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HomeMy WebLinkAbout0218 OCEAN VIEW AVENUE - Health 218 Ocean View AveN k-P— A= 033-036 Cotuit TOWN OF BARNSTABLE LOCATION o%:q J j g-ut s40 SEWAGE# 1 VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. °-1eiL.aot.�( (_eMt Q�• 171-134 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) U.-ins NO.OF BEDROOMS /a OWNER ; PERMIT DATE: JeC�,o"7—L.3 COMPLIANCE DATE: Separation Distance Between the: rt 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 Tar ' , y/'� � ' 311 No.20IQz�' q00 *' Fee �/56 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pfiration for Disposal *pstpm Construrtion permit Application for a Permit to Construct(d�/Repair( ) Upgrade( ) Abandon( ) RKOmplete System ❑Individual Components Location Address or Lot No. %S'Oda n-View O is Name,Address and Tel No. � � q I&`Val �tl� ClG l4 E Cn ker f �se.5 Assessor's Map/Parcel �� CO -`'e't' P-0, � � 644 O;)k63S- Installer's Name,Address,and Tel. io. 601r -'j'a 199 Designer's Name,Address,and Tel.No. s G 6-r %` -a Lj:1;iC 4•U g6k G!� kwo, Is AIA ' p 0�o3 51 Type of Building: g Dwelling No.of Bedrooms Lot Size ° ` sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re(uire ) `'go gpd Design flow provided 3 Y7- gpd Plan Date /3 Number of sheets 1:p_ Revision Date Title111Q^ Ago o Jt%0 WlZCi Size of Septic Tank Type of S.A.S. X Description of Soil 6,ee Y Nature of Re irs or Alt rations(Answer when applicable.Z ' 9 x x 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 C of to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' ed �^----___._ Date ld►`/tSl1,3 f Application Approved by Date Application Disapproved Date for the following reasons Permit No. Z013—40& Date Issued &/111 2.013 ---------------------------------- ——— — -------------- - - - - ,r `.+:... •._-^c.i•M.r�+`^"*+.-w.�...y-^'s�+c�vunw^«`*a.s'�'-ti 5-0 20 6- No. E s Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Misposar *pstem,Construction Permit Application for a Permit to Construct(I')/Repair( ) Upgrade( ) Abandon( )', N- omplete System ❑Individual Components r Location Address or Lot No. a/ odd(h Ut,--Lv j4U-Q- Owner's Name,Address,and Tel.No. Sod _ 5/ •V9 Assessor's Map/Parcel U 3?, ,U'3(, O. 205c, v vi , YV►l� o 3 Installer's Name,Address,and Tel.No. `r� -'� 1 3 Sq Designer's Name,Address,and Tel.No. ?, ; G�-k�•l r Tel.No r usfry/?�f cx;5//.o G'r�c c ,M')c 0.0 /fax G/Z 1�1�s�va�, ';t1� . MA c�� � t' !Ja uA�It4 T)rpe of Building. l I Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type cf Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re%wire/) gpd Design flow provided % gpd Plan Date /D/ i/�3 v Number of sheets 4 Revision Date Size of Septic Tani: "--jG QdX > � Type of S.A.S. 67 Description of Soil��.�. n '0� So, / /0 v Nature of Repairs or Alterations(Answer when applicable G7r� ,41/0 /, cj��,e i 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`and3not to place the system in operation until a Certificate of s Compliance has been issued by this Board of Health. / y / �/.3 .. S'�edd .. Date /o / , Application Approved by (/ Date Io l ev 13 ' Application Disapproved k Date for the following reasons Permit No. Zol "-90(, Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that tthhe,On-si/te Sewage Disposal system Constructed( � Repaired( )� Upgraded( ) Abandoned( )by at /k 017P424 has been constructed in acco done with the provisions ofTitle 5 and the for Disposal System Construction Permit No. '� rated Installer &-to/y7.7,t ( pit �j{l�.J'l�,rl One Designer x ;'S�i g � fr , C_ #bedrooms Approved design flow gP d /! The issuance of this permit.shall of be construed as a guarantee that the system ill function as designed. �� Date �l �l Inspector No.G t�j C)/ s Fee 15 �� K� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION:BARNSTABLE,MASSACHUSETTS 30isposal 6pstem Construction Permit Permission is hereby granted to ConstruclOK) Repair( ) Upgrade( ) Abandon( ) System located at j?A /7 and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 permi �o r �2o t3 Date Approved by L { _ 1 NOV-07-2013 08:42 From:BORTOLOTTI CONST 5084289399 To:15087906304 P.1/2 Town of Bvirnstnble Regulatory Scr++bms 9 1 Richard V.Scali,Iatarlm Director A Yublic Henith 1*61an 'rhomne