled otulkliAjZ000 Time 0',OCR Fee Pd. ,00,C)D Soil Suitability Assessment for Sewage Disposal Performed By: TA v S9 n i`G& Witnessed By: �a " �i 111Je o r 4 Aq.d a LOCATION & GENERAL INFORMATION Location Address ' 1 O V ^ (� *, Owner's Name *lam d ` Address W` r �cyliola,wds Assessors Map/Parcel: �' b� 'a'j� Engineer's NaName t+ NEW CONSTRUCTION REPAIR Telephone# --T 72 ' Land Use S�y Slopes(%) G S 7d Surface Stones Distances from: Open Water Body It Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 0 G t ° 23 Parent material(geologic) O.�><t..�f lr Depth to Bedrock Depth to Groundwater: Standing Water in Hole: 1146 Weeping from Pit Face Estimated Seasonal High Groundwater . DET Y2IVIINATI0 FO SEASONAL III;GH WA'I'EI2`I'��LE Method Used: Depth Observed standing in obs.hole: //G in. Depth to soii mottles: ?^. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST bate ' Observation Hole# Time at 9" Depth of Perc y8�� Time at 6" Start Pre-soak Time @ /a:i Z Time(9"-6") End Pre-soak /O• Z Y Rate Min./Inch Site Suitability Assessment: Site Passed v Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed'on Back Copy: Applicant s r �T s DEEP.OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.o Graveh z� �/ C S� io)'e 6/4 DEEP'OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell). Mottling (Structure,Stones,Boulderes: Consistency,° Gravel) DEEF OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil,Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o Gravel) DEEP.OBSERVATION'HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistencv.°o Gravel) Flood Insurance Rate Map: :luuve 00 year?uua`ncunti i y II Yes' Within 500 year boundary No V Yes Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material i Does at least four feet of naturally occurringpervious material exist in all areas observed throughout the area proposed for the soil absorption system? yes- If not,what is the depth of naturally occurring pervious material? Certification I certify that on '114 S (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 1.5.017. Signature � ' Date �—� BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address Prop S � Date of Inspec} ,^. Map 1P arcel Owner PART A — CHECKLIST CHECK IF THE FOLLOWING HAVE BEEN DONE: v PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE S(S Y EEN RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE 1 J(, INTO THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. j2 AS—BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAI ITH N/ THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK—UP. 00 r JJ "•�{/ v HE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. T 19 96 ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. HE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE S I NK WAS INSPECTE�DJ� FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH aLt E PSLUDGE, DEPTH OF SCUM. THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON—INTRUSIVE METHODS. THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL No of Bedrooms No of Current Residents Garbage Grinder Laundry Connected to System Seasonal Use NON RESIDENTIAL: Calculated flow a WATER METER READINGS,IF AVAILABLE: I Pumping Records an Source of Information: GALLONS Q U � -� SYSTEM PUMPED AS PART OF INSPECTION?,/� IF YES,VOLUME PUMPED = GALS Reason for Pumping: (TYPE OF TEM: Septic tank/distribution box/soil