HomeMy WebLinkAbout0019 FOREST HILLS ROAD - Health 19 FOREST HILLS DRA/E °
COTUIT
A = 025 007 002
�I
I� jq„r,,��g7s4TOWN OF BARNSTABLE
LOCATION �``o�'\\a � SEWAGE # ZOO 3r6,
VILLAGE �tt��t �^ \ ASSESSOR'S MAP & LOT
-�, INSTALLER'S NAME&PHONE NO. lYlcShao 'ma
SEPTIC TANK CAPACITY ��OO
LEACHING FACILITY: (type)(4 socD !44A (size) Q.DLX a's
NO. OF BEDROOMS 3
BUILDER OR OWNER
PERMIT DATE: 6— —OO 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
CZ- ae
n.r A3 - q a
C3= dint:.
i A
r
NO. s �FlJ5_
THE COMMONWEALTH OF MASSACHUSETTS FEE
g��OARDOF EALT
I 1
/ O F
APPLICATION FOR FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Applicationor a Permit to Construct tRc parr U i grade Abandon Com Mete System Individual Components
,9 X '1 cal 4 �I_L b1 , >�-`r,'�e COMA—(
Location Owners Name
Mali/Parcel k Address
lv Lot N cicphone ft
Installer's Namr Designers PC
Address Address
Telephone# Telephone#
Type of Building: Lot Size��2'\ Sq.feet
Dwelling—No.of Bedrooms Garbage Gander ( )
Other—Type of Building No.of persons (42 Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min. required)C-C�> gpd Calculated design flow gpd Design flow provided YJ'�gpd
Plan: Date Number of sheets A Revision Date
Title r ,�' �L f r� '
Description of Sois)� u
Soil `' l t�C1✓��� 5cu _�V y' �� ��` Q�csi �
Evaluator Form No. ame of Soil Evaluato ly tiDate of Evaluatiotr9-tply-CSD
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 agree t to the ystem' operation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date 6
I�.sPeetietfs _ '%�
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
NO. TH"E COMMONWEALTH OF MASSACHUSETTS FEET
,.� }::• • � L ':�,_ �'�--�B'�O A R D O F EA LT _. . __ - - -- . . �. .. •
OF
APPLICATION F.' DISPOSAL SYSTEM CONSTRUCTION PERMIT
�ppl'"Application a Permil to Cunstr t ( Repair ( ) Upgrade ( ) Abandon ( ) - 'omplcte Systems ❑Individual Components
Location Owner's Name
�� -�-Z..
Map/Parcel N Address .
'xM1YSJU* . n Lot H Icphunc q
¢.. Installer's Name U)esigncr's me
_... Address ddr ss
Telephone 8 Telephone N
Type of Building: f Lot Size ( t Sq.feet
Dwelling—No.of-Bedrooms 3 Garbage Grinder" ) "'
Other—Type of Building • No.of persons L: 'Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.required) gpd'- `Calculated design flow gpd Design flow provided,7-�pd
Plan: Date " - l Number of sheets r Revision Date_
Title a4 rp
Description of Soil(s)
Soil Evaluator Form No. "ame of Soil Evaluato M4 r(��Date of Evaluation _ Ii-
DESCRIPTION OF REPAIRS,0,R ALTERATIONS
The underiigned'agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5'cnd',furt*agwotto
the ystem'n operation until a Certificate of Compliance has been issued by the Board of Health.
`- Signed Date 6 "2�
t wc.tiensWong
- w
FORM L.� APPLICATION FOR DSCP DEP APPROVED FORM 5/96 ~'
THE COMMONWEALTH OF MASSACHUSETTS FEE 400=- J
BOARD OF HEALTH
CERTIFICATE OF,COM_P'LIANCE
Description of Work: ❑ Individual Components) ❑Complete System ,W-
e:
roTlie undersigned hereby certify that the Sewage Disposal System;Cohstructed( ),Repaired( ),Upgradedf(` Abandoned( )
- by: - 4
at
1�
,has been installed in accoLaptice'with the rovisions of 3 0 CMR 5.00 (Title 5) and the approved design plans/as-built
plans relating to appli rr " - dated A9.0 Approved Design Flow ?S-S (gpd)
Installer
F<ZL �� d
Designer: Inspector W Date
OV
The issuance of this certificate shall not be construed as a guarantee that the syst m will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
No.,? --:?4ceTHE COMMONWEALTH OF MASSACHUSETTS FEE
BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereb gran . ___to Construct ��8_
air U d ( Abandon ) an i. vidual sewage
disposal system at ��' 4 �- ) �iC�F as described
01 i
in the application for Disposal System Construction Permit No. ek dated 0 -- Z jF�t_
f _
Provided: Constructions 11 b co pl ted wi>;hi m three years of the`date of this r o c ndition t be met.
