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HomeMy WebLinkAbout1180 MAIN STREET (COTUIT) - Health i 180�Main`Sfreet`(Cotuif) T ~ c6LuiL, A = 033 033 Mar 29 05 04: 45p p. 3 i Town of Barnstable Regulatory Services Thomas F.Geiler,Director i M Public Health Division ' Thomas McKean,Director 2OWMain Street,Hyannis,MA 02601 Office: 508-862A644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 5 -XYSewage Permit# o) 00y L193 Assessor's Map\Parcel 33/33_ Designer: Falmouth Inc Installer: Address: 101 mntTn Hall-_Square Address: Z 7 COy"-ry le Falmouth, MA 02540 American Excavating On Contractors Inc. was issued a hermit to install a (date) (rest ler) septic system at based on a design drawn by (address Falmouth Engineering, Inc. dated 11/23/04 (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. 1 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. OF M,tssgc i MICIiaEI,l. yGs g BORSELLI (Installer' a ure) IVI 3 �OMA� (Design s Signature) (Affix Des :p Here) PLEASE RETURN TO BARNSTAMX PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE W L NOT BE ISSUED UNTIL BOTH THIS FORM AND AS--BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISIOPL_ THANK YOU. i Q:Healt4JSeptic/Designer CerFification Form 3-26-04.doc TOWN OF BARNSTABLE LOCATION ,� n S SEWAGE # c2190 z1 VI LLAG ASSESSOR'S MAP & LOT 3, 3 INSTALLER'S NAME&PHONE NOAT- 6<Q^ A - Ze 5 0 a 4171" 7 ' f i SEPTIC TANK CAPACITY fro 00 LEACHING FACILITY: (type) fc-"k4 W 1 Ckf-k (size) X 13 NO.OF BEDROOMS BUILDER OR OWNER 6-(, p-v t3uo f-nS Ai c PERMIT DATE: 10 1.146' 10 4 COMPLIANCE DATE: ' //I I/A 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 fac' 'ty) Feet Furnished by - LJ 2 ®� E3-2-z 2 0 b 3 ' n &,J i�ui1Se- 13 4 AI a;5-0 O � A I f- A 3 ', ©" No. 4 —�� Fee 150 :THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZfppYtcation for Migpogal bpgtem Co::o`mplete, ruct"on 3permit Application for a Permit to Construct Repair Repair( )Upgrade( )Abandon( ) System El Individual Components Location Address or Lot No. /l�i`�14��t/S�T' �2'/r� Owner's Name,Addrep annd e;.No. Assessor's Map/Parcel �; la-:5'-3 Installer's Name,Address,and Tel.Wo. Designer's Name,Address and Tel.No. caw- O ® j Type of Building: � / Dwelling No.of Bedrooms Lot Size�sq.ft. Garbage Grinder(4)(0 Other Type of Buildingba No.of Persons C2 Showers(31 Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow �/®f gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank A'/1 Type of S.A.S. �` '= �a 9.:5 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 ed by this Boaz of Health. Sign Date Application Approved by Date 44 krt Application Disapproved for th wing reasons Permit No. ;:;)00,4—� Date Issued ——————————————————————————————————————— • ^•^-`�i'�."t�...'+1-+.-++'.•�.. -`.' • pp3 —.w'. - ►- ..1Y' 7.Y .!':}e.._.3` �d—d. .. .. .�".i !r• --'�-f�ti.-13n�•_-.. ..,.�.r...T.�� -�f`�.�.re..n�^"—n�.ti'.'