absorption system Single Cesspool Overflow Cesspool Privy Shared system ('If yes, attach previous inspection records, if any). Other(explain) Approximate age of all components. Date installed,if known. Source of information. e ; SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM f PART B — SYSTEM INFORMATION (Continued) SEPTIC TANK: Depth below grade: `Z /� Dimensions: �- . X ✓C , Material of construction: oncrets Metal FRP Other} . Sludge Depth Uwe Distance from top of sludge to bottom of outlet tee or baffle Scum Thickness Distance from Top of Scum to top of outlet tee or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments: Ott lh P „LDS Cct i l i`/!i/yJ DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: as+ r PUMP CHAMBER: Pumps in working order? Comments: SOIL ABSORPTION SYSTEM (SAS): IF NOT PRESENT,EXPLAHJ. TYPE: Corpments. Oele e- CESSPOOLS: Number and configuration Depth-top of liquid to inlet invert Depth of solids layer Cepth of scum layer Dimension of cesspool Materials of construction Indication of groundwater inflow(cesspool must be pumped) Comments: PRIVY: - Materials of construction Dimensions Depth of solids Comments: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' oP ys" ' 0 a� DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: I rdX�� a�� �r�©•� �.1, �� ,r-o � �7��•^e� G��� ice/ j Je !le ¢l7 4 , .S /Oli Ap r Q' I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C — FAILURE CRITERIA (Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not) Backup of Sewage into Facility? I� Discharge or ponding of effluent to the surface of the ground or surface waters? i Static liquid level in the districution box above outlet invert? I I Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? I I/ Required pumping 4 times or more in the last year? Number of times pumped �I /yam Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiftration? /_ tank failure imminent? Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? -- -- Within 50 feet of a surface water? Within 100 feet of a surface water supply or tributary to a surface water supply? i I Within a Zone I of a public well? Within 50 feet of a private water supply well? Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools &privies only, not the SAS)? Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION iI �!INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS �!COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399 J.i CERTIFICATION STATEMENT �I I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION it REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY IRECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE i IN THE PROPER FUNCTION AND MAINTENANCE OF ON—SITE SEWAGE DISPOSAL SYSTEMS. CHECK O I � I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC !! HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. li I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I II i ii iINSPECTOR'S SIGNATURE: ('DATE: J 9J it ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY (P„ TOWN OF BARNSTABLE LOCATION 7 --ht m-4 AD SEWAGE # 93 '��'� VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY ��OD i LEACHING FACILITY:(type) (size) NO. OF BEDROOMS --:2 PRIVATE WELL OR UBLIC WATER BUILDER .O OWNE DATE :PERMIT ISSUED: DATEy COMPLIANCE ISSUED: -2,) "l VARIANCE GRANTED: Yes t No J `act — __ .