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0404 YARMOUTH ROAD - Health
404 Yarmouth Road Hyannis, A = 344 013 - 1 f 4 �I TOWN OF BARNSTABLE LOCATION / ?1fz SEWAGE # ( '(/ VILLAGE ASSESSOR'S & LO �O INS A EIt'S.N -&PHONE NO. Y& �c� SEMp TANK CAPACITY LE�CHIIWG F�CII.TTY:(type) size) NO*.BEDROOMS _ BUELDER.OR OWNER ' PEFE IIT:DATE' p � COMPLIANCE DATE: Separation Distance i$etween the: Maximu tt Ad joted,Grovndwater Table io the Bottom of Leaching Facility Feet -private Water Supply Well and Leaching Facility (If any wells exist -on ate&within 200 feet of leaching facility) Feet Edge of Wdiffitid.and Leaching Facility(Itany.wedands'exisr within.'30. et.of.leaching'N*,'610) Feet Furnished Y. b. > `` ' v� � � �. ':� � - � - , �, -� G 11 �c` V� �iJ � � C No. 9,QC3 4 t3, r' s FEE 50 Board of Health, � OCV-i&Ar0.b4Q MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair>4CUpgrade( ) Abandon( ) - )<Complete System ❑Individual Components Location Owner's Name Mfj..4 Er M Map/Parcel# 3-4 4- Address Lot# NIA Telephone# Installer's Name Designer's Name , 4A 5a Address W A Address I-p O M A Telephone# 91 (a _OZ 00 Telephone# —0 Q Type of Building ,�►�enQ� Lot Size 8.Q38 sq.ft. Dwelling-No.of Bedrooms �ACi2Q- Garbag grinder Other-Type of Building None- No.of persons Showers (Cafeteria ( Other Fixtures Low a--ow?, 6 re-"E,wl So k .LAt)-t gi. Design Flow(min.required) gpd Calculated design flow 3So Design flow provided 331. 6 gpd Plan: Date Number of sheets Revision Date Title ,t Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator iP►QM Y Date of Evaluation 3 IZA 04 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees t�install the abov. described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to no �� lace,the sys in operation until a Certificate of Comp ance has been issued by the Board of Health. Signed Date :7 Inspections •0_7' '" (d .� '�'ir'l�i�(1.�'�3"' 7�"�.ry�+"'�7yyj� W�•^ 'vdpa1�����K�� ri.r�V:f�r`'�r'--•-.'. No. a �C..O� 4 iE E: w- + '" t FEE 5© ;.y+t+d COMMONWEALTH ®FMASSACHUSETTS Board of Health, C�� �A�4C MA. APPLICATION FOR DISPOSAL SYSTEMCONSTRUCTION PERMIT Application for a Permit to Construct( ) RepairKUpgrade( ) Abandon( ) - ,Complete System ❑Individual Components Awl Location Q Qt � v± QC11��S Owner's Name Map/Parcel# 5.4 o 12) V. Address A E Lot# tilA Telephone# Installer's Name ;�Cci ts4- C. Designer's Name S AA AY Foot M(-)Me✓A0A &CS Address. * he.1 K �.? "-new Ic" Address 7 Q F�'(vDoA-k,, M A Telephone#N a,LA (p -p�8 pQ Telephone# SHB_U_19 b QQ om.. Type,of Building 1 S1 C1e 1 Lot Size 8113� e 'sq.fr. n. .Dwelli g No.of Bedrooms �"l �_ ) Garba grinder Af/A Other=Type of Building ®i 1 e No.of persons Showers (Cafeteria (V `''^ •,,,,Otl%er,�Flxtures�".." t��� � 'r0 fL� , f'G1 T"C 1-Ir nd �tl �: LA U 1J Oa-� Design Flow (min.required) - D gpd Calculated design flown Design flow provided J 1. B gpd Plan: Date I y + Number of sheets Revision Date Title v t C6�c��QC\ c� '"�"�C �1 �Qlti1 �PC�C�Q ,► 'Y' Description of Soil(s) � Soil Evaluator Form No. Name of Soil Evaluator 66eM CA SN AY Date of Evaluation !17-1 04 DESCRIPTION OF REPAIRS OR ALTERATIONS A-0 � I It I The undersigned agreees,fo install ltthe ab/ydescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to novti,`place the sys e1h in operation until a Certificate of om 'ance has been issued by the Board of Health. Signed ----, Date ?