Date LO/) Board of Health
FORM 2 - DSCP DEP APPROVED FORM 5/96 }i
FORM 1255 (REV 5/96) O H&W HOBBS&WARREN TM PUBLISHERS- BOSTON
Jun 28 00 12:51p (5081 477-9072 p. 1
Town of 13arnstable PN Ia�D
Department of lieallb,Safety,and Environmental Services
Public Health Division Date 2-A-00
367 Main Skeet,Ilyannls MA 02601
1 axut E
NAM
a7° Date Scheduled Z- t.r — O 0 Time Fee Pd. LyO
`S-oil S1uiit�ability Assessinent for Sewage Disposal
PetRnmed By. Witnessed By:Pon was .,44,o v s e1
LOCATION&'GENERALINFORMATION`''
Location Address / y �OreF � O-ea's Name V1 WaA,',(no+.
{ ` '" Address pp ��
Assessor a MaidPanxl: %4e 2r� f "- " (�0CY7- Vn2'r=r's Nema t�
NEW CONSTRUCTION � REPAIR Telephone N —,
Land Use W e&44.J AA— Slopes(OA) Staface Stones
Distances frock: Open Water Body II Possible Wet Area ft Drinking Water Well ft
Drainage Way R Property Line R Other R
SKETCH:(Street name,dimensions of lol,exact locations of test holes&Pere tests,locale wetlands In proximity to holes)
--�`----
® f
• N
n
L
�a31
Patent material(geologic) Du)14A&S Depth to Bedrock
Depth to Groundwater.Standing Water In HOW Weeping from Pit Face
Estimated Seasonal 1110%Groundwater
;DCTGRIvIINA7'ION itbli SEASONAt;.HICH-VATI;It'I`AB1,L
Melbml used!
Depth Observed standing In obs.hole: In. Depth to Solt mottles: In-
Ikpth to weeping from side crabs.hote: in. Grouindwaler Adjustment ft.
Index Well N Reading Dale: Index Well level Adj.factor Adj.Groundwater Levcl
PGRCOIATION:TC+ST -'-Ding T�ihe
Observation
Rule g y f a Time at 9" ,
Depth of Pere ?-O Time at 6"
Slam Pre-soakTimeQ st O Tune(9"-6)
End Pro-soak
Role MlnA nch Z
Site Sunabnily Assessment: SRe Posed Stle Falted: Addhkru t Testing Needed(YJN)
original: Publiclleallh Division Observation little Data To Be Completed on Back—�
Copy: Applicant
i
Ik J1�2 t K a• k. -- _
5 rxb t a T�^'t it - � n � "t. .•-� £"',ram".-' .A y � -� s
_ ���1 ���,�,-(/S�rOWN OF BARNSTABLE _ •:
LOCATION ` \� SEWAGE # 2ccG' 3�b
VILLAGE ASSESSOR'S MAP & LOT Z 5-
INSTALLERS.NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACM=: (type)CD) SO(-' gI\ dM\-,r.S (size) 1�,D 2c a'S— +
NO. OF BEDROOMS
BTLM.DER OR OWNER
4 PERMiTDATE: 6 COMPLIANCE DATE: y Z'C —0
I I
{
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.
F on site or within 200 feet of leaching facility) Feet
I Edge of Wetland:and Leaching Facility (If any wetlands exist
I
within 300 feet of leaching'facility)
Feet
Furnished by
I
J
�1
A3-- 9),
GnRAr�r . C 3 a`l
AC, 134
S >
N/F .\ \
TOWN OF BARNS TABLE
` 17. 89
` 040
L'.P.
cA \
A PEA _SCJMMA P
L D TS D �,
UPL AND; 267, 713-*S. F. 6. 15�A C.
