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HomeMy WebLinkAbout0079 SUFFOLK AVENUE - Health 79 SUFFOLK LANE HYANNIS r A = 291 126 a N r a McKean, Thomas From: McKean, Thomas Sent: Wednesday, May 04, 2005 5:36 PM To: Dillen, Elizabeth Subject: Amnesty Applications/Septic Questionnaires 79 Suffolk Avenue/ Andrews The septic system shall be upgraded to accommodate four bedrooms. The application can be conditionally approved with the understanding that the system shall be upgraded prior to occupancy of the amnesty unit. 8 Curlew Way Cotuit/ Villa The septic system was approved for three bedrooms in 1990. Therefore the application is approved. QUESTION: Are there any windows provided within the basement bedrooms? If the answer is yes, are they properly sized for emergency egress? 23 Elliott Street, Centerville/ Anderson PROBLEM: The existing septic system was designed for four bedrooms. However, there were six or seven potential bedrooms counted when the submitted floor plans were reviewed. The submitted floor plans do not show doorway dimensions, door locations, room dimensions . Please have the applicant provide neatly drawn floor plans showing doorway locations, doorway widths, door locations, room dimensions, and window locations. 1 TOWN OF BARNSTABLE LOCATION SEWAGE # 10aS--S2I VI {AGE ASSESSOR'S MAP & LOT2l7 JAG INSTALLER'S NAME&PHONE NO.,�S- 5�20-97�'8 /oszrpli V-c. 13,o-nGS SEPTIC TANK CAPACITY /SDO / LEACHING FACILITY: (type) 1444 OIL' 2'_ I /I tr14/or g x �S(size) NO. OF BEDROOMS BUILDER OR OWNER /gyr, 54y5 PERMITDATE: A9`17 OS COMPLIANCE DATE: /O Separation Distance Between the: Maximum Adjusted Groundw ter Feet � a Table to the Bottom of Leaching Facility 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 facili ) Feet Furnished by -� i 1 i �� Q �- - -- � � '. R o � � � + � I _ �h `� ; �w �; ,_ � ' �� �„ 9�._ `L ' � No. 5P Fee �J THE COMMONWEALTH OF MASSACHUSE47S ; Entered in computer: -I s Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYtcation for. 10iopogal *p.5tem n.5truction Permit Application for a Permit to Construct(-;jRepair pgrade(_ andon( ) O Complete System O Individual Components Location Address or Lot No. 7 e1 �Wr_c?_ /1< Jq V1! Owner's Name,Address arj4 Tel.No. Assessor's Map/Parcel 9 / X V/= �� Installer's Name,Ad ress,and Tel.No. s^rj�—!/'1 a—-Yy.Vd' Designer's Name,Address and Tel.No.3-d8_ 1 ffi,—g5/1 t/as rp17 ?e /3�� s cl p y ,q. 13,4.olr / Ckv—o,10'/.L 41/ oZ /17�l S' �s' 6gr° �/ ST%Yal /2 /�rhyJi. 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature off Repairs or Alterations(Answer when applicable) / / C 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 Certifi- cate of Compliance has been issu d by this oard f Heal igned Date Application Approve Date Application Disapproved for the following reasons Permit No. 0!!�w Date Issued _ g s• Y } No& 5o I Fee 150 THECQMMONWEALTH OF MASSACHUSETTSS Entered in computer: PUBLIC HEALTHFDIV SION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes ���Yicator�=�for��i��o�aY �pgtetu ott�truction �ern�%t Application fora Permit fo Construct(✓rRepairgrade(Cj<bandon( ) []Complete System ❑Individual Components Location Address or Lot No. !.1 Y�� Ow er's Name,Address Tel.No. ,v yeti �s W,_TW,�, ��� ��vs Assessor's Map/Parcel //� /�G t J Install s Name,A ress,,,apd Tel.No. f D�'C/ U'��-� De gner's Name, drresss pnd T LNo.5`eO'- 39e't),'r l/ _ Type of Building: P !N Dwelling -No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria Other Fixtures Design Flow gallons per day: Calculated daily flow gallons. Plan Date Number of sheets "3 Revision Date f� Title Size of Septic Tank r Type of S.A.S. Description of Soil . ti Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r 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 Certifi- cate of Compliance has be . iss ed by s Board of Heal igned Date= Application Approve y Date Application Disapproved for-the-following reasons 4 Permit No. c;�60 5 Date Issued Z i THE COMMONWEALTH OF MASSACHUSETTS Y BARNSTABLE, MASSACHUSETTS ---,certificate of (Compliance THIS IS TO CERTIFY, that th On-site Sew ge Di posal System,Constructed ( G') Repaired' 0! Upgraded(" ) Abandoned( )by yv,5 r l 0-e �l1:01_1'a S at � G!F/CO 111" / /� �'�iS has b en constructed in ac ordance with the provi ions of Title 5 nd or Disposal System Construction Permit No. r, 5. � D / �5 / dated Installer t/OS 4/04 oS Designer /0/ The issuance of th is pe�rrr t hall not be construed as a guarantee tha&e sys i fti ction as designed. Date / P Ins ector _ No. �00 ,� � — -------------- --------Fee �!