� __- � { } � � �� , . �6� y� ,I 1 ,w' 1 f ti � .f .r j c a �'1 • •:��t+l • �� 1 i No../q .s ./. Fss...` ............. THE COMMONWEALTH OF MASSACHUSETTS 0� BOARD OF HEALTHQ�43� TOWN OF BARNSTABLE l tt r Diripwiai Vvrlu5 Tomitrnrtion Fam Application is hereby made for a Permit to Construct ( ) or Repair LN,,4 an Individual Sewage Disposal System at: .............. .....�- ----- 2D------••--••------•.. .................. iJ[ ........................................................ Location-Address or Lot No. j ------...........------ �?--- -----------------------s�',�.�!�4 .....,,... ......G�®.. Own Address Instalter Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms________________ ...__._._._._ ... Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................... . . W Design Flow..................���.............gallons per person per day. Total daily flow------------ ..................gallons. 1:4 Septic Tank—Liquid capacity/ ..gallons Length---------------- Width................ Diameter_-- ............ Depth................ Disposal Trench--No. ......., Width......7.-/___._ Total Length.-- -_. Total leaching area....................Sq. ft. 3 Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) .4 Percolation Test Results Performed by-------- ---------- ...................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ----•---•---------------------------------------------------------------•-•...................--•.--......................................................... 0 Description of Soil...............................................-----...............-------•----------------------------------------•-•-•----._...-•----------•-•--..................--- W. U -••••---...•-------•-•--••..................••--•-•-•--•••-•---•------------•-------•----....._.---•------•----••----•--•---------••-----•----------••--•-•-----•--••---............................... W x --- ••----------------------------------------------------------------------------------------------- ..................................................... -------------------- - --------------------------- ............................................ U Nature of Repairs or Alterations—Answer when applicable-1 .Ad.�- jGPO•- �_-, 4..............�../ ��7 �i ii '. =........1._ ........................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environments Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianc 6 be n iss ed t rd f h alth. Signed ........ ... . ........ ........... ..... .. ........................................................ ------.(/-- Da,e Application Approved BY ..........t ....................... .... ....................................:.............. ..... Duea' Application Disapproved for the following reasons: ....................................................................................................:................................... ................................................................2. ... ............................... . .......--........................... . -- .. ..... -- .. ........................................ Permit No. .......-.. J--.... .... `/-------- 1' .-.. Issued -. ..................................._...-....--...fe...... Due - � `•..r•-tii.� .y ..v .✓e,..-+�,,pn..,,, f,;Y` .r '1'S:w.-"�tyl;yl L�r 1: airy- n .. .� No.. . Fims............