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HomeMy WebLinkAbout0014 MARSTON AVENUE - Health .- �arstons;Ave Hyannis A= 288-197 1 a 0 as TOWN OF BARNSTABLE f LOCATION 1 q M A R S'T0 Ih S' 4 yt SEWAGE#:2 O/'? y4�� VILLAGE ,ehl S ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.,f SEPTIC TANK CAPACITY 0,0 � 'aaa-z' 0 LEACHING FACILITY: (type) f ?"'Id z m d Gj/h (size) f X 32 NO. OF BEDROOMS OWNER l/ �f lq PERMIT DATE: �� �s f COMPLIANCE DATE: ' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within ' 300 feet of leaching facility) tX Feet FURNISHED BY_ :.t Fr u pi T 13 o rl iZ .� j3 3 No. Fee A HE COMMONWEALTH OF MASSACHUSETTS Entered iA computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pphration for Misposar 6pstem Construrtion 3permit Application for a Permit to Construct(Repair(G)--Upgrade( ) Abandon( ) ❑Complete System 04ndividual Components Location Address or Lot No. 07 mner's N//'�ame,/A�d�dress/�t�]d(T�el.No. Z,;;7 /I/�;/ /dA Assessor's Map/Parcel 2�S'g I taller's ame,Address,and Tel.No. ,ADS—�/�p-�'f 3$ Designer's Name,Address,and Tel.No.Sp$-j2�_3j�d o asep�i Fps svr• �J' mac°- 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) �30 gpd Design flow provided 33 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil • f Nature of Repairs or Alterations(Answer when appli able) 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. "St Q Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Xty,� LkloopDate Issued } ..ram t .....w � �,4.• ,,.., .a a • - .. ' x. No. s Fee THE COMMONWEALTH OF MASSACHUSETTS ;rEntered in computer: Yes . s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS n . ftpYlcatton for ;Disposal *pstem Construction Vertnit •,, Application for a Permit to Construct(,es)—Repair(G)•••Upgrade( ) Abandon( ) ElComplete System ❑olndividual Components Location Address or Lot No.141 4 f,(A96"S 7'U4? Owner's Name,Address,and Tel.No. Assessor's Map/Parcel�2 / 7 5 G�/� Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other I Type of Building �No.of Persons Showers( ) Cafeteria( ) - J Other Fixtures Design Flow(min.required) 3.3D gpd Design flow provided 331 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) �G/fi�j.� ! �%r�bi'r�/:"/f.=.,ff �''��?.•'•./ ���,.i'i' �9 ,:..-f/ �G.;r'a f`"!' /1.�. t Dae last inspected: w y »Fs' 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) .p10 / Jr`^ Date Application Approved by�et � t f Date Application Disapproved by / f Date for the following reasons K Permit No. Date Issued ��,/ /,/ / ------------------------ z / >a THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS - (tertificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(,r)r Upgraded Abandoned( )by k ,c �r,° /xF r: c . � f/ rye �`^- ;- at f�{ ,Fs'Jx1 S 7°fl<%! (/, /1,/ 1/= r f•'t YAl!`P r has been constructed in accordance f; d ,/ .f - )) with the provisions of Title 5 and the for Disposal System Construction Permit Now eyed Installer,/95 ol1 J/r° .f if?/'d^� S" Designer - #bedrooms Approved design flowgpd The issuance—off this permit shall not be construed as a guarantee that the system will function as designed. Date 1 f? G•t J, Inspector ;-- .�__ ---------------------------- - - - -- -- -- --- - - - - _ __- .. - No. 1 _ Fee V I I I ( r THE COMMONWEALTH OF MASSACHUSETTS ` PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal Opstem Construction Permit Permission is hereby granted to Construct( ) Repair(r,) Upgrade(�)� _-Abandon System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 andthe following local provisions or special conditions. Provided:Constructi 'mu b /completed within three years of the date of this permit. c' Date l-1 7 i Approved b �, y � 4� � ✓R. PP Y r c f y C/ Town of Barnstable ReaulAtory Services Richard V. Scali,Director Public Health Division 1639. ► " Thomas.McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Date:2�z,z `W Sewage Permit#�/�/ Assessor's Map/Parcel Installer&Designer Certification Form Designer: Installer: �WYVk �7wzg05 Address: 1'-1 Z.2 Address: O�k<Z&-MK"a-- 20 On_ t►/i S/9. Jls�4�Y�iL was issued a permit to install a (date) (installer) septic system at 1 4 MAQ�a04Vr based on a design drawn by (address) .3 - dated CVyt -A 9 (desi er 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. Stripout (if required) was inspected and the soils were found satisfactory. I- certiA, that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of t1h.r 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. Stripout(if required) was inspected and the soils were found satisfactory. I certify that th.q system referenced above was constructed incompliance with the terms of the UA approval letters (if applicable). OF DAVID taller's Signature) FLAN R TY, JR. y No, 1211 IST�� 4� e ' 'er's S gna ) (Affix Desi rt r' S° tarr{ H re) 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. gaoffice fonnsldesignercertification form.doc `` \\c WEST MAIN STREET LOCUS DATA ``cwv WEST END ROTARY CURRENT OWNER JAMES M. MULLIN LOCUS PLAN REFERENCE 110-29 �JG Z N of DEED REFERENCE 13637-139 MARSTON AVENUE ZONING DISTRICT RB FLOOD ZONE "X" LOT 1 LOCUS MAP NOT TO SCALE: ASSESSORS MAP 288 LOT 3 s S9• PARCEL 197 ��4oy 19-0134 OVERLAY DISTRICT WP ZONE II F r � o S LOT AREA 7,500t S.F. ti DECK PROPOSED LOT 4 0°.a RETAINING WALL 7,500f EXISTING OAK TREE _ •SIP TO BE REMOVED tiONE \\ SITE & SEWAGE 14 REPAIR PLAN PD'�BOX POSED O° 3 BEDROOM S• PROPOSED LINER ` 10 0 SLAB DWELLING cF #14 TOP=13.0 BOTTOM=10.0 VENT.* LOT 5 F�SF�'Fti MARS TON A I/EVUE PROP D r IN \\\ HING IELD w 0' x 23' 1 HYANNIS, MASS D:7 #2 DATE: NOVEMBER . 15, 2019 LS` 5.0' 10. `::: 11.4' c ` ;:.�...;.. o ry OWNER/APPLICANT: JAMES MULLIN BASIN 9 P.O. BOX 341 12'6 BENCHMARK WP� \\ ��\ / EXISTING � CORNER OF CONCRETE TLC)Ile, Al . PARKING G � � SLAB. ELEV=11.15 HYANNIS, MA 02601 I DMH�"- 9,2, / 508- 364- 6345 �`��OF, S �y ¢o•1w / SEPTIC TANK EXISTING 1, GALLON REMAIN SHEET 1 OF 3 ,J= El) AA STONE \ / � \\ C�rO � �\ / � PROPOSED 600 H-20 No.28980 V PUMP CHAMBER PREPARED BY: �o� '�sGJS_f �� ,9 IRON FOUND EAS SURVEY, INC. UTILIT P. O. BOX 1729 d�, \ POLE � SANDWICH , MA 02563 20 30 40 CELL (508) 527-3600 GRAPHIC SCALE: EAS.SURVEY@YAHOO.COM 1 INCH = 20 FEET E WALL PROFILE SYSTEM DESIGN DATUM: VARIANCES REQUESTED EXISTING DESIGN FLOW VERTICAL DATUM: 3 BEDROOMS AT 110 GPB/D MQ GPD MSL± / BARNSTABLE GIS f BENCH MARK USED: NONE TOP1WALL 4 L REQUIRED SEPTIC TANK CORNER OF CONCRETE PAD \\\\ ELEVATION 11.15 330 x_2 _ _ 660 GAL. SEPTIC TANK PROVIDED = _600-GAL. 40 MIL 2.4' SIZE OF LEACHING FACILITY REQUIRED OFl I CERTIFY THAT I AM CURRENTLY APPROVED BY THE POLYLINER DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT TOP = 13.0 DESIGN PERC RATE _--.:Q--___MIN./INCH o� qVl ' SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL BOT.= 10.0 LONG TERM APPL. RATE-2•74_GPD/S.F. r+` EVALUATION ARE AC URATE D I ACCORDANCE WITH 310 FINISH GRADE 11.0 D.F R CMR 15.10 H 1 07 �\\\\ SIZE OF LEACHING SYSTEM PROVIDED: 3 19 F EDWARD A STONE ERTIF--IED SOIL EVALUATOR ° , , BOTTOM WALL 330 _ 0.74 SF/GPD = 446 S.F. MIN. REQ. °,°,°°°,°,°,°, ELEV 10.0t USE LEACHING FIELD RNTIaM R ° MIN 1 BLOCK BELOW 6" MINIMUM FINISH GRADE BOTTOM = 14' x 32' = 448 S.F STONE BED 24" WIDE 448 S.F X 0.74 SF/GPD = 331 GPD CONSTRUCTION NOTES: 19-0134 99,^ 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 331 GPD PROV > 330 GPD REQ.= 1 GPD RES. SITE CJ(. SEWAGE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING WORK ON THE SITE. NO (GARBAGE DISPOSAL / GRINDER ALLOWED) 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE REPAIR PLAN WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. P 19-181 f�� i1 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING fj `t MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND D.T.H. #1 D.T.H. #2 10 MARSTON A VENUE- S.A.S. AREA IS PROHIBITED DATE: 10-29-19 DATE: 10-29-19 GENERAL NOTES: B.O.H. GROUND ELEV. 10.9 GROUND ELEV. 10.8 IN 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. DAVE STANTON