^ G, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BAR NSTABLEs.MASSACHUSETTS 7izpogal *p$teul Con5tru don permit Permission is hereby granted to Construct )Repai ' .. grade Abandon( ) System located at / �/� l�h 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. Provided:Constru•tion ust be completed within three years of the date of th*I pe Date: /Q I -1 Approved by i c ( L r i I �- ��'�� � i �y� �� 10-17-2005 07:45AM FROM SWEETSER ENGINEERING TO 5087906304 P.03 La _ 91 �� 0 =7y'9 .S' lY1fJ x D t9 L�1 0 Ys� .I S o 'o a�HS,N , �n 0 0 s c� Qtn �Jn n �� G�astNr� Mn II l K Z oorj rij!I+1r1 0 ` p fir TOTAL P.03 10-17-2005 07:44AM FROM SWEETSER ENGINEERING TO 5087906304 P.02 e S Lr p a 9 Q J., e p r o d- ? C4 f5 IT Ll It z h b� F �r g T h ` Z y v r l CRAIG R. SHORT, P. E. 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis. MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER,SOIL EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS,COASTAL&BUILDING DESIGNS FAX TRANSMISSION SHEET NUMBER OF PAGES INCLUDING THIS SHEET 3 TO: -7 ADDRESS: 4 Fax#: .S-0 S ?9 U G 3 0 ¢ DATE: / ��/ & �5 PROJECT: Al , r-9 --7 C11 c --.- -S FROM: CrdZ R. Short P.E. FAX#: 508-398-3063 TO'd b02906L80S Ol ONI633NION3 d3S133MS WOd-d Wdbb:LO SOOE—LT—OT Town of Barnstable P# L 3 `� Department of Regulatory Services F Public Health Division HateKAM (D S .shy. ' 200 Main.Street,Hyannis MA 02601 MKS� � . Date Scheduled `� / v Time Fee Pd._ r—) Soil Suitability Assessment for S g-wae Dis o y Performed By: � r"4_/ 9 >� ��J O Witnessed By: Vim: LOCATION&GENERAL INFORMATION n Location Address 1 9 S.u Oro-W &c, �� Owner's Name,A/e Is o 7 pQ/_r��r-�C►t df "o-7.f / Address Assessor's MapTarceL• ` 1 j Engineer's Name NEW CONSMUCnON �_ .,REPAIR Telephone# Land Use 2e ,� ..�C h Slopes Surface Stones �fe ►<'� Distances from Open Water Body .5�� _ft ..,Possible Wet•Area '� ft Drinking Water Well '�-� 'g ft -Drainage Way N�i9 ft Property line O ft. Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands 3n proximity to holes) ' G. Z_S l ' C • W 4 Q ,A co A N sr~i 5 Parent material(geologic) 94a Jot Depth to Bedrock Z G m Depth to Oroundwater. Standing Water in Hole: � ' Weeping ft+om Pit Free Estimated Seasonal High Groundwater DETERM[ ATION FOR SEASONAL HIGH WATER TABLE Method Used n:�� Depth observed standing in obs.tole: In. Depth to soli mottles: Depth to weeping from side of obs.hole: in, aroundwater Adjustment Index Well# Reading Date: index Well level'�,�..... Adj.,factor ,,.�� Adj.Gn=dwnter Level ,� PERCOLATION TEST Date— Tim—, Obser,ration ` Z. Ttme at 91, Hole# Depth of Pere / Time at&, Start Pre-soak Time @ �./ / . e 75me(9"•6") --- End Pre-soak Rate Minllnch Z <Z Site Suitability Assessment: Site Passed ._ Site,Failed: Additional Testing Needed(YIN) original: Public Health Division Observation Hole Data To Be Completed on Back-- ----- ***If percolation test is to be conducted within 100,of wetland,you must first notify the Barnstable Conservation Division at least One(1)week prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole:# 0 Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) 6 (USDA) (MtatseU) Mottling (Structure,Stones;Boulders. G ,q m y Bey "io DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Struc Stones Boulders. Mottling ( lure, . Surface(in.) �/Z 9/� (USDA) (Mansell) g Consistency.% 3 O . e e�4 , c -Z �f i /3 Z DEEP OBSERVATION HOLE LOG Hole# Depth from" Soil`Horizon Soil Texture Soil Color. Soil Other Surface(in.) (USDA) Win solo Mottling (Structure,Stones.Boulders. Consistgn 96 Gravell- DF"OBSERVATION HOLE LU Hole# Depth from Soil Horizon''` Soil Texture Soil color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones',Boulders. i Flood Insurance Rate Mau: Above 500 year flood boundary No— Yes --__—_ Within 500 year boundary No Yes '._..:. Within 100 year flood boundary No v Yes ' Death of Naturally Occurrins Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas obsarved throughout the area proposed for the soil absorption system? e-3' If not,what is the depth of naturally occurring pe ious;natorial? - Ceti-0cation I certify that on IC(date)I have passed the soil evaluator examination approved by the sis was performed by me consistent with 'on and that the above analy Department of En vironmen tal`Protectt the required training,expertise and experience described in 110 CNR 15.017. Signature Date • L Q:%.SI?Vn0PERMRM.DOC ' J Town of Barnstable 1 ®3 �p THE Tp� �. Regulatory Services Thomas F. Geiler,Director • BARNSTABLE, 9 MASS. g Public Health Division �pF iG3.9�A�0 FD Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: a Designer: C-�Q g % ���� t Installer: Address: 2 3S Address: S ( Ccz_,-� --,-7 .S�c���i Vie.