HomeMy WebLinkAbout1311 MAIN STREET (COTUIT) - Health 1311 Main Street (Cotuit)
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YOU WISH TO OPEN A BUSINESS?
3.,� i�;' s :C A.: Certificates
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MiA 026i01( 'ou,,fn 1,011 and" thet.¢.a,� rya s...� C.:c�r ific atei thcit, is req Ared by lavlf..
DATE
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APPLICANT'S YOUR NAME/CORPORATE NAME BUSINESS TYPE: 71e+
BUSINESS YOUR HOME ADDRESS: 3 i( /YEA 0 G `
) —6e)X / lrs
TELEPHONE # Home Telephone Number 7 (0 7 S J
NAME OF NEW BUSINESS :�F2/ /,e S EIN: t4-7 a6
Have you been given approval from the building division? YES NO 01
ADDRESS OF BUSINESS APIPARCEL NUMBER CJ �
i
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST G"O''
Yc.`JQ'U^� oidth Rd. Rx Ikflaii U tc) r aka,:, f t!Ars you h�koe! Mile al,1,11.41-ri'1?priate pt'?U'Ri(Eks and 8;cawssF, U"eB:tJUk6U`&"a�6 �N:84i` Q�(y�.,G�31t:P �oU,GU' ((:;In,. :_.W6
OU t:GCfi ':¢UefiiPD. �jl (�G�A d
1. BUILDING CO ISSIO R'S O7r�
® This individ al n fn er it a uire nts that pertain to this ty MU T$nPLY WITH HOME OCCUPA �Q,`
Nt 1 EGU:,ATIONS. FAILURE
Au hor=igna-fgrel�
COMPLY MAY HE8ULT IN FINES.
COMMEN S. s
2. BOAR O AdH
This individual has bee of the permit requirements that pertain to this type of business.
Authorized SignVature"
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature"
COMMENTS:
No.�/�/P� �l� FEE
Board of Health,6 rt.00 4 S t ," /,-, -, MA.
""APPLICATION FOR DISPOSAL SYSHM CONSTRUCTION PEPMIT
Application for a Permit to Construct(wirepair( ) Upgrade( ) Abandon( ) - Q.Complete System ❑Individual Components
Location 1 i M#)1V $ ( lT Owner's Name I+U R C� /
Map/Parcel# o / 01 L Address
Lot# .7 a Telephone#
Installer's Name Designer's Name
Address! �GAgIl /hd Address c10 -I�►c�uS'Fv ✓1'l I�S�`'1S l�l
Telephone# iATelephone# c
Type of Building �/I1 ��A ,�oIN�L Lot Size /J sq.ft.
Dwelling-No.of Bedrooms Garbage grinde
Other-Type of Building No.of persons Showers ( ),Cafeteria( )
Other Fixtures 9
Design Flow (min.required) 33 0 gpd Calculated design flow ® Design flow provided 369 gpd
Plan: Date Number of sheets Revision Date
Title /4 AJ
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluat i-',.,'C.e 6:Olu�� ate of Evaluation 1 0
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install th above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrves.te t to 1 e the stem in operation until a Certificates of Compliance has been issued by the Board of Health.
Signed— Date L 0
l4wpeetims gzz
'3N.fit+�
FEE
-OF MASS C14USETTS
OMM6WINVIA'
�cz,rvtSu� {'
� Board of Health � 1VlA. !
A VIICATION FOR..DISV®SAL SYSTEM'CONSTRUCTION PERMIT
Application for a Permit to Co struct( Repa>rUpgradeO Abandon O Complete System ❑Individual Components M i`
Location J i ` !7'1 Jq S € 'v�l�l Owner's Name 6 U od
Map/Parcel# 0 / 8 0VI L Address
=Lot# 7 Telephone#
Installer's Name Designer's Name V(-Y7 A'4
Address 0 Ile OvlGf �f' is)d� i Address �p �►Cj�,S��, )/►�UQ t�S `'1 S I�1 l
Telephone# Telephone#
Type of Building -5/ri dI/1a� Lot Size ' t ) s .ft..
Dwelling-No.of Bedrooms 1 Garbage grinder
Other-Type of Building No.of persons Showers ( ),Cafeteria( )`
Other Fixtures Design Flow (min.required) 33 y gpd Calculated design flow 3 3 0 Design flow provided 69 gpd
Plan: Date a-eZ L!-'C� Number of sheets Revision Date
Title S-eot:y i
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluat r�kc - Mores y ate of Evaluation d 0 '
71
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ti
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install 1110
above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
agre further es-to t to a .th system in operation until a Certificate of Co^pliance has been issued by the Board of Health.
V! 1
Signed Date p!
