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1240 MAIN STREET (COTUIT) - Health
6ksraM'}�#FaA# � J} �t� -•w�a� dY a-� ; x z �r`12'40�5MainStreet ++Lift } i 1� 1 �r TOWN OF BARNSTABLE !yL,OCATION'' Jo2 4D ✓ 741'Af cST. SEWAGE#o�OD�-6-W VILLAGE CON T ASSESSOR'S MAP&PARCEL 33/00S' INSTALLERS NAME&PHONE NO. fJ,` c����� sod-yab�-ss�ZQ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) SDo 6g[Cfti4M/WJ (size) Ja/O Y �a NO.OF BEDROOMS " OWNER )2 (^ H/ 4,. PERMIT DATE: /02—/. ;-_ COMPLIANCE DATE: eC �Q4 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. G • rule i s$ 13i 1 C/ tab., RISe� {/O .r-e— I 0. 0 1 S Town of Barnstable r# oF� Department of.Regulatory Services Public Health Division 1• Date a •200 Main Street,Hyannis MA 02601 't.. �+ j•';;I.1 tti .'� Date Scheduled Titne Fee Pd. ,foil Suitability Assessment for Sewage Disposal Performed By: 4 y C Witnessed By: c LOCATION & GENERAL INFORMATION G>cs Location Address Owner's Name M. —�� _ �Q Lt t n d rl l - Add ,3 Address t fit/ ('� �/ ✓ ro ✓V y /00Z a,6� Assessor's Map/P$rcel: 3 3 s 0 p!• Engineer's Name W(�S f dL,-0 �- C "► N"2C� '�Fa rre. NEW CONSTRUlt`TION REPAIR 'q.,. Telephone# 6?3 J~ Land Use 1 r� Slopes(go) �z Surface Stones y " Gar-''�✓ �� � • ; Possible Wei Area Distances from: Open Water Body )eft ft Drinking Water Well Drainage Way, zw• t ft Property Line _Zft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,_locate wetlands in proximity to holes) Il w 10 l Zel S' 2 Z /1w� (got. I , 1Z� t I 3 ' ��rc �i % obs Tcl1'' ►`'lob 33 A0R-C.C- L C- Parent material(geologic) � kA'fS)� Depth to Bedrock_ 7 Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face CEsEifna®ted Sermon-ai:tiigii Groundwater DETERMINATION FOR S EASONAL HIGH WATER TABLE Method Used: _,o in, Depth tt1 Soil tnOUJOS: A In. Depth obperved standing in obs.hole: p fr, _ Depth toiweeping from side of obs.hole: ^� in. ©roundWater AdJugtment _ A factor _ AdJ,(Irt"dwater Level r� ` Index Well# -— Reading Date Index Well level - dl PERCOLATION TEST Dat�° -/a Time / -._. . . Observation Time at 9" Hole# ...- r / Time at G' L � Depth of Perc / 'Time(9"-6") Start Pre-soak Time.@ End Pre-soak - 2 gel Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed; Additional Testing Needed(Y/N) / Original: Public He*lth Division Observation Hole Data To Be Completed on Back------- ***If percolation test is to be conducted within 100, of wetland,you must first notify the Barnstable Ckiservation Division at least one(1)week prior to beginning. Q-,\S EPTICIPER CF�RM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil t Other Surface(in.) (USDA) (Munsell) Mottling (Strucre,Stones,Boulders. Cons stenc ravel to Y9 8 DEEP OBSERVATION BOLE LOG. Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) o -• zo 'r ��rr �6 38' It C c CW4691 $OOAO �oY► 7 0 �l� � • v f e� b DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA] (Munsell) Mottling (Structure,Stones,Boulders. Consi tenc Gravel i 'DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Calor_ Soil _ Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistenc ra 1 l Flood Insu ran e Rate Ma • Above 500 year flood boundary No— Yes "C— ; C9 Within 500 year boundary No— Yes„e.T Within 100 year flood boundary No— Yes, . Depth of Natufally Occurring Pervious Material r feet of naturally occurring rvio s material exist in all areas observed throughout the . Does at least fo�l y g Pe - 5 area proposed fbr the soil absorption system? f naturall occurring e ious material? If not,what is the depth o y g P �---�-�---- Certification I certifyartment ofnvi nmental that on. 4 Y 9�(date)I have passed the soil evaluator examination approved by the DeP Protection and that the above analysis was performed by Me consistent with . J the required train' pe se and ex rie bed in 310 CMR 15.017. SignatureL�j Q:\SBPTICIPERCMRM.DOC . No. . J ° , Fee — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for ai.5pont 6p6trm Con0truction Permit Application for a Permit to Construct( ) RepairJ00 Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. /p? /�� S�• � � Owner's Nam ,Address,and Tel.No. Co`Tvi✓ ��9Rr CASyiN �T�Q Assessor's Map/Parcel Installer's Nme,Address,and Tel.No. S p$- Designer's Name,A dress and Tel.NQ. 0�8$�3 rJw �`LAGr:�I"�S I c� {ag-5"SoIQ g�l� �/4%1U 5L'/�t�e3 s`?��on�s C�Slerwi �c 6/8 fyAin ST w.��,� . aa6''�3 Type of Building: Dwelling No.of Bedrooms ,5 Lot Size sq. ft. Garbage Grinder (4/0 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 55-0 gpd Design flow provided S6/ gpd Plan Date X/O N. 5)a o O 7 Number of sheets / Revision Date Title Size of Septic Tank /500 G/ir/• Type of S.A.S. SOo C okL C_itq h3d1S - 1 Description of Soil 5 �Qc�Sory�ogJ an Nature of Repairs or Alterations(Answer when applicable) %�ga f Fi711 Jl /tit C 5--50oAP L CtfknnLees th A ✓e2/ "X �Q'freyy Ar l� &TohG 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 Certificate of Compliance has been issued by this Board of Health. S'gned Date :DEC. �/02 Application Approved b Date /`J Application Disapproved by: Date for the following reasons Permit No. pZ�'� 2 � Date Issued ( 0 r———————————————— —— —— Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zfpoftraffibn for �Diopoal �&pgtem Cougtruction Permit App.licatiqnffor a Permit to Construct O Repairle Upgrade O Abandon O ❑.Complete System ❑Individual Components ' Location Address or Lot No. Owner's Name,Address;and Tel.No. Cen. i Assessor's Map/Parcel �O� � u � .5o 71 r /<P7 7 5Q� Installer's Nape,Address,and Tel.No. C S- Designer's Name,Address and Tel.No. 5s3R3J� Type of Building: Dwelling No.of Bedrooms .� Lot Size sq.ft. Garbage Grinder (3/0 Other Type of Building No.of Persons j Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) $SO gpd Design flow provided �`-6/ gpd r- Plan Date �/011- 1.7 Number of sheets / Revision Date Title -- • Size of Septic Tank /5 00 GA/ Type of S.A.S. SOO 6 fN I. .0 M,i I►A-5 ,'J) 5 ,r Description of Soil i SO,I kqJ cri e9�9vt x tti Nature of Repairs or Alterations(Answer when applicable) f i%�TX t S J �_C 0��S - eGr1 J7- ZS%70-Y S?c,IC Date last inspected: Agreement: The undersigned agrees to ensure the construction and-mai tenimce of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envirbnmental6de and,not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health{ S'gned Y Date 0E-C. /l Application Approved 41 Date / 7 0'� Application Disapproved by: ys. 