HomeMy WebLinkAbout0051 SHADY LANE - Health 51 Shady Lane
Hyannis
A= 269 - 128
p
TOWN OF BARNSTABLE
LOCATION S�g��y' L ei-,J G SEWAGE# ;?6 a— 061
VILLAGE 6 t,01n,S ASSESSOR'S MAP&PARCEL . C 1 1
�jE
INSTALLER'S NAME&PHONE NO. ,,���
SEPTIC TANK CAPACITY 0 /V-4-0
LEACHING FACILITY: (type) (size) lJ
NO.OF BEDROOMS leC-
OWNER
PERMIT DATE: OJ/I ti e l 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) / Feet
FURNISHED BY
Ba3
A l� 5 _ �4.1
TOWN OF BARNSTABLE /� J
LOCATION eS-/ -SA qO y L g i c SEWAGE# d G /e— 0
VILLAGE ASSESSOR'S MAP&PARCEL 06 fbae
INSTALLER'S NAME&PHONE NO. /�,,�� 6
/46.J e'a,5'40 �G�71�
,
SEPTIC TANK CAPACITY %So® C�e���c-` /- /O
i
LEACHING FACILITY: (type) 6w d ,JZC,,T (size) w, Q0)L A f r �
NO.OF BEDROOMS 7 e!
OWNER
PERMIT DATE: COMPLIANCE DATE: 7
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) A — D Feet
FURNISHED BY
4 v
9�
�
o —
It
Ln
QA
No: { / Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplitation for Misposal 6pstrm Construction 3permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) �romplete System ❑Individual Components
Location Address or Lot No. /
s SA&I t� L 4.4 Z *mA_ s,,l Owner's Name,Address,and Tel.No. 7/y- 'L%1
Assessor's Map/Parcel (o iah r vor 64 e
Installer's Name,Address,and fel.No. l70 1701/7)/a Designer's Name,Address,and Tel.No. Stle- ' 69&6
L.
i kv Z41 ✓I At" SYcd,,� Swtr�Sv' rui» G3 C t ��
Type of Building: j S; Pf,A ai 1,0 G�LGO
Dwelling No.of Bedrooms �/IsPCC Lot Size �a/!e 6 sq.ft. Garbage Grinder( )
Other Type of Building . jr No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.req-ired O gpd Design flow provided gpd
Plan Date. Number of sheets Revision Date
Title
Size of Septic Tank I500 Type of S.A.S. 3 X ut
Description of Soil ,1.. ��� dot �l `Q0 C64es.- f,�, r� �o` Si" /o y a.•t�
Nature of Repairs or Alterations(Answer when applicabale) LA
� P- X ?(-1 s*c G
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. t
Signed Date _? lJ1�
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. �DO1-? $� Date Issued
�^; ,:4., ,'a„ w`d1.,..a....ai'�Y!.[b�'Ir".-^-.- ._ 'rw .•t•+r"e**....,�-ry,�,:+`•.'F'`.�"e- .,. ,. - ., .._� .-.- .�• f "`. -. .•%•
No. 0 / A Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered m computer:
PUBLIC HEALTH DIVISION_-.TOWN OF BARNSTABLE, MASSACHUSETTS Yvs
J JYILAtiOn for I8tJ08AY &pstrut Construction Ferran
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) W Complete System El Individual Components
Location Address oriot No. '
Sl sbd'! L a ' +` ?ls"e Owner''s Name,Address,and Tel.No. 7794 71.49/
Assessor's Map/Parcel
Installer's Name,Address,and el.No. 110 RpY 7),16 Designer's Name,Address,and Tel.No. SUS- iS G°1�G
pp yy �6
)C-77G-Vey&(,L,4n S YYhw MA stt4sr_ " f Type of Building: .S. Dc��.sl rr 9 C.)"'O
1 Dwelling No.of Bedrooms Alm i Lot Size U% 707/• 6 sq.ft. Garbage Grinder( )
Other Type of Building rS.'de, A No.of Persons Showers( ) Cafeteria( )
Other Fixtures
: Design Flow.(min.req•ired y gpd Design ow provided9,a gpd v
Plan Date � , G) Number of sheets Revision Date
Title /Y?
Size of Septic Tank ISUG Type of S.A.S. 3 X4!
YP D,-iwtlk
R Description of Soil ,+. �,er ��t 3/�`lip I)(' I '
Nature of Repairs or Alterations(Answer when applic ble)n )=,'lI A svc ®r,'5�..� -"„ // J=ao /
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.
