HomeMy WebLinkAbout0023 MELBOURNE ROAD - Health 23 Melbourne Road
- -�_ Hyannis
268 244
° °
x �L-f.TOWN OF BARNSTABLE
LOCATION f / /t Jl 1 QU R PJ IE RID SEWAGE #
VILLAGE IRA- ASSESSOR'S MAP & LOT g
INSTALLER'S NAME&PHONE NO. W ikf J/A-rrL. V- 11UC ck
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) ��'���' `"�� (size)
NO.OF BEDROOMS
BUILDER OR OWNER Si��? T�JYG(JLGr
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) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
0
-.r.. M
-/0 -
��
lYo. �O v- [�'10! Fee
l
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
2pprication for ni6pogar 6potem (Congtruttion Permit
Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) C' omplete System ❑Individual Components
Location Address or Lot No. 1' Owner's Name,Address and Tel.No.
Assessor's Map/Parcel 6 q
Installer's Name,Address,and Tel.No. X Designer's Name,Address and Tel.No.
1B ,(i cejr�� i� Cqr E s � SV6�gq� �
Type of Building:
Dwelling No.of Bedrooms _ Lot Sizej�sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 2220 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank j) ut' Type of S.A.S.
Description of Soil,
^�^��r�NINr IGINEER MI IST SUPERVISE
AND CERTIFY IN WRITING
Nature of Repairs or Alterations(Answer when applicable) THE SYSTEM WAS INSTALLED IN STRICT
t
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 an of to place the system in operation until a Certifi-
cate of Compliance has been issued s Board of Health—
Signe�FDate
Application Approved by A i Date
Application Disapproved for the following rea
,.
Permit No. —s Date Issued
Fee
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer: a
Yes
PUBLIC HEALTH.'DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
' application orN,�fgpool bpztem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( ' )Abandon( ) VOM
plete System El Individual Components
�, Location Addressor Lot No. JMG V r Owner's Name,Address and Tel.No.
1fP4�r hii5 «4 a �^ Sow a-?F6�
Assessor's Map/Parcel (-1
��"s�L�
Installer's Name,Address,and Tel.No,
Designer's Name,Address and Tel.No.
Q ' (4 /I�� �r ' &_E c4r f-ke N E S 6-S y g o796.
Type of Building:
Dwelling• <No.of Bedrooms T Lot Size/t sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures ,
Design Flow gallons per day. Calculated daily flow '`3� gallons.
Plan Date �` Number of sheets -- Revision Date
ti Title `
Size of Septic Tank �?� Typ
e of S.A.S:
Description of Soil
FT =s
Nature of Repairs or Alterations(Answer when applicable) +
Date last inspected:
i Agreement: N,
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 Certifi-
cate of Compliance has been issued by this Board of Health r _
Signed .*'f // n . Date T/ G
Application Approved by .y�� ., '^ Date
Application Disapproved for the`following reas
14
�r
Permit No. Date Issued
- ---------�---------
THE COMMONWEALTH OF MASSACHUSETTS
�",, ARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CE TIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned( )by
at A A, 1 has b constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No dated 6 t1
Installer Designer
The issuance o f this pbrr':.1it s;all not be construed as a guarantee that the s j�te will f tnction as d si ned.
Date 1 TO a-i Inspector I �n
--- --l��-------
-------------------------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC'HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
l ,
Misposar *pstem Construction Permit
Permission is hereby granted to Construct( Repair(�)`Upgrade( )Abandon( )
System located atcr•t—,^
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
f r Provided:Cons ction must be completed within three years of the date of this p
Date: � ' O L' Approved by
B k 18385 Ps261 _�23350
03-31-2004 8 11 =31 a
21571.res
RESTRICTION
WHEREAS,JOSE AMARAL,Trustee of Amaral Family Trust,under declaration
of trust, dated October 30, 1987, recorded in Book , Page , of 45
Candlewick Lane, Hyannis, MA 02601, is the owner of the real estate located at 23
Melbourne Road, Barnstable (Hyannis), Barnstable County, Massachusetts (hereinafter
referred to as "Premises"), and being shown as LOT 46 on a plan of land recorded in Plan
Book 250,Page 143.