'F, a /''s� t Date F for the following reasons 1I Permit No. : 0-oo 7 ""' 7 f Date Issued j� ti—— ———— ———— ——————————————————————————=- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 5-tQ- 64 Certificate of Comp iauce C-0C THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( � Upgraded ( ) Abandoned( by at /,�y0 /`/iq,A/ J(, Go—K;T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. `00 7 5 77 1 dated ,17)0-7 Installer �resCP /7CZCe.///'S/r r Designer /-)-f kl CIAAm #bedrooms �"— Approved design flow 5—0 gpd The issuance of this permi shall of be onstrued as a guarantee that the system 1 func on as MpedlDate Inspector %%, 1 --- � _ / ------------------i---- �Od --- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS &!5poal *p5tem Con5tructiou Permit Permission is hereby granted to Construct ( ) Repair (t5� Upgrade ( ) Abandon System located at j 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 c mpleted within three years of the date of his e t. 11 Date 77 Q Approved by i A & M Land Services Surveying and Title V Septic Services 618 Route 28 - West Yarmouth, MA 02673 (508)771-5263 Office *** (508) 737-1777 Cell House Plans 1240 Main Street Cotuit,MA For Septic Repair Plan Dated 11/05/07 L( j j3 CD � T f Town of Barnstable Regulatory Services Thomas F.Geiler, Director HAM f ienxsr�►s�, Public Health Division ATFD ' Thomas McKean, Director - _ 200 Main Street,Hyannis,MA 02601 Office: 50878624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: E'Ca/aOo/>SewaQe Permit# 0�7 S7i b Assessors MaplParcel Designer: Installer: Address: Address: (97 �?no S/, Val,6S On ,��'l /'07 !'yCe��C�f/�/�� was issued a permit to install a (date) (installer) septic system at O/1-1/ based on a design drawn by (address) / A- �^� M � GIA ,S P, V► Ce�Cated fi t - > 07 (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. Jt OF Mgss , (Instal er's Signature) qP >dIVSLOW yG c0a SPOFFORD .p #2030 ' (Designer's ig. (Affix D �LHere) 4 PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORtiI AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. 1 Q:Health/SeptioTesigner Certification Form 3-26-04adoc TOP OF Raise covers to within 8" of FOUNDATION finish grade install risers as needed Raise covers to within 8" of EL 33.1 Sweep C:O m/screweep finish grade install risers as needed to Ora de Z, F. STANDARD NOTES F: 3,22 F.G. 32.1 GROUND SURFACE EZ_s2.o__ - 1) THIS PLAN IS FOR THE lNSTALLA7YON/ REPAIR OF A SEPTIC SYSTEM :•: 4 Bead Stai�aless Steel Connector Proposed 2) ALL INSTALLATION PROCEDURES AND KATER1AL,S' SHALL CONFORd! TO 910 CMR 15.000, THE STATE ENVIRONMENTAL CODE, Top EL 31.3 D - Box TnU 5, AND THE TOWN OF Barnstable_ SUBSURFACE DISPOSAL REGULATIONS. mom mom Pro 3' •29.p 3) NO DETERMINAT70N HAS