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HomeMy WebLinkAbout4890 FALMOUTH ROAD/RTE 28 - Health 4890 FALMOIJTH RVA,P COTUIT -- - -- - A = 009 001 005 TOWN OF BnARNSTABLE { LOCATION SEWAGE # C�Q VILLAGE C C> U IASSESSOR'S MAP &.LOT 30 j INSTALLER'S NAME&PHONE NO. K�✓i ,v' S/»c/✓c'iZ "'C �i —% 7Y t i SEPTIC TANK CAPACITY / S y rt l LEACHING FACILITY:'(type) : (size) NO. OF BEDROOMS 47" t4u'+ e t,,,v tD �c BUILDER OR OWNER 1�1'1d'2'e=l 4.e r< PERMITDATE: 2�'-�a 1�? �y.. 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 , r -� iG TOWN OF�BARNSTABLE I ocATION g ® l"tgf s'#J� � S8W/AGE # 004 dog—Oo1�6oy' VII.LAGE-_ C '�U I ASSESSOR'S MAP & LOT ' INSTALLER'S NAME&PHONE NO. �F✓/�t S/n©���2, �C/— �Yc7 SEPTIC TANK CAPACITY 00 Y !� LEACHING FACILITY:.(type) '�7'- (size) 1 X O NO. OF BEDROOMS---- l4✓�1'r C e') t D`P fL BUILDER OR OWNER �� Q PERMITDATE:, "2S' 0-,>- COMPLIANCE DATE: 00 f@ 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 r within 300 feet of leaching f Feet Furnished by t... . :` . � � � �+ p 5 �- �� ` . : � }:�4. //( V � } 1, g � L i' r ,,{ � � � "�1 �r� i F J � vf� ��:. f ,� ��.� ,, r r_.�� No �' Fee O� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS application for Miopool *r5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. o ��y��v Owner's Name,Address and Tel.No. P Assessor's Ma /Parcel �- �' k — 00I —Q, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Kg� 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 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 i su d by tpis,Board of tl�th. Signe Date ^/� —GO�C Application Approved by Date Application Disapproved r the following reaso fo Permit No. Date Issued ° 10/7/00 tied.: ��— �-- Fee 0� No. —�— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprtcation for �Dtgpogar *pgtem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components `Location Address or Lot No. Owner's Name, /Adddreress and Tel.No. Assessor's Map/Parcel / I v J M" ' )" —f DD oo/ —coo Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 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 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 i u d by tiooard.of Ppalth. Signe ' / Date '�� -6� Application Approved by 4 ` Dat Application Disapproved for the following reaso Permit No. Date Issued } --------- ------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of .(Compliance THIS IS TO CER ,that the On-s'te ewa a Disposal System Constructed( )Repaired( )Upgraded( ) Abando ed- )by at FA I 7M72-0 4 V I f h p be nncconstructed in accordance . with the provisions of Title 5 and the for Disposal System Construction Permit N -" C—dated A Installer IDesigner i A, The issuanceefes p / 't shall not be construed as a guarantee that the sj,/ nkiill function as(d�esigned j fJ /L Date 1 l V Inspector Y /1/10 d Ut & t r; r r v --� ��� ✓�-------=---------------F `—� No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS m•igpogar