•�-ter.S it/I.q- r�'Z b G a !%1�f /1�� rls , �/� ' On /� / �s ,?',o eY -5 -Sc tic, was issued a permit to install a (date) (installer septic system at �� //-, based on a design drawn by (address) dated_ 6 2 9/o 5 (designer) �I certify that the septic system referenced above was installed substantially according to the design, which may include minor apprgVed changes such as lateral relocation of the distribution box and/or septic tank. J 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. dAO CRAIG sta f rer's Signature) Na Imo '-; © LVim * (De ' er's Signature) (Affix Designer's Stamp 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 .. ;. . YA RD Avim• CTE . VINE CONS = 99 0 , ■ 98.8 OpT'QN NO 401 THIS P 76.25 RESERVE S.A.S. AREA 8' X 62' 10.3' cx) 100.0 "AS BUILT" OFFSET_ TIES: S.T. #2 ' AC = 48 O' BC = 10.0' AD = 40.0' BD = 20.2' AF = 39.5' BF = 26.5' 00 AE = 43.8' BE = 23.0' �"_ 99.3 '. 98.9 AG = 54.6' BG = 18.4'99.0 x 99.2 AV = 59.0' BV = 28.7' 20' MIN I C!) 99.0 99.3 C n1 BH 0 98.5 I 99.1 1 I 9.0 FULL CELLAR rn EX/S77NG �� �rDECK 10 -9s.s .0 � o��o�-« 8,2 z sA.s EX/ST/NG SEPTIC AS-BUILT T DWELLING 1 97.9 FOR EXISTING 991 9.0�8: NELSON ANDRETS CRAWL SPACE SEPT/C TANK 9 NEW 0 � ADD/T/ONAL S.A.S. �L ,7 I LOC. 79 SU1�'FOI K A PT v m a DRI VEWA Y / BARNSTABLE MASS. WEN � EX/ST/NG _ _ RG GAS LINE // -'� 97.5 LARGETREE CRAM R. , ' . 0,- P. E.GARAGE SLAB �� 235 GREAT WESTERN ROAD .8 (98) 1 off P. "O. BOX 1044 fox _6 508 39e.e3l1 SOUTH DENNIS, MA 02660 508.398 3063 LARGE TREE 31 9' -•97.9 SCALE 1 20 97.3 97.7 N w JOB NO. 1_1013-� REV. r OCT. 24 2005 SHEET . 1 OF 1 FILENAME. Andrews 01-f013 AS BUILT ©20p5 CRAIG R,. SHORT, P,E. RAIG R. SHORT, P. E. 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis, MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER, SOIL EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS AGREEMENT FOR PROFESSIONAL ENGINEERING SERVICES-SEPTIC DESIGN Craig R. Short,P.E. (Engineer- _ a or thre€ee-of$775 plus disbursements to: Nelson Andrews,the following services at- u olk Avenue,Hyannis,MA-02601 En ' r *Disburse TOTAL Test ole: -Eeadact-felt 300. $ 300 Backhoe/Auger $ 150 $ 150 Town Inspection Fee $ 100 $ 100 Design: Field Location Surveying $ 300 $ 300 Engineering $ 475 $ 475 TOTAL FEE PLUS EST.DISBURSEMENTS: $ 775 $ 550 $ 1,325 Work to commence upon receipt of signed contract and deposits. TERMS: $ 850 / Deposit to Craig R.Short,P.E. (Engineer)with signed proposals $ 475 Upon completion of plan,prior to its release&filings $ 1,325 TOTAL *Disbursement items(i.e.filing fees,copies,etc.)shall be paid directly by CLIENT,or if paid by Engineer,a 10%fee will be charged. (excluding disbursements listed above). Fee is based on normal suitable site conditions, if unsuitable soil or high groundwater table is encountered, if there isn't a properly recorded plan at the Registry of Deeds, and/or if variances are required, then parties agree to renegotiate fee, prior to proceeding further.A finance charge of 1.5%per month will be charged to all amounts remaining unpaid 30 days after date of original bill. Possible Additional Fees if required. Wetland Flagging($300+), Well location($250+), Pump Design($150+), Reinforced Concrete Wall Design($300+) , Pressure-dosed treatment plant($600+), Inspection and Certification of system installation ($300+), floor plan drawing($300+) dimensional and to scale if Board of Health Variance Hearing is required. Craig R Short,P.E. assumes no responsibility for any damages created by the Backhoe or to any in ground components that may be damaged during Soil Testing,Inspections,Locations of and/or Installation of Septic System. N/A Addendum for BOARD OF