^.,. _c� 3 No. �L �: a � Fee / � i * COMMONWEALTH,OF MASSACHUSETTS 'Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS - io for iq ool -5te' Congtruc on Permit ����Ytcatx n � �. . p � -;. ' Application for a Permit to Construct(_ )Repair'(". epair"( )Upgrade( )Abandon( ) Complete System ❑Individual Components kAssessor's tion Address or Lot No. Qrlf/ ' Owner's Name,Addr an Te.No. Map/Pazcel ller's Name;Address and Tel.No. Designer's.Name,,Ad ss and Tel.No. 7-1 Type of Building: —� ' / Dwelling No.of Bedrooms a/ Lot Size 62 q ft. Garbage Grinder(N� Other Type of Building No. of Persons Showers,(J)•Cafeteria( ) Other Fixtures Design Flow —7:5 v gallons per day. Calculated daily flow l ! �` gallons:: Plan Date Number of sheets CT' Revision Date Title Size of Septic Tank —�® Type of S.A.S. — S� al, 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 provi 'ons of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- y cate of Compliance has been iss d by this B ar �Hlth Signed Date Application Approved by Date Application Disapproved for the fat owing reasons Permit No. y9©Oy Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compriance THIS IS TO CERTIFY,that the On-site Sgwage Disposal System Constructed ( x) Repaired ( ) Upgraded( ) Abandoned( )by at J �d o,m S �Pen 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 i ll functionjdesigned/. Date f Inspector c..- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1Wi9;poga1 *pgtem Construction Permit Permission is hereby g a d to Cot�s ct(Repair( )Upgrf dta�( )Aba don( ) System located at ! Igo.° \ ` and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her dutyto comply with Title 5 and the following local provisions or special conditions. Provided:Coonstruction must be completed within three years of the ate of this Date:_._ 4 '�� a APProved by n TOWN OF BARNSTABLE LOCATION A in ,S SEWAGE # ®Z 20'I VILLAGE l� "f0 d� f ASSESSOR'S MAP & LOT 31. 33 INSTALLER'S NAME&PHONE,NO.�M ivy\ A A417p S Q?- 7'p/ SEPTIC TANK CAPACITY 1600 LEACHING FACILITY: (type),� Gk4-N b 0,y (size) 50 •6 X 13 NO.OF BEDROOMS BUILDER OR OWNER ffirw4r 1�)Adorz AJ&nX_ Vh PERMTTDATE: tO 1,11104. COMPLIANCE DATE. R./t.to 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 fac' 'ty) Feet Furnished by �Zz Z&-t� � ' `1 I (�° a a�l AZ = a=�r it ) Z .17 A 3 3g 7' uL -o ,� m to v s a = L V � 22'-0 1/2• o0 ,•- o" 9-2•-3I/Y a. H-G._D. — PORCH - LIVING y DM 3- r1 Y-31/Y 9-Y-31/2' ON H G'2' F�OYB m� mi DINING u A D fV - - � Mm cr GARAGE ry PANTRY FAMILY D •-,1/2' ----------------- EXTERIOR ___Q_O __ - ao> ofi `o SHOIIE:R O O 7-9' Y SSS - D KITG4EN 20•-2 1/4• LU w• Q W W Z . C-2 1/2' I,•-O' I,•-2' Z — LL Z � Z) - F I R 5 T F L. O O R P L A N � OiL 9GALE� 1/4' . 1•-0• ieb ro.: 09D6 d�u V=.30,20M -41. VA..I.4' I F ' —2 Y = L ° F p/ 3-I 3 1'S3 0 3 MASTER © ` BEDROOM 5_�_. u w� GL nS DN BEDROOM A2 Z. 