pgtem: Congtruction Permit � Permission is hereby Construct System located at 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 be completed within three years of the date of this p t. Date: Approved by / /< _S - I n NO. fdl� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH V-C-2—am- O F & 2��a'/LVG APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Appliciition for ii Permit to('otntrUCI ( ) Rchair ( ) t\)hgrarlr ( ) Ahandon ( ) - ❑('on11)10C Systcln El Individual Components 4670 YALMWT t IZOOTF Z8 J Am 17EA FAQ2Y Location Owner's Name M111,1'01cel N Address 0 'cof N 'telephone N C1121ST E►� COSTf1 1r�tsac_ Installer's Name Designer's Nam, 4U,s MAIrJ ST. I E. FA )A0Q 4 N1Q r7Z(�4 Address Address -45-(c4M .telephone N - Telephone N Type of Building: Lot Size SE5,1 it Sq. feet Dwelling—No. of Bedrooms 0- 1 Garbage Grinder ( ) Other—Type of Building A1/7khe_-j) U f No.of persons Z Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required) 55- gpd Calculated design flow SSO gpd Design flow provided 55�gpd Plan: Date 2.1? 0o Number of sheets / Revision Date Title tznpo�,-W Dkm LLw(J LdcAmIno �2nPnoFo S-_L3AcX= 3y,�, m I oc aTtcxo Description of Soil(s) SE ' Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation o? 8 voo DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in _operation until a Certificate of Compliance has been issued by the Board of Health. Signed. - - Date a/o?�/o,0OQ Inspections Pctions 2- FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. 2©06 - III THE COMMONWEALTH OF MASSACHUSETTS FEE 11'DO BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) RComplete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ). Repaired( ),Upgraded( ),Abandoned ( ) by: / /� j at. '7 (1 G y� C—CsYs�c.e• '^o 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. I .. dated !.� .�' ``Z4a Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. THE COMMONWEALTH OF MASSACHUSETTS FEE 1 c)c� " &ZW4,Q BOARD OF H E A LT H DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( V) Re air ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at yk S��z_r raQ.�„� q &L(� 21.Cl as described in the application for Disposal System Construction Permit No. gf dated Novided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W Hams&WARRENTM PUBLISHERS- BOSTON SEWAGE SYSTEM PROFILE & DETAILS 146.46' TOP FOUNDATION 55.0 H F.F.=-- 56.0 FINISH GRADE= 54.5 FINISH GRADE 7FINISH.GRADE 53.0 FINISH GRADE 53 0 OVER TANK= 53.0 R D"BOx= • 52.90 RISERS & CONCRETE COVERS TO CLEAN BACKFILL LOT 30 �° �. WITHIN 12" OF FINISH GRADE 3" PEASTONE 58,191 s.f. 1.34 acres IN : 10" 1� Cl C7 L7 14" 50.42 a I� M M a I� • 52.40 511. 7 50.67 3„ 4Y '0" 50.17- Cl 0 � © Cl � - LIQUID DISTRIBUTION 50.0 I� !� ® 0 0 LEVEL GAS 50.34 Box . 52.70 BAFFLE SET LEVEL 1500 GALLON SEPTIC TANK - �' BOTTOM USE ,4/5'wideXF-).5'longX2'deep 54 ---SET LEVEL • 52.20 48.0 ' EXISTING 69' Sa% DECK ] LEACHING CHAMBERS w/36 OF STONE A„0"�v Ti iE Sii�`S FOUNDATION - 20. & 38.4" OF cTONE BETWEEN S2� GARAGE PROPOSED NX.