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 30t,�'`�37 TOWN OF BARNSTABLE ,� lirtttinit for Dirt' mial Workri C outitrnrfinn rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: .............7..._-..`........ I...7....1.----.......=...---.........-----.... ................... ^J.� ........................................................ Location.Address j 40 or Lot No. -- ---------- --------------------------- ----/J---- - = w ...................... .. > e Address 'Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms.................` --___.___.------.-Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building ---------------------- ----- No. of ersons._-_-____-__-_--_______---_. Showers a g p ( ) — Cafeteria ( ) dOther fixtures ---------------------------------------------------------------------------------------------------------•------- .. w Design Flow.................... _............gallons per person per day. Total daily flow.-__-_._--_ -?:j3....... WSeptic Tank—Liquid capacity/—.gallons Length---------------- Width-------_ -___- Diameter................ Depth--------.--.---- x Disposal Trench--No. ------- _.__.. Width......7......... 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........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth of Test Pit----_............... Depth to ground water........................ a Descriptionof Soil ---•------•---------------------------•----------•---•-----------1 •--•----•..........------...... rV ........••••-••--•••-••--•-••--••-••-•--••--•••-----••---•-•-----•••-••-----•••--•----•-•-•••-•---•••-••••--••-•••••---•----••••---••••......--•--••-•-•-•-•••-......-•------------•...... w ----------------------------------- U Nature of Repairs or Alterations—Answer when applicable.-.Z�:�-�...__ Ga0__5....... 5 ��....:_. �.;.... l-5 i R.. ----... ...�.....Z� w . .. Agreement: ! a The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance.-has be n iss ed b the,o rd f h alth. Signed .......��. .1............ . [ < / Dace Application Approved By ------..... .. ........... - e .-..p.�� Application Disapproved for the following reasons: . ... ...................... . ............. ......... ......... . .... ........................ ............................................... . .................................................. '. Dace '. Permit No. �.��..-. >. .��................. Issued ..........................- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 01'Prtifirate of Q-Ttlomplia nre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ................... _............. 5V Ces�J 7--------.----- Installer -- ......... ..................... has been installed in accordance with the provisions of TITLE �f The State Enviro ental Code as describe} in _ the application for Disposal Works Construction Permit No. . -..... .-�o� .c1. ............ dated ._........ _.'.. --�.r.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ..................... ........ ----y -- ---..----..............---- Inspector --------------� .--,,...-i-✓. _ ------,------------_----.--- ---_--__-_--.---_---_----_._,-_._-_,_.__ ------_,_.__--_- THE COMMONWEALTH OF MASSACHUSETTS 3t7� �37 BOARD OF HEALTH TOWN OF BARNSTABLE No...��3= FEE... 1..._.. Dispimal Workii Tonotrurtion rrrmi# Permission is hereby granted---_--------------_ GJ'L --PJ---�------ itiaSi%_!JG<�7�d ................................. to Construct ( ) or Repair (X) an Individual Sewage Diisposal System at No. - ftJC/ ->�hJ. �G.1. ----••----..... '.L- 1 [ �................ Street e�, q as shown on the application for Disposal Works Construction Permit No...�_ y._ Dated.......... ............................... . .................................................... Board of Health DATE.........4 .-. AZ_. ....... . ...................................... FORM 36508 HOBBS B WARREN.INC.,PUBLISHERS I 5 0 cR- p �1 75 Is __ 21, / {I1 � I I I I , j N111 -- r--7 _ T -�s vt, '. I' r �P I �y I i f i�•i � � I! l I - I l i � I I i .............. -- - - L�_.-� I ------ -- �\1 Ji'I iil LI i I I I\ I Ill - I , - •.II Ii ` III I I I I I —i ------ -- \ I • , I � (i"�1 I I l �� --L———— ----------go -:�SAogm oz Io m m �..,� G ASTA - HOUSE . 3 y R �y� ��s��\•\ bi/ 7 fHOUGHTON S®A® Z z - y \? HYANNIS•AAA 02601 _ ? c{ : •, a - REMOVE F.XISBNG OUTDOOR O 0 SHOP/ER AND DECKING �.y REMOVE EXISTING STAIR---`_ AND WAIL \,. I / REMOVE WALL AND BUILT : IN SHELVING r REMOVE 3ATI RCOA! FIXTURES AND F'NISIiES REMOVE EXISTING GARAGE AID PORTION O`P/ALL FOR ENTRY STAIRS E. REMODEL r mooy/ ��� I I II I I I} IIiorl, II II II iL I _ — : II - ---- i II REMOVE WN.I. �I ; .AND DOOR. ;1 \ .:I J REMOVE VI NDO85 SAVE — .FOR INSTA;ALA;.I:, . OTHER AREAS OF TH \\ II IIIII - . 1 - HOUSE,SEE SPECIFCATIOII \ IIIII FOR DETAILS1411 I - REMOVE C F ---AND CHIMNEY PROV01 ADEQUATE I . $HORIN'G IF ADJACENT `EXISTING STRUCTURES STAIR \ I�'JI PATCH AND REPAIR �� bb4 U,� REMOVE EXISTING ENTRY SUBFLOOR AS REQUIRED III"III N.\ I I IIII REMOVE VYINDOWS,SAVE - ' - REMOVE V1 IJDOW,SAVE \\ \\ L FOR INSTAI.ATION IN FOR OTHER AR \i OV I- \\ II q� OTHER AREAS OF THE HOU APRON OF il•E �. \\\ \\ 1 I` P HOUSE AROSE;IO PROVIDE \\ PROTECTION Ffi0!.1 \\ \\ REL4GVE PORTION OF WALL - ELEMENTS DURI:S I: - I FOR NEW ADORION. CONSTRUCTION PATCH AND \\ \\ `d — PROVIDE.ADEQUATE REPAIR.Ii.TERIOR WALLS TO \\ I� !I.4TCN ADIACENi \\ \ SHORING OF EXISTING \ STRUCTURE _ }1gARC PtA r.OHitFc. I II II/,I I I I �'�. I I ayT�o±J> �yl;• WELTcv .. ..,\ \.•\ \\ I ;�,�� Illly/,L�yl I I I i _ \� Mr. THOPT'�� '..RUHLWALKER/!.r•'hdects 'CEP4ERAL.6f_Ii!CLI1101d ROTES ` - \ / - - Bastoq MA 02127 — — _-- �� T 617.268.5479 //(` 01c I REMOVE EXISTING F 617.268.5482 �T��O� / REPRESENTS WALLS AND FRAMING 10.6E R_POVCO .v ,IIIII STAIRCASE.PATCH AND REPAIR. M//7020_L4lLJ. REPR_SE\TS FINISHES TO BE REI.'OVA `\` ACCOMAfODA1F NR VTO w.ruNlwalMer.com /J� I� I ADDITION .. / I REMOVE EXISTING CARNETS :• � :I ADO u l' FOR Yl ADDITION, GN.PROVIDE SUPPORT AND PROVIDE ADEQUATE SHORING FOR ALL EXISTING STRUCTURES SCHEDULED 10 REMAIN,NOTE THAT - SOME EXISTING STRUCTURES MAY HAVE i0 REMAIN FOR TEMPORARY SUPPORT OF NEW',:OFY. / ADEQUATE SHORING OF I - auweea fiensla+ oAT6 `'':I' EXISTING STRUCTURES :./ - TEMPORARY SURF RI STRUCTURES REOUIRED TO'PRESERVE E%ISiING CONDITIONS DURING THE INSTAI.,ATIOU OF NEW WORK ARE TO BE REVIEWED WITH PROJECT STRUCTURAL.ENGINEER PRIOR TO DEMOLITION. •� � ' REMOVE WINDOWS,SAVE FOR INSTALA11ON IN - EXISTING WORK NDT SCHEDULED FOR DEMOLITIOR IS 70 DF.PROTECTED DURING DEItO'_IiICN Po'D - OTHER AREAS OF THE CONSTRUCTION;AND ALL RELATED OArAGE SHALL'BE REPAIRED. - l HOUSE PA CH ANC REPAIR WALLS TO AIAi it EXISTIN;AT LOCATION OF'DEMOLISHEO WALLS - r -- VERIFY BEARING CONDITIONS PRIOR TO DEMOLITION NOTIFY ARCHITECT OF ANY FIELD ISSUES THAT CONFLICT WITH DRAWINGS PRIOR TO BEGINNING WORK PROTECT ALL EXISTING WORK TO REMAIN WHII DAMAGED'BY ON-GOING CONSTRUCTION OPERATIONS REMOVE NI`IOOViS,SAVE--. - SCALE: 1/4"=1'-0° `OR INSTALLATION LV DRAWN BY: HIM SALVAGE ITEMS DETERIAINED BY THE OWNER FOR POSSIBLE REUSE.SEE SPECS. - OTHER AREAS OF THE e I - - IOUSE ISSUED: 18 JANUARY 20il CONTRACTOR TO EVALUATE EXISTING ROUGH PLUMB'.