WHEREAS,Jose Amaral,Trustee,as the owner of the premises has agreed with the
Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can
be included in any home built on the said premises as a precondition to obtaining a variance
from the Town of Barnstable Board of Health and to obtaining a building permit for this lot;
and
r
WHEREAS,the Town of Barnstable Board of Health, as a precondition to granting
the variance from side line setbacks and authorizing the issuance of a building permit for the
construction of a single family home on the premises requires that the agreement for the
restriction on the number of bedrooms in any house constructed on the premises be put on
record with the Barnstable County Registry of Deeds by recording this document.
NOW, THEREFORE, Jose Amaral, Trustee, does hereby place the following
restriction on the premises above-referred to in accordance with his agreement with the Town
of Barnstable Board of Health,which restriction shall run with the land and be binding upon
all successors in title:
1. The dwelling constructed on the premises may have no more than one (1)
bedroom.
Bk 18385 Pg 262 #23350
21571.res
This restriction shall continue in full force and effect until such time that the premises
is connected to Town sewer or the construction of a residence with greater than one (1)
bedroom is allowed as of right, at which time this restriction will become null and void.
For title of Jose Amaral,Trustee,see deed Jose Amaral and Maria C. Amaral,dated
November 21, 1987,recorded in Book 6036, Page 024.
Executed as a sealed instrument this day of March,2004.
Jose a ,Tru ee
COMMONWEALTH OF MASSACHUSETTS
Barnstable County
On this J/ day of March, 2004, before me, the undersigned notary public,
personally appeared Jose Amaral, Trustee,proved to me through satisfactory evidence of
identification, which was /y ��Gefis2�o /399 to be the person whose name is
signed on the preceding or attached document, and acknowledged to me that he signed it
voluntarily for its stated purpose.
44 r .
Notary Public r••�•1� f � . '•ti
MY coMMISSION DARES
My commission expires: MAY 9,2008
COMMONWEALTH OF MASSACHUSETTS y �'• 'o ••
BARNSTABLE COUNTY "�"��•,•
REGISTRY OF DEEDS R4RNSTAIKE REGISTRY OF DEEDS
A TRUE COPY,ATTEST
<5c�N-k'
JOHN F.MEADE,REGISTER
Town of Barnstable
�t"E'"'r�� Regulatory Services
Thomas F. Geiler,Director
* BARNSTABLE,
MASS. Public Health Division
1639. 0. Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 8/21/04
Designer: Shay Environmental Services Installer: �Willam Dinger
Address: 34 Thatchers Lane Address: Willow Street
_East Falmouth, MA 02536 Yarmouth, MA
On 8/10/04 William Din eg_r was issued a permit to install a
(date) (installer)
septic system at 23 Melbourne Road,-Hyannis based on a design drawn by „
(address)
Shay Environmental Services dated 3/17/04
(designer)
XX 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.
v I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
OF AI,4S�cyG
(Iz�le_� M
ns a ler's Si m /ature) �o CARE EN
0 SHAY
No. 1181
G�3-T
esigner's Signature) (Affix p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:Health/Septic/Designer Certification Form
1
N
TOWN OF BARNSTABLE
LOCATIO //1G 1�(.dJO�J aG ILL RID SEWAGE#
VILLAGE Yi4WAIIS IKA,- ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO. UI l of d rrL. )D1 �nts,�>,ylU
SEPTIC TANK CAPACITY r Sa
•� LEACHING FACILITY: (ty�e) ��,�/� oQ.S (size)
NO.OF BEDROOMS
BUILDER OR OWNER Si4 n'I T�J�'YGCJ_ lG
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) Feet
Edge of Wetland and Leaching'Facility(If anywetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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SECTION A -A ALL OUTLET PIPES FROM THE
'NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. DISTRIBUTION Box SHALL BE
10' mina from- PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET LEVEL FOR AT LEAST 2 FT. 12' caNCRETE COVE
[house to septic tank ;,
NEW Foundation 3" of t/B" - 1/2" Washed Peastone r _ r-
Septic took covers must be _ 3 - 5"OUTLET - - "��-�.,. 2 �
TOF = ELEV. 105.00 within 6 in. of rrNW»d grade ode over SAS- 10200 �3/4" to 1 1/2 " Washed Crushed Stone KNOCKOUTS -
` Grode over Septic Turk - 103.00 Grode ow D-Box - 102.00 /�/- �� - "c
-
4" PVC (CAPPm ET) INSPECTION PORT TO BE ,, _ OUIL , ) 12" INLET
1
INSTAL I cn AND TO BE"INN 6" OF GRADE `\ 6•
S - 0.02 3 HOLE H-10 Top L.00d - Elev. -100.00 _ ,,, .ice 35 �. �•
S-0.10 3' Maximum Cover '• C$
OR GREATER DIST. BOX Top of SAS - Bev. -99.50 15.5"
1p' O NEW EATER S- 0.010" per foot � 4" - SCH. 40 T 1.75" �as ,
Kw 1,500 GAL. in �, ;
J0' / PLAN SECTION CROSS-SECTION a
b o SEPHCITOANK o + cv 20 0" Effective Depth 5 Units 8 6.25' = 30' ,<<ae`a `
0
FULL FOUNOAJ Ilk
> N 8 O o 0.83' (10 inches) 3 31.25' L3' ra> ....