BEEN MADE AS TO COMPLIANCE OF AVAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS Crawl Space : 3i.27 2"MIN--3"MAX Tee TOP EL OR ZONING REGULATIONS MIN 2' LAYER DOUBLE WASHED 4) THIS PROPERTY IS SERVICED BY TOWN WATER INVERT EL / y ''`-- vs• 1/2• STONE , 3022 " „ 5) ?HERE ARE NO KNQiPN WELLS' A7THIN 100 OF THE PROPOSED SOIL ABSORPTION S 'M 10 14 30.02 24 3a --------- Existing INVERT EL � " - - _ - - -... - - - - 8) ALL COYERS OF SYSTEM COAfPONENT,9' SHALL BE BROUGHT TO WITHIN. 8" OF F7MSHED GRADE `y INV EL _ - _ _ - - _ - - _ - - EFFE'C?7VE 7 ALL SYMM CO&POAMM SHALL REdIAIN ACCESSIBLE FOR LNSPECTION. NO STRUCTURES MMLL BE LOCATED DIRECTLY INSTALL '' SIDE WALL UPON OR ABOVE THE COMPONENT ACCESS LOCA?YQNS, WHICH WOULD INTERFERE WITH THE PERFORMANCE, ACCESS, INSPE'fG"TION GAS 28 37 BAFFLE 28.20 PUMPING OR REPALI� 28.0 Bo EL 15 7 INV EL INV EL Four 500 Gal ConC H2O 'b 'b 3/4"- 1 1/2' DOUBLE 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER LlIPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION INV EL Chambers w 4' stone all round v) WASHED STONE SYS"= EXCEPT WHEN VEN77NG HAS BEEN PROVIDED. 8" STONE BASE " / „ , " .4 28 0 BOTTOM EL 9) SEPTIC TANKS, GREASE TRAP$ DOSING CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 8" STONE BASE (4 -10 x 8 -8 x 3 -0 � o+ TO ENSURE STABILITY AND PREVENT SETTLING. Proposed (H--10) 10) OUTLET DISTRIBUTION MNES SHALL RENALV LEVEL FOR A AMVIMUM OF THE FnW IWO FEET OF THEIR LENGTH. 1,500 Gal Septic Tank S = 0.04 �, , " O 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' S = o.o25 S = o.10 s _ o.o1 SAS (i2 -10 x42 -0 ) �� b � OF DRIVEWAYS OR PARKING OR TURNINO AREAS, IN WHICH CASE H-20 COMPONENTS SHALL BE USED. 42.0 1q' 1 ® S i2) ALL BUILDING SEWER LINES SHALL HAVE AN DVNEI? DL4METER OF 4" AND SHALL BE CAST-IRON OR SCHEDULS 40 PVC. 1 0 2Cl EL 20.1 No Groundwater 13) THE DEPTH OF 771E TOP OF ALL SYS"TE71! COMPONENTS SHALL NOT EXCEED 38" U LESS VEN77NG HAS BEEN PROVIDED 14) IN THE AREAS OF EXCAVATION, EXISTING GRADES SHALL BE REESTABMMMD UNLESS NOTED AS PROPOSED CONTOURS Map 33 Parcel 006 1 42 0 ; 15) IF ,STOW ARE ENCOUNTERED DURING THE EXCAVATION OF THE SOIL ABSORPTION SYSTEJ( THAT DIFFER NOTABLY FROM #14 Sea Street 711E DEEP OBSERVATIOM HOLE LOG, CONTACT A & M LAND SERVICES AND TOWN BOH BEFORE PROCEEDING. /Y /Y 18) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND U77LC11ES. PRIOR TO CONSTRUCITDN (32.8) PROPOSED LEA L�HING FA(.�ILIT Y 17) CHANGES OR REVLSIQNS TO SEPTIC DEMON ASQUIRE Na7YFTCATl4N j,� /�/') Gal s� /Y TO A & M LAND SERVICES AND TOWN BOH FOR R&'VMW AND APPROVAL Four ur 5V V L,T a 1 H�G 0 Concrete Crete 18) CONTRACTOR SHALL NOTIFY TOWN AND DEMON ENGINEER AT LEAST t-b� 24 - 48 HOURS PRIOR TQ IAISPECT7ON(S). Chambers with 4 Stone all around Total . Dim s 1,2 10 x 42 0 Wooded �sz , Area y DEEP OBSERVATION DEEP OBSERVATION Proposed 1, 500 (H-10� jo.o,��' � 13 pp �.�, (3,24> .. DESIGN DATA Gal Septic Tank P $3- � HOLE LOG HOLE .LOG 12• _ Number of Bedrooms: Test Hole #> Test Hole #2 a �\ Garbage Grinder: N17 (EL = 3.21 f) (EL = 3.21 �E} 0 / •'. .'