ADJ. G.WATER 7.0 ADJ, G.WATER N/A H YA N N I S, MASS TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS SOIL EVALUATOR FOR SUBSURFACE DISPOSAL OF SEWERAGE. ED. STONE A A 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE BACKHOE OPERATOR. LOAMY SAND LOAMY SAND DATE: NOVEMBER 15, 2019 ACCESSIBLE WITHIN 3" OF FINISH GRADE, WITH ANY REMAINING JOEY DeBARROS 10YR 4/3 10YR 4/3 „ ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. SOIL TYPE: _1_ 6 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE PERC RATE: <2 MIN. PER INCH EL. = 10.4 EL. = 10.4 8 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS t LOADING RATE: 0_74 GAL/SF/MIN OWNER/APPLICANT: OTHERWISE SPECIFIED. B B 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION LOAMY SAND LOAMY SAND OF ALL UTILITIES PRIOR TO ANY EXCAVATION. I 10YR 7/6 10YR 7/6 JAM ES M U LLI N 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE t DTH #1 i ITESTATES HOLEDEEP P.O. BOX 341 OR WITHIN 6' OF GRADE SHALL BE MORTARED IN PLACE. H YA N N I S, MA 02601 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER 30" 30" FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. 5 08-36 4-6 3 45 INDICATES 3s" 3s' 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF P-1 30" PERC TEST C-1 C-1 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE LOAMY SAND LOAMY SAND SHEET 2 OF 3 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND NO MOTTLING 10YR 6/6 10YR 6/6 LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN NO WEEPING amlo 47" 47" PREPARED BY: 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT 47" INDICATES ADJ. GROUNDWATER (EL=7.0) (EL=6.9) ELEVATION OF THE OUTLET PIPE. "� 60" 62" E A S SURVEY, INC. 9• THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES 72" OBS. GROUNDWATER 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC GROUNDWATER ADJUSTMENT C-2 C-2 P, 0. BOX 1729 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND DATE OF WELL: 9/2019 COARSE SAND CoA.0-ser Op SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE 2.5Y 6/6 FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL INDEX WELL: MIW-29 SANDWICH , M A 02563 WELL ZONE: B 72" 72" BE LEVEL WELL DEPTH: 7.8' (EL=4.9) (EL=4.8) 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION DEPTH OF WATER: 6.0' 1108" 108" TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW WELL ADJUSTMENT: 2.1' EL. = 1.9 EL. = 1.8 CELL (508) 527-3600 AND APPROVAL. . DEPTH OF ADJ.: 3.9' EAS.SURVEY©YAHOO.COM 13. MAGNETIC TAPE ON ALL COMPONENTS. t I_ ` • RAISE 24" COVER RAISE COVER TO WITHIN TO FINISH GRADE 6" OF FINISH GRADE OBSERVATION PORWTO RAISE 3 COVERS TO WITHIN GRADE / SCREW ON CAP TOP OF FOUNDATION 6 OF FINISH GRADE ELEV. 10.80 FINISH GRADE ELEV. 14.2 ELEV 13.8 GROUND ELEVATION 13.5 TOP WALL FINISH GRADE FINISH GRAD PUMP `\ �\ �\ `\ ����\ = 13.4 GRADE 10.6 ELEV. 11.0 ELEV. 11.0 //A� ` ///&: IZN lftC ////C� /// �\////�� //�/�� ///��� �� CONTROLS kPANDER 8 OS= 0.01 TOP ELEV 13.1 12" OF COVER ELEV. 11.0 STRIPOUT TO TOP i � //4": OF "B" HORIZON TOP 9.7 = TOP = /�`\ E + PER 310 CMR ?t' 9.67 °� °� +° a ; ° � d 15.255 (C) 5'C�S=0.02 I �, , +�' ° " GRADE 11.0 4" SCH 40 PVC o 0 o e o� on o o+ one+ e o e enod 4" PVC SCH 40 OUTLEr. 2 MIN-3'MAXINV.= 15'OF 2" 10 DBINV.= TO REMAIN 8.62 14TEE °°°°°° „ INV.= PVC °O°°° =12.83INV.=12.58 INV.=12.5 j pr g°°g°gg°g$ ZABEL 88888 10 TEE 8.45 INV.= SCH 40 2.66 0 uj FILTER 8.35 INV.