McKean.Direcbn' Ioe;'tAII Berea,t4ys1213111,MA 016ut 0111m;sea 86:seas h'ia= iUB.7Du-41CA trial a gg�>~pgl� ltkatina Farm Date: �,,1,;rs Sewage PermhM Aseoswr'e MaplParcei a 1343 DaNiamon I� IN 4L, 4. -e- Installer. Addrere: Addresu S`Ftt.l lux nIr ,t�tt c�wsr r �imu imled a peratit to install n data) iusin ar suplic dvbtaiu Rt Z� S OG .e I a'j 7v ir based on a design drowu by datod V it —�dstgllel' _ I cortily that Ilia septic systaul rofoibiked above WdR 1i191islltld SldisIR1It allF aoCol'dia�to Iha darian,which cony inclndo minor appiwoil clualgtls■ueli us lateral 101Ocation of 1116 diahibuliou liox taidhir saptia rank. Strip out(if required)was inapoclad and the voile wora found mtkdnelory. 1 Certify Thal Ilia mptic oyslam reforoneed alive was installed with major chongos(i.e. greator than ar 10'lateral relocation of die SAS or ty v4dical rolowlim of nsly elnnP4netlt ONO utliiic gatant)but in accordmico with Stale&Local ReRulatinoa Plaa mmion or eeitifiod no-buill by deaigaar to follow. Strip out(ifreQuuod)wue mspectod and the wilt Wata found smiaf y- 1 con IlA fial the'system teferooced above was conatntCl b it915 h:Ilia Lanus of !Pprovallongs(ifopplicablo) Syr �► EaW+ b .p. nit 'or s Sigimlurof QLESS,.1R.. N CIVIL (Desiguor'sSignature) A r Q.'Sapti�dl�dg:ix Callll mm Paftn Rev r-14•I3 Aga . NOU-07-2013 08:42 From:BDRTOLOTTI CONST 5084289399 To:15087906304 P.2/2 TOWN OF BARNSTABLE LOCATION -�4 'V-L C Vt� sr SFWAeE# &2 - VILLAGE i ASSESSOR'S MAP&PARCFLkg%�'i,1-a INSTALLER'S NAME&PHONE NO. f_ Q!;- e,r-7 If SEPTIC TANK CAPACITY 1� c�3.&kl— LEACEN'GFACILITY:(type) (size) �_ "-et J-4-•93 �h, 1-r NO,OF BEDROOMS OWNER PFMT DATE: 7 COMPLIANCE DATE: Sapamdon Oismnco Setweenthe: �t Maximum Adjusted Oro=dwater Table to tho Bottom of Leaching Facility Fact Private Water Supply Wall and Leaching Facility(If any wells exist on site or within 200 feet of 1«iching Facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within i 300 fact of!caching facility) Fcat i FCJ1tMSHFsD 13Y �i�lf�ip�..t��J= Qrv� lea 1,r � Town of Barnstable VIE P# ' Department of Regulatory Services Public Health]Division mw� Date 0 200 Main Street,Hyannis MA 02601 G� 7�� ���Fb pAlCt y J Date Scheduled /Z-3 /Z.<,)/ 3 Time /U Fee Pd. C>O Sail Suitability .Assessment for Sejvage DiISP anal Performed By: SGo%T ML�7/�/y� Witnessed By: Location Address LOCATION& GENERAL INFORMATION e Owner's Name If /FW [/�' C GL! Address /22 Ut i—s od p P,i tt,! al 2 �� �GS TWGO rJ A Assessor's Map/.Parcel: Engineer's Name t/ Aje_S7/ems j,< NEW CONSTRUCTION r REPAIR / n_ Telephone# T7y V Z: 04(:5q Land Use K- s/./J�j./?/IfZ Slopes(46) L Z �G Surface Stones Ak dc _ Distances from: Open Water Body.> f'00 ft Possible Wet Area /UU S ft Drinking Water Well 100 ft Drainage Way �UU ft Property Line > �� _ft Other ft SIM'TC1_1:(Street name,dimensions of lot,exacwations of test holes&pere tests,locate wetlands Iu proximity to holes) 3 v *4 c O p �- Z Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: 20 Weeping from Pit Face Estimated Seasonal High Groundwater 15. 12.c> DE TE RARNATION FOR SEASONAL HIGH WAT�C�t'�'t$hL,� Method Used: Depth Observed standing in ohs.hole: la, Depth to loll mottles: Depth to weeping from side of obs,hole: ltt' Index Well# �•—,--•.---its. Groundwater Adjustment ft• Reading Date: Index Well level Adj.&ctor— Act Groundwater Level e Observation PERCOLATION VEST Date Time /I 3 v Hole# I --h���-- Time at 9" Depth of Pere Ott 6Z.� -- l Time at 6" Start Pre-soak Time @ 12-:0 Z' 12: 16 Time(9"-6") - End Pre-soak 1.2./ /2 24 Rate Min./lach } 2- Site Suitability Assessment: Site Passed V Site Palled: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- If percolation test is to be conducted within 100' of wetland,you must first notify tlie. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\.SEI'rrC\PLRCrORM.DOC DEEP.OPSERVATION IIOL}E LOG Dale# �_Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil _ Other (USDA) (Munsel[) Mottling (Stnucture,Stoncs;Doulders. b _I o 9istency V Ia- el) �0 y4 3 2 tZ-32 G ".y SAW9 G uC,* SAY, 2..5 03 DEEP OBSERVATION DOLE LOG Bole# '2— Depth from Soil Horizon Soil Texture Soil Color Surface(in.) Soil Other (USDA) (Mansell) Mottling (Structure,Stones,Boulders. / nsisten % rave f Lo � /ors 5 Z- k/,� �"�2' Z' - I Z-'' DEEP OBSERVATION HOLE LOG ]Cole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) Munsell Other ( ) Mottling (Structure,Stones,Boulders. CQualatency- 0 e 3 2 va�G DEEP OBSERVATION DOLE LOG ][Tole# Depth from Soil Horizon Soil Texture Soil Color 5a11 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency. 2U w " ZZ-`f 9 v L��tu sL 8-t2" G S 2,5� Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No:'� Yes ]Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that one 2 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in�10 CMR 15.017. Signatur QPc- Date Q:WEP rlC\PERCPORM.DOC ! TOWN OE BARNSTABLE LOCATION Lot" � � �j �(,v+� Oee,,,, Vi'iv 4q SEWAGE # 1- VILLAGE ASSESSOR'S MAP & LOT03-3,- j,?y/,' INSTALLER'S NAME & PHONE NO. )• . 0�cS(D�e SEPTIC TANK CAPACITY f,J-00 L,(f��nS LEACHING FACILITY:(type) Z - DDOti��(d(nS � NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER 1 �= BUILDER OR OWNER IL���5 '� `�Ju'04vf 7-7 1 ©ts!'Y DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: "' VARIANCE GRANTED: Yes No %14 rn UZ�o 5 � i i ' 0 73 3 6 W, qq��4 No..-g�,-.�.d.,l... FEB........LQ...(p......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Allp iratiun for Di-tipasal World Tunntrnrtiun rrrntit Application is hereby maAe for a Permit to Construct ( t_�or Repair ( ) an Individual Sewage Disposal System at: '7y .. .6 TE�_._._.W�t�adress__________________________ /` , iV f ¢" or Lot No: -- --•-- . .......••--••-----•---------------------- Installer Address Type of Building Size Lot..- .....Sq. feet Dwelling—No. of Bedrooms------------- Expansion Attic ( ) Garbage Grinder (+/� A4 Other—Type of Building G.l.J(�'�___�L No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - W Design Flow.................... ....-gallons per p per day. Total dail flow..........._ ._.._....--------__gallons. WSeptic Tank—Liquid capacitJ I—Ogallons Length----- Width__b----------- Diameter---------------- Depth__G__'6_�' x Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------oL......--.. Diameter----- 0-1-------- Depth below inlet......6........... Total leaching area...(e__7.t ...sq. ft. Z Other Distribution box ( ) Dosing t nk. ( ) Percolation Test Results Performed by a .. r Date... a . 1 Test Pit No. 1---- ._._minutes per inch Depth of Test Pit__._��._....... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Description of Soil .. - -- -- x ------------------------------------------------------------------------------------------------•--------------- W --•-•-••---•---------------- -----------'--------------------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of C liance a b n issued by and of health. Signe --- ---------- ................ . --.................................... ............. Date Application Approved By ............. ,v w,�... ... .. D�-----� 11 UU .................................................................. Date Application Disapproved for the following reasons: .......................... .................. . .... .... -- ...............----------------------------- ...................................... -- ........... ........... .. .................. .... -- PermitNo. ...... -------------- ------------- Issued ......................................................... Date No.. '�1...c�. - Fss ......... ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Diupw3al Wurk,6 Tonitrurtiun ramit Application is hereby made for a Permit to Construct ( v)'or Repair ( ) an Individual Sewage Disposal System at: r 4 / lC rc'G/7 YiJP CCU T(J f .... .................................................� ..........................................v eo:at'on-ilddress /`r _�6)! , or Lot No. } Owner Address 144 . Installer Address at '/? 013 U Type of Building Size Lot____---....................Sq. feet Dwelling—No, of Bedrooms............. . _.__Expansion Attic ( ) Garbage Grinder (\Iee)) ... ... P`4 Other—Type of Building ae�__----- c.t No. of persons-------------------------__ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------ W Design Flow....................f.lr���yy___._._--__gallons per p Gn per day. Total day flow......__..�U_............_.___..gallons. WSeptic Tank—Liquid capacitil ggallons Length___. _.!__ Width_--et..__........ Diameter................ Depth.X.��:'' x Disposal Trench—No_ ____________________ Width... _.._-_-______-_ Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No-------a.......... Diameter____/U....._..._ Depth below inlet......6..-........ Total leaching area...�_.7 Esq. ft. Z Other Distribution box ( ) Dosing tank ( ) ///3 0A-3 aPercolation Test Resul.s Performed by.._..T-------------- --------- Date.-.-__-.-____------------------.----_... Test Pit No. 1.....`�-�----minutes per inch Depth of Test Pit-----/_�...._._.._.. Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... a Description of Soil -�"e......� -------------•-•------•-•------- x . -- U --------------------------------------------------------------------------------------------------------------------------------------------------------•----------------------•------------------------ W x -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of C liance as been issued by Oard of health. Signed ---- :.. ... .. Y ---_....._ ------..:..............................................._............ Dace Application Approved BY - -?.-. 1- ..t�.Z Dace Application Disapproved for the following reasons- ---------------------- -------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------- --- --- ----------------------------------------------------------------------------------- ........................................ Dare PermitNo. ----- �.3.. .1 9.............................. Issued ......................................................... ue...... Dace - ------------------------------------------------------------------- ----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertiti ate of Cgompliance T_ I.S_IS TO CERTIFY That the Individual Sewage Disposal System constructed ( V/) or Repaired ( ) byJ... 4-- G --------------------------------- at ......L 0 7.........S-t3 ...�........ 'Quin.....(/ 1.�--n.,t, P....... ------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5yf The State Environmental Code as described in the application for Disposal Works Construction Permit No. .-..../.... _.-.4_9_9i'------------ dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ? DATE ------------�<7.....S .,.. .... - Inspector ---------- !"✓ !J------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No...�:�_-�`/7' FEE....J.n,.r! RiiVv.qaUVvrhfi Tunutrudiun "amit Permission is hereby granted.__1-....j =5 D L ---------------------------------- ......................................................... to Construct (l or Repair ( ) an Individual Sewage Disposal System atNo...� ------•`'-s.:`- 1........ )COtr V(.Q.Gt1_....(l.(a-P ` --------------------------------------------•--•---•--.... Street as shown on the application for Disposal Works Construction Permit No/______ ___________ Dated............................._............ t ------------------------------------------------------ f y.................................... Board of Health DATE-----•---------�---�---�¢-�--�-- • /// FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TAIAA�. OF .. 51 06C-1—E FAMIL`( Q- $ELK W F. wt-14 �,A OAI;E 61ZINVEK �. -PAIL-( R--)Vj L4<II0-f-5D%-6&06PD SEYT"I C TANS.�4Ac'lvo 1i � �D �� '• • :f lei loop ('tic____ D15FO54 L PIT o% 2- 1000 GAc,�zsTatl� SIDEWdL.L AWFA 3`I(o 5F 5 ' R..AO 0►J '43AZ4L A T' SR,SF-A -Ir = (jdb, P,m TL16N = l 0 a(o aG�A 1.1 �►�l,() t/� C�Tv TOTAL DAILY rL0V =ld00D oi4 � PE2GDLA`rt oN QATE. = I'fu 2�n i�J oe �S Rib A. PETER c. BAXTEa ^ SULLIVAN NO.24M No. 23733 ISTV '�rfY.7ss��NAI e �ell -r�s r p P>I58 4CoL e- f I."0 P13 TF=roe St ►c _:. , �o INv. .. ... �. �1c��_ Ifs✓ 2 2 'Z vKT Tqe tau GQL 9 wt; y _-10 �- 2-3 -1 12 I wASI{ .. AI-L StQucruQE3 sir sT6 MDW T11ArJ 4 V EEP !WALL Me 14-2.o ICI ED PST' FLAN I I o SGDL>= LoaTiDtl : 49TO rT -'' r 4A Lam: t 4-0 DATA S q 3 No �Tz Os PLAN 9JC,1= I COMFY 1-} ,kr THS Pi7o>,1'cl o -lad �� 5� �� �� ,AOW w N�oN coM'PpyS yvI-rA 'n�� 51VEUWE Mo. t; llf& TDWN OF ' Af2,r.>�;lAgt,B 6T-. 266 Pv`71 DA` IZ,►�-- 3 _ Cps '�1SXY�7Z � NYE ING . P..Po,F��S�a�.c cA1Ja 'Suw�yo�s -rf4K R-AW _ IS Nar F34ED oN tiN lg47XMEtJ'T' uscSU[ �4lJD Ti{E OF ieT'S 44flu4D uuT' 'QE o 5TE2vtu.E MAS4 . -n-WcY { rT$ sIDE BU►ca�►J� Co 1� 16- 9 3 SEA — ewe_ °71 Lors I �3 SF K '- 7 O 5o I 9 ° 26 , I DT c IQOP 2 /8 20 10 EXP. r MCA. � � -_t I � i o w<reZ �. f �,I V 1 1�t/ EJ•IT m 1803 T6. • lg l o .