IYns
No. FEE
COMMONWEALTH OF MASSACHUSETTS
_. ._
-'Board`o-f Health,' r3�✓�S�w e
P- 5v�c 4 J.T• rile
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) a<10mplete System
The undersigned hereby certify that the Sewa e Disposal System; Constructed ( ` ,Repaired ( ),Upgraded ( ),Abandoned ( )
by: 9 _ 711,4od
at
has been installed in accordance with the r}'�sions of 310 CMR 15.00 (Title 5) an the approved design plans/as-built plans relating to
r application No. �1 So dated _/ Z 3 �� Approved Design Flow -5G ( (gpd)
Installer \'4**,q kycA_AX
Designer: "n e0ASt'tt"14 nspector: Date: G 2 0
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. v"" FEE w�1
Board of Health, S �e MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Z,.� Sf4WJl0
Permission is hereby granted to; Con�sstruct(Z<Repair Upgrade( ) Abandon.( ) an individual sewage disposal system
at f A-, S^l — �QTU 1 )� as described in the application for
Disposal System Construction Permit No.ZUd/- dated s 'Z 3 U, f �,
Provided: Construction shall be complete dth/'n three years of the'date f_ .' ermit. All local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ( � Board of He.,1�_
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TOWN OF BARNSTABLE
LOCATION 1311 Md„n S SEW ED 20ol- 3o S'
VILLAGE ° t ASSESSOR'S MAP & LOT OW-0 7 2
INSTALLER'S NAME&PHONE NO. 5 ra a at a ym n
SEPTIC TANK CAPACITY 570 d & �—
LEACHING FACILITY: (type) (size) / /X
NO. OF BEDROOMS 3
BUILDER OR OWNER r
PERMITDATE: ^ a COMPLIANCE DATE: a 6
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 st a o> ithin 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
11'T1111 Fill
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PROJECT REQUIREMENTS AND NOTESr
actor shall comply with all requirements or the One and Two Family Dwelling
r the Massachusetts State Bulld Code 17180 CMW latest edition and with
onto of the local Bullding Commissioner,
actor shall comply with the Energy Conservation Requirements for New
tion. Low R1eo Residential HulldIngo,In accordance with Massachusetts A4
Ilding Code Chapter 13 and Appendix J. _ U
Doak ro■n P.T. UO
actor Is responsible for securing required approvals from applicable oa r
Commle°Ione,Planning Board,Board of Health,Sewer Commission,
ation Commis°lon/DEP,Fire Department, Highway Department
6-/• ,- r
scion shall comply with local zoning by-louse and all restrictive covenants —
Icable.
tractor shall verlryy all dimonelons and conditions at the site and report L�Q� L� QO
Bpa riclee to the Architectural
,Designer prior to ordering material and rN 1
Ing with construction
t
010
sing eyetom and gas requirements shell comply with the Plumbing and Gas ib
18 CMR)latest edition. 9 o c ieiend O10
o rWtX:�`I 1 _
nical systems shall comply with Section 36 of the Massachusetts State
o 1 vT04
C L e,Code l80 GMW latest edition. a v oa ,o
trlcat wiring and equipment shall comply with Maesachusotts Electrical Colo ' � `• �,°
R 12)latett editlon
t designations,strength of materials,grading standards,manufacturers ' - -
edol number,etc, listed In these specifications are intended to establish
uality and design standards for this projecL
actions,details,notes,methods or materials shown and/or noted on the '
Hors or elevations shall apply to all other similar locations unless II
a noted. a
�1.. . oMIM III
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torsi drewinge shell be used in conjunction with architectural drawings and , � 4
done. ,•! . -
eheil be no changes that effect the aesthetics of the design without the �
tten c xL srt.of the Architectural Designer.
an dimensions shell have precedence over scaled dimenslons. Scaling plans �
act dimensions Is not recommended, p .. ..
drawings are required for any building component,that'shell be
to the Architectural Designer for review prior to fabrication 3-a' � a a � �
drawings are the property or Hitchcock Deslgno and are protected n +
copyright laws of the United States. AxN reproduction of those drawings °"'s°ECKWI
prohibited and may subject the offender to civil liability and severe
altles under Title 11,United States Code.
IST FLOOR PLAN
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1,8183 CBIDff I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE
IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL"
STAKE STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN COTUIT
(SET) COMMONWEALTH MASSA
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• PAUL A., MERfTWEW PLT ATE CB1,Dff
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AREA=19,795* S.F
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LOCUS MAP,
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HOUSE
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1110 Br REA117 IV) v.
ASSESSORS MAP 18
PLAN REF .6
G. &, �/7
EMSTING CD ZONINC: "PF
CESSPOOLS T
/ 4, / FLOOD ZONE:
/, / rj - -
77-- . . 0 1 . COMWUNITY PANEL#
10v 18�ot y't 7/. 256001 0021 D
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Cd 719F=100
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?0. DATED.- 7102192
Tp 0 VEREA Y D?STR7CT- "AP"
ell
BrA" PROpa
(Mr) ' \-9. , NOUS�� � '��s'?' ��Q
SITE' AND SEPTIC PLAN
SET)
(SE T) BENCHMARK.- LOCATED AT
TrAZC TPjf2
TOP OF WATER VALVE A.M. 18171 'ye \
.0. ELEV= 100.0, 1311 MAIN STREET.
