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HomeMy WebLinkAbout0020 ALBINA AVENUE - Health ALBINA AVEt41- - - - - - - - - -- -- -- COTUIT A = 018 094 No. FEE/W,r �---. Board of Health, MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Repair( - Complete System ❑Individual Components Application for a Permit to Construct Location ! ( Owner's Name _ f` G .i Map/Parcel# ram . Address Lot# f Gj , ZZ Telephone# Installer's Name ®`�"'� "' �,��.�/�- Designer's Name YAQ E Ch LA Address ��`` -�^ Address S..a J 1vt R e51- w5 L_ Telephone# -7 Telephone# Z Type of Building 51 N6 L'i— F7stA 1L y 21 W&LL I J-JG Lot Size sq.ft. Dwelling-No.of Bedrooms Garbage grinder Other-Type of Building No.of persons Showers ( ),Cafeteria(() Other Fixtures /I Design Flow(min.required) /44® gpd Calculated design flow AS-3 Design flow provided i gpd Plan: Date -1 ?L4&2 Number of sheets Revision Date 1 /A, Title 51'T`z. 4Fib -L aPOW Description of SoiI(s) C e YZ" IMSM,&)MX 5" /�°"3(0 /b_$1FM 5,4A-2)YnC Gt- Lam: >6, (r1 M'K FPN� Soil Evaluator Form No. Name of Soil Evaluator eAjI[L/AM Date of Evaluatio -7&»/99 L&Z!Fe.M A]j DESCRIPTION OF REPAIRS OR ALTERATIONS _ri Individual Sewa a Dis osal S System in accordance with the provisions of MIX 5 and The undersi ed agrees o install the above described �' g P Ys further agr to n t t lace the sys n in brai6n until a Certificate of Compliance has been issued by the Board of Health. Signed Date - _ ZQ TOWN OF BARNSTABLE LOCATIONS AI SEWAGE # �L�' Lis) VILLAGE Cc iT ASSESSOR'S MAP & LOT E7�f3— 0�1y INSTALLER'S NAME&PHONE NO._13 Ci,-N LC x tf i SEPTIC TANK CAPACITY 1 S 0© 9 c LEACHING FACILITY: (type) (3 5•60 Q G l Lewx4 el of,(size) NO. OF BEDROOMS L( BUILDER OR OWNER Ls PERMITDATE: 7/2 'JI J� COMPLIANCE DATE: 3 _-7—'Z I Separation Distance Between the: I Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet I 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 A7 3 �� � 36L11 r1 f N' ,! {f � 1 FEE M s Board of Health, '6QF'-N sT A 6LI.., , mA. -APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct Repair( ).'Upgrade( ) Abandon( -X Complete System ❑Individual Components Location v�, V� Owner's Name N C.V-- LAG LA OS Map/Parcel# SS S + Address Lot# i 19 O G ZZ,j 19 /�p Telephone# Installer's,Name �j0���7`� �17S�T; Designer's Name YAO J��Z V Address ys� � Address -4013> 1 D j�.�- "Al i C L.5 S Telephone# j' Telephone# O 0- O S Type of Building 5 10G L':F— FJS4A 1 - OWE,LL I fJG Lot Size Z9V7 ZIS sq.fit../ Dwelling-No.of Bedrooms Garbage grinder Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures /L E Design Flow (min.required) .140 4 0 gpd Calculated design flow Design flow provided 7 3 gpd Plan: Date 7 Z7 / Number of sheets Revision Date 11 /A Title 5 I T4, A r jb s&&w<-a&C f- C-L A W pp 1/ Description of Soil(s) Q' 12"- i'► -,-b F1r-4 SAtut1 `2�3Cfl /"Q/rtluf S KA 50vIN£ G , >(,-4-9 M:r-.tf Sc�YN EiNF-- A1) -►32: - M� 5�1 h Soil Evaluator Form No. Name of Soil Evaluator-Lt1ILL/A ry) Date of Evaluation 717/°I DESCRIPTION OF REPAIRS OR ALTERATIONS The undersipied agrees o install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr s to n t t ' ce the sys n until a Certificate of Compliance has been issued by the Board of Health. Signed Date /' t No. O FEE C®MMONWEALT14 ®f MASSAC14USETTS Board of Health, 'BA.94J Sr�A'(UL< -,MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) �Complete System The undersi tied hereby certifyy thhatl �the Sewage Disposal System; Constructed �,Repaired ( ),Upgraded ( ),Abandoned ( ) by: %W � // / �Jrr at M410l R-24 ALa1+Nis U 9-"STFa f.4PAA. c o yPf has been installed in accordance with the pro tsgio _ 310 CMR 15.00 (Title 5) and the roved design plans/as-built plans relating to application No. �/ y( �, dated / Approved Design Flow S (gpd) Installer � 7 / Designer: Inspector: � •� <.