� -. � I ° Top or- `mgs EL,000 WVA4GD H OF 44�9 A�ao A. r PETER Ea two SULLIVAN "°- ,pp No. 29733 a+ a No.... .T v....... ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH_ 0 �. .......0 F............ �'✓ 1!c',5 .d ... � Appliratiou for i-spaiia1 Worko Towi#rurtion Prruid Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at: .............................. ..... ....A............................................................ .-Location-Address or Lot No. ......, . /1." ................................. c?11�*�a0......, ,/ .:._.;iw......,�% owfel I t Address w a ............. ..... ._._..----....... nI__ ....... .. ... ..... .... � nstaller Address � Q Type of Buil ing Size Lot.4; l y _ .....Sq. feet U Dwelling—No. of Bedrooms....._y...."'..........................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building ........... No. of persons............................ Showers — Cafeteria QOther fixtures --------------------- --------------------------------------------------•--•-----------------------------•------•---••-- ............................ W C �esign Flow.......,}rd............................gallons per person per day. Total daily flow............................................gallons. eptic Tank—Liquid capacity.../QD llons Length................ Width................ Diameter................ Depth................ Disposal Trench—No.................. . W idth...............�...,.�Total Length.................... Total leaching area....................sq. ft. x ;,/Seepage Pit No......�4_".. Dia�eflrl._.`......... .el7epth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................-------•-••-----•--------•---•---- Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.__.-_-__-__-_-_______- fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 ---------- ................................................ -........ -------------------------------- ----------•....._..---•------•------------- -------------- ODescription of Soil----------------------------------- -----•----------------------------------------------------------------------•------------•---------•-------------.....-•-••--•---- x -------------------------------------•------------ ir _-__..._.. ------------------------------------------------•--•---- r� U Nature of Repairs or Alterations—Answer when applicable..._............................................................................................ --------------------- ............................................................ Agreement: . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article aI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss by the b and of health. Signed..--- --� ---- -- -•-•-5 F --------- --------------------••-•--- D/�, �•G•� Date Application Approved By........ =.� _ ....._ .....--- ------------------• Date Application Disapproved for e following lasons:................................................................................................................ ...............•-----..._....----••••-------•------••-----------•......--------.......--------------•---•---•-------------•--------------------••--------------•••---------•----•---•-----•-------••-•. Date Permit No...........0..... .U-._.�....................... Issued...... ----- ..3".�..-------....... Date No _. ...... F��. ..: .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF . .._.. ...-..i. rf ..... .. ....... A phra tlill fir IN-41111fial Iforho Tomitrurtijau rrnfit Application is hereby made for a Permit to Construct ( } or Repair ( ) an Individual Sewage Disposal System at ,F. a", ,aa iam �'s'#t !,c�,s` _ ,y"',�,._. ,,rram��. ......S.y.....JN r. ...,...,}.s..G.°.e t.s.. ................ ................... ...... ..7.: s!....i.s. ,.. ,......................................_- Location Address or Lot No ............ :::. �""` .................:....... .. .g..fN ... ;: d .z r .,.. f.+- y!r owner - Address - ' .. �t ............... .........................._.. ...... ..............„ Pl Installer Address � r, Q Type of Building Size Lot ' ....% '.'..Sq. feet Dwelling-No. of Bedrooms.