Signed Date
Application Approved by t Date p 4
Application Disapproved by Date
for the following reasons
Permit No. 1
Date Issued 1
i
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Oi, Upgraded( )
Abandoned( )by ;kv 4„
at ,�1 .S�,�c c� -`.r,,� --. ,, has been constructed in accordance
With the provisions of Title 5 and the for Disposal System Construction Permit NA e—<F 1 dated 3 / L
Installer Designer St.-,e+9.1--
#bedrooms 7hrce— Approved design flow—, 3/') gpd
The issuance of this permit shall not be construed as a guarantee that the syskeem ill function�as ,'gned.
Date Inspector p ctor
i
-----•-----------------------
No. _Q_ Fee
v THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
MiSPOsal 6pstem Construction permit
Permission is hereby granted to Construct( ) Repair( 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 and the following local provisions or special conditions.
Provided:Construction/must
be c6rnppleetted within three years of the date of this permit.
Date j/�-7 // (1 Approved b}��
~`a{"
� �
w.
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
KASS ' Public Health Division
s639.
Thomas McKean,Director
200 Main Street, IT,yannis,MA 02601
Office: 508-86 -464 Fax: 508-790-6304
Date: �8 ZU�� Sewage.Permit#0/1-630 Assessor's Map/Parcel
Installeer&Designer-Certification Form
Designer: �✓✓.orrf� L�^�y��/ /�L Installer: Xj eer- Lellid 64,:4a:kl,,
Address: Address: 7)�
On Apr"/ �GfG AAA F ,F.Mcl-, was issued a permit to install a
(date) (installer)
septic system at � ,Jx0r41-"d based on a design drawn by
(address) c�
��GJUrtTfcrt �.J�.i.�,ra�i+�L dated /0`42,
/ (designer)
1' I certify that the septic system referenced above was installed substantial) accordingto
the design,_which may include minor approved changes such as lateral relocation of the
`distribution liox and/or septic tank. Stripoi t (if required) was inspected and the soils
were found satisfactory.
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. Stripout(if requir - ' ected and the soils
were found satisfactory. ,A of�,;
UGC )SFr. „`.;1•
TEREPJCrE
C N "
r, NI. t
HAYES
nstaller' ature, PJ0. 9-9
'�'�ITARIP^1
(Designer's ignat� e) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CtRTIFICATE
OF COMPLUNCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED 13Y THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
gAoffice fonnsWesignercertification form.doc
Department of Health,Safety,and;Environmental Services
f
Public HFeahti` ision Date
Main Street,Hyannis MA 0260.11
�t!�
TEalw�+" Date Scheduled Time Fee Pd.
rur�
Pw�
Soil Suitability Assessment for Sewage DisposaTI
Performed By:
Witnessed By:
;....,;...........
,; ••.:•:..:::::..:.....•:.......................
........
E. •.
Location Address
:...:.:::::::::::.,:::..::;::.::•>:.>:.. :;:::.::> ;:;; ::.:::......'>.....
Owner'sNan'ie` �°�
5.l Sh (.ctne ,� •��eA��re�L
�f:,yctrt h i�� /'✓1 Address �t; 6tti s�c.L n+l
Assessor'sMap/Parcei a lea( `7
_.--,... 02�0.4 !� Engineer's,NamesCJ2>,e 52 - e�,f19
NEW CONSTRUCTION; REPAIR - Telephone#
0 60SG90C
Land Use ��/fro-✓7,� o _ p�
Slopes(10) /G Surface Stones �
Distances from: Open Water Body 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&pere tests,locate wetlands in proximity to holes)
)NO
dj
Parent material eolo to U ��`
Bedrock. ZC,
Depth to Groundwater Stand(ng Water to Hole: Weeping Eom P,it:-Face
� r
Est►mated�SeasonalI3igtrit Gioupd'water --- ---
�' :&.- �Y^s-.,t ar
x.
/ !. .f .ti W. :�:.• ..a,..,
IDepthObserved standing"9In offs Thole�r rw i r „f in Depth to so11 moturds f' ,k
Depthrto vreeping from sIde of 's'hole; t in.
g =loclexrWeii# /�Z t In Ground water:Ad�ustrnent t
°t R�adiris Date 28 Jndex Well level : t
s -- Ad factor� ,AdJ Gtoundwatei:Level
1 i.�..!•..,.!•r.....
:' 3 {y
j
...... ,#;S'' TtS`{};•;aG'i,•':Rk;::i::r?:::�ii:•>Yr;•;•
• g •i!