HEALTH variance filing (f necessary) N/A Addendum for CONSERVATION COMMISSION filing (if necessary) Agreed upon by: C L I Em N mia Aug'UA"' P Y Craig R. ort, P.E., (Engineer) Date a/ S ,vim Client: Nelson Andrews Date 7 This proposal may be withdrawn or prices and time-frames may change if not accepted within 30 days No plans will be released for permit or filings until all balances are paid in full IF YOU ARE PLANNING AN ADDITION,PLEASE PROVIDE THE FOUNDATION DIMENSIONS AND LOCATION., PLEASE PRO VIDE A COPY OFYOUR SEPTIC INSPECTION REPORT,IF You HAVEONE. Any requested plan revisions will be billed at the rate of$75 per hour. a co -----� V_ 1 mq C � - P Y4.,JT w / rT, 14 s 1 Z 71 N X. G � C G �l �S CD H � c o � O o to' TJ Z VNFL W3114 _0 oCliop 4 N � . v Kj t=4 14 Is it c t) VIV tNiSWD s . 0 a � i o o f x IN 41 r , a O r a a x a R t a V/*�S7 Town of Barnstable Health Inspector Office Hours °� TO'yti Regulatory .Services 8:30-9:30 Thomas F.Geiler,Director 1:00-2:00 9� Public Health Division 1639. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT— SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: 3&'Xe-T Address: �� �� LJL A��� i ��i,� Map .Parcel / ~�'�11 wj' C1 Name: /;V �,e� Phone #: `J��' 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unitp 2d. Please include a copy of the floor plans for the entire property-showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please.label . each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or 1V0 �Ifhe,dwe`l�mg..rsconriec��rl to�p�li,„iLc seEver,s1ciP;guestions;#4 thropgl�.#��b�e�pw,�, j x.,:,,x, , 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? t 5. Is the dwelling connected to an ONSITE WELL or to CPUBL:1C:W:ATER 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? _Bedrooms. i 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within 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: -�� 1 -4 Signed: St5ni2hlM Date: 10 D O;/health/wpfil es/amnestyapp T OF BARNSTABLE I,OC,ATION SEWAGE # VILLAGE //ASSES OR'S MAP & LOT ZIA' INSTALLER'S NAME&PHONE NO. Lloa.9S rJ G au� C' SEPTIC TANK CAPACITY a LEACHING FACILITY: (type)-S rt OD Si tie14A1'4(size) NO. OF BEDROOMS Ch A mS e� BUILDER 0� PERMIT DATE: S'Z 3 COMPLIANCE DATE: Zf O 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-leachi g facility Feet Furnished by - ie�-o { F rT-) 1 i w 0 r v ^Y f ' No. F�/' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes / PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ✓ Application for Miopozal *p5tem Con5tructton i3ermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) EJ Complete System ❑Individual Components Location Address or Lot No. �,f S �/-*AAI* Owner's Name,Addre s and Tel.No. Assessor's Map/Parcel 2<� I is �e�ddre d Tel.No. n Designer's N e ddresss d Tedl.No. M`V RJ. Y'V G�G dac/ R.7 "'.tJ 6 r flG D(de�i 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank l Ty /e1of S.A a e/ Description of Soil P 614 s� lc¢f f ,4.d) Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to en constructio and mainten c e of the afore descr�bed on-site sewage disposal system in accordance with the provi ' ns of Title 5 of on enta de and not to place the system in operation until a Certifi- cate of Compliance has be is d by th' ar Signe Date ® d Application Approved by Date Z Application Disapproved for the following rea ns Permit No. 2,&U Date Issued " ^ FA No. / _ Fee } 'Xi. � Entered in computer: 'v THE COMMON"61,f - f MASSACHUSETTS Yes / PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ✓ ZIpprication for XDigpoza1-*p9;tent Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System ❑Ingividual Components Location Address or Lot No. / s e 9� Owner's Name,Add s and Tel.No. y ml,s (:5 �4s . Assessor's Map/Parcel 2 Q I Is N e ddre d Tel. Designer's Name ddress and Tel.No. y� �ss t�yp I/ g Ca4)'r r uC.'