*TE: THIS LOT IS IN NON FLOOD HAZARD ZONE C AS PER EACH UNIT & AT BOTH ENDS. �. = F.E.M.A. COMMUNITY PANEL #250001 0021 D 7/2/92 51.70 SLAB-54.5 DWELLING I • 53.30 52.20 F.FL.=56.0 5 j _ PORCH _ OFF: SOIL EVALUATOR'S LOG 54 N ot'� �y Depth from Soil Soil Soil Soil Other • - NaLAs GN Surface Hor. Texture Color Mott. Relative �c o SCNNEtDER (Inches) (USDA) (Munsel3 Factors Dc.�IGN CRITERIA No 3V0 . S? I NUMBER OF BEDROOMS DEEP OBSERVATION HOLE 1 PERSONS PER BEDROOM 2 w 0, AIL Y FLOW PER PERSON 55 m I cn rn TAL DAILY FLOWd / 0 0"-6" AOE L/S 10YR3/3 - Q I •I REQUIRED 3'9V. 6 sq. ft. Z�l? 6"-30" B L/S 1OYR5/6 - LOT 29 ° I w ,:,ICI-IINC PROVIDED 750 sq. ft. b v� LOT 25 CALCULATIONS 30"-120" I C M/S 2.5Y6/4 Not Well Graded • 51.41 H+DEPTH+WIDTH)(LENGTH) I • 52.20 15 X 50 = 750 sq. ft. 52.60 52.51 53.10 �� OF A/qS sq� DEEP OBSERVATION HOLE '2 GENERAL NOTES 2� CHRISTOPHER 1. ALL ELEVATIONS SHOWN ARE a COSTA 0"-6" AOE L/S 10YR3/3 - N ASSUMED. "s D.E.P. 6"-3O" B L/S 10YR5/6 - v! 2. ALL PIPES IN THE SYSTEM TO BE o� RTIrE �� #2 CAST IRON OR SCHEDULE 40 P.V.C. _ EVAwP 30"-120" C M/S 2.5Y6/4 - Not Well Graded) W , K"/A 3. REMOVE ALL UNSUITABLE MATERIAL #1 N , BENEATH THE INVERT ELEVATION o FOR A RADIUS OF AS PER 310CMR 15.255(5) a \ AND BACKFILL W/ CLEAN COARSE TEL. o, 3 1 GRANULAR MATERIAL. :. POLE .-- - - -- 4. ALL BACKFILL SHALL BE CLEAN PERCOLATION RATE = 2 MIN./INCH - DRIVEWAY EASEMENT COARSE GRANULAR MATERIAL FREE 4 6° DEPTH TO GROUNDWATER NONE ENCOUNTERED FROM DEBRIS & LARGE STONES. OBSERVATIONS BY: DONNA MIORANDI • 52.3 5. CHRISTOPHER COSTA & Assoc. MUST BE NOTIFIED WHEN THE. DATE TESTED: 8�00 J 1 SYSTEM IS INSTALLED PRIOR TO BACKFILLING FOR INSPECTION. APPLICANT: ANDREA HUTCHENRIDER BARRY f 6. UNLESS OTHERWISE NOTED ALL .� � SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH - PROPOSED DWELLING LOCATION r MASSACHUSETTS TITLE V SANITARY PROPOSED SEWAGE SYSTEM LOCATION SEWER CODE AND LOCAL RULES L=171.00 \S2 WHICH MAY BE APPLICABLE IN A - TEL. R=1970.29' WORKMAN-LIKE MANNER. _ ROAD RO UT j ()o 60 LOT 30 FALMOUTH POLE -_ - 7. T1�159�OT-IS NOT IN THE FLOOD PLAIN. EDGE OF PAVEMENT 8. A GARBAGE GRINDER WILL NOT BE HOUSE #4890 INSTALLED ON THE SYSTEM. FALMOUTH ROAD RO UTE 28 BARNSTABLE, (COTUIT) MASS. _ NO CHANGES SHALL BE MADE TO THIS PLAN OF 'N WITHOUT PRIOR APPROVAL FROM CHRISTOPHER COSTA & Assoc. SCALE: AS NOTED DATE: 2/2/00 BARRY-30 R tea �,- DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER - LEGEND 4X5 PLAN VIEW ST -4fi} LOCATION OF EXISTING UTILITIES PRIOR TO ANY DRAWN 'BY: J.A.B. CHECKED BY: C.C. JOB NO.: PROP. SPOT ELEV.. 50.t1�- 3 ` EXCAVATION. EXIST. SPOT SCALE: 1 = 30 ELEV. = 52.90 ° o�" rrassoc. , SL�v�� CHRISTOPHER COSTA 8c ass PROP. CONTOUR �.�.,,,,.-54 P.O. Box 128 / 465 Main St., East Falmouth, Mo. EXIST. CONTOUR = �� ASSESSORS MAP #9 SECTION # ' PARCEL #1-3 LOT #30 HSE. #48 0 52 GIB'" leeV1sE�: a