;I ^ 3 HOLE H-10 DISTRIBUTION BOX
SYSTEM' PROFILE 6 In.of 3/4"-1 1/2" V 37,25' NOT To SCALE
c compacted stone ; ; . rn Effective Length 4
O7:bar r.nool�.� i"2n N�w�>�
3iCol-,T-
Not to Scab - c O 0 4' 4' SOIL ABSORPTION SYSTEM (SAS)
_2 I
--I
c c y .5'- ;
6 In.or 3/4"-t 1/2" 10 V INFILTATR❑R HIGH CAPACITY (H-20 LOADING)/ GE❑RGE ❑'BRIEN GENERAL NOTES
compacted stone v Effective Width (OR EOUNALENT) Not to Scale
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE m NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10 1. Contractor is responsible for Digsafe notification
� Bottom of Teat Hole 1 Oev.-92.00 "_ and protection of all underground utilities and pipes.
v Obs. Groundwater - Test Hole 1 Elev.= NONE OBSERVED 2. The septic tank and distribution box shall be set
level on 6" of 3/4"-1 1/2" stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
4. This system is subject to inspection during installation
P E R C 0 LAT I 0 N TEST by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
NOTE: SITE IS IN A ZONE OF CONTRIBUTION - REQUEST A 1 BEDROOM PERMIT ONLY. with Title V of the Massachusetts state code, the approved plan
Date of Percolation Test: DECEMBER 19, 2003
Test Performed By. CARMEN E. SHAY, R.S, C.S.E. and Local Regulations.
Witnessed By DAVID STANTON (BARNSTABLE B.O.H) 6. If, during installation the contractor encounters any
SHAY ENVIRONMENTAL SERVICES, INC. soil conditions or site conditions that are different
r
Percolation Rote: 2 MPI O 36" from those. shown on the soil t or in our design
CA ND L E' T�YI CI-� � 9
installation must halt & immediate notification be
` T
L made to Carmen E. Shay - Environmental Services, Inc.
Test Hole Test Hole LA 1 V L' 7. No vehicle or heavy machinery shall drive over the
No. 1 No. 2 septic system unless noted as H-20 septic components.
DEPTH SOILS ELEV. DEPTH SOILS ELEV. 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends.
0 103.50 0 102.00 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
Loamy Loamy 10. All solid piping, tees & fittings shall be 4" diameter
Sand Sand
10 YR 3/2 10 YR 3/2 Schedule 40 NSF PVC pipes with water tight joints.
0"-10" A 0 102.60 0"-10" A o 01.10 11. Municipal Water is Connected to The Residence and Abutting
Properties Within 150 Feet.
Loamy Loamy
Sand Sand
10 YR 5/6 10 YR 5/6
10"- 34-1 Be 00.6 10"- 34" Be 99.20
Medium- Medium- LOT #45 THE PROPERTY LINES ARE APPROXIMATE AND
Coarse Coarse COMPILED FROM THE SURVEY PLAN GENERATED BY
Sand Sand - C.K.M. ASSOCIATES OF W. BARNSTABLE, MA ENTITLED
34"- 12o c, 3a"- 12o C, "SUBDIVISION PLAN OF LAND IN BARNSTABLE, MA - STRAIGHTAWAY"
DATED JANUARY 14, 1971. IT SHOULD BE USED FOR NO PURPOSE
S 07d I 46" W OTHER THAN THE SEPTIC SYSTEM INSTALLATION.
PL 125.70' TEST HOLE #1 ------ -------104 NOTE: NO WETLANDS ARE PRESENT WITHIN 200 FEET OF PROPERTY.