�7 O Inspections _',,�-_._=;3;;��u.,...:_....._.�`.:= �.w-==:».-lv.�_�_-__.�_.s.—�«,.�--_._�-.mac-.-<...-.�.,__._.:.-..,.�..ir.c.---. �....�-T--�-�'rw,:,.:4;k.�,,.r-_..��"m��-+� ...';`�•—. ... ��-._..mac....-�-�a_ No. _ dAJ"' ro+"5 �7 FEE J " J COMMONWEALTH OF MASSACHUSETTS Board of Health, !S r_r�+ G MA. r CERTIFICATE ®f COMPLIANCE description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired (VY,Upgraded ( ),Abandoned ( ) by: at 1/) V, ►M.ist / has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. a�UJ`Y `/� dated 3/2 VA) t'I . Approved Design Flow (gpd) Installer r (^\ 0 b //.. j� Designer: Inspector: �` .li t/ !U D?�" Date:tiA V �✓ f The issuance of this permit shall not be construed as a guars ee that the system will function as designed. No. c � FEE �© COMMONWEALT14 ®F MA SACHUSETTS Board of Health, LJ' ''�^�S Ia �Q MA. DISPOSAL SYSHM CONSTRUCTION PERMIT Permission is hereby granted to; Construc ) Repairpej Upgrade( ) Abandon( ) an individual sewage disposal system at �`' G�-r l y`hn15 as described in the application for t Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of thi�,-permil ocal conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date3A9Adoq Board of Health`- i TOWN OF BARNSTABLE LOCATION t / SEWAGE # VILLAGE ASSESSOR'S &LO D j,,M-S.N &PHONI;NO. �. SI Ptn TANK•CAPACITY LF,A�GHII�I?G-. ? ►CI] II"Y:'�tyPe) 1 ize) NO..:&.B'EDROOMS w BU LDEIt:OR OWNER PEl&1TDATE:'. '" ' COMPLIANCE DATE: Separation Distance$e�iveeI. Maximu 6ted•.Groandwater Table io the Bottom of Leaching Facility Feet f �•Private Water Supply Well and Leaching Facility (If any wells exist n site or within 200 feet of leaching facillt')' Feet 13dge qjW-6tftd.and Leaching Facility(K..ady.wetlands`ezisr within.;;. et.of.leaching facility) Feet Furnishedbyiz-1:2 o ,_5'y rr � AV f Town of Barnstable oFtF,E r Regulatory Services Thomas F.Geiler,Director 9 I BARNSTABLE, MASS. Public Health Division i659• ♦� AIFo �A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 3 O y Designer: eulszcvy�1 Installer: �C%AS , , Svc 5. Address: 5LJ s Lpc�q Address: M PA O 5�- On_U 1���'� ��� was issued a permit to install a (date) (in ller) septic system at 4�04 ycsxy-,on-��& s based on a design drawn by (address) y�-�n ��J•ccx�cY�c���, dated 61 oLP (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. \ZH OF MgSSq C CARMEN tiGN (Installer's Signature) o E. A SHR( No. 1181 �G I s S Sg \P esigner's Signature) (Affix Desi s 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 SECTION A -A 10' min from - `NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. VENT PIPE (O Least 24 inches toll)-'-- ALL OUTLET PIPES FROM THE a Schedule 40 Pvc W/Charcool odor filter PROFILE VIEW OF ADDITION TO LEACHING SYSTEM DISTROUTKMN Box SHALL BE 12• __ CONCRETE COVER s.hraae' EXIstWV Foundotbn house to septic tank _ a tr �.,•: Septic tank covers must be SET t£VEL FOR AT LEAST 2 FT. ro A •.r tone CONCRETE FLOOR = ELEV. 1D0.00 (Assumed) 3" of 1/8" - 1/2" Washed Pe Stone I IIVmt within 6 In. of finished grade r (Xok raver Septic frank - 96.50 Grade over D--Boz - 96.00 ode over SAS - 96.00 3/4" t0 1 1/2 " Washed Crushed Stone I 3 - 5.OUTLET '''•-'-'y'-i'• 2 '�• 1��1'C'95ttMfb f° KNOCKO0IS - �,' ey A° 4- PVC (CAPPED) INSPECTION FORT TO BE S.5- , 12" INLET 1 INSTALLED AND TD BE `AATHIN 6. OF GRADE t ��T ' I �^i _ 1 S - 0,02 3 HOLE H-10 T Top Load - Elev. =93-75 ` f :f _- _ _ DIST. BOX 3' Maximum Cover _ `.