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W i R- Lu LU 13FG _ - - 1 lu tn -PT sTe IL 4'CONCRETE SLAB(3 03%LV0 P51)J I Job ro B'CONCRETE WALL--- O, b ML VAPOR BARRIER O ON 20'x 12- IW ON 6'MIN WEL GRADED GRAVEL W DI5TRIBITION OF PARTICLE do 11G le A 21.2004 ! taNLRETE POOT W KEY ,SIZE.a R5S LON TIO,V o I StO 6RADE TO BE R5R ecBIO AS,NOTED 6L PE c CRT FLOOR RY SLOPE CON..FLOOR 2' TOO.DOOR tlrBuln PAN I N I N 1� 0 5 E G T 1 O N o iz - SCALE: 1/4' A--4 I 1 I Po / �o I- ESSti� w PROJECT LOCATION ,. ROSS EET/ D Z .. o N/F co7Urr �_ - II X FLORENCE M. RYDER ear A r / I y PP m N81' I o � 05'4p �, f STONE" 94•55' GRAVEL DRIVEWAY _ NOT LOTO SJCSLE 45 34.1 I 34.4 ?o'�tii RICK ' W MAPLES_R _ N. / PATIO C? A,?,'4 CB/DH M C FOUND 34.6 M ONCRETE WgLKlygy 34.1 1 U _ J - EXIS 13.g I 4 0 , _ HOU nNG BENCHMARK: `-� :�_ _ _ _ FF SE 1 CONCRETE BOUND t � c� EL 35.0909/ WITH DRILL HOLE EL 34.56 x 34.2 "'� `i j' 0 5 — 500 64LL6W o 3.8 CHAMBERS TE L x 3, 1,500 CAzi:6w 33.6 33.7 w, H917i f �" i � ,3. SEP77C TANK Sr6WE ALL ARGIUN� � � Q s{S-• 1 MAPLE O O �� , 3 1 33,1 Al AN—OUT z �.. MAPLE ' GARA 4e 11' C 33.1 LOT 8 o33.4 DOGWOOD 0 LOT 9B PP MAPLES 0 12,081 t S.F. II S 01• y �i 106•53o E w q GENERAL NOTES: LOT 9A ARBOR -- r 1. HOUSE NUMBER: 1180 TP o DECK 32 9 2. ASSESSOR'S NUMBER: MAP 033, PARCEL 033 I 3 033.2 33.0 3. ZONING DISTRICT: �0 TEST HOLE 4. FLOOD HAZARD ZONE: C a / 5. TOPOGRAPHICIN ExrsnN FORMATION COMPILED FROM AN ON THE GROUND SURVEY j x 33.6 HOv 1,94 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. 33.1 FF Ei 35 38 7. THE CONTRACTOR SHALL LOCATE THE EXISTING WATER SERVICE AND / 38 33.1 RELOCATE OR SLEEVE AS NECESSARY TO CONFORM TO TITLE 5 PLOT PLAN PREPARED FOR N AN CY M. CON N OR IN COTUIT MA PLAN DATE: SEPTEMBER 1, 2004 PLAN SCALE: 1"=20' CIVIL ENGINEERING WETLANDS PERMITTING M0 OF M4s � v rj WASTEWATER DESIGN I— COASTAL ENGINEERING + o BORSELLI G TITLE 5 PLOT PLANS �` PIERS AND DOCKS C L GIN 'E,RA\ 20 0 10 20 40 •3 54� LAND USE PLANNING COMMERCIAL/RESIDENTIAL 9 r F[;! a�' � Serving Cape Cod and Southeastern A/assochusetts SCALE: 1 INCH = 20 FEET 101 TOWN HALL SQUARE — FALMOUTH, MA — 02540 — 508.495.1225 — 508.495.3229 fax ---FPROJECT NUMBER: 0411 CCAD FILE NAME: 0411OPP DRAWN BY: L.M. SHEET 1 OF 2 I RN16A WX0F SHALL BE 1X MIN/MUM OIER ALL SEPAL SYSIFM COMPONENTS USZr 4r O/A. SOXEDUL£ 440 PIS' 6W CAST/R6W PIPE x'M/N/MUM S mwao'mw EDGE-a-smw 70 GEZLAR #A'LL 10'M/N/MUM SETBACK _ REMOVABLE COVERS SET TO WITHIN TEST HOLE #1 12- OF FINISH GRADE (TOTAL OF 4) 7177 m. n,r I� A LOAMY SAND SOIL TEST 12" 10 YR 4/2 3' S = IiAR/E3' .02 M/N. ' Date of soil test: 8/19/04 B • s� w w - LOAMY SAND /N12rRT EZEK =.T0.87 1 LAYFR Ga-1�8 T70 1%Zw Test taken by-M. BORSELLI 36 "�i H'ASYIED STAKE Results witnessed by. BARNSTABLE B.O.H. - 1500 GALLON SET FRSr SLLpE VARIES Percolation rote: <2 MIN./INCH SEPTIC TANK 2'LEI�FL S = .O1 M/N. Ground waterNONE ENCOUNTERED a- ESTIMATED DEPTH: > 20' c COARSE SAND ; II 11 h Z BOX _ EZE{C 26�87 / tkt '7 SET SEPT/- TANK ANO 01SIR19070N BOX 1j