`K-r d� �NG '� aaJS��uc�r d� 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /J—U y _Type of Description of Soil AN �� x rl X 1�, c2 / B7i1 S <� 4- e4orf 1 f Nature of Repairs or Alterations(Answer when applicable) Date last inspected:',-" a ? Agreement: The undersigtiea agrees to ensure-theconstructio hand mainten ce of the afore described on-site sewage disposal system in'accocdance with4fie provis-i6nsof Title 5 ,f i onruenta de and not to place the system in operation until a Certifi- cate of Compliance has been is d b th' , ,`ar e > Signed Date 'Application Approved by Date Application Disapproved for the following rea ons Permit No. Date Issued y THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS f Certificate of (Compliance THIS IS TO R -at On Sew ge Disposal System Constructed( )Repaired ( X)Upgraded( ) Abandoned( b (�l a�E.1STi/ IIVA �r a"a �A1C" at "I �r u o t. �� �v e ry ou 15, has been construct9d in aecordance r �"o�-3� dated S" Z3 O with the pro ons�f T/iile 5 an •the for isposal Systerg�,Construction Permit No. Installer r� /i C a S �u r �ow . ,L�u C Designer 1� e��a, The issuancethis perinit shall not be construed as a guarantee that the syst 11 fu to s,,design d. Date Inspector No. / -------—27 �1I26 ----------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigoml *p5tem Construction Permit Permission is hereby granted to Constructt )IIRepair()( )Upgrade( ��)Abandon,( ) System located at �1 �u T o c 1� P /i l/9Ayg /S 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. Provided:Construction must a completed within three years of the date of this a it. Date: S�Z 3 (IApproved by ...........2,5 Of, TABLE T BARNS TABLE SEWAGE VILLAGE ASSESSOR'S & LOT "/ INSTALLER'S NAME NIE &PHONE NO. A)c 4J SEPTIC TANK CAPACITY T x)C(size) LEACHING FACILITY: (type) NO.OF BEDROOMS BUILDER 04 N COMPLIANCE bATF—, COWL i PERMITDATE:_ Sep4ration Distance Between the: Maximum Adjusted Groundwater Table to the Botio'ni of Leaching Facility feet.: any wells east Pnvate.Water Supply.W41 and Leaphi4 Facility:;. Feet or within 200 of.leaching facility) on site feet hi Ficility (If any etlands exist Edge of Wetland and*Leac ng w X1 hi 9 facility. . ,�I . Feet Z, within 300 fe!5;, hi F UMI 'Shed by q. . .... ...... �0 F 4J r FC MAP r �+ °•.. ,► I/6/99 NOTICE: This Form Is To Be Used For'the Repair Of Failed Septic Systems ;Only. CERTIFICATION OF SKETCH AND APPLICATION FORA DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) L �' , hereby certify that the pplication for disposal works construction permit signed by me dated concerning the property located at meets all of the following criteria: �• This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. C/• The soil is classified as CLASS I and.the percolation rate is less than or equal to 5 minutes per inch. �• There are no wetlands within 100 feet of the proposed septic system V• There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed �• There are no variances requested or needed. �• The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation..[Adjust the groundwater table using the Frimptor method when applicable] V• If the S.A.S.will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS information) 3 r 9 B) G.W. Elevation �., +the MAX. High G.W. Adjustment . J•Z = j`�• d1 DIFFERENCE BETWEEN A and l SIGNS DATE: `5 [Please Sketch propose n of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert �i T � . Dw , Y _ 1 I �} A 0 T OF BARNSTABLE WA SGE # LOCATION &LOT ASSES OR'S, VILLAGE S (JG 06a INSTALLER'S NAME&PHONE NO. ! I-/110 �c�1 SEPTIC TANK CAPACITY � . SOD �p�•�etc�"x) (size) LEACHING FACILITY: (typed Gh o w;e - NO.OF BEDROOMS— R�"z BUILDER O<§� (101 PERMIT DATE: Z 3� COMPLIANCE DATE: ® Separation Distance Between the: F Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 1 Well and Leaching Facility (If any wells exist Feet private Water Supply leaching facility) on site or within 200 feet°f Facility (If any wetlands exist Feet Edge of Wetland and Leaching within 300 fee hi facility, Furnished by -- 4 �C V 'ft� �•. n w, r. CIL Q C��J\ C LZei QJ t u� w. .Ca CATION SEWAGE PERMIT NO. VILLAGE I N S T A LIEN'S NAME i ADDRESS R UILDE R OR OWNER� DA T E P ERMIT ISSU E DG DATE COMPLIANCE ISSUED/6_/��(� No.$4 Fis...$... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... -own......................OF................ mt. bie ApplirFation for Disposal Works Tnnstrnrtiun Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 79...l uff .....02601................. ..............................•---._......---..._. _ ........................................•. Location•Address or Lot K No o. May..Rama...............................•...........-------•---------•------•-----: .79..�uf�o1?�.AY�.t; .....026Q1..........._.. Owner Address A..&..B Ces °O .Se_ryice..... 