Observation /
Hole#
7 7 �. f.,. .�x, t.. l Time at 9'
Depth of Pere
s Time at'6"
Start:Pre-soakTiine,@ (� ,
,.• c . Timer(9 a6, 1
End Pre-soak l
�' �� _ Rate Mm/Inch �,.,?�- a '� ��:•s ,
Al
} - ;� � �N - yi, -
.� f.. Site Suitability Assessment SttesPassed�} ` -
i r � r „ Adciitionit T{ esUngbNeeded
traw+f x-frx.R,t31+ t er s t
� 4 a� Ongmal Publtc,Health Division "VA
t :' 4 a` ar p• yi
06servatton NolenData To Be_.C.ompleted onBack—=--_.�
_� s Copy,. Applicant
( �•,
t .r
Depth from Soil Horizon Soil-.Texture Soil Color. Soil 0
Surface(in.) (USDA) (Munsell) Mottling` (Structure,Stones,Boulderes.
conslsiefitv�0
Depth from SoiUHorizon Soil Texture Soil Color" Soil Other
Surface-(in.) (USDA) (Munsell) Mottling (Structure,Stones,BQuIderes.
t o
a- v
<.. ,.................... .
Deptli'from` :Soil Horizon Soil Texture Soil'Color Soil Other
Surface(m) ([J$DA) (Mansell) Mottling (Structure;Stones,Boulderes.
+ e
ZV
�� „1 So �r Y �Y,�'XK-.A,�. �e R•J§( �'F d� dcsff� A��.=C^ �� r'J'k". ��.5* Htl 4'�, Y ti� "�fl� - -
*R�atetEl�is�o
1EloodInsurancek �� j
i # Above 0 year flo�obo na�ary, jNol YesY�
� A
tF
' Yes i i t "i,R , r
Withi 500 year boundary �No
} wNtke �
a E '�fi ��3.['�i'
F �" �W4ithin 100 year flood boundary No� Yes t � "
Does at least four,feet ofaturally�occurr�Ingpervtious materlalexist m aal areas�obseedthroughout the
area propose& Slow
11 Wtthe s absorption�system? F._ �.,,. r.
If not,what is the,depth of naturally occurrin'g.pervious;material?-
�grtificatitin ,
i "" IP have eased the.soil evaluator examination approved by the
I certify thaf on � F(date) P �.1 r a. e.. +�r s
FDen'artment:of Env>ronrnitalProt�chon+andthat the atbove analysis wasFperforihed byte consistenf with
i
�"" „i � ed'exper`ince: fj eti ui 31OCMR 15.017.
•the required;tramm r i� � ,� �
_L_
t
:Signature
Date
kM
�# ti
L£' 4
k nit t U 3
� � e
III -OR -CRAWC-SPACE. - 'SOIL TEST OM CELLAR"T, op fT, UNIMUM TR AtOk" OF�-SOIL� T RCH 19. 2918�EST,-TES 0 0 FT.- INIMUM,FROM,SLAB CLEAN 'SAND �SOIL DONE,BY affZjq9B__f N
_GINJLR NC L
ELCV P#1115617 WITNESSED 'BY ED v P LOAM AN SEED'- 'D 0 4 SCHEDULE 40 VC PI E BSERVATION,- HOLE I LEV-:2 'LAYER ,�'J/8* 'fo JL/2"PITCH I/8" PER.Ft IPERC6LA71O -MIN.,4NCH AT INC14ES N RATE WSHED S TNE MOTT. OTHER DEPTH, 14ORIZ MTURE COLOR OR' LT FAB IC �f4OT REQUIRED FILL, �NO o zio IYR6-PER PT bAMY,�AND 10 COAR E ND 25 W/4 LE 20�: C 87.0;,FILOW-UNE 00 F-LEV. WATER ENCOUNTERED AT: 96" ELEV..0:0 o" 95-0'T�ON HOLE E' __ —T 2r OBSERVA' ' LEV�=LEV - M.17 b'm -30 "4b-mL ELEV. DEPTH, HoRtZ TEXTURE COLOR� OTHER IELEV 6 Lul ELE MOTT.G S Vw*yL�"BA FLE 0-30* FIH UNER NO DISTRIBUTION LOAMY SA D 1 OYR6 30 B 4 ' ,OUTLET /6 ID TFS -J BOX;-(TO- BE PLACm-'ON-FIRM BAst),. -120" C COARSE 'ANb i!5�7 S ES ig I H -2 &2 ELEV..�BE WATER T 3 FLOW blf"ORS WrTH 0 ESTED STbNE-1.IN N 7:g:�"-1500 �'-GA S�: w� ORE HA4:ONE OUTLET ELEV.LION WELL'SEP11C (TO FTIONON FIRM �BA,�'sc PLACED' c FEE ZONE (2/201 3 TO ..�DESIGN CALCULATIONS