-� ';„' 6_ _ia- p c M !'tatNtouth ----- NEW S>=0.01 or Great, ///���Top of SAS - Elev. _93.25 - -" t� i EXIST, PIPE- `' to 1a � 1.500 GAL. - S- 0.01, per foot `-1�5-- 4" - SCH. 40 Te 1.75 n O 28' 0' Effective Depth J FROM Ex,aT. FOUNDATION ,,-, SEPTIC TANK 0 0 _ 5 Units e 6.25 30' _PLAN SECTION CROSS-SECTION ;• �� -- > It U CONCRETE FULL. FOUND. v n rn N 0.83' (10 inches) 31.25' '` 3 HOLE H-10 DISTRIBUTION BOX ww / SYSTEM PROFILE 8 k'of 3/4"-' ,/r " II 37.z5' Isom 'c compacted stone ; d m Effective Le th NOT TO SCALE :, Not to Scale - c u m son 404*601, > n 4' -� 4' SOIL ABSORPTION SYSTEM (SAS) D aatwhdrekr\acaroar 6 in.of 3/4"-1 1/2* 05 INFILTATR❑R HIGH CAPACITY (H-10 L❑ADING)/ GE❑RGE ❑'BRIEN GENERAL NOTES compacted stone EFFective vkfth OR EQUIVALENT Not to Scale NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE w o ( ) 1. Contractor IS responsible far Digsafe notification Bottom of Test Hob 1 Elev.-85.00 m NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10" and protection Of all underground utilities and pipes. ♦Obs. Groundwater - Test Hole 1 Elev.= NONE OBSERVED 2. The septic tank and distri ution box shall be set level on 6" of 3/4"-1 112" stone. 3. Backfill should be clean sand or gravel with no -_ _----.__--- ----I stones over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance P E R C 0 LAT I 0 N TEST with Title V of the Massachusetts state code, the approved plan and Local Regulations. 6. If, during installation the contractor encounters any Date of Percolation Test: MARCH 12. 2004 soil conditions or site conditions that are different Test Performed By. CARMEN E. SHAY, R.S., C.S.E. from those shown on the soil log or i Results Witnessed By. WAIVER (per BARNSTABLE B.O.H.) Excavated By. SHAY ENVIRONMENTAL SERVICES, INC. N/F EDWARD HIGGINS installation must haft & immediate notification be our design Percolation Rate: Less Than <2 MPI mode to Carmen E. Shay - Environmental Services, Inc. 7. No vehicle or heavy machinery shall drive over the septic system unless noted as H-20 septic components. 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. Test Hole 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. NO. 1 10. All solid piping, tees & fittings shall be 4" diameter DEPTH SOLOS ELEV. o � rp Schedule 40 NSF PVC i with water tight joints. 0 96.00 o a pipes 9 Sandy \ �� �; 1 Nlt �9d O5' 30" E a� 11. Municipal Water Is Connected to ALL OF The Residence and Abutting Properties Within 150 Feet. Loam IZ o"-s" 10 YR 3/2 Ar 95.50 \ ' 1 \\ TEST HOLE #1 h THE PROPERTY LINES ARE APPROXIMATE AND \\ + \ ELEV.= 96.00 COMPILED FROM THE SURVEY PLAN GENERATED BY Loamy w WHITNEY & BASSETT of HYANNIS, MA 10 ,rR 5/6 �\ \\� i \1 3Sand 7.25' \\ 0' E DATED JUNE"PLAN 1946,FPLAN LAND BOOK 88, PAGE n13. 