128Hyarmia,...MA.....Q2�41..... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..................3.......................Expansion Attic ( ) Garbage Grinder ( ) � Other—T e of Building No. of persons...........3............... Showers — Cafeteria a' Other fixtures .................................. ----------------------- W Design Flow............................................gallons per person per day. Total daily flow........................................._..gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2..............:.minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .....•---•••--•---------•---•----•-----•....................•--....--•-----------------------•--•---......................................................... oDescription of Soil.....................................Srtind...----------.....-----••---.....•--•-•••••-••--------•-•----------••---•-•-•-••-•---•-----•-------------............._.. x W UNature of Repairs or Alterations—Answer when applicable...i.Ut4l1atim..Qf..a.. stonepacked...each__R t...(overf], ......................•-----......----------•-•------•-•------•-----------------•-------------------------..............--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'L LE '5 of the State Sanitary Code— The undersigned further agrees nS, _9/ lace the system in operation until a Certificate of Compliance has issued by the bo f. h.Signed --a/8Q.._..._..... D to Application Approved By------ .... '.....��;�. ............................... -----------9/ 67$Q------------ Date Application Disapproved for the following reasons-----------------------------------------••-••-••-----•-.......--------------------------------•---........----=- ...................................................:..................................................................................................................................................... Date Permit No.__._.8......-•----•---•---------------••--•--•------.. Issued....................9 .QQ-.................. Date Fine $....S,QQ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town. ........ OF................ @be............... Applirattiun for DispuuFal Works Tuntrnr#ion nutit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 7.9..Suffolk-Ave..,�...Hxaririis.,.,NA___026QI..............•- Location-Address or Lot No. Mart....?..eves........................•----•--•----......---...............--•-------... M....Q26QL.---.....---- owner Address a A&.B-.Cesspool_.Service--------------------------------------------•-• 12fi Bishops_. e.. ��►...#�3! >a .> ,..I Q 6Q�..... Installer Address UType of Building Size Lot...........................S q. feet �--� Dwelling—No. of Bedrooms................... .......................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of persons .............. Showers YP g ---------------------------• P ( ) — Cafeteria ( ) dOther fixtures -----•------------------•------•---•----------------.....--------------...---•--------------------•-----.................- ......._.. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground wa ter........................ G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------- --------------••-•----•----------•----..------------------------•------------ --•-•-• ----•---------••----•---------------------- --- ODescription of Soil.....................................S -•-••----•--•---.....•---.....------•-•------•-••-•------•--•--•---••-•-•••.............................................. W U Nature of Repairs or Alteratio s—Answe when applicable.-Anst4lat on--of•a--1,0o0._&aj.ojj__pjV stonehacked leach •pit (overflow).-------------------------•--••-----------------------• ----------------•--•----------------------------................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT ITZ5 of the State Sanitary Code— The undersigned furtl.er agrees not to place the system in operation until a Certificate of Compliance has been issued by the board'of health. s Si ed.f E!../ " = QJ S,(8o •-••-•-•----•-- •--....__ . .- ............ ,y D to Application Approved By.............. a .....r''�!- -_91-880------------ Date Application Disapproved for the following reasons---------------------------------------------------------------------------------•--.._..._............