\O;AND ELECTRICAL.;SYSTEMS. CONTRACTOR TO DESIGN CO'APLETION OF THESE SYSTEMS TO INTEGRATE.WIT"NEW WORK AND/OR CAP OR IERIAHA7E AND REMOVE EXISIIVG SYSTEMS 10 BE ABANDONED.SET'SPECS. - I FIRST FLOOR - DEMOLITION PLAN �I 1 A 4 I _ • 1L <'cm ® � xo 4 -- — NEDs VI S NR TO BASEMENT STNR AND DOOR AT �—J l III 4 —icy GARAGE - - EXISTING 47PJ00'!! � 3 RELOCATED _ p GUEST BATH I 1 - _ NF'STNR'TO SECOND 12'_2" 4 110 I I a I•_/Ct FLOOR -- -� tD NEW - BOOKSHELVES __._� D� I !1 S ROOM �I II I'i II GUE i08 . I YARIM'S'OFTIC I'I E GARAGE - - • UP - `G• % V p Dor °/' p POWOER ROOM-J J _ - -0• . _ 1 U, -Fi \'F '.�I —— -- I xlsnJc v'mv!—� ---,r. s'e, tz'-s" °� LIVIN I II E,T IOt ' \RELOCATED I - A UP , NII — II OSET , e . •YI STAR'n DECK AEJVF---'/ �' DS q N.Y1 DECK:EXTENSION. -_-_.-_� \ `\ \ \\�1 / \ �L. p`ARC �.• REFII.IoH E%aING TO \\ \ \�.R.1 I I I F — CO.BIES .E T.R JFc�, r VN� 1 w ,Q CLOSET 1Ni H:4E A'US.N:GLF \t.,E \•� NFW STEEL COLU.VN'S;SEE - 7 0 1.,:.iCH',OF:*;.rGVE vE ,.0 S;RUCIUZI_ I 4\ I 9 x \ \\ \ Imo+ II J - .. - \y .1.• i 4_0, -UP NEW PRIVACY FENCE LTN OFH' , ..' 'I ... � \ \ •' ;. .. I E� OUTDOOR SHOWER - r MUD ROOM - " N\ .- \\ � �'• � I i i I� I i IJ3� �' RUHL WALKER Archifech. \ `'q ✓/ � W _ 5.0.. Bosl ni•MA OM GENERAL NO7FS,FLOOR PLANS. .-- --____-- - .I I= g T On.268.5479 - - -�' P617.268.5482 C� INfdCATES !.! W„_L I! 701 I- _ ____ � DS, L KITCHEN __ -- - —MI - {• 2 B CL w lk r. SEE STRUCTURAL D,RAVTNGS AND SP�CIFiCAilONS FOR A9D710NAL RECJIREME�N'TS. fa Iz NE.." DIMENSIONS ARE lO FACE.OF FINISH SURFACE UNLESS O1HFR'lISE INDC EO TeI -INTERIOR PARTIFIO%FRAMING IS ASSUMED TO BE 7-1/2-W:000 STUDS VAN I%2-S_UEBOAP.D 1 ___ _. ___ _____ -- - - I I _ C u:�eea �vlslm onre AND SK.MCOAT. MATCH.EXISTING FRAMING AT OPENINGS!0 BE FILLED OR WALL:ID bF � I F � -� ': UNOR': - ..- EX,TENDED USE 2.6 FRAMING FOR WALLS WITH FLU!FI C,STACKS l\'D FOR E'IIEF OR V"•Al._S: - � � � � I I ;; ' C 104] H- NEW ALL N_Y!WALL BASE,DOOR AND WINDOW!CASINGS TO MATCH EXISTING.' �- •,�, I-. I �,_�__ - RAISED WODD DECKING 7 / ! DRAINS TO GRAVEL BED SEE S1RUMPA FOR --- ' lea _ -- BELOtV OUIDOOR PRESERVE EXISTING WRING AT LOCATONS WHERE EXISTING ELFCTRCAL DEV10ES ARE To REMAIN; InrORMIIION On NEW'BEAU. - - 'NC!00'N SEAT 9 I --REPIACC DEVICES AND iACIPIATES REMOVE ALL P-ANDON=D MIRING =RGVIOE IIEW ' I SHOWER ELECTRICAL DEVICES PER ELECTRICAL DRAWINGS/AD CODE REOUIFUIENTS __ 1 T R I OUTDOOR SHOWER -. lI ]•-0" 24-2" /-V.I.F.(EXISTING) kkk 12'-0" _ _ SCALE: t/4"=l'-0' : OB'-2'. - DRAWN BV: 'HIM RELOCATE EXISTING ISSUED: 18 JANUARY 2011 LAUNDRY EOUIPMENT _ D _ As.a EXISTING WINDOW _ RELOCATED IN NEW WALL FIRST FLOOR PLAN �, AI7 0 BIT 2 ful s'm5z ut� G A rn VV M = r q 1 I gxisnN i INEw I P DoYIN - � �Ip — I I \ - BOOKSHELVES IL NEW; EXISTING VIU 0 -- , - -; J� I a �� �. ... ,; III\i:/I I s 4 3• . ..... 4_2" I L�'V'J I DC VN E u L01 aSE�T aosEf Ih- +3N 3 - I �tI _ .. aL;vO H ABQV_E N �- J. lo =a BELow I -2S 3 'EQ` E0. EO. E Q. c 9'-7 1/2' 12'_0' 16'-6' 1 1/ -2 56•-11/2' r i 0 mg - N `rn 7 HI OUGHT- A ON ROAD m z HYANNIS,MA 0260A c t=' S YS TEM PROFILE NOT TO SCALE FINISH GRADE TOP FNON. FINISH GRADE OVER OVER TRENCHES 12 . r EL . I FINISH GRADE 12 . �- FINISH GRADE OVER DIST. BOX IZ . Co SEPTIC TANK 12 . 