--...! -„_---„ _________________•___Expansion Attic ( ) Garbage Grinder ( ) p,a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) C� Q Other fixtures ... -------------•--••--------•--------------- ........................................................ -----= W Design Flow„_..,, 'Y�' ... _gallons per person per day. Total flow ._:__.. ..................gallons. W ! eptic Tank—Liquid capacity / .tons Length--,.„,__..__--Width---------------- Diameter................ Depth__-__-_____--- . x Disposal Trench—No.. :... Width.................... Total Length.................... Total leaching area....................sq. ft' ee a e Pit No.. ,� Dia tefr_ l5 th below inlet.................... Total leaching area-__.........._: s ft. ( . P g 3 = P g q Z Other Distribution bcx ( ) Dosing tank ( ) aPercolation Test Results Performed by Date - -------------•----=------ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__:____-_________;___-_ ----------------------------------------------•---------•---„------------------------------- ----------------------------------- ------------- ....,_... Descriptionof Soil_.... =----='-•----------•---- ............................................................................................----------------------•-•-••-•-------------------------------------------------------------. ..................................... F W VNature of Repairs or Alterations-Answer when applicable..-..:........................................•.,-.---___._.__-__-_____-_____,_____-__---_-__-_. -------=-----------------------•-----------------------------------------------------••---........--•--------•--------------------------------------•-•------ ......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss b the bard of health. Signed _, �.��_ .. ..a_. . ` :._... ... ............................. Date Application Approved By....---- - --___,, ----�- -------------------- ......... .. . Date Application Disapproved f or idle following ? a ons:-- ------------------------------------------------------------------------ ------------.................................. •-•-------•-------------------------...--------------------------------------------------•-------•-------------.,...----•-------------------------.---------•.......................................... Date PermitNo............ {__0....=....................... Issued........= -'------------.... ......................... Date THE COMMONWEALTH OF.MASSACHUSETTS BOARD OF HEALTH AT ruftrate laf Tomplir THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .*'..m1 yy rf r r ; ------------•---•-----•-- ....... -.._ has been installed in ,accordance with the provisions of Artl le XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit NN o..... ... ._..._._. dated---- t ......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. --7 ` DATE...............: 7^ 1 .................... „ Inspector----• -•-- -, , ••.•. t....doe /X THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ ::.:. ...oF......._ No...... ;. .... FEE , ... Permission is hereby granted....... a W ; Jv, a' •........ .. ....... ......:.. . ` . to.Construct ( , ) or Repair (. ) an Ind vidual',Sewage Disposal System mot . fi: f .r as shown on the application for Disposal Works Construction I'er ztit t PP P 11 No- '.A ... Dated Z Board-of Health / DATE--------- -------------------------------------------:.......................... 1. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS � � - BENCH 1 0 sr SEA STREET C30 WIDE) MARKCfo�St .o- , BENCHMARK ine Ridge Ad.' Keeia Rd�� '�.3 !✓EMENT Nickerson Rd 01 EDGE OF P. 'ti S 72.45'00' E fi MAG NAIL/DISK � , J,� FLOW LINE 265,41' ELEVATION 49.88' f SETBACKS RF ZONE ry PROP D BARN - - - - - - WITH B ROOM - -.- .-.- - - - - - - V - - - - - - -� c BUILDING SETBACKS (MIN.) 1 Rd J� (-' - AgHY EXISTING GRAVEL DRI i (SETBACK TYP> w � FF EL=50. 7 W/ COBBLE STONE � %O FRONT YARD 30' fh 112.83 X 25.0 c j SAS SYSTEM EXISTING TREE Zoo BORDER ti SIDE & REAR YARD 15' e`°^ `� co .RESERVE - TO_ TO BE SAVED y o T 1#3 TP #4 \ ! E STING SEPTIC SETBACKS (MIN.) z 20 LAJ f �� 2°` RA EDTO BE Z LEACHING TRENCHES LOCUS M A P -, 70, ' j 10, W PROPERTY LINES 10, NOT TO SCALE 1.37'S0' o, 1,500 j > BUILDINGS 20, Li C 5 TANK ( ¢ Q SEPTIC TANKS I 3 PROPERTY LINES 10, H „ BUILDINGS 10, z EXISTING ONCTET EX TING W SLAB TO �� WAT I >BENC q MARK z BE RAZED -� D FOUNDATION Z 3 GENERAL NOTES EL=48.98 a P #1 #2 218 OCEAN I Q TOP OF CONCRETE U 1L0, D-BOX VIEW AVENUE j Li ` 1. RECORD OWNER TENNIS COURT w I 12. 