••--•-••-- ---------•----------•-•-•--------•----------•----•-••------------•--------------------------•--------•------•-------•--••---------••------•-----•-•-•-•--------•---•-••--•----------•••--••----•----•--- Date Permit No......80' _...._. / ...-----•--•------------------------ Issued..-----------------•-9-J--•VcS0_......._..-•------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................Town..........OF............%rnstable _..�... .................................................... fierr�gfirtt�le of f�unt�rli�nr�e A 1HiS Tp'�06 .jE9jjFiYceThjt�*e�nd vidua]r�e eEDiwossall gste con d or aired $P I y '' , !A � � 7�15-b (-by-------------------------------------------------I ------ -- - --------- ------•-•-••••----•---•-••••--•-----.....---•--••••-•....---------•-_.... 79 Suffolk Ave., Hyannis, MA 026ol - ftft�Cy Neves at...................................................................................................................................................................................................... has been installed in accordance with the provisions of T T F 5 of The State Sanitary Code/as escribed in the application for Disposal Works Construction Permit No....... .................. dated------- 80 _ _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GU RANTEE THAT THE SYSTEM id111ILL FUNCTION SATISFACTORY. ': — ifi �— fS_f6 DATE.............•. Inspector.. •-•••--•••-••---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH $S- Town Barnstable .........................................OF....................._........................._..................................... No...................=.. FEE..........00....... Disposal Works Touts ion "[unfit A & B Cesspool Service Permission is hereby granted -- -- -- ------------------ •.---- . to Cons c ) ai� y an Indi li uab ��r�ge D's osy Svsvte at No... �a�ffo �...... H �nnis - .•-•--•----•---•....................................--••••---- ------•--- Street as shown on the application for Disposal Works Constructi rmit No.....80........... Dated.9�_.8�8°........................ 9/9/80 U arORHlth DATE................................................................................ FORM 125E HOBBS & WARREN. INC.. PUBLISHERS BENCHMARK SOIL TEST SOIL TEST #2 20 FT. MINIMUM FROM CELLAR 100.00 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST 6J,(0y.___-_ DATE OF SOIL TEST TOP OF FOUNDATION 8J29L5-_ ELEV. = r-CLEAN SANG 4" PVC PIPE PAINTED SOIL TEST DONE BY CRAlC R_ SNOR T_P SOIL TEST DONE BY (ZRAIG R. SNORT.P., (ASSUMED) CONCRETE r-OBSERVATION PIPE FLAT DARK GREEN OR WITNESSED BY -LW1)E5M/9RAI5_-_- WITNESSED BY ---D-QN-DESMA-"---- COVERS LOAM AND SEED BROWN WTH CARBON __ 4" SCHEDULE 40 PVC PIPE FILTER IS REQUIRED OBSERVATION HOSE 1 ELEv.=__9e.s_ OBSERVATION HOLE 2 ELEv.=_ 99.00 MIN. PITCH 1/8" PER FT. 2" LAYER OF PERCOLATION RATE < 2_ MIN./INCH AT INCHES PERCOLATION RATE < 2- MIN./INCH AT 42-54 - INCHES 1/8" TO 1/2 DEPTH HQRIZ TEXTURE COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 9.00 MAX. WASHED STONE 24" 4" CAST IRON PIPE 98,5 MIN. _ I 3' 0 ORGANIC ROOTS I (OR EQUAL) MINIMUM PITCH ' /4' PER FT, z 8' A LOAMY SAND 10YR3 3 NO ROOTS DD ZABEL FILTER,-, N I 6' A LOAMY SAND 10YR 5 1 NO ROOTS i 1 ----- FLOW LINE 95.76 III 10" ELEV. = 98.00 MIN �" E`- -EXISTo MATCH 24' 8 FOAMY SAND 10YR5 6 NO 24' 8 `LOAMY SAND 10YR6/8 NO ROOTS i EXISTING -T ----------- o -- ---- ELEV. -- EXIST 'll ------- LEVEL I c 3 �3>a� 10 - ---- _ =- _ 94.43 EXISTING ELEV. - -� ADD GA ELEV. _ _97.30 - 6' SUMP ELEV. - _97.13 - _ _ _.__ BAFFLE WAS DISTRIBUTION c �. ' . 1 38 Cl LOAMY SAND tOYR 6 4 NO ROOTS EXISTING ELEV. _ /ADD TWO HIGH CAPACITY INFILTRATORS j �L'QUID OUTLET BOX Q WITH STONE TO EXIS77NG S.A.S. 7 93' TC BE WATER TESTED IDFPTH TEE EXISTING FOA' A B' X 15' X l0"TRENCH FORMA TION 144' C AR SAN 10YR 8 4 NO W ORA 132 C2 COARSE SAND 110YR 6 6 NO 4 FEET 14 INCHES IF MORE THAN ONE OUTLET 5 FEET 19 INCHES - � 1500 GALLO WELL_N A _ NO WATER ENCOUNTERED AT 1L ELEV. _ .