WETLAND; O-*S. F. O-kAC.
TOTAL; 267, 713�5. F. 6. 15=kAC. 28.8 % N �,
ROADS 116, 189 -4S. F. 2. 674A C.. 12.4% � ,' �•
OPEN SPA CE '
UPLAND; 514, 568-LS. F. 11 . 81 SAC.
WETLAND;. 32. 116�S. F. 0. 74�AC. ��,: a
TOTAL; 546, 684�S. F. . LZ. 5-4AC. 58.8%
TOTAL 930.,586�5. F. 21 . 37-kA 100%
y+
�. �G. OPS,'V SPACE
' P
UPL A NO=132. 818-&S. f
WETLAND=O$ . r.
TOTAL=.432. 8'8t.c,. r
i 9 1
58' /"I
N/F NIF
RAYMOND R. B 1RENE ANTONE
RODGERS SOUZA 1
ir
:e ..............
s0•-t• r-� v�- t•-T fr7' r-�- i-i 3i,• _ j -41 yr Y-W V {
DECK"TAM VG
Q
1w Sr RorosaoIt-
FAMILY ROOM
= a `
PROMO TIE dlAms To CONTIN. CLG. JSTS. • T
lSALCON OR PLATE MATE llli! POR FLAT j
REINI&OR r-MeNT. REP. COILING. I'ROVIOE Q
SEGTIO !Se AM!I A S'SHOWN IF
,� CATHEDRAL CEILING G
Va
CLOSET T
1 LIVING ; o
MASTER CATHEOR I.; S
AA _ I o DINING RM _
lK
�+ ER CLI! i
� .w OrT•L � � {
_ I I +" w COLUrFNS �• t
I SJ,• f cmL
V7- FLICK M \i .•
5 LIME.Or SALCO1lY��
o � naovn
0
r-r I
c'-t• yr 4 _ u,- - s'-c- s GARAGE
7i r MASTS ZI•�f•
-I W ATFi It>L Q POST roS
roil n7 13!,• x 4 v-r .MICROLAM - O .Q
c~- --- - ----rra is IOXM STEEL BEAM
-r x c•
LIN: :r: 1 \ ISLUI Q POST c0Tm
eA,I p b
up r Q COATS
KITCH@N
I
t
s•-r �•-r r-r �•_2 Vr r-Io
r-r r-I yr P-i yr T-o- --fi Ur s•-• v r-o• r-
►r-o- 2r-• Vr
- xt-o-
FIRST FLOOR PLAN 1382 Srt FIRST FLOOR 138:2 Sr-
SCALE: 1/.4- w 1•-p- SECOND FLOOR S 8 SF
TOTAL AREA 1980 SFSF � v,,,�(C
l9 �
euAl
i
47-0-
17-0-
k 13•-(. Vr W-1 I/r
�._s. T-3- s•_$0- s-r yr
PROVICE TIE EE S TO
O DALCONT OR PLATE '
F REINFORCEMENT. IRMP. O
SECTION
\ i
n•-a yr le 2 �' n•-4 yr r- I/ .
�' PEN 1LV BEORO H 13
1/7-
BEDROOM a� ,
I I SKYLIGHT
\ HEAO •
A : HAL MALL
'CLG AR A
LOFT : t—f Kr-ol ��� r-r KNIMIUALL
ON � •' — a
r to-r r-r _ �•-s x-a yr F
HALL .UALL4Y,
° ATTIC O
° � � I I ;•
A ^
\ c
4xc TLa\ /
ATTIC SEAM
S-i' \ -r KNCHr1ALL
! OrEN f
i LL3 E
` ATTIC ,� I N \ i.