3' X 25,0' I 3 Q O WHITE PETER & JOAN o I SA SYSTEM j � c 122 WOOD, DALE ST u� WESTWOOD, MA 02090 N ---___----------- --I I CU in DEED BOOK 9107, PAGE 216 a, PLAN BOOK 266, PAGE 71 & BOOK 320, PAGE 66 to T I .. i I y z I 2. PROPERTY IS SHOWN AS LOT 36 ON ASSESSOR'S MAP 33 AND r APPEARS TO LIE WITHIN THE RF DISTRICT PER THE BARNSTABLE j EXISTING GIS RECORDS. SEPTIC _� j 3. PROPERTY LINES SHOWN WERE DERIVED FROM AN ON THE GROUND SURVEY CONDUCTED 09/2013, LINES OF OCCUPATION AND FOUND L-- --------------------------- ------------ ---t--- -- MONUMENTATION. I 4, ORIGIN OF ELEVATIONS IS ASSUMED. VIEW EASEMENT L- - - ----- - - --- - - - - --- - - - ...... .- J 5, PARCEL LIES WITHIN FLOOD ZONE C PER FIRM so MAP 250001 0018 D LAST REVISED 7/2/1992 AS S SHOWN ON THE FEMA WEBSITE, 182r09' 6. EXISTING CONDITIONS SHOWN HEREON WERE COMPILED FROM N 72.19'55' W AN ON THE GROUND SURVEY CONDUCTED 09-2013 AND PLANS ON RECORD, ¢ 7, SEPTIC LOCATION FROM AS BUILT RECORDS PROVIDED tN°F SAS BY THE BARNSTABLE BOARD OF HEALTH. oti� EDWIN �<�, 8. ORIGIN OF BEARING FROM PLAN BOOK 266 PAGE 71, Existing Grade Inc. ral e JR. �7 Surveyors & Civil Engineers CIVIL a SCALE CLIENT SEPTIC DESIGN PLAN PROJECT1511 PO Box 612 No.41294 ARCHITECTURAL INN❑VATI❑NS FOR IM,E: 10/11/13 Dennisport, MA 02639 ST �G 0 15 30 P.O. BOX 2056 218 OCEAN VIEW AVENUE SHEET NO. 508-694-6501 Ph/Fax SSIONA�- E� C❑TUIT, MA 02635 C❑TUIT, MA 02635 # DATE REVISIONS 1 OF 1 1 SOIL LOG TEST HOLE #1 - ELEV.=49.751, DEPTH FROM OTHER (STRUCTURE, SURFACE ELEVATION SOIL SOIL TEXTURE SOIL COLOR SOIL MOTTLING STONESAOULDERS, NQTESI DESIGN FORMULA, (INCHES) (FEET) HORIZON (USDA) (MUNSELL) CONSISTENCY, X GRAVEL) • 1. ALL SYSTEM COMPONENTS SHALL BE•INSTALLED IN COMPLIANCE WITH THE STATE SANITARY CODE 0'-12, 48.75' A LOAM 10 YR 3/2 NONE FRIABLE TITLE V AND THE TOWN OF BARNSTABLE BOARD OF HEALTH REQUIREMENTS. SYSTEM REQUIRED ROVIDED 12'-32' 47.08' B LOAMY SAND 2.5 Y 5/6 NONE FRIABLE 2. ANY CHANGE TO THIS PLAN MUST BE APPROVED BY THE HOARD OF HEALTH AND DESIGN ENGINEER. DAILY FLOW# 32'-120' 39.75' C MED SAND 2.5 Y 6/3 NONE FRIABLE 3. HEAVY EQUIPMENT SHALL NOT TRAVEL'•OVER DISPOSAL SYSTEM DURING OR AFTER CONSTRUCTION. 3 BEDROOMS @ 110 GPD/BEDROOM 330 GPD SOIL LOG TEST HOLE #2 - ELEV.a49.75 4. TIGHT JOINT (T.J.) PIPING SHALL CONSIST OF POLYVINYL CHLORIDE (PVC) PIPE, SCHEDULE 40. SEPTIC TANKSi DEPTH FROM ELEVATION OTHER (STRUCTURE, ALL PIPES TO BE LAID ON FIRM BASE AND TO BE WATERTIGHT. ALL CONNECTIONS AND JOINTS 330 GPD x 200% 660 GAL 1,500 GAL SURFACE SOIL SOIL TEXTURE SOIL COLOR SOIL MOTTLING STONES,BOULDERS, SHALL HE MECHANICALLY SOUND AND TIGHT. (INCHES) (FEET) HORIZON (USDA) (MUNSELL) CONSISTENCY, X GRAVEL) 5. DISTRIBUTION BOX SHALL BE WATER TESTED FOR LEVELNESS. LEACHING AREACi 0'-26' 47.58' A LOAM 10 YR 3/2 NONE FRIABLE 26'-42' 46.25' B LOAMY SAND 2.5 Y 5/6 NONE FRIABLE 6. NO GARBAGE GRINDER IS ALLOWED. 2 CHAMBERS @ 8.5' LONG x 4.83' WIDE 42'-120' 2' EFFECTIVE DEPTH - 4' STONE 39.75' C MED SAND 2.5 Y 6/3 NONE FRIABLE 7. DISTRIBUTION BOX SHALL HAVE AN INLET TEE EXTENDING TO ONE INCH ABOVE THE SIDEWALL,C(12.83x2) +(25.O.Ox2 ))x2 151.3 SF SOIL LOG TEST HOLE #3 - ELEV.=4&25' OUTLET INVERT ELEVATION. r BOTTOMi (12.83'x25.0') 320.8 SF DEPTH FROM OTHER (STRUCTURE, 8. SEPTIC TANK SHALL BE EMBOSSED WITH SEAL STATING CONFORMANCE WITH ASTM C 1227-94. TOTAL• 472.0 SF SURFACE ELEVATION SOIL SOIL TEXTURE SOIL COLOR SOIL MOTTLING STONES,BOULDERS, (INCHES) (FEET) HORIZON (USDA) (MUNSELL) CONSISTENCY, X GRAVEL) 9. ALL SEPTIC SYSTEM COMPONENTS SHALL BE DESIGNED TO WITHSTAND H-10 LOADINGS. LEACHING CAPACITY, SIDEWALb. 151.3 SF x 0.74 GAL/SF 112.0 GAL 0'-10, 47.42' FILL NONE FRIABLE 10. SEPTIC TANKS SHALL HE PROVIDED WITH AT LEAST THREE 20' DIAMETER MANHOLES WITH READILY BOTT❑Mi 320.8 SF x 0.74 GAL/SF 237.4 GAL 10'-24' 46,25' A LOAM 10 YR 3/2 NONE FRIABLE REMOVABLE IMPERMEABLE COVERS OF DURABLE MATERIAL. TOTALS 330 GAL 349.4 GAL 24'-38' 44.25' B LOAMY SAND 2.5 Y 5/6 NONE FRIABLE 24'-38' 38.25' C MED SAND 2.5 Y 6/3 NONE FRIABLE SOIL LOG TEST HOLE #4 - ELiEV.