= HORIZ. T' 16.0' EACH SIDE ---I a • 12.0 4'-1" LIQUID LEVEL /BAFFLE 5.67 8.35 REQUIRED BOTTOM S.A.S. 4.43' 14.0'x32.0' LEACHING FIELD ELEV. 7.0 121 ADJ. G.WATER TH#1 0 o e e o 0 0 1j BOT. 40MIL POLY LINER 3.9 AROUND ENTIRE 24.0'x42.0' OVERDIG - EXISTING 1,000 GALLON SYSTEM. SEPTIC TANK TO REMAIN PROPOSED 600 GALLON H-20 ; TOP 13.0 BOT 10.0 PUMP CHAMBER (SHOREY 4" k1N. LOAM & SEED MDC/1120 MANHOLE) SET ON 6' /2% MIN. FINISH GRADE 2 JOB # 19-0134 STONE OR LEVEL STABLE BASE / LOAM & SEED DISTURBED AREAS -36" X. - 12 MIN. COVER WATERPROOF AT FACTORY 3,1 MAXIMUM 1 j ��""SITE SEWAGE DOSING CALCULATIONS: ' , e ► , oe a neq "2" WASHED STONE r „•W e n e n a d� i' e e o 2 MIN. OF 1/6" TO PLAN DESIGN FLOW TO CHAMBER = 330 GAL EMERGENCY _ A g '�� e ee / REPAIR L N REQ'D EMERGENCY STORAGE EMERGENCY STORAGE PROV'D = 331 GPD (2.25' x 147 G/FT) e #1 4 NUMBER OF DOSING CYCLES = 4 PER DAY/TITLE V ( ) 14' A ^ p TON/ ^ /cq�/ /c DEPTH PER CYCLE 0.6' = 7-1/4" INCHES 4" PVC PIPING MA/? ,5/ O V A V C/V V L 0.6 x 147 G/FT = 88 GAL/DOSE CROSS-SECTION CONNECT ENDS N DESIGN TDH (2.62'+7.66') = 10.28< 13.4 CHART ® 40 GPM ASH To 1 ONE ( DOUBLE DESIGN GPM = 40 GPM WASHED STONE (NO FINES) H YA N N I S, MASS RUNNING TIME = 88 GAL _ 40 GPM 2.2m +/or 2 MIN 12 SEC. DATE: NOVEMBER 15, 2019 24 DIA MIN. MANHOLE COVER jNOFAgq_�_c 11.0 BROUGHT TO FINISH GRADE OWNER/APPLICANT: D,D. APPROX. 9 COVER JAMES MULLIN HER TOP ELEV. = 9.60 8" 8" ao a QUICK DISCONNECT P.O. BOX 341 GISTS��O i 4 PVC DISCHARGE H YA N N I S, MA 02601 agNITARIP PIPE INV 8 35 iNV.= 8.35 508-364-6345 � _ = 6.10 S OR. 27" 0 1/4" WEEP HOLE ALARM ELEV. 00 SHEET 3 OF 3 w I- �; = 4„ CHECK VALVE °D o o I 1 PUMP ON EL. = 5.77 ADJ. G.WATER 2 SCH 40 PUMP CHAMBER BUOYANCY CALCULATIONS o �. `r o = 6" ELEV. 7.0 PVC THREADED PREPARED BY: Z) 0 6". 7- /4 PIPE 600 GALLON H-20 TANK ui 0 m i PUMP OFF EL. = 5.17 v� E A S SURVEY, INC. WEIGHT OF TANK= 10,794 LBS d V) � BOT. INS. = 4.50 8 LEVEL CONTROLCURY S FLOAT WEIGHT OF SOIL= 4,116 BOT. EL = 3.92 0 '7 o P. 0. B 0 X 1729 c 186'. �ba A �b°�c MYERS 0.4 HP TOTAL WEIGHT= 14,910 LBSvl_% ,WW2 _ oI���,o�q, v'_ o� o,� SEWAGE PUMP SANDWICH , MA 02563 6" MI /4" TO 1 1/2" STONE // (MODEL SMR4) BUOYANCY FORCE: (3.1 x 32 x Tf ) x62.4 = 7,353� LBS OR EQUIVALENT = 7 557 LBS 4"x8"x16" SOLID - 600 GALLON H-20 /MDC MANHOLE LOCATE UNDER MH CELL (508) 527-3600 UPLIF LBS < 14,9 10 + LBS + CONCRETE BLOCK PRECAST CONCRETE PUMP CHAMBER PUMP TO HANDLE EAS.SURVEY@YAHOO.COM UPLIFT TANK/SOIL 5' INSIDE DIAMETER / 6' OUTSIDE DIAMETER MIN. 2" SOLIDS r AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION �'� �di+�S�% _ SEWAGE # _ VILLAGE� ASSESSOR'S MAP Cr LOT INSTALLER'S NAME & PHONE NO. {���( ��� SEPTIC TANK CAPACITY_ (()7-ZbZt Zct LEACHING FACILITY:(type) (size) I7y7 NO. OF BEDROOMS PRIVATE WELL O BLIC WAZE'R�� BUILDER OR OWNER n DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No V �y f � A1ry F�f�t24'icRS' http://issgl2/intranet/propdata/prebuilt.aspx?mappar=288197&seq=2 4/29/2019 Town of Barnstable Health Inspector oFTME ro�yti Regulatory Services Office Hours 8:30 ' 9:30 �.� Thomas F.Geiler,Director 3:30—4:30 BARN SZA$ . # Public Health Division MASS. g Thomas McKean,Director t �ATFO MA'S A 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM,APPLICANT SEPTIC QUESTIONNAIRE Date:March 23,2011 1. General Information: Size of Property:0.17 Address: 14 Marston Avenue Hyannis,MA Map 288 Parcel 197 Name:James M Mullin Phone#: 508-775-3700 2a. How many bedrooms exist at your property now?3 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?3 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width.measurements of any open doorways. Please label each room clearly. 3. Is the dwellingconnected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE a Zone of Contribution to public supplywells? AP 6. Is the dwelling connected to PUBLIC WATER?YES 7. Is a disposal works construction permit on file? YES R. If yes,how many bedrooms were approved according to this permit? 3 Bedrooms. 9. Were any building permits obtained for construction.of additional bedrooms? YES or NO 10. Is there an engineered septic system,plan on file at the Health Division? YES` or NO 11. Has the septic system been inspected by a DEP certified inspector,withn the last two years? YES or NO FOR OFFICE USE ONLY ` The Public Health Division has no objection to� bedrooms at this property. Special Conditions: Signe Dater ( . Q:\GMD-Housing\Accessory Affordable Apartment Program\ADMIN\FORMS&LETTERS\Blank Forms amnestyappl.DOC y BUYER: jAWAE Vgmdon exdUGes le form-ance of moveable sheds as mWWm r s. .