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HomeMy WebLinkAbout0070 WALTON AVENUE - Health 70 WALTON AVE.,HYANNIS A=310.025 I i y i 0 I i A Town of Barnstable Pi, 3 V Department of Regulatory Services ..�„�t.�,= Public Health Division Date 7 � .e19. �i' 200 Main Street,Hyannis MA 02601 Date Scheduled t Time Fee Pd. /0 0 ' Soil Suitability Assessment for Se ge D posal Performed By: Witnessed By: � A✓ 'LOCAT_ION&_GENER_AL INFORMATION!: Location Address Owner's Name 1 10 Address `y-,•,�p,V_ 1�,'li�F,'J p,�A ��M Ian` why `�®'10�``UY` ,-y Assessor's Map/Parcel: t�l Engineer's Name Q r, ^ J0 "'&J NEW CONSTRUCTION REPAIR Telephone# � AL1.m C l� ' Land Use 1 Slopes(%) 2% Surface Stones L i Distances from: Open Water Body ft Possible Wet Area3Qt-ft Drinking Water Well L'71:C/' ft `r Drainage Way 2 ft Property Line 10+ft Other ft SKETCH:(Street name,,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) Cs M PaSS C,,root, TP-I TIP.2 It ot T®3 V_y - cs D.o L },t dp Parent material(geologic) Gc. U i'S Depth to Bedrock 2j3D+ Depth to Groundwater: Standing Water in Hole: Ndl� Weeping from Pit Face Estimated Seasonal High Groundwater-I A DETERMINATION FOR SEASONAL HIGH WATER,TABLE,; 1 !, 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 PERCOLATION TEST, t;_ - Date 1_�oroi Observation _1 Hole# 1 `��`11� Time at 9" Depth of Perc ` Y6, 4V' Time at 6" Start Pre-soak Time Q 01100 %00 Time(9"-6") End Pre-soak 'J:00 15,100 Rate Min./Inch �1 u` 1,14,� Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) 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.:\SEPTIC\PERCFORM.DOC ;DEEP OBSERVATION HOLE LOG Hole#. _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. J Consistency.%Graven 0-3 A F M LS I'D 142-1. 3-30 g MSL 10 J1,414 30 - 1►Z C, N1 S,"A 10 q IZ s/(, 30°). (Pvv at 11J�- ILO CL M 5w� 10 A IZ 4& 4VI DEEP OBSERVATION HOLE LOG L.t, Hole# j Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) D-14 MLS 10 Ala-'JI, 4-3) MSL 1,u y2 411 32-ho lA re. C)(. DEEP OBSERVATION HOLE LOG—I 1 Hole Depth from Soil Hcrizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) F-M LS 10 0-L/, �- 3 2 M SL to y a-"jy 32- 114, C, M Say1 I a y(L")t. 3A Grx.v�i 14 -110 C,. M S4111 LD DEEP.OBSERVATION HOLE LOG I:"' Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) o -�s (� F-M LS 19'1e,11, 1� C3 MSL I'D yQ 414 Z - Ily C. ylSe,-j 1,0 1 C,z, M S61_lj I I Flood Insurance Rate Map: 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 pervl s material exist in all areas observed throughout the area proposed for the soil absorption system? Na If not,what is the depth of naturally occurring pervious material? Certification I certify that on ZOOL (date)I have passed the soil evaluator examination approved by the Department of En ironmental Protection and that the above analysis was performed by me consistent with the required traini g,expertise and perience described in 310 CMR 15.017. Signature Date �1 Q:\SEPTIC\PERCFORM.DOC TOWN OF BARNSTABLE G LOCATION ' 0 LILA, h SEWAGE # VILLAGE I S ASSESSOR'S MAP& LOT 3 lCo- b a, INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ( vt -� ( (�-s (size) NO.OF BEDROOMS a ;� BUILDER OR OWNER 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 LFurnished by � J � J v S i I � ,e,i5 . No. / 9 1-7 E.• . y` ; Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(pprication for Zigaar *p5tem Construction Verna Application for a Permit to Construct( )Repair( --<Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. '2OW 4F(Y- k 4l/C' Owner's Name,Add s and Tel.No. Assessor's Map/Parcel 3 f 0 _O 'Z S <07 d 1 p Installer's Name,Address,and Tel.No. -7 qD^116 Y Designer's Name,Address and Tel.No. r r l /,G/Lo 4 e!(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 Type of S.A.S. f �g� 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 not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo of Hea Signed Date Application Approved by o Date Application Disapproved for the following reasons Permit No. — F Date Issued r ` No. ! �- [iJ '_....fir. 3( O y m _.� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS f; 01ppYication for 3Digpoml *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. "70461 4_h`41 k 4vC Owner's Na/(me,Addr/eJ�s and Tel.No. Assessor's Map/Parcel J 1,::::) - p Z 5" 07 Installer's Name,Address,and Tel.No. 7 q�� SS ( Designer's Name,Address and Tel.No. -442 ;Ike 4 e-G r 7 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 .5 D G 1 4-1 Type of S.A.S. Description of Soil Nature of Repairs or Alteratio�s?CAnswer'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 not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo of Hea k Signed Date �✓'�'9 Application Approved by ...... ��- Date Application Disapproved for the following reasons Permit No. g Ff r 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( ) Abandoned( )by 1'�A 1 'fie L<f4 f` q at `7 O Lo-Q ) Job /9J 2 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector 1 ---------------------------------------- - No. 1 -7 Fee _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'Wioogar *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair(>r)Upgrade( )Abandon( ) System located at 7/2 W 449h &,f r Jand 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 be completed within three years of the date of this permit. Date: -- �"/ a 9`� Approved by N �-�-> Q / TOWN OF BARNSTABLE .G LOCATION 70 rO h SEWAGE # !9- 17 VILLAGE a 0 yl I S ASSESSOR'S MAP &LOT INSTALLER'S,NAME&PHONE NO. IaI' C SEPTIC TANK CAPACITY 01 © 0 LEACHING FACILITY: (type) t4 K -C ( ( w (size) NO.OF BEDROOMS BUILDER OR OWNER Z) /1 PERMPTDATE: I Cf L? 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 �(UL( S F 6 fir ` D - 50 6 ' s G q5 ` -41 b n 1/6/99 �l NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) e hereby certify that the application for disposal works construction permit signed by me dated 5- — Z ` g l concerning the property located at "7 0 w cZ I +o w k4' meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • 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 • 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] • 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) B) G.W.Elevation 9U +the MAX.High G.W. Adjustment. _ DIFFERENCE BETWEEN A and B 72 6 SIGNED : DATE: tl [Sketch proposed plan of system on back]. q:health folder:cert - Rte 132 Air ort 1 Route 28 Route Q a w LOCUS w m o ,sue � z Bearses Way ',. Locus Map N. T.S. I NOTES. Parcel is not within Zone 11 Contribution Zone: RB Min Area 43,560 Sq. Ft. Min Fron tage 20' Min Width 100' Setbacks .Fron t 20' F d Side 10' CB/nDH Rear 10' S 7070 41 , I ��O' Owner of Record Lot 10---B Janet F. Farrenkoff 15, 655± S Ft. Deed Reference q -� Cert. 183436 d Plan Reference CBDH LC Plan 17201D Sh t 1 Lot B-10 ^Q g d � Z _ ® r" Hs 0 "- �" ASSESSORS MAP 310 LOT 25 0 / __ 4° -� 60,po— G Gas �^^^, ^ Plo t Plan _.._. .L.zr�e .�,�, .-_� �° ° Shea Deck , --w....^ �, � for • 1 r ` �' i C , O Pa wed D/W .. Proposed A d dz tl on �__ ___._ ti oo � ^Q ".., In rrls t a bl e, MA F d -------- ----,A, 1 SAS Per Septie (� .As--Built on .Record � Located A t Proposed 70 Walton Avenue l ti Addition Boa 10 Hyannis, MA 02601' 41 yP -" Applicant Janet F. Farre.nkoff 70 Walton Avenue Hyannis, MA 02601 SCALE` I" = 20' DATE,• March 4, 2011 NOTE" PREPARED BY LOCATION OF UTILITIES IS APPROXIMATE AND ALL -%NOF A & M Land Services 618 Main Street West Yarmouth, MA 02673 UNDERGROUND AND OVERHEAD UTILITIES MUST BE WINMLo G Ph. (508) 737-1777 - anmlandOcomcast.net DETERMINED IN THE FIELD PRIOR TO COMMENCEMENT .o y OF ANY WORK, THIS INCLUDES, BUT NOT LIMITED TO 8040 REQUESTS TO DIGSAFE, ANY PRIVATE UTILITY COMPANIES GRAPHIC SCALE 20 0 10 20 40 80 AND THE LOCAL WATER DEPARTMENT. 71 { IN FEET ) 1 inch = 20 ft. Diwg. { 5036.dwg