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C Il� A.
OTU M
100 ... RNSTABLE)
(BA
Cb PREPARED FOR-
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C�l AR�
MA URA ' CONRO Y
FEBRUARY •24, 2001
GRAPHIC SCALE
YANKEE SURVEY CONSULTANTS
Y ROAD
30 0 30 60 120 UNIT 1, 40 INDUSfR
CHUSEFT
S'T 4 400 OA
N
P.O. BOX iE65
pMARSTONS MILLS, MASS. 02648
TEL- 428-0055 FAX 420-5553
IN FEET CBIDH
I inch = 30 fL
J . 52461A
EL: =_loo__
719P OF MUNDAXION
1
20 MIN.
10' MIN, CONCRETE COVERS .. . ,
ki 4" SCHEDULE 40 P. VC
MIN. PI7L^H 118 PER FT 2"LAYER OF
a 1/8=1f2" VENT
i . e MAX / -� i . . i i i CONCRETE COD - WASHED S 719NE
EL 92
. . . . ,
4` CAST IRON PIPE 12., EL=94
(OR EQUAL] MINIMUM CLEAN SAND
PI71^H 114 PER FT W 9„
FLOW LINE EL=89 MIN.
INVERT 1 10`
MIN. 14" _
EL. 91--- GAS INVERT LEVEL ° ° °°
BAFFLE 6 SUM ° °° °o ° °°
INVERT EL.= 90.5 INVERT INVERT ° ° ° °8
EL.= 9_0. 75 EL.= 89. 75 EL.= 89.5 _ °°°0° 000
°°8° =87:5'
(7V BE PLACED ON "" BASE) DISTRIBUTION
AcwHANmALLY COA/PAcrED oR 8. OF smNE BOX ,
�SQIL__GALLONS 719 BE WATER TESTED h
11 X 38 TRENCH 1�YIRMATIOIN
SEPTIC TANK IF MORE THAN ONE OUTLET cp
PLACE ON 6 S71�NE 314` 717 I=1i2` SOIL iAB,SORPTION
PROFILE OF DOUBLE WASHED STONE SYSTEM (SA S)
SEWAGE DISPOSAL SYSTEM BOMM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV
NOT TO SCALE d NO OBSERVED WATER TABLE (12107199) ELEV.=_81_O —
OBSERVATION HOLE 1 . ELEV=_9z__
PERCOLATION RATE MIN./ INCH AT 4z" INCHES OBSERVATION HOLE 2 ELEV.__ 93' _
DEPTH HORIZ TEXTURE COLOR M077 OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER
0-12" A SANDY LOAM IOYR 4-1 0-12" A SANDY LOAM IOYR 1—I
12-30" B LOAMY SAND lOYR 5-8 12-30" B LOAMY SAND IOYR 5-8
GENERAL` NOTES " FINE " FINE
30-132 Cl 30-126 Cl
• - MEDIUM SAND IOYR 6-6 PERK MEDIUM SAND IOYR 6-6
1) ALL �WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
TITLE 5 AND THE TOWN OF —BARNST4RLE____ RULES AND NO WATER ENCOUNTERED NO WATER ENCOUNTERED
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.
2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO ' SOIL TEST Pf 9890
WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 1211912001 SOIL .TEST DONE BY BRUCE G. MURPHF, R S.
3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR' WITHIN WITNESSED BY: DONNA MORANDI
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CA L C ULA TIONS.'
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 3
4) ANY MASONARY UNITS USED TO BRING CO VERS TO GRADE SHALL NUMBER OF BEDROOMS . .. . . .
BE MORTERED IN PLACE. GARBAGE DISPOSAL . . . . . . . NO
5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH, TOP LOAD TOTAL ESTIMATED FLOW
DEEDED OR ZONING .REGULATIONS. OWNER/APPLICANT IS TO 5 INFILTRATORS WITH ( RO—_GAL/BR./DAY x _3___ BR.) 330 GAL/DA Y
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 4' STONE SIDES AND ENDS REQUIRED SEPTIC TANK CAPACITY 1500 GAL
6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 11 X 38' SOIL CLASSIFICATION . 1
IS TO CALL "DIG— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS DESIGN PERCOLATION RATE 2 MIN./IN.
PRIOR TO COMMENCING WORK ON SITE. * TO BE REMOVED AND REPLACED
7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EXISTING HOUSE AND FOUNDATION EFFLUENT LOADING RATE . • 74 GAL/DA Y/S.F
� `
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. LEACHING CAPACITY (AREA X RATE) 369 GAL/DAY
WITH CLEAN MEDIUM SAND
8) PARCEL IS IN FLOOD ZONE--"'C" . RESERVE LEACHING CAPACITY . 369. GAL/DAY
9) LOT IS SHOWN ON ASSESSORS MAP __18 AS PARCEL _7�2 . * CESSPOOLS TO BE PUMPED AND FILLED (38XIIX 74)+(38+38+11+11X .83 X 74)
7110 ArrTAlDTD 90-4P1 A