�c T Z ZS .cD0 I �To MT O o of 0 1 -T L9T J oT '7 Sao A A�.'1 G M THE ( ) MORTGAGE INSPECTION PUN AND ITS TITLE INSURERS I IIED IN CERTIFY THAT THE BUILDINGS BMOMN DO( ) CONFORM TO SETBACK REQUIREMENTS �A N►11� WHEN CONSTRUOTFD. OR ARE DO)dPT PR 4 NOlAT1 CEMMEENT ACC-TI�ON UNDER MASS. O.L 1111 ���' '� Ham/11 TITLE NI, CHAPTER+OA.Sra1I0N 7,LMtSS OTHERWISE NOTED. MAMCHUSETTS I FURTHER CERTIFY THAT THIS PROPERTY IS&E PLOCATED IN THE ESTABLISHED FLOW HAZARD AREA.00MMUNITY PANEL N0,;Y?O OI.OUtz(,pC DATE: 5-Ic�•'86 lo'Jl� THIS COMPANY IS NOT RESPONSIBLE FOIt ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BOOK DATE OF THE LATEST DEED OF RECORD. .PACE �I - WHENEVER BUWNKS ARE 9101M1 =5 THAN ONE FOOT FROM THE PROPERTY LINE IT IS ADVISED CERT.NO. THAT A WORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUWAENTS q THIS:RTIFTCAT)ON IS BASED d! Y MARKERS OF OTHERS.AND DOES NOT PLAN DK. I I 0 PAGE_� WIESIN A PROPERTY BURVE LY MARKERS USED AND OFI'WM AS SHOWN, PLAN r DATED- — MAY BE ACLCAONM_PLISHED ONLY BYSURVEI DRIVEWAYS ARE NOT DEPICTED �I; C -nnCATION kU$MftF0 TCAGE PURPOSES ONLY. AS AR T TO 8E SCALE USED FOR T ROPERTY LINES . BRADFORD ENGINEERING CO. P.O. BOX 12A4 JAMES W. nom TJRAS R.L.S. #9529 TEL�)4A.09.SD8 ASSESSORS MAP NO: eARcELNo: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1� APPROVED nTOWN OF BARNSTABLE Elamstapl®Canserv�tion aepuime 1trtt#iiagri� 'fnx 3�in nnttl '1 nrkn Cnnnn rurfinn Permit App i-bon is hereby-maw o a Permit to Construct ( ) or Repair (t,�an Individual Sewage Disposal System at: — — ..._.........-_......... cation-Address or Lot No. - - - .......... ................................ _5 ," -----•------ . .- 1!. Cl_ Q V Add ......................... - - - - Installer Address d Type of Building Size Lot--------------------------- -----__.Sq. feet UU DwellingNo. of Bedrooms------- .--:_..:Ex anion Attic — �------••-•---------•-• P ( ) Garbage Grinder ( ) Gil Other—Type of Building ........................... No. of persons..---------.---------------- Showers ( ) Cafeteria ( ) a Other fixtures --------------- --------------- -------------•-----------•-- ......................-•----- W Design Flow-__.__�?�--______.__,.._._gallons per person per day. Total daily flow----------------- _._..._-______.__gallons. WSeptic Tank—Liquid capacity--__._ gallons G Length................Width................Diameter................Depth................ x Disposal Trench—No. �.v.F1 Tg dth._..6t..-___._____Total Length..../_� Total leaching area-------------------- ft. 3 Seepage Pit No..................... Diameter.-.---------.---.-- Depth below inlet---- Total leaching area.-----------------sq.ft. z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by-------------------------------------- ----------•-----------•------------ Date....................................... Test Pit No. I.........._-----minutes per inch Depth of Test Pit--------------._-_Depth to ground water........................ G. Test Pit No. 2---------------minutes per inch Depth of Test Pit----:.__-_.---_-_--Depth to ground water........................ a Descriptionof Soil ----------------------•---••----------•--••--•-----_---------•--------------------------------x ----------------------------------------- U --------------------------•------------------------••----------•-•-------.--------•------------•--------••-------- W U Nature of Repairs or Alterations—Answer when applicable-.fit—"'.— .__ fl✓ Lk�Y'�% 7J � -e �� -r�:1 t ._._5-� srz „ ---------------------------------- Agreement: 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 bee issued b the boar of health. signed........`- .._m .. . .. ..........._... ---- Application Approved By /. .. ... ..................... _ .f e �....... ...................... ........................................ Dace Application Disapproved for the following reasons: ... _....... .... .... ............................................ .............. -• ....._.... ....... ......