ELEV = 1
TEST HOLE #2 �� 16 4' 1 04 '
LOT #47 ELEV = 102.00 ��� ASSESSORS MAP - 268 LOT - 244
ZONING RESIDENTIAL
,i -•-_!:'..:�-: �� r ' I FLOOD ZONE C
Perc #1 Perc #2
PROPOSED c I THERE ARE NO WETLANDS LOCATED WITHIN A 200' RADIUS
Depth to Perc: 36" to 54" Depth to Perc: 36" to 54" 1� =f: = DECK 104X 1 I OF THE SITED SEPTIC SYSTEM.
Perc Rate= 2 MPI Perc Rate= 2 MPI o _
Groundwater Not Observed Groundwater Not Observed r \1 t 7'��- LEGEND
No Observed ESHWT No Observed ESHWT " --
�n
ADJUSTED H2O Elev. = None ADJUSTED H2O Elev. = None w ' : 123
7.25' > ;1
o PROPOSED DENOTES PROPOSED
w - _�, D-Box ROPOSED (b 104X 1
Design Calculations FOUNDATION FUTURE co N LOT #44 SPOT GRADE
Number of Bedrooms: 1 Equivalent to 110 Gal./Day (330 Gal./Day Min, per Title V) W •` GARAGE W � DENOTES EXISTING
TOF ELEV >05.00 0� 4a
Garbage Grinder: No ;i Fr • -�; X 104.46
Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) ¢' -+ }`� BSMNT FLR = 97.50 V SPOT GRADE
FNSH FLR = 106.00 \� r
Septic Tank - 3 x 330 Gal./Day = 660 USE NEW 1,500 GAL. Septic Tank. 20, I I �• ,
SOIL ABSORPTION AREA: Using percolation rate of G2 min./inch - 2.5' I �� Q PL PROPERTY LINE
Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons W 104X I i �� 1 J
Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons 4a 1� \ 9r PROPOSED,. CONTOUR
Providing: 331.80 gallons " I \
IPROPOSEDi �\
- - - - - -97 EXISTING CONTOUR
NEW 1500 gal. t I DRIVEWAY:
Use: (5) INFILTRATOR HIGH CAPACITY ti-10 'UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE LOT #46 00 Q � � �
Septic Tank 30.
DEPTH, TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5'a OF WASHED STONE 10,500 Square Feet +/- I I
ON THE ENDS. NO STONE UNDER. 1 104 % 7 i I �\\ ® DEEP TEST HOLE &
1 102 I - PERCOLATION TEST LOCATION
3-24•DIAM..ACCESS MANHOLES ---- 1 15.87' `. .� ° \��Oq .---- 6 FOOT STOC-MADE FENCE
PF
N 07d 1 1' 46" E'�___- -- ---r- ------------f02
,I 100 -- ------ ------L--------------100 -
P LOT P L-A N
3 /
in
V
INLET / \ ` ou T
r` THE ACCESS COVERS FOR THE SEPTIC TANK, ME'L B o UR NE R oA O F PROPOSED, SEPTIC SYSTEM
_
DISTRIBUTION BOX AND LEACHING COMPONENT
SHALL BE RAISED TO WITHIN 6" OF ( ) ( FOUNDATION LOCATION
n FINISHED GRADE. 4O FOOT RIGHT OF WAY
STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS PREPARED FOR
ON ALL OUTLET TEE ENDS
PLAN VIEW
3-24" REMOVABLE COVERS-� M R . SA MAT T RAYW I C K
rid �. ..f.-� 4- #32 MELBOURNE ROAD
min: in. inlKx. - - PROJECT BENCH MARK
MLET e"mTT=m1� t outlet e. ;��3 OUTLET - PK NAIL SET HYAN N I S MA '
5' -r t , s -r ELEV. = 100.00 Assumed -
E s 1 +-o" min. -- ' A PREPARED BY:
Liquid depth - / i1a�•`1!�c `:!.:
1
.•_: ' o•-cr 5. 6:• -' 0 20 _ 40 50 ��' GILBERT o 1�1, ENVIRONMENTAL SERVICES, INC.
CROSS SECTION END-SECTION _ T.
" '
P.O. BOX 627
_ r►o �>> �FcrS�cF``� p EAST FALMOUTH, MA 02536 1
TYPICAL 1500 GALLON SEPTIC TANK . .. S�rvt �R���' TEL/FAX 508-548-0796 -
0,7
SQ-ALE. 1 =20 C a ,
NOT TO .SCALE "mil � S 1 "=20' DRAWN BY: CES DATE: MARCH 2, 2004
H- 1 0 LOADING ' PROJECT SD532 FILENAME: SD532PP.DWG SHEET 1 OF 1