-_ Date: V V- The issuance of this permit shall not be construed as a guarantee that the sysiemwj#function as designed. No. . FEE COMMONWEALTH OF MASSACHUSETTS - - Board of Health, 'A►21V 5TA 13L4-, , Na DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at rORP 16 QUAD. q4 QL.'&Q- f� k\K.�yfAQ-PJ�1' Lr #'(A• 1V as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within th ee years of the date of this permit. Allgzz ns must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health 68' 147 2'3 75' 4' 1 61 78 5'10 3'6 T 37 7 78 T 3.2 Fo DECK SCREENED PORCH = 13'10 x 13'8 N 14'8 x 13'8 < 15' �—4'6 78---1 78- 2446.2 7'7 7'3 2446.3 FWG 10-611 �25 r6E 244s F BEDROOM N Al 14'1 x 11'6 _ Smoke p LIVING o za11 x 1Ts 0 3'4 Entertainment Center ' � o N BATH 10'10 x 5' '3 3'2 1'11�{.1'8 1 1'8`�.—2'6�3.8—`�—3'8 T 518 5'9 1 0 0 T Smoke Dt..W-,- F Smaka 0 0 ® KITC 10'x i z ENTRY s BEDROOM )1W G ` Tx 11'6lo 14'1 x 11'6 C76 1'1 x 15 11 C2: io "a a 2446 2446 2446-2 4 .--67 4' 4'4 —78 47�� PORCH 33'4 x 6'8 LIVING AREA 1904 sq ft 5' 68' Of i �- 0 R 12' 11' 0 N �Z A m �m N A ............................... •...• ............ •..• CO m (n : 0 rQ —i �+ x 0 � � � A O O x C6O 0 A � om J� .........................................r....................... U N m x J lT] � r A G1 O Z N w CO A 6'1 27 22'3 '� 6'8 2'9 15'4 4W _ J m Lagadinos Building and Design Inc. 5 Project: Albina Home N N Custom Homes, Additions, Remodeling ' o 13 Thankful Lane Cotuit,MA 02635 Tel. 508-428-4097 Fax 508-428-7709 p 10-2 ,e 6 4' a' 4- rn F4T 0 n n co 2 N 2446 446 U o — u1 DECK 13'10 x 13'8 F5'6x .� QC Co MASTER BDRM -0 00 o 0 N 15'6 x 14'10 a r8 ra 4'4 a) m H rn 2446.3 a Oqtector N C go � a 3.6--+� 2x6 Stack wall 432 _ < - m m Q O W ��r ) O N O L N [ REAKFAST P ® C o Co 16'8 x 1 r6 STER B 87 x 157 a (13 O Ca N !A t c-c-�_ N7 � V r~i o in El I Shelves Shelves N © 2'3 2'5 4.6 .g '10 9'2 e e KITCHEN 10'x 13'6 I Q I I I I E _ C23 n GARAGE _C 21'4 X 215 .� � 2446 Q 4P I I I I I i i- I I I I I I I I — I I ---- ------ -- Drawn By:rlu Date: 8-1-99 5' 5'9 105 Scale: im,v S I 5,g t0, I Sheet: —r 22. A-1 ZQ TOWN OF BARNSTABLE C/ LOCATION V- r + SEWAGE # 9� Lis) VILLAGE Ceh�i'1" ASSESSORYMAP & LOT INSTALLER'S NAME&PHONE NO. ©EN Ua ff l (°14 : "1 q SEPTIC TANK CAPACITY 1 © a LEACHING FACILITY: (type) _(3 S•60 Q'1 LeiaA C 071 dsize) a a '40, NO. OF BEDROOMS7. �I BUILDER OR OWNER PERMITDATE:ZL'Jj-_COMPLIANCE DATE: 3 'J— 21M 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 _ I Hevs f 49 w OTUIT AY 700 SHELL NE dill HSE jpp 00 A INN CE RO D 1 S" LOT �'� }; fN l.I o23 . LOCHS POLE BE NCHMARK for l Cb ( EL=IOO. ASSUNEDJ •o �/ 95 5 ti ,SCR MP OF i:� � O c` LOT LOT O � 22 � 15 2 ��/ / 99° ti/ LOCUS 0 l ° h LOT a i� / RES. ZONE: "RF" PLAN REF. fop �l s o° 1s ��n/ SETBACKS.; 275/61 •sqj �, .o �' Q'I FRONT 30 CA7r l 98 5 I `� SIDE.• 15' 303/24 BASYN LOT O `S�� �` , 449/43 / ��'��, � o O' REAR- 15' '21 h0 fpQ vt1' � � ,'4 o R� h _ ASSESSORS MAP WATER S I p ��l y VALVES O X X A. 18 i (fnd) '" o D LOT HSE. GROUNDWATER PROTECTION �O w W ° 17 ', O VERLA Y DISTRICT "AP„ FLOOD ZONE. "C" GAR 1 9� o � (Ind)• q 9� o � 78°O"- PROJECT LOCA T/ON ¢9 I I O�(b LOTS 0 BARNSTABLE' (COTUIT), MA. ' 20 99• Y AssEsso @ APPLICAN - w .. to . 