_......................._....._ Permit No. ....................... Issued .. Daft ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (gertifi ate of Cnum;�iirxxcce THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed( )or Repaired b , 1;. has been installed in accordance'with the provisions of TITLE/5-of The St te,Enyironmental Code as described in the application for Disposal Works Construction Permit No. .`.; _ _.- ._! :%�.._1-..-. dated .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED'AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ..._.....__........ ...:-r...........:........................................................ Inspector.............................................. THE COMMONWEALTH OF MASSACHUSETTS - ' � BOARD OF HEALTH TOWN OF BARNSTABLE i / FEE...__...-.L;........ %ijimial nrkn Tnnotrudwn Permit .,.V Permission is hereby granted................... k , r' to Construct ( ) or Repair ( -,).-a n Individual Sewage Disposal System at No. ........... r ............ =- - 1 r street j7 as shown on the application for Disposal Works Construction Permit No l r Dated i : l% T `��� �- -/ �. Board of Health DATE .. ......---= ----------------- FORM 36508 HOBBS&WARREN,INC..PUBLISHERS FLOORPLAN File N..01010782 HIIRRMyF.R James Mullin _ - PRnPF.RTY ADDRESS 14-14A hlarstons Avenue CITY Hyannis - STATE MA Zil' 02601 1 F\13FR Advantage Mortgage Corporation _ Not to Scale c (n Bat aa)) 0 Kitchen Bedroom- 2 Q Living/Bedroom m 0 Living Room Bedroom Kitchen 50.0' Sketch by Apex IV Windows AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Description - Size, Totals breakdown Subtotals - GLAL FLrst Floor 1340.00 1300.00 First Floor 26.0 x .50.0 1300.00 1 i a 1 I TOTAL LIVABLE (rounded) 1300 1 Area Total(rounded) 1300 TOWN OF BARNSTABLE LOCATION J� /I I�i ?� � SEWAGE # 9Z), VILLAGE `taD�x— ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO._ �� SEPTIC TANK CAPACITY 1( LCd �9-tc- s'rc- V LEACHING FACILITY:(type) (size) i Y-7 NO. OF BEDROOMS PRIVATE WELL O BLIC W BUILDER OR OWNER A y � DATE PERMIT ISSUED: ,- l �, DATE COMPLIANCE ISSUED:�L�-f- VARIANCE GRANTED: Yes No--Li Y F6�Tl2� �5 i °. ASSESSORS MAP N0: 02 i No... . ....._._..... .R.u.,� OltlVic.¢� -2.Q FEB........ .._ THE COMMONWEALTH OF MAS CHUSETTS BOAR® OF HEALTH APPROVED OWN OF BARNSTABLE 8arnataAb Ca►Secvatem Q.�peRms� �^^ lirtt�ia�i�u� Application is hereby mad'elor a Permit to Construct ( ) or Repair ( 'k--<an Individual Sewage Disposal System at: ,M .............. ` ..1! 1C oov5-_-_-_(a:�?- . ...•...-----... j4'Z!!A !.c i_S •-•- .-----•--•-----------••-------•---•................ .cation•Address or Lot No. .................. _..... . --. -•-----------••-••------•--•-••---•-------. ................... !''. . .. .........................' ......... W Own Z n U Addre.s ✓� ,A� Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms.......�., g— ________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d ' Other fixtures ........---•-•--•------• ••---•----------•--•-•--•----•-----------•-••-••-------------------- W Design ....................gallons per person per day. Total daily flow----- ......._.._. gallons. Flow.._...' . WSeptic Tank—Liquid capacity...........gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. �i dth_...i......._._.. Total Length..../..F........ Total leaching area....................sq. ft. 3 Seepage Pit No--_----------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water----------_............. fs. Test Pit No. 2................minutes per inch Depth of.Test Pit_.................. Depth to ground water........................ O Description of Soil......................... W U ---- •---- •-------------------------•-----------••--••-----------------------------•---------------------•-•--------------------------------------------- ---------------- •-------------------•-•------- W ----------------------------•------------------••-•••-••-•-----•=---------------••-----------------------------I.. •. ...