--_ &Cn 6 FEET 24 INCHES !TO BE PLACED ON FIRM BASE) � SOIL ABSORPTION NO WATER ENCOUNTERED AT _-_12: ELEV. _ __8d.;� 7 FEET 29 INCHES ZONE �_ 8 FEET 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" CLEAN INDEX X EXISTING DOUBLE WASHED STONE SYSTEM (SAS) ADJUST_X DESIGN CALCULATIONS PER "AS BUILT" FREE OF FINES & SILT _ NUMBER OF BEDROOMS 3 EXISTIba-,�QDiNG 1-4 USGS PROBABLE WATER TABLE ELEV. _ _blr:A__ G.A.RBAGE DISPOSAL Cl/Vfr NO, ISIM-ALLOWED SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. lk . TOTAL ES77MATEED FLOW NOT TO SCALE BOTTOM OF TEST HOLE ELEV. _ �Q_ (110 GAL./9R.IDAY X 4_ Bit) _4-40 _ GAL./bAY REQUIRED SEPTIC TANK CAPACITY _1500_ GAL EXISTING ACTUAL SEP77C TANK CAPACITY 1500 GAL. EXISTING SOIL CLASSIFICA77ON -I DESIGN PERCOLA 770N RA 7F S.i_ M/N./ZNCH EFFL UEN T LOADING RA TE -02-1 GAL.IV A Y/S.F, EXIS77NG LEACH AREA LEACHING AREA TO BE RODEO I5"1-1 S0. FT. D ^ ! E. Tcn (8.8' X 46') + (100.8' X 10'/12') - 488.4 SF (8' X 15') + (46' X 10'/12`) V G✓ LEACHING CAPACITY _11L GAL/DA Y VJNEYAR -� CONSTR� 99-0' 488.4 SF X 0.74 - 361 GAL/DAY PES t� C 98.8 TION NOTEJ:(8' XE82r+G 40�X 10'/12-)) 0.74: GAL./bAY N O 4,� �� CAL CUL A TIQNS PER 200 J AS BU1L?~" PAR r + ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND f N 76 25 RE SER liF S.A.S AREA " 8' 6? THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 10.3, 100.0 2, ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. S.T. 2 ' j. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF 1 ' DRIVES 0R PARKING AREAS.PARKING ARE OADING SHALL BE USED UNDER OR WITHIN R DRIVES I �+. 99.3 ' 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED AIN PLACE. g�"0 l 99.2 t ,. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR 'ONING REGULATIONS- OWNER / APPLICANT IS TO OBTAIN SUCH 20' MIN C • 99 0 DETERMINATION FROM APPROPRIATE AUTHORITY, 99.3 6. UTILITIES SHOWN ARE ,APPROXIMATE ONLY, EXCAVATION CONTRACTOR 15 TO _- CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. %6.5 7 CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE I BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 1 I g. PARCEL IS IN FLOOD ZONE _ _ C 99.b -V 1 99 0 ! g. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL ` EW F'LL CE cAR m ,+0. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER,ANO FOR A cgs 6- o MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM, AND BE EXISTING , , BOX GECK 140 �-q c� 8.2 z REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) (I.E. TITLE 5) iF i SA.S. 1 S 1 1/ -8 i �_ C ENCOUNTERED BELOW S.A.S. PIPE INVERT. I , 1, ` I £XiSTItrGI EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND OR REMOVED. --'98 DYYFLL/NG I 97,9 +2. A ZABEL A1800 FILTER IS TO BE INSTALLED. 1 _ I - a' F_X/STING 99i1 I�� Q--�B � 'J. CONTRACTOR TO PROVIDE SHORING AS NEEDED TO PROTECT BUILDING AND PROPERTY LINE. I �;/ SEP77C TANK qg O 5, +4 CONTRACTOR TO UNCOVER TANK OUTLET TO CONFIRM ELEVATION BEFORE PROPOSED --1� }l I "1 CRAWL SPACE 16 zc ytki OF +yi1� _' �• INSTALLING S.A.S. RJ4tei � r AOD177ONAL S.A.S I 1 1'1_ 7� '' URAIG �'• WI LI fJ ` S r J' ahORT Ir s G T � DRIVEWAY N CIVIL , N c34 APPROVED: BOARD OF HEALTH 1 t/EN 'JO. 27483 i E Ste' 1 EXiS nNG . >� 1. 4PGF 7REE GAS LINE 97,5 GARAGE SLAB �-�' AGENT ._-- �� � ' z!L � DATE 1 i� z �f i�. a33 /2 �cy.3� 2757-0l� LEGEND: ARGE TREE-- qb97�7 PROPOSED SEPTIC DESIGN TOWN 'WATER- * WATER SHUT-OFF 31 9 97.9 9' 3 FOP? I WATER 'VALVUE � � GAS LINE- -" -- 97.7 NELSON ANDREW.S' I ti - GAS METER 2 GAS VALVE 1�'. ELECTRIC LINE E -E -- W, i R°�� FLOC 79 SUFFOLK AVE _ ^' ELECTRIC METER . . . . • Q ELECTRIC BOX I 1 103 . . . . ` I i MASS"ELECTRIC MANHOLE . . . . . ® L­­BARNSTAELE� - -- CATCH BASIN _ cr,� � 1 CESSPOOL . . . . . .tt. . . . Q . 1. LEACH PIT • � � CRAJtG R. SHORT, P. E AN T F�'C.o N�E� ^,j_5 GREA T WESTERN ROAD CLE Ou IRE EXISTING SPOT ELEVATION x 0.0 `'^ M P. 0. BOX ,'044 fox. SITE PLAN EXISTING CONTOUR (O.0)-- 20 0 fo 20 LOCUS � �P P 508.J98.eJ" SOUTH ✓ENN/S, MASS, 02660 508.J98J06J FINAL SPOT ELEVATION L L - 1 FINAL CONTOUR- ill----- SCALE ! I,VCH = 20 FEET a ffE 6'� 2 15 ALE 1 = 20' FLAGPOLE. . . . . . . .r. . f -J HYDRANT. . . . .. .. . . .. . . . . LIGHTPOST . . . . .. . . ..1� REV. JDWE 2g, 00 JOB N0 1_1013 MANHOLE . . . . . . .. . . O CBS. WELL. I I SEWER LINE-s J --s --- _ SEWER MANHOLE C �- LOCATION MAP REv. SOIL TEST LOCATION- 1 SHEET 1 OF 1 TELEPHONE BOX Q j UTILITY POLE: `'7:b FLE NAME J2005 CRAIG R. SHORT,_P.E. V 05 In.. ., . - . _ _ -..... , . . .--......a_r..-.:arr_...:._..>t �,.a.,: a_L.. :..�c,-.:.r--.,ea.na....,r.a►or-�...at,..�-•-.a.s..7,.w_,. y..., ..: _`, - .,.' ',-.. 3-'�-+�s�iz s-4� ��.'ffi�. tall- w 3.. w } :+•