94 go- LOTa `qV,N LOT f T. 29,728 sl /LOT �A ti � 18 � NICK LA GADINOS 0 19 YANKEE SURVEY CONSUL TAN TS P. O. BOX 265 d� (ppPPALA�� UNIT 1, 40B /NDUSTR Y ROAD \ \ �R S, D "Lamh MARSTONS MILLS, MA. 0264� of PH.(508)428 0055 — FAX(508)42 —5553 sue +°� � SCALE: 1 "=30 DA TE.• 7 ,27 99 GRAPHIC SCALE _ o , �,uw y 30 0 15 30 60 p � � - (And) �Wo. 239��Q�� GISTE� �� REV REV ONAL ( IN FEET ) JOB NO. 51915 SHEET 1 OF 2 1 inch = 30 ft_ r. EL. =_100.5' Top OF FIDUNDATION 20., MIN' � 10' MIN. coNc co vEnS 4" SCHEDULE 40 P. VC 2"LAYER OF 7z MIN. PITCH 1/8 PER FT. CONCRETE COVER EL=99.5 EL 99' WASHED SYONE EL= 4" SCH 40 PVC t , (OR EQUAL MINIMUM PI?CH 1/4 PER FT 36„ _ EL-96' 2' EFF. DEPTH MAX - FLOW LINE , 10' " INVERT — 110 EL.= 96.5, MIN. ,. INVERT ;5 LEVEL 12, o 0 oo°° O O O O O O O oo°°o:o BAFFLE =96.00' /NVERT�B SUM INVERT o ° o 0 0 0 0 0 0 ° °8° INVERT EL. _ = 93.2 EL.=96.25' -- EL.=95 75' R EL.= 9_5_5'_ 49 °\ �r 4,. (7V BE PLACED ON FIRM BASE) k DISTRIBUTION V EL.-9_5 2' 3fASHED STONE"112- y M rHANICALLY COMPACTED OR B" OF SME ' BOX W GALLONS' TO BE WATER TESTED 12.8' X 33.5' X 2' TRENCH MRM4TION � SEPTIC TANK IF MORE THAN ONE OUTLET 4 PLACE ON 6" sTnNE SOIL ABSORPTION • ' � SYSTEM (SAS) PROFILE OF BOTTOM OF TEST HOLE ELEV. 88_0 • SEWAGE DISPOSAL S YS TE]VI No oasERVED WATER (5/17/99) NOT TO SCALE OBSERVATION HOLE 1 ELEV=9- _ OBSERVATION HOLE 2 ELEV.=_99'_ PERCOLATION RATE __<_2_ .MIN./ INCH AT 48"t18" DEPTH HORIZ TEXT COLOR MOTT. OTHER DEPTH HORIZ TEXT: COLOR MOTT. OTHER P O'-12"` AP LIS 2.5YR 6/12 O"-12" AP LIS 2.5YR 6/12 12"--36" BI S 2.5YR 6/6 N/F SOME GRA VEL 12"-36" Bl S 2.5YR 6/6 M/F SOME GRA VEL 36 48" Cl S. 2.5YR 616 NONE M/ SOME FIN 36 48" Cl S .2.5YR 616 NONE (I SOME FIN95. 48 -132 C2 S, 2.5YR ;7 2 NONE M/SAND 4B=132 C2 S . 2.5YR 7 NONE M/SAND GENERAL NOTES / NO WA.-TER ENCOUNTERED NO� WATER� ER ENCOUNTERED: ' 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM 719 R E.P. 1 TITLE 5 AND THE TOWN OF _BARML9BLE---- RULES AND r �w REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. TO .� DATE 6F SOIL TEST 7/27199 SOIL TEST PERFORMED BY WILLIAM LIEBERMAN 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" WITNESSED BY: E F BARRY B.B.O.H. SOIL EVALUA7t�R 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF os fG WITHSTANDING H-10 LOADING. DESIGN CALCULATIONS' WILLIAM � 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL a NUMBER OF BEDROOMS . . . . . . . 4 uEA)EpMAN H BE MORTERED IN PLACE. GARBAGE DISPOSAL . . . . . . . . . NO No. 239110 7107AL ESTIMATED FLOW $�r 5) NO DETERMINATION HAS BEEN MADE AS 719 COMPLIANCE WITH 440 GAL DAY DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS 719 INSTALL THREE_(3) ACME (110 CALD SE DAY x 4 BR) 1500 / NAL ECG OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 500 GALLON LEACHING REQUIRED SEPTIC TANK CAPACITY CAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VATION CONTRACTOR CHAMBERS WITH, FOUR FEET SOIL CLASSIFICATION . . . . . . . . I IS 719 CALL DIC— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS: STONE SIDES AND. ENDS DESIGN PERCOLATION RATE . . . . . < 2 MIN./IN. PRIOR TO COMMENCING WORK ON SITE. 12.8' x 33.5''Fx 2', EFFLUENT LOADING RATE . . . . •74 CALIDA YIN F. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS LEACHING CAPACITY (AREA X RATE) 453 GAL/DAY SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. RESERVE LEACHING CAPACITY . . . 453 CAL/DAY 8) PARCEL IS IN FLOOD ZONE_ C"_ . (12.8 X 33.5 X .74)t(12.8't335t12.8t33.5J(.74)(2) 9) LOT IS SHOWN ON ASSESSORS MAP 18 PARCEL 94 `• _ SHEET 2 OF 2 ✓1 51915