\ STOR:
/I ` �L \
GARAGE ROOF
C — — — — — — — — — — — — — — — — — - — — — I
'S EC O.N D_-F L OO R-P L AN, 598 SF (OPTIONAL LOFT ZZO SF)
SCALE:' I/1- P-O- 17 Q�
2868 . 243ODH 24300H 24300H
BUILDER TO CONFIRM ALL CONDITIONS
_
. Y{a.r;�".,.3r�.?�:vw_: r_.�.�' -�"�?�`��"-'� ��e=�.'�.S,wia,�..33:`..G�% �,;.�:.-;: .s'n.'i; >'t� i.': �2..`. tY.:��",a'•w�,�z sib,: ,.�'a � itl
, .-'r' r..� �,._. �. -. :;r++��y _�.�i`�Y��--..yy, :`x�..Y•y `."xi 4a .n 1"_ -
7 AND DIMENSIONS ON 51TE
E a N E
40'-2" o
E E
+-1 N i6 N p ADD NEW `` �
T Y4ALL5. i = z
f '
o ° unheated storage area _
Ir , `DES b o
V1 Eli •—
- - ..•-�use=w�e•�•:-' 2668
� cA N
�t wCo }
x b' 5" ® CL
n:x:=-_.r:.;,..nh 3068 -.A:_.Jr�-�.-.v+rK.r.v.-�.->'rrw -....,,,,.-,;,. n..e,,.,..._„. :,w:,.w� .,.. ,�,,.....z�,�,:� q..o oR<._.>w=.,.W....�-�-.> O
LU
LU
Ul I In Q
w
z
14' w
sobb
—� '
INSTAL DROP DOWN R ,59R B24R 524R B24R 24R B24R
k N ElN WALL i ry I i I ir, w
CEILING IN ENTRY
y m Z
11'-3 1/2" Lit
12-11
Date:
Co � �/ � • s1 •
3-28-17
Revisions:
11-9-1-1
U
�
Final Plans:
ENCL05E 1568
UTILITY M Note: These plans are for the sole purpose and
O
Proposed Scale• 1/4=1-0 use of Gapizzi Home Improvement and are not
FLOORPLAN: Pr >to be distributed or used for construction other o
than by Gapizzi Home Improvement.
S YS TEM PROFILE
NOT TO SCALE
TOP FNON. FINISH GRADE OVER FINISH GRADE
EL .- 0. ? FINISH GRADE �8. 8 FINISH GRADE O VER O VER TRENCHES -'0.4
•,o..pp• DIST. BOX ?O•Q
'' •4:a SEPTIC TANK
12 MAX. 777/7
G '4 4' :...' ..t .., •d.•G•.A�;.Q'.iQ.o'.p• ' "'.v /,•P.b .0p'?.3 •o. b'•L-0
OUTLET PIPE LEVEL
3 TOTAL LENGTH OF TRENCH 25'
°•'°�p0
°•o _ ° FOR 2 FT. MIN.
•a•:Op
'•Py.o 1.'p: Q4 - l� I \J O Of . '•w: o. ,00. ..A, •e �,04. .r6• •.v ,e. d'6r0.10,3
O
�-7
e do c. I. OR P VC TEES G7- G o a c� c� a o
0pp
Q 0 GJ6,t!pO �' C7
I"�
:�,o• eo' - COLS 1�LFFLE :
D GA L L ON
BSMT FL . .1500
'��S I�R. ' UT. 'ON BOX
° _
EL . Z_ZO INSTALL ON LEVEL BASE "500 GALLON DR YWEL L S "
PPECA S T CCNCPE TE
H /.0.___.f IEIN OPCED P o:
p• '•p
s'tf k' '•'.v tr:p; • . e"o v °
.. .r •^..�,gr , -a•o••y•o.°•>.•t>�.�_p;V. .a..e. . �.•� �+r°.nn�d .'•4.3 '47a74;
sS EP T- T C TANK NK TPENCH SEC T.I CN
INSTALL ON LEVEL BASE NO TE.- EXCA VA TE TO EL EV V. N/.A OR
L OYER TO REMOVE AL L IMPEAVI®US 7
�Em r u [-iL� MA TERIA L BENEA TH THE L EA CHING AREA 12„ MIN.
I M aF G. �' `�` REPL A CE EX CA VA TED MA TE•AIAL WI TH q" orAM.
3" OF 1/B"-1/2"
CL EAN, CL A Y FREE SAND °" ° � r•g' WASHED PEAS TONE
e
3/4 " - 1-1/2" kA SHED p:o:
o
CRUSHED STONE
_--- -- GENEt' 'L TES TRENCH WID TH
BSC GROUP
40:37 / 1 . A L L EL EVA'TION ! NUMBER OF TRENCHES
SHOW AF�E BASED ON
40. 8, > > SOREST ILLS ROAD' 61°4 r21' ALL P1•P
3 r / I t�1 3 t 2. A .�.� spa T I. _. ! �J � ' Q ;,=,r Yp✓r_)�\ 4, s�. 6=98'05'16" R=225.00` —_ - �.�'
91 40.62 OR SCHEDULE 46• P YC.
