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HomeMy WebLinkAbout0018 PLYMOUTH AVENUE - Health 18 Plymouth'Avenue`` ` Hyannis A = 310 001 i I I i I i I TOWN OF BARNSTABLE LOCATION. �(► > Ave SEWAGE J006�D3tg VILLAGE N- -ANNI" ASSESSOR'S MAP&PARCEL _3j 0 ®0 INSTALLERS NAME&PHONE NO. ?ob`W Soc&) S frFrc Sdy- 7:25-21-7 SEPTIC TANK CAPACITY Sep® LEACHING FACILITY:(type) .a-$®o NO. OF BEDROOMS o� a„ tee,,,, U Je Z(L sl iilo L OWNER Cik)7N 1c CAU X-t( + fl CIN8!k c1(Z6 PERMIT DATE: S COMPLIANCE DATE: S I 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), Feet FURNISHED BY '10 r., . Y c;b co N No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rppricatiou for �Digo!ml *p5tem Cou9tructiou Permit Application for a Permit to Construct( ) Repair)( Upgrade( ) Abandon*( ) X Complete System ❑Individual Components Location Address or Lot No. %W P/ jv?j)u jk i og 1A O er's ame Addre s,and el.No. 5C6'77 1 RY 3' Assessor's Map/Parcel C 18, -PL*WI ou Tl{ A V G PyAno'IS o2 ba / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size 1(/ 7z0 sq. ft. Garbage Grinder Other Type of Building No.of Persons 21 Showers(f ) Cafeteria( ) Other Fixtures Design Flow(mi .required) gpd Design flow provided gpd Plan Date �' i�,3 Number of sheets Revision Date Title Size of Septic Tank S 0 O 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 the Environmental Code a d not to place the system in operation until a Certificate of Compliance has been issued by this B�-ofaltFA Sig a Date J o Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. "� Date Issued yam" 4+ No. Fee 60 r THE COMMONWEALTHOF MASSACHUSETTS Entered in computer: PUBLIC HEALTHDIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ,. � e y , ptication for aigoat �§Pztemc Con5truction Permit Application for a Permit to Construct(" j Repair Upgrade( ) Abandon(( Xcomplete System ❑Individual Components Location Address or Lot No. �� f� �O�f h ) �A 0 er's a e dreg,,and el.No. S -?�1-9 37 Assessor's Map/Parcel � L >='104- 18 )'v�ouTi( /��C NyAoifS v26oi Installer's Name,bAdldlress,and Tel.No. ry"�} Designer's N me,Address and Tell..No. V R4 04W ,Type of Building: Dwelling No,of Bedrooms , 21 Lot Size �4 7Z? sq.ft. Garbage Grinder A Other Type of Building 7prL No.of Persons Showers(� ) Cafeteria( ) -N. Other Fixtures Design Flow(mi .required) gpd Design flow provided gpd Plan Date 3 a3 Number of sheets / Revision Date Title Size of Septic Tank - 1�S 0 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 the Environmental Code-and got to place the system in operation until a Certificate of Compliance has been issued by this Board of alt Signed o Date Application Approved by ,• _ O _ Date Application Disapproved by: v o Date for the following reasons i Perm t N o. Date Issued —=------ --'—=�------ ---=— --- , THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed'( ) Repaired ( ) Upgraded ( ) 4 � Abandoned( )by at has beeen�c n tructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. (/ ) '"t dated Installer 'Cc 40 Designer .9bedrooms - Approved design flor "2 '�_ r" gpd The issuance of this p rmit shall not be construed as a guarantee that the system function as desig, d. Date ��p Inspector l r'`�kllvv. NO. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Digogat i§P5tem Co 5truction Permit Permission is hereby gr ted Con truct ( ). Re air Z ) U, rade/( NJy Abandon ( ) AA System located at 0( a , �I and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: o truction must be completed within three years of the date of thi�pit. �._. o. Date Approved by F1HE Town of Barnstable � r Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, MASS.039Public Health Division v 363 �AIED'i1P�A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 - Installer & Designer Certification Form Date: ��� (�-0 Sewage Permit# O( Assessor's Map\Parcel Designer: Stetson Hall Installer: Wm E Robinson Sr Septic Address: 28 Rambler Road Address: PO Box 1089 Osterville Centerville - On Wm E Robinson Sr Sep4gs issued a permit to install a (date) (installer) septic system at 18 Plymouth Ave, Hyannis based on a design drawn by (address) Stetson Hall dated D(o (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e: greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. STEMON . ' OF *( esi r'st'Signature) R. & No.5HALL6 27 O EDSer' i e) (Affix Desi_ 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 3-26-04.doc 'Town of Barnstable P# v .1 Department of Regulatory Services Public Health Division Date 1111v,)2 200 Main Street,Hyannis MA 02601 • BMWSTABL& MAM ArEo t►��� Date Scheduled o_ 0 3 U Z Time V0 U M Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By:�J%i Fr1� J- IR Witnessed Location Address Q / /� Owner's Name C0 f ce-r�� U -� cl-I- J�jGp ( Aoro-C CA'L�r✓FLL Address ��r✓r✓I 1. f� IYOOJ� Assessor's Map/Parcel: 31L) ' �U) Engineer's NEW CONSTRUCTION REPAIR Telephone# -6-0 Land Use F Slopes(°/.) L / _ Surface Stones 6Z&*V-0 Distances from: Open Water Body ZIA O ft Possible Wet Area,?e?�10_6 ft Drinking Water Wellt/aarJ ft Drainage Way ;;'/OD ft Property Line ,?0 ' ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) no t �._ .. _ � 1 Parent material(geologic 00;;/I 1X11-7f,Aiiv Depth to Bedrock �S� -� �r l�•c�T3' P g r✓c Nis Depth to Groundwater: Standing Water in Hole: /��(P Jc__1 Wee in from Pit Face Estimated Seasonal High Groundwater ' TTI( i li' AC►11 HIT' N.T' R8 Method Used: Depth Observed standing in obs.hole: . in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level— ' 1C3LA'�I( N TT „. Ua# Trml .. Observation Time at 9" Hole# r.w Depth of Perc /e�'/ �o� � Time at 6" �-- Start Pre-soak Time @ /0:6 Time(9"-6") End Pre-soak f O, /0 4,01 Rate Min./Inch ^� Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- Q:HEALTH/WP/PERCFORM Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in. (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency o l 01 • - D q_ it C y �� 714 p��P QB�ERVA�'I�N HC?�tE LAG Ha e Depth from Soil Horizon .Sol1 Texture.- Soil Color Soil Other _ Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. 