INSTALL 9/4" TO 1 1%1" ON 6 LAYER OF CRUSHED STONE W �, fYA,WZV,, OPU.9 VED S70VC ALL 5' 120- �" Z W AROUND CHAMBERS AND ,00 NV li7 Th'E BOT71�1/ THE OyAMBE?P SYS7FA/. REFER TO LAYOUT OF PROFILE SYS7FM F6W MOPE DETAILS 180776W 0- 7FSr I1a V EZEI! = 24F 0 NOT TO SCALE J - REMOVABLE 24'"O/A. CODERS RfYOYABLE 240 O/A. COWR "--�_IFE OPEN AT 70p _Wr - INLET 3"KNOO'(OUT MIN FR6W TANK COWR a,',?ET KNOCKOUT INLET 1FE SZ7 OY/7ZE7' TEF SZrT I 10"M/N. &70#' 14f0BEZ00' t L/a/0 LEIkEL UQU/O LEIfz O GAS BAFFLE - I 1 N j a �± w d ,- 21 91A, REA/OVABLE COLFR PACTS FOR DESIGN- 400 70,rAL 041L Y,4ZOiY IS BASED 6W 5 BEDROOMS NO GARBAGE DISPOSAL 10' - 6" 5' - B" O i ` INLET •� - GY/1L % /NLET� 70,rW OAIL Y ROW= 110 a0WAEDR06W A'5 BEDROWS 550 00,0 � I i B0776'V AREA PR00OSED = 624 SF. 6' B" -` 1500 GALLON SEPTIC TANK H-10 LOADING -70F AREA PROOOS£D = 138 Sr • - NOT TO SCALE TOTAL LEACHING AREA PROPO-9-W = y0 w APPL/CAAaV RAZZ-= 0.74f &-POAF. (►. _ DES%CN LEAOVING C4PACY7Y= 56.E 6PO > 550 6P0 8• - 3 , ;' ��P� 'qs4cy PLAN VIEW CROSS-SECTION MICo� 6' o BOCHAEL DB-9 DISTRIBUTION BOX (H-20 LOADING) ® 1�2UEEO 34- o�SPEG\a�``�' SCALE: 1' = 2' 24" ® ® ® ® ® ® ® I ® ® ® ® SS�ONAL� ® ® 8' - 6" 9/13/04 ADD GROUNDWATER NOTE CONSTRUCTION NOTES: CROSS-SE DATE REVISION 1. /NSTALLAAGW AF 171E PRAOO.SFO SEPAL SYSTEM.9i'4LL BE/N ACCOK'OANl,E iHTH 177LE 5 ANO T _ SEPTIC SYSTEM DETAILS HE BOARD CF HEAL 7H REGULA TIONS 8' - 6- 2- A CAOY OF 171E PLANS SHALL BE AVAILABLE OW Sr7F FA?REFERENar AT ALL AMES - a • _ .= PREPARED FOR OUR/NO THE INSTALLAAAY Ar THE SEPAL SYSTEM" -" 5- KNOCCOUf NANCY M. CONNOR .T NO O'1ANGES R7 P1E DESJ'GN SHALL BE PE RFA4MED fN7HGY/T 7h'E APPROVAL Gc'BOTH FALMOY/P1 fNaNEZW1N0, INC ANO TH£BOARD OF HEAL TH. � �21• DIAMEER COVER IN 4K PIE SEPAL SYS'7£M IS 5V9,607- 70/N.SJ°EC77W BY FALVal7hf ENOWTR/NQ INC COTU I T MA AND 171E BOARO OF HEAL/W o I 5" KNOCKOUT c 5' KNOCKOUT PLAN DATE: SEPTEMBER 1, 2004 PLAN SCALE: AS SHOWN 5. 171E COWTR,4076 P"ALL NOAFY FALMOY/P1 ENONEFR/N4 INC ANO 171E BOARD A<HEAL P1 70 INSPECT 171E SZ-PAC S?5'7EM PR16W 70 BAQ'rRU. IN S6W-INSTANCES, MA4E P/AN OWE `r �_ SYSTEM 7t/A�T HAVE BEEN/NSPEC7FD AND APOl�FO BALMGY/TH Eil��EZrR/ ACO E a CIVIL ENGINEERING WETLANDS PERMITTING T,t O 7 r P1E BOARD A<HEALTh! WASTEWATER DESIGN A lvs U I� COASTAL ENGINEERING 6. IF 771E COWRAC7Zi4 E V6WN7FRS AND VAR/AAA1/S IN-V)F CW,0/AOW.S S7/O/AS O/FFER/NG 5" KNOCKOU' f SOIL. Tl7POCRAPHY, J C71ANOS 6W 07HER GZ�ND/AO1VS P/AT MAYRELY//RE RE-EVALUA)7aV A'- Y 'r'•, TITLE 5 PLOT PLANS �, ` ��` PIERS AND DOCKS 171E DES/G71; 17I£C6WRA rOF SJYALL IMMED14M Y CONTACT FALMOUPI EWNEFR/NG, INC — 1 LAND USE PLANNING VGI N EERI COMMERCIAL/RESIDENTIAL Lam E. Serving Cope COd and Southeastern Ma"oehusetts 500 GALLON LEACHING CH.A_' ��ER (H-20, LOADING) 101 TOWN HALL SQUARE — FALMOUTH, MA — 02540 — 508.495.1225 — 508.495.3229 fax SCALE: 1, = 2 PROJECT NUMBER: 04110 CAD FILE NAME: 0411ODT DRAWN BY: L.M. SHEET 2 OF 2