.3/4 SOIL'. 'ABSORP1IN '. �INDEX 8,' T,-, t� - I i� r� :�1`�L NUMBER OF eDROOMS' :DOUBLE WASHED- STONE: ADJUST 1,3 B AR8AGE FREE OF FINES & SILT I SYSTEM - (SAS) G DISPOSAL UNIT TOTAL ESTIMATED, FLOW_ELEV,OSCS PROBASLE'WATER TABLE. L'=_ GAL�DAY V. 11b.QAL/bR./bAY X Sy TEM OBSERVED WATER JABLE (3/19/20,18) ELE EWAGE SROSAL PRO s REQUIRED SEPTIC TANK ,�CAPACITY GAL NOT TO:SCALE BOTTOM :OF TEST ELE V.: ACTUAL SIZE OF SEPIC,TANK GAL�SOIL CLASSIFICATION DESIGN PERCOLATION RATE MIN./IN.IEFFLUEM LOAD1140 RATE -GAL./DAY/S.F.LEACHING AREA SO. FT.�(12=)*(44XVI.o)LEACHING CAPACITY (AREA X,RATE) ,�A,2A &AL./DAY'472.00 X 0.74 RESERVE LEACHING CAPACITY AM- GAL./DAY NOTES: 'CONFORM TO D.E.P.1, ALL, WORKMANSHIP ANO�,MAT ERIALS $HALL Tf,1TLt`5 AND THE-TOWN'S RULEES-AND REGULATIONS 'FOR THE SUBSURFACE DISPOSAL OF SEWAGE,
BE BROUGHT TO 2. ALL COVERS TO SANITARY UNITS SHALL WITHIN 6" Of FINISHED GRADE.THE �SANITARY SYSTEM SHALL BE �CAPABLE OF.2 ALL COMPONENTS�.OF WITHSTANDING H-10 LOADING UNLESS 114EY ARE UNDER OR WITHIN
10 FT. OF DRWES�'OR PARKING AREAS. :H-20 LOADING SHALL BE V USED UNDER OR *THIN 10 FT.'OF DRIVES�OR PARKING AREAS. ,LOT 30 ul
1 721.6 S.f'. 4.,ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL,BE MORTARED IN PLACE.5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH A4 -ZONING REGULATIONS. OWNER APPLICANT IS TO
DEEDED,OR 94.3 OBTAIN SUCH DETERMINATION FROM APPROPRIATE�AUTHORITY.N LITIES SHOWN ARE. APPROXIMATE ONLY, EXCAVATION CONTRACTOR UTI 94.3 IS TO CALL "DIG SAFE' AT 1-888-344- 7233 AT L AST'72 'H01jRS`0,PRIOR TO COMMENCING WORK ON SITE.7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS 99., SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIA71ON
1.8 94.3 ' IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IT 'IMMEDIATELY.IS IN FLOOD ZONE x 8. PARCEL -MAP...�_9_9__,AS PARCEL -A-4—9. LOT IS SHOWN �ON ASSESSORS
L -OF 10, ALL.UNSUITABLE MATERIAL SHALL,BE REMOVED FROM .UNDER AND I'MIT TION SYSTEM AND _BE G, FOR A MINIMUM OF 5' AROUND SOIL AOSORP
rl L REPLACED WITH MATERIAL AS SPECIFIED IN S 11. THE.INSTALLER IS TO GIVE THE- ENGINEER A MINIMUM OF 48 HOURS SOIL TION (NUMBER BELOW)-'(2 ORKING DAYS) NOTICE FOR THE FINAL tNSPEC TEST, \7-4�95-0 D.L 95.7 12. ,EXISTING CESSPOOLS.ARE-TO BE'PUMPED AND�BACKFILLED.BOX,95. C 31341 0 T![I L A APPROVP'D: BOARD OF HE LTH
9,9 9 .7 1500 CALL TIC,T 96.3�98,0 -SEP 95.5
AGENT DATE 75 C.O. G�6� BARNSTABLE, MASS. PROPVOSED SEPTIC ' DESIGN Iis 97.8 95.9 i i
HYANN FOR 97,7 96,8 51 SHADY LANE, LOT 30
BARNSTABLE, MASS.LOC. HYANNIS S WEE 7 ENGDVERRNG P. 0. BOX 713
508-LEGEND: Jwc S� 385-6900 SOUTH DENNIS, MASS. 02660 A4A11V EXISTING ��POT ELEVATION OOxO s DATE SCALE EXI TING CONTOUR '00---- - - 20"
MAR. 19, , 2018 FINAL SPOT ELEVATION Ap ,"FINAL CONTOUR SUOMI SOIL TEST LOCA71ON REV. JOB NO,UTILITY POLE -0- 7990-��TOWN WATER —W - W CATCH BASIN SHEET 1 OF 1 GAS 'LINE CLEAN OUT LOCATION MAP CESSPOOL' C.P. 0 C.. S8 PROJ 7990-00 dwq 7990-SA S D WG 0 2 018 SWEETSER ENGINEERING I