------. ------.. f fret b cdYL U Nature of Re airs or Alterations—Answer when applicable_. 1 :l!......___�...�v._(.F.�..............�....__. d- /Gf Agreement: 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 bee issued b -the boarA of health. Signed... _- - .. ...... -----�:.. ------------------ Application Approved By ---- --- - ��'------ ----- 3••-' --------------- --------------------------------------- d Date Application Disapproved for the following reasons- ------------- -- ------------------------------------------------- --------------------------------------------------- i ----------------------------- -�-----.......- ..... . . ------ ..............-- --- -- -------------- . --- --- ---------------.........---------------- --................................ Date :. Permit No.� -- - ..-..--- ....................... Issued ....--.......-...................-....-...---....... - .-... Date lqf � I . I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirati� n fit Disposal Works Tonotrurtion Orrmit Application is hereby made for a Permit to Construct ( ) or Repair ( t, an Individual Sewage Disposal System at: ........ .. ............... .. .........•...... - ..............................Location-Address or Lot No. .. .................. ................... W Owner Ad.. d .dress................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...... ................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of,Building ............... No. of ersons............................ Showers' a YP g -•------•---- ..---------•-•.P ( ) — Cafeteria ( ) d Other fixtures .. Design Flow...... .`C�.....................gallons per person per day.,Total daily flow...... ..`.......................gallons. W Septic Tan —Liquid capacity............gallons Length................ Width....._.......... Diameter-----. Depth................ Disposal Trench—No..��n 1 _ lWidth....?. ..... .. Total Length ...... Total leaching area....................sq. f .x f Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (1r4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ ix ----....................................................................................................................................... ..... •-- 0 Description of Soil......................................................................................................................................................._._.:......••--•• x U ----------------- --------------------- -................................................................................................................................................................. W V Nature of Repairs or Alterations—Answer when applicable...:"0/.�CMS...... ._. « !. fir? !2 ....... Agreement: 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 been,issued by the boar .of health. Signed fil-- ......- - .. i ........'.y'y/{_.. ........................................ i-- -----.. ................Dare Application Approved BY ... --./ : ....................... e-...... -- i � Application Disapproved for the following reasons: ...............................---------- :................... } Permit No.� r.111..... . v .... .............. Issued .............. Dare !• � � Dace ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (fer#ifira e of C omplinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by---------------------------- ------------------ ---! -..le :: c .... *:.a--?........--- .......................................................................................... Installer at ------------------------------------- �� ....i .-fin`' t-- )" .... .t-Q........... ............t � ;r .... - has been installed in accordance with the provisions of TITLE 5}}of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..... ............ .-- �� dated ................................................ �... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BCE CONSTRUE AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................