OBSEP VA TION t DI T
•11 I / I . I u, 3. -THE, BOARD OF f-!;EAL TH NUS T BE ,NOTIFIED • ° P-9670 �'
35/' ��, PERCOL A TION RA T
I WHEN CONSTf=UC7101V IS COMPLETE PRIOR yo
�. 6a 1 U l TO BA CKFIL L INC
:J
Lu
/ � 5����i�� ! 4. ANY CHANGES IA THIS PLAN MUST BE APPROVED <5 MIN./IN.
uj/ ,�o�/ ���F ,��� �S i�LO,T 2� BY THE BOAR'? G:�" HEAL TH AND CAPE t� ISLANDS WI TNES.�ED B Y.'
���� ���� o,� 16",�81�5F. SURVEYING CO. , .TNC. DONNA MIORAf4DI
\ °°° �5°° -� 1 5. MA TEAIAL S AND INS TAL L A TION SHALL BE IN °
BARNS.
�� 2 i/L� ' - COMPLIANCE WI t';L/ THE .ETA TE SANITARY A�7. OF f raL TH DESIGN DA TA
/
� _ CODE - TITLE V - AND LOCAL APPLICABLEEO. 2B_247
'67 1I ��� ��o. 0`bj' ,� 04 / /4' ham, 5� - RULES AND PEG`l�.'_A TION, 3
p T I �+ NUMBER OF BEDROOMS
.� ___ ti � p ", / 6. NORTH AARO. IS FROM RECORD PLANS AND o � o
I ,a2 GG� Quo /�5 ���ry IS NOT TO BE U " � Lorin z &w Lodre, ��—
� � � SED FOR SOLAR PURPOSES 3 r�;,��:m w�� GARBAGE DISPOSA L
I o i '' �' 1 �`� 7. .FL DOD HAZARD ZONE C (NON-HAZARD �o[Sr1Y SAND DAILY FL OW SAL .
� NN. , a B. WA TER SUPPLY IY�� LOOP-� r � :,Np ��-
GAL .
-- SEPTIC TANK REO 'D. -150-0- GAL .
w „ LL'}�: SEPTIC TANK PROVIDED
a GPD.
s 80°52�52„ �' �; ° L EA CHING REOUIRED �
E / i
MEDIUM m5-D tuNt
• // ,/ � S OL1 D S�1 C7 S WALL A E = 152 S-
/ / S D ,q A
►oY� �6 c>y z � 5 S. F. X. O. 74G/S. F. _ GPD.
LEGEND / I B�Q j�OM AREU U. 74--S. F. 243
S. F. X G/S. F. - GPO
LEACHING PROVIDED = GPD
P IPOSED EL EVA TION
17�0 O WUNDVIA
--r0 -- E�kLTSTING CONTOUR
OB,'=PER VA TION PIT
, �,, _ _o f S T NCYL E FA MIL Y RESIDENCE
r7,�; X^,.
C3 DI;a TAIBUTION BOX r
' PROPO� ED SE AGE DISPOSAL SYSTEM
__� BENCH PREPARED FOR
0 0 5 , TIC TANK MC SHA NE CONS TPUC TION
° ''✓ � ', LOT 2 FOPES T HILLS DPI V/E
i —_I RE. ER VE AREA
��FINS TABL E-•CO TUI T--MASS.
PIPE INVERT EL EVA TION
PLOT PLAN � ,� :_ r DA TE.' J UtJ . 22, 2000 CAPE 6 ISLANDS ENGINEERING
SCALE A S NOTED 0 -
SCAL�:• 1 � �,� -7 2 2 _ � <;� . ,,_, 1� `+� 8 0 FA L MOUTH ROAD SUITE 301
4
f f� ,SEC PCL LOT H SE
PL A N NO. 50Ga 22 0o MA SHPEE• MASS.
,. m...oe.•ennr.xwa•°a.w..i. ..„r... . w„..aw—. .w.w.aw... .uraep „Pw .i--..Gel _. _.