6'- 36" 8e 93.00 �\ ; 4' CO AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN ko Med. w �` 1 4, _ �' IT SHOULD BE USED FOR NO PURPOSE OTHER THAN Sand \ I I ' ' e: THE SEPTIC SYSTEM INSTALLATION. 2.5 r 6/5 5.00 136"- 132 G � �\ EXISTING CESSPOOLS TO BE PUMPED OUT AND \ r' C,O1 D-Box 4" PVC FILLED IN PLACE. Vent Pipe NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE \ 10 1 \ FROM THE EXISTING CESSPOOLS TO BE DISPOSED \'\ i Fail ''� 1 GRAVEL p \��\ OF AS PER BOARD OF HEALTH SPECIFICATIONS. \ h i CeSsp al ; DRIVEWAY o6 �.9 ��\ "10 WETLANDS RE PRESENT WITHIN 200' OF THE PROPFRTY 1- PROJECT BENCH MARK i i I i 1, N/F Manuel Montiero -- -- I ASSESSORS MAP 344, PARCEL 013 WALK OUT BASEMENT FLOOR Perc #1 ELEV. = 100.00 (Assumed) I r' 1 LEGEND Depth to Perc: 36" to 54" Perc Rate= Less Than 2 MPI ,�' \��<•' 0 0 Observed ESHWTO - NONE OBS.- 132" Assumed I i �'� �y�/ q� 1 DENOTES PROPOSED ' 104X1 ADJUSTED H2O Elev. = NONE OBS. - 132" Assumed I tsoo gal. 9$ ' SPOT GRADE I ,( I � _ Seeptpt ic Tonle 1 1 DENOTES EXISTING x 104.46 SPOT GRADE 1 PL PROPERTY LINE HOUSE #404 \ PROPOSED CONTOUR (ZO'i I ��' EXISTLVG �0 EXISTING CONTOUR - -- - ---- I i,.' 3 BEDROOMi - - - - - -97 I HOUSE 3-2+• o+AkN. ACCESS MANHOLES DEEP TEST HOLE & Oz PERCOLATION TEST LOCATION ' ' 1 w -li� -104 6 FOOT STOCKADE FENCE UJ I _ Q �y i Q > I cr I �' AsAess. Map 344 Lot 13 INLET 00 1 1 0 Q 1 1 d 1 1 I \I % p 118,938 Square Feet �. 3 I I A t THE ACCESS COVERS FOR THE SEPTIC TANK, �^- -x LOT PLAN ^� '-�` DISTRIBUTION BOX AND LEACHING COMPONENT I \��/ I \\ 70.00' , O I 1 P SHALL BE RAISED TO WITHIN 6" OF I I •E t5 j \\ STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. I I T1 PL - O F PROPOSED SEPTIC SYSTEM UPGRADE PLAN VIEW INSTALL TUF-TITS GAS BAFFLES OR EQUALS ; N 29d 46' 00" E \� ON ALL OUTLET TEE ENDS �i I i I �� }24- REMovAe� COVERS� I I PREPARED FOR - ` -- YARM0 �TTH R OAD MR . MANUEL MONTIERO mh deorance I IS M4ET Ira ET e`mi7 Jr min. Inlet to sullen � I AT NL> -,� r- ,� OUTLET - #404 YA R M O U T H ROAD I tr (50 FOOT `SIGHT OF WAY) 5' �- 1- I `5' -Y Eo I - 4*-0' min. HYANNIS , MA Llqukl depth Design Calculations �ZH OF htgss PREPARED BY: lo,-Cr Y 5' -8• Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) �,�, ^ icy\ CAR L'N E. SHAY 'lt •� `- ` Garbage Grinder: No E u�• CROSS SECTION END-SECTION Leaching Capacity Proposed: 330 Gal /Day Minimum (Min. Per Title V) Septic Tank : - 3 x 330 Gal./Day = 660 USE NEW 1,500 GAL. Septi(. Tank. 0 20 40 50 a Sf' ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch 0 , A r TYPICAL 1 500 GALLON SEPTIC TANK Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons -- --- R T o + P.O. BOX 627 ER Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons fs EAST FALMOUIN MA 02 J 56 NOT TO SCALE Providing: = 331.80 gallons glVITAR\P vN (H- 10 LOADING) SCALE: 1 "-20' :• TEL/FAX 508-548-0796 Use: (5) INFILTRATOR HIGH CAPACITY H-10 UNITS, HAVING A 0.83' ('0 INCHES) EFFECTIVE DEPTH, SCALE. 1 "=20' DRAWN BY: CES DATE: MARCH 14, 2004 TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE ON THE ENDS. No STONE UNDER. PROJECT#SD535 FILENAME: SD535PP.DWG SHEET 1 OF 1