0 .... .. ...... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) SK Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) Flood Insurance Rate Mangy / Above 500 year flood boundary No_ Yes ✓ Within 500 year boundary No— Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio s material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on // (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the required tr ' i g,a ise an perience described in 310 CMR 15.017. Signa Date 3 L 9�✓ �✓ far�./G r//<a w� A LpT,«� o�✓ Q� .. ��� ��• �J,Od � ��'� �✓/��Qr,/,S' � `` LJ� f�.J�S'C��I�� L�s�`��'7 p�n��G✓ o''� v � Sys - . 7-1-1 `41 --- �r,r �. - ,.5- cis r,,,JC �, ,,-✓ 3&' , F��-,a,✓ �._T�t-Ccn�o � ��✓ 10 571 J c ) ' _ .ass, � As sDEEP OBSERVA T/ON HOLE L-_ C to A I D - oftr3'J�3 lrrr / yB!/Z — GrS T .mac%E 7 6LAIR r r. ►./�r!/q F t �� t�C'C �C� ,y Z6 7- - ,.. . i ..• •"'-fir" g _ _ C";Z'00 c� »e G, u o9R ur ' o\ `DN „ C - E� NA -�- TOP OF FOUNDATION G CONCRETE c COVERSAIAJW � ✓� 1�2 � V 9 .. 4 CAST IRON R SCHEDULE'40 4 _ R R. 0 SCHEDULE 40 P.V.C. (ONLY 9 MIN , LEACHING TENCH ( ) EO ►.. P,V.0 PIPE MIN. PIPE-MIN. 1/8"_ 1/2" WASHED STONE 36 MAX. :PITCH 1I4 PER.FT .FT. - PITCH I/4 P� 6` ,.../y INVERT GAS BAFFLE- � INVERT " ' 24 INVERT / 6' 0 � _. r .Q;;A �.i CI�:Q,'l=t,'/>�a Q;'f.,]�- - ''"'"�� c ��• SEPTIC TANK �j EL_�__yd . .; �'G33,22 � .INVERT 4 INVERT 4. GAL.: INVERT 'di ST, :. EL....�,1..... Precast 500Ga1.Lea Ch 3/4,._1V2„-/ BOX EL-._Z (a) REO. 6"CRUSHED STONE Chamber WASHED STONE _ . C ROFi LE OF rr -r a le - b GROUND WAIZR TAdL'c �✓c O— 37/. SEWAGE DISPOSAL SYSTEM SOIL LOG TYPICAL CROSS SECTION i /ca NO SCALE LEACHING _TRENCH ' DATE1 � t Alt TIME . 4. NO s: L- -EST ,ROLE I TEST HOLE 2 � DESIGN DATA 7. 9. MIN. _ µ-SHED 36 MAX. ; i /' sy�Gd�I/►'7 N'UIMSER 0- °_.,ROOMS ='. .p �!r ✓gyp - , . . S DNc �// - 211 ?�� Ly I TOTAL ESTIMATE-) FLOW .. .--33c� . .. GALLONS/DAY _ _ 8l, 8 ; Q�- " Cow r� .1ia„/� y1 BOTTOM L=4C"IVG AREA . O.r�. T'ENCi ........... S 24S1 TE PLAN 18 PLYA40Ll TH AVE HYANNIS9 ✓ A SIDE LEACHING AREA SO.^T./TRENCHc GAR°AGE DISPOSAL . . !!/Q . ..(50°o AREA INCREASE) TOTAL LEACHING . .. � �'�.: SO.;T. 4n/�)/1.�' G�Lv�✓�.LL dc•- //?i�s/��L w,�b�,�'Q � � . �.��✓.� P46 -RCOLATION RATE ' ' ✓/ Gf� P_.4. I Nc + i re •CACHING ARE PER PERCOLATION P.T ` rr-'�. So I . r N zG e7,/�! OIo6 GROUND WATER T..SLE �-� APPROVED�_ ^0 0 Li H ELF / - � ��i✓r/11�� � � � ;��� �� � � _. ENCOUNTERED DATE .. . . . . . . . . . . . . . .. .. . . . . . . . . . � M ssgc AGENT OR INsP_•�TOR � E Al/', WITNESSED BY 1 ' I LL"E N -477?cA) /� /-1��L �, �' 2Gi0'� r; 1�!��i/iL`�` }l�sK�!�! �•�C'n!�. 30ARD Or L=ACTH An'I 4�9C3 ty" � `c►5�t �` , .mac? 'ILi� 5 =NGINEE.. ��PQ 1 LP 10 fDS1� oQ, �^. PETITIONER . . . sue, - - - _ y. �^,,',-- .aN"e!' ,..�-:�;�'."`.. 'A._ 'F,w = wr, ^�' '9ft'y'-"• x'.-�_,.,�y:.'.�ar;; '-r- €. - x:a. ,�<..: �,...�P .,... mac. H . .. .'. x .F. .... .. e....r .., .-. .. a -,-» ,.P. ..., � .. �. ..:.- ,.,...Y +«::.. _ .'`"- t 1. J•..,4 i i �, �_