=4&50 13. CONTRACTOR SHALL OVER EXCAVATE LEACHING PIT BOTTOM TO A DEPTH DEPTH FROM OTHER (STRUCTURE, 11. BEFORE BACKFILLING THE SYSTEM THE CONTRACTOR SHALL NOTIFY THE BOARD OF HEALTH TO INSPECT. OF FIVE FEET TO VERIFY THAT NO GROUNDWATER WILL BE ENCOUNTERED, ELEVATION 12. CONTRACTOR SHALL COORDINATE WITH THE BOARD OF HEALTH TO OBSERVE THE EXCAVATION OF SURFACE (FEET) SOIL SOIL TEXTURE SOIL COLOR SOIL MOTTLING STONES,BOULDERS, (INCHES) HORIZON (USDA) (MUNSELL) CONSISTENCY, X GRAVEL) UNSUITABLE SOILS UNDER THE AREA OF THE PROPOSED LEACHING SYSTEM. 14. ALL UNSUITABLE SOIL MATERIAL IN AREA OF AND BELOW PROPOSED SOIL 0'-20, 46.73' FILL NONE FRIABLE ABSORPTION SYSTEM (SAS.) SHALL BE REMOVED AND REPLACED WITH CLEAN, COARSE SAND WITH A PERCOLATION RATE OF 2 MIN/INCH. 20'-28, 46.17' A LOAM 10 YR 3/2 NONE FRIABLE 28'-48' 1 44.5' B LOAMY SAND 2.5 Y 5/6 NONE FRIABLE 15, AREA 5 FEET BEYOND LIMIT OF SOIL ABSORPTION SYSTEM (SAS.) SHALL BE 48'-120' 1 38.5' C MED SAND 2.5 Y 6/3 NONE FRIABLE (NOTES 13 , 14 AND 15 D❑ NOT APPLY FOR THIS DESIGN) EXCAVATED OF UNSUITABLE MATERIAL TO TOP OF C2 LAYER. PERCOLATION TEST BY, SCOTT McGANN FORo EXISTING GRADE, INC. THREE MANHOLE COVERS, BRING A MINIMUM OF ONE WITNESSED BYi BARNSTABLE BOH AGENET DONNA MIORANDI COVER TO WITHIN 6' OF FINISHED GRADE. BRING OTHER NOTE& DATEi 10/03/13 COVERS TO WITHIN 12' OF FINISH GRADE. 1. SEPTIC TANK SHALL BE EMBOSSED WITH SEAL PERC RATEo ( 2 NPI IN C LAYER TP3 AND TP3 PROVIDE 9' MIN. COVER OVER TANK. STATING CONFORMANCE WITH ASTM C 1227-94. (1) ROW OF (2) 4.83'x8.5' LEACHING CHAMBERS TOP OF FOUNDATION 2.- CORROSION RESISTANT GAS BAFFLE SHALL BE WITH MINIMUM ONE ACCESS PORT PER CHAMBE � GROUNDWATER � ELEV=50.6T INSTALLED ON SEPTIC TANK OUTLET TEE. 2' OF 1/8' -1/2' PROVIDE RISER IF F.G.=50i DEEPER THAN 9' 4' (TYP) 4' TYP) DOUBLE WASHED MIK INSIDE DIMENSION 12' �. PEA GRAVEL PROVIDE WATER TIGHT COVER INVERT C� a 44 0 3/4' TO 1-1/2' 4' PVC 2' OF 35' n 4� °� 4� °� DOUBLE WASHED STONE SEWER LINE DOUBLE WASHED PEASTONE 24' a 4 a O C� 0 4 a 47.36' 4'PVC e 4% 1� TOP OF PEASTONE ELEV= 47.0' INV. IN 1,500 GALLON 4' PVC 2 4% 6' SUMP 4 -� F.G.=50t 4 14-0 �4'-10 47.14' SEPTIC TANK INV. OUT 4' pVC E TYP TYP t46.90' 4% , ' O O O O O O O O INV. IN o0 0 0 0 0 0 0 0 0 0 0 0 0 o c o 0 0 th no °o o `vo0o INV. I o 46.0' 5' MINIMUM LEVEL STABLE 6' 46.34' INV. OUT 25.0' SEPARATION CRUSHED STONE BASE 28' 46.16' BOTTOM OF BOTTOM OF DISTANCE F 8.25' TRENCH 44.0' 3/4' - 1-1/2' DOUBLE FROM 3 MIN. 2 MN. WASHED CRUSHED STONE TRENCH 44.0' BOTTOM OF TRENCH GROUNDWATER USE CONCRETE PRODUCT, INC. 1500 GAL I ----�-y /FOR LEVELLENGTH NTIRE r-6' MIN. SEPTIC TANK OR APPROVEDLEVEL STABLE 6' EQUAL CRUSHED STONE BASE MAINTAIN 10.0' TYPICAL LEACHING CHAMBER 2' MIN. CORROSION RESISTANT GAS BAFFLE FROM CREISS-SECTION f BY TUFTITE OR APPROVED EQUAL `10' MIN. 14' ^ RESERVE (NOT TO SCALE) MIN TYPICAL SEPTIC SYSTEM PROFILE N°FMq p EDbNIN oy,. Existing Grade Inc. H.• �= Surveyors & Civil Engineers clvli SCALE CLIENT SEPTIC DESIGN PLAN ts�t JECT ° PO Box 612 No.a1 sa ARCHITECTURAL IN❑VATI❑NS FOR oA�: to/t t/t3 Dennisport, MA 02639 o 15 30 P.O. BOX 2056 SHEET No. 508-694-6501 Ph/Fax '�Fss o,NA C❑TUIT, MA 02635 218 C❑TUI T, MA 02635 AVENUE # DATE j REVISIONS 2 OF 2 i 6'-8 112' -- 0 D� I 1 I U )A NM(j STAIR I V!D BALLOOnI FRAME I y IW I: � O I3 D p 2J T- a A N 3K1J ---�--- N O 's I N O 3'-CT 3'-2' 6'-I O' D w D y I 3K 1J r Ii - m 3K 1J o m a D 2J D � Z O 21 " _ 00 O O • 1 3K 1J 3K 7J ® I NPr f` I T al A it w lk A OOO i Dv 3.-01 7'-2' 5'8' 13-01 C. Z z C. x _ Z H x m m m '" m / m X 5K y i O !! taF i rs "sb _. ir (n Pq� E^�•'•.y � fps N rr m z a r 26'-O' m m 2-31/2 0 5 0 O o 0 0 2 G 0 0 0 N VI -- _ - -- --- N .2J 0 L 1111 q I I OO©0800 < A UJ f 3K.2J I D N d W 14 X 43 STEEL BM. I a Z D i. N x N 1 N If z 'p G� e m I 0 I n n r m co I - D 'I x D I J I ^ A i Q i ® ®, k �Im N m m N H Z (— i N z O O l O D i m 4K,2J 1 4o Z N - v W14 X 43 STEEL BM. a X ,: 41.21 p I 0 z 2 1T T R m Z m Z Z N O '() O N O I = W N 0 o m y y 3 T _ m K O c 0 0 Z m m c M O Q f p O O A A y 0 0 O n z _ ]1 0 I v I N = I 41 2J I m 0 m 1 I C m ———— 0 0 0 Z m m m m r r r 25-0' A n D PROJECT: REVISIONS: i z m WHITE GARAGE (FAX(58)428 p FAX(506)428.4295 N 218 OCEAN AVENUE, COTUIT, MA ® 0 TITLE: ARCHI To CTUR aLrvrERPNOVATIONS FLOORPLANS AND SCHEDULES P.O.BOX 2056,COTUIT.MA 02635-