3 12" MAX. a o:4Q, °n:..e;:;�fj; ;C�'.4C:D.t9;:0.':;Q.o��O.°'.o• oP.Y�b.4p;l.'•• ! .e•ti•O.•.r i0 e ,•, o TOTAL LENGTH OF TRENCH — S�.. _ OUTLET PIPE LEVEL o.'o•P• d 3„ :o. FOR 2 FT T. MIN. u OO 0�• • : ..,C: , :d• b" a s• b6r'��° ,, •v.1..D. •4' �O :.. 6 , ..p; .e p •Ao .gyp 'p OO�QO IO.�F2 ::� 8�0 0 C. I. OR PVC TEES ob n�a.•�. f D.• f•""i I' 1 o.a.o 1500 GA L.L ON bo DIS TRIBU TION BOX BSMT FL . p..o.,o a p. e.. N EL . Co . O : o;o v 9° INSTALL ON SE FL OW DIFFUSORS ° PRECA S T CONCRETE .e.o p.;;:,..+:o'.•a'. �' _ o H-20 LOADING 4... .s '... .., °b H-.../0 :_ REINFORCED - __ SOU tJ D. T S L 1?:aao.6,:o•.op•e:n.•b•.o�.:o'A'a'R�.;a v :c'�•�a•e• °Q"�i ' . ...o.o , .°.°.• .00. •D.•s:... .Q.�r.:oa. .q.,..•�.Q: TRENCH SECTION SEP TIC TANK _ ��° INSTALL ON LEVEE_ BASE / _. (_Off 2 NOTE: EXCA VA TE TO EL EV. N Q OR L OWER TO REMO VE AL L IMPERVIOUS I�', 7"73'�' S. �. / �( 12" MIN. / MA TERIAL BENEA TH THE LEACHING AREA 4• oraM. REPL A CE EXCA.VA TED MA TERIA L WI TH 3" OF !/B"-1/2 EbGE of U CL EAN. CL A Y. FREE SAND �4'' . b •;A. o�� WASHED PEAS TONE .. .v o• u k \ 314" - 1-1/2" WA SHED o$ Q: ®" o �• CRUSHED S TONE GENERAL NOTES TRENCH WIDTH ^x° (rlo�2lC 1. ALL EL EVA TIONS f HO�✓N ARE ,�3A SED ON NGV0 NUMBER ..OF TRENCHES ? ,� . -. _ _ NUM8FP rig D.A'FF.:/�S,ORS . .. _,. .O W OR SCHEDULE 40 F'VC•. R'�� - ��, 3­ . THE BOARD •OF HEA L TH MUS T BE„NO TIFIED GD` -R�� TION GN . PIT " P,-9790 WHEN CONS TRUC TI LAN IS COMPLETE PRIOR PERCOLATION RA TE.' TO BA CKFIL LING �� � . \ S 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED <2 MIN./IN. L 0// �C \ \ WITNESSED BY* BY THE BOARD OF HEALTH AND CAPE 6 ISLANDS SURVEYING CO.. IA'C. DONNA MIORANDI �` �0 w \ S 5. MA TERIAL S AND INSTAL L A TION SHALL BE IN COMPLIANCE WI TH THE S TA TE SANI TARY BARNS BRO.. OF HEAL TH DESIGN DA TA �� AUG. 8,.2000 \ s 6`` \ Q CODE - TITLE V -• AND LOCAL APPLICABLE DA TE: RULES AND REGUL A TIONS 9 (�� 6. NORTH ARROW IS FROM RECORD PLANS AND o NUMBER OF BEDROOMS �— \0 �p_ r OG� Gj IS NO T TO BE USED FOR SOL AR PURPOSES I Z„ �-.-: LO LAM ' Z GA RBA GE DISPOSAL NO 7. -FLOOD HAZARD ZONE B �_L0,LMY S&W oyrDAIL Y FLOW 440 GAL . 8. WA TER SUPPLY TOWN WA TER ��}„ G 1 4 SEPTIC TA NK PEG 'D. ?500 SAL . t1��IuM SEPTIC TANK PROVIDED 1500 GAL . LEACHING REQUIRED 440 GPD. } 10 YYZ 6�6 O S` o / 64„ I M ED, t I N E S�N D i AA REO 'D = 440 GPD/0. 75 SF/GPO 587 SF. LEGEND 10 Yz �4 III" —G1 ,'OUND .W4"tErZ _. AA PROVIDED = 12 ' X 56 ' = 672 SF. ��►�� ` ,�' \ I I PROPOSED EL EVA TION ' I32 EXISTING CONTOUR -- c HOUSE' RECONSTRUCTION 6 SEPTIC UPGRADE OBSERVATION PIT - ..._.� C71z1'WELL !L �' 01 0 DISTRIBUTION BOX FOB -1ZOOF - PROPOSED. SEWA GE. DISPOSAL S YS TEM TRENCH o FOP etef, ,`Q I M_oF .�5 PR ARED „3 ST TSON ST�W i rkl 's o o SEPTIC TANK �� o� L° __ c: :.• 0 KA RIM BA S TA e �a ifs firm `t G,rrJ ;L • .. . rl r(.4• Kam RESERVE AREA �E,rna , HSE. NO. 7 HOUGHTON RD. each or HYANNISPOR T — MASS. KEY ea h - --- - v'�•: ' DAVI i • - $ c13AN�� KI DA TE.7 �, 2000 I i0: 2 PIPE IN EL EVA TION J ��� 5 II' CAPE; 6 ISLANDS ENGINEERING �- PLOT PLAN _ �E�• Ro ;1` SCALE AS NOTED 800 FALMOL/TH ROAD I H YA NNI S H r S ISTE , UI TE. 301 ARBOR SCALE.`_1 "=..20,� _ MASHPEE; MASS. PLAN NO. MAP SEC PCL LOT HSE 77 080�00