.• Design .Flaw; 550 � D Soil it ii D Soil Soil git Pump Crush and Sand P� � ' C iar Pump, / (110 Gal/BR/Day x Number of BR) Mori n ?(USDA) for Tel 8orlaon ?eacture o Fill a required b 9' (3,2 4) / �. (USDA} (Hansen) (USDA) (Munseu) s 4 .Y ES ti �a. / Septic Tank-. H-10 1,500 0 - 2z' so.3 FUl 0 - 20" 30.4 F91 Title 5 / 4� ��, 0 �� (Minimum = Design Plow x 20ox) Gal. _ _ 2 �',� r000 Req. 2z' s4" 29.3 B LOAMY SAND 7..5YR5/6 20" se" 28.9 B LOAMY SAND 7.5YRS/6 �bS A / / Leaching Area: O e@ `Sfor� Sidewall: s4•• - 144•* 201 C COARSE SAND fOYR7/8 38'• >44" 20.1 C COARSE SAND f0I'R7/8 Hole W/Blotches WlBlotches Pra osed--- �a 0 Sidewalla x 1� x �) + Map 33 Parcel 00900a? / etc 2.1 / 4�2 D' 2 D-BaX (H-,G0> (3,G.1) �i . (2 Endwalis x _____FT x �_r.Ft) `,�19 32 SF Deep Oba Hale Date: 8131102, Soil val Hole Date: 8/Sf%07 #1 rG 3�G A ain ° Street \ \ Boil Evaluator. 1SD STONE Soil Evaluator. ED STONE Bottom: 538.88 S Witnessed By: DONNA XORANDI Witnessed •�- DONNA 1lIORANDI TP T L2.83 n x 42.0'n) Para Ratan Para Rate s 2 min/in ® 68" (31.3) ``• 2A32 1) �2,9) 758.18 SF Boil Survey Description: CARVER Boil survey Description: CARVER + # Long Term Acceptance Rate (LIAR): x 0. 74 06ologio Material• cWUL aan►►ass Arwzerers 0e010210 MaterlaL. 01JOL"w w"'ff" rt"n Inst811 C:(� with / / Depth to Standing Water: NA Leaching Area Design Capacity. 581 GPD Depth to Standing Water: NA 4 screw cap to grade Obsc g g ' Depth to Weeping Water: NA Depth to Weeping Water: NA .•, (Bidewall Area + Bottom Area) x LIAR Depth to llottUng(Color): NA Depth to Mottling(Col+nr): NA Hole . l l Not Seasonal High OW: NA Est Seasonal High O► NA ° 0 USaS Observation Well NA US(iS Observation Well: NA Date of Last Measurement: NA Date of Last Measurement NA Install 4 Band / _581 _ 550 = _ _ Comments: Comment Stainless Steel .�' . • . • Q) / GPD Provided GPD Required 11 Reserve S !6 ld <1 Connector Crawl ace rS' Cra Sp r0 sO ed v p � •tb In House Variance� C 1, 40 Mil Liner i Request vari/ / . ance to the 20' setback between the edge of the SAS �. tb and the existing building.'A 15' setback and 40 mil Liner is provided p \ \ / A 5' variance is requested. Title 5 Section 15.21 l(1). Sep tic Upgrade Repair Plain .Bldg #1240 / / in 5 Bdr's / Co t ui t, MA •1 �,�t) ("�► l ASSESSORS MAP 33 LOT 005 TopFndEL - 33 3 �V off' 32.5) nn ,, / Located A t � t �J Zone: RF 1240 Main Stre e t Crawl Space ,y�J / � Setbacks n�,• Co t ui t, MA •� •9 / "Y / FI'ol2 t 3(�i -,.,A �aF:q ,r _ .0 / Side 15 � 'o wt s� w a Applicant/Owner �� ° \ l / Rear 15' 2 M y SPq OR Mary Cash in °� 45 Su t ton Place South - t ` Deed Reference �ha suRv "tsd� +!4` p Bk. 1,2896 Pg 05,2 New York, NY 1002,2 schoor SCALE.• 1 = 10 DATE. November 5, 2007 Street l l Plan Reference PREPARED BY.- PI Bk 14 Pg 41 Ln ram'=t-"=Mew - A & M Land Services \ \ / 618 Main Street a� West Yarmouth, MA 02673 \ \ / F'ema Ma Ref. �, Ph. 508 77t-5263 anmland®comeast.net p o Gotuit 250001 0021 Locus rn st. Bay Zone C July 2, 1992 � GRAPHIC SCALE 10 0 5 10 21) 40 \ Locus Map 1 incIN h FEET ) \ \ NTS