=.. .... `---'. ;...I'M ......----•---------...----...... Inspector ....------�. ..............--------------------------------.............----.. l � C1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '"/ 7 TOWN OF BARNSTABLE ��•, No....... ........... F.E. !. .. Disposal Works 0-Constrnrtinn. rrmit Permission is hereby granted................. �A- ,/7...C:-/)T to Construct or Repair ( )�an�ndiv-an Sewag e Disposal System 0 f at No.....................................k/ ,itr1 _ ! n �� A4j. I 1�.� /are ! IF a.• ._ .: tEi L� / /as shown on the application for Disposal Works Construction Permit t o�l_ !_. , d..�.I.... ./.._ q � � Board of Health L ` DATE / ;J ...`..J-------------------•-........._•••--- FORM 3830a HOBBS 6 WARREN.INC..PUBLISHERS y,r.-...•-o-�:,�..••-•—�.-..�.•.�....�r�d,:,.`-�•-n,,..+a-r-w...--..r..•.•-,.-..-��....,..'gwvr�+�+aaw'..� - ,w...,.-�. w,•-w l +rw-a'-•.'i-•---•--.�';� " THE.COMMONWEALTH OF MASSACHUSETTS.. BOARD OF HEALTH cITYOW - � N `���� �t ✓ �� i DEPARTMENT sA'DDRESS � ,max _ i l / <�� TELEPHONYX r Add ressff% ff j l iFf Occupant Floor r �__ Apartment No:Occupants • No. of Habitable Rooms` No. Sleeping Rooms No. dwelling or rooming units `� No. Stories 1 ?. it .I ame and address of owner �t F _V } r, ref• R r` J Remarks Reg. Vio. YARD Out Bld s.: Fences: '11" Garbage-and Rubbish: Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps, Stairs, Porches: " Dual E Less: and Obst'n.: / : 4;. O B EJ F ❑ M Doors, Windows': Roof - .R __..< - ._ Gutters, Drains:' Walls: " Foundation: Chimney: BASEMENT Gen. Sanitation: " v Dampness: - ,� Stairs: r .. Lighting: STRUCTURE INT. Hall, Stairway. A 1\l�Hall, Floor, Wall,.Ceiling: V Hall Lighting: ' o. �f Hall Windows: z HEATING Chimneys: Z Central ❑ Y ❑ N Equip. Repair r w . TYPE: , Stacks, Flues,Vents: Er a PLUMBING: E• Supply Line 3 ❑ MS ❑ ST ❑.:P Waste Line: ' m H.W.Tank(s) Safetyand Vent(s) o ELECTRICAL Panels, Meters, Cir.: ; _ ❑ 110 ; ❑ 220 Fusing, Grnd.: a - AMP: Gen. Cond. Distrib. Box: i° Gen. Basement Wiring: - DWELLING UNIT, . Ventil. Lgtng. Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen ., _ Bathroom 3 ' Pantry. " t Den Living Room f _ Bedroom (1) "✓ a Bedroom (2) Bedroom(3). Bedroom (4) t Hot Water Facil. Su .Ten., Gas, Oil, Elect:. .� yC _ Stacks FI•ues Vents Safeties`', Kitchen Facilities Sink Stove / I Bathing, Toilet Facil'. -Vent., Plumb., Sanit'n.: Wash Basin, Shower or Tub:, ����? �) -��� f J 1�.is'�� � J., ✓ dc-� f.��,� Infestation Rats, Mice, Roaches or,Other: Egress Dual and Obst'n: �_ 4 General Building Posted: Locks on doors: r .x "` a �, ,• ONE OR MORE OF THE.VIOLATIONS CHECKED'"ABOVE IS A'CONDITION WHICH • _ MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY'AND WELL BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750;OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) _ "THIS INSPECTION REPORT.IS,SIGNED AND.CERTIFIED UNDER THE PAINS AND A " / , ✓ PENALTIES OF PERJURY. s� •: , ✓, rs . r rj INSPECTOR t1� � ✓'t�'l,>°� _ �.�.! :.TITLE•� ��� �t �t%` `•' ,r'��'`�'�r��l'`�rL�`~Lz DAT f , f TII M E `p-Nj ' r A.M. THE, NEXT SCHEDULED REINSPECTION P•M• 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 crate minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 01R 410.201 or improper _ venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or (D) Failure to supply the electrical facilities required by CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (G). Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or dafety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are required by 105 CMR 410.351 and 410.352 so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. (3) any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating, gas-fitting, or electrical wiring standards that do not create an immediate hazard. (4) failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A) and 410.503(B). (5) failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the board of health.