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COTUIT
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LCiC ►TION ®/ l✓ill 1/�' Oel /:01/• SEWAGE # �6 —72-V
�-I.LAGE ���'ct�� ASSESSOR'S MAP & LOT-0 d.DVM4
'INSTALLER'S NAME&PHONE NO. A01-71?7 %
SEPTIC TANK CAPACITY 4,44-
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
{
Separation Distance Between the:
Maximum Adjusted Groundwate'r 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
43 - 3 -
No. . L�/!O FEE l✓v�I
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Board of Health, j"3 d r n s`T q Na.
APPLICATION FOP, DISPOSAL SYSUM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components
Location 1014KVMCVCird
p Owner's Name 5 u S G Y-\ S cot n n c
Map/Parcel# sy fy ifi Address /0 TUf,T�{b C4 C so ci+
Lot# Telephone#
Installer's Name o� Ze�� ��� Designer's Name k`r SU rvt
Address fj � Address q0 u\/
� c� Kvo, Grs-fun is
Telephone# Telephone# �pt Y Z Y v pp H
Type of Building ,��5{ Lot Size /00 _sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.required) lis�� gpd Calculated design flow. 7�r0 Design flow provided 716 gpd
Plan: Date AJoVer,4Gr 300 Number of sheets 2 Revision Date
Title 0,Wk ]-{ I G ?1(,n JoG,,4,ed 4- --M1 V)s1 t#U!nr ! RAJ
Description ofSoil(s) ..Sep -plwn
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS
The dersi ed o install the bov described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
furth a es t u op ation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date 0
,� ,--,mod �y �a• � i� � ?�
t srs •«, . .. ... �..•.:.�„� _Fw._ --d:rs'__:.fit ...,, ._fij�+«�.�. '^�ti..�es'r. v �.,e.+.-:'t.:..* „ v-
No. f may �:i tI FEE
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Board of Health, B A r n S`T A 6- MA.
AP LICA ION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( )Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location O 16 V f�P G a Owner's Name 5 U sa Y-\ 5 cook o n t
Map/Parcel# Address //0 TL r f /{ b c, (k C #.
Lot# N. Telephone#
Installer's Name �Gam! C0�5�, Designer's Name G,,)
Address g� j' �.n/��rcJt Address
Telephone# Telephone# }
(�Z}'
(S �l� -ate s�-
Type of Building r /5�.. Lot Size 00 sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.required) gpd Calculated design=flow `716 Design flow provided �y6o gpd
Plan: Date./U0Vttr--1k r /G 2C,00 Number oaf+sheets` Revision Date
Title StR e. Cin4 '5e '4 ,'c.!! ?1itr1 �4 A4- -Io14 Vi1 iyG'�CIA� /� c
Description ofSoil(s) J�C°t" 1�. �r
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
t
DESCRIPTION OF REPAIRS OR ALTERATIONS
The Linde a gr to install the bov described Individual Sewage Dis s System in accordance with the provisions of TITLE 5 and
furth� a t place- e- em'_ op ation until a Certificate o' I om 'ance has been issued by the Board of Health.
�ja0
Signed D
aAe
No—zwy- / Xi( T FEE
Board of Health, I clre)S'fi t• ,MA.
C ERTIYompl"lete
E Of COMPLIANCE
❑Description of Work: Individual Component(s) System
The undersignedAiereby certify thpi4he Sewage Disposal System; Constructed ,Repaired ( ),Upgraded ( ),,Abandoned ( )
by: MCf �( �Yf/f�j
>i at /d�� / h,L-X �.6 // -, a 6".
has been installed iin.,accordance with the provisi ns of 310 CMR 15.00 (Title 5) and the pproved design plans/as-built plans relating to
application No e?,#-72 dated f a� ZO"OP Approved Design Flow��(gpd) It
Installer !/lV 1 ro
Designer: Inspector: oymnd 4A / Da e:_ F
r�
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No!C -7 7 FEE /�
_ / �
COMMONWEALTH OF MASSAC14USETTS
Board of Health,
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct(L-�Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at /o/U 41t hk yAt el V / 6 41 5r as described in the application for
Disposal System Construction Permit N076?0-7 zy , dated Z
Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co Boston,MA Date Board of Health-/S
s
. I
apSME T ' DATE:
* * ' FEE:
* •
* 3ARNSTABLE
y MASS.
QjA i639• �0 REC. BY ,
TTEo
own of Barnstable SCHED. DATE: / ��r�
Board of Health
367 Main Street, Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,R.S.
FAX: 508-790-6304 j /J c� Sumner Kaufman,M.S.P.H.
Ralph A.Murphy,M.D.
LOCATION ' J /
P~operty Address: �� /o U 1l7 S i119'17C1 gc � yl�
Assessor's Map and Parcel Number: Cl)5' �;ij -�,Z Size of Lot:�y � 1 �.•�;
Wetlands Within 300 Ft. Yes Business Name:
No Subdivision Name:
APPLICANT'S NAME: i U Phone 4?LPI -7 U / 7
Did the owner of the property authorize you o represent him or her? Yes No
a
PROPERTY OWNER'S NAME CONTACT PERSON
Name: I1S C S(>`213 Name:
Address: W (f� � C� /LI�C�t12 /L Address:
Phone: t " 7�5-7 CT OWO Phone:
r—
VARIANCE FROM REGULATION(Last Reg.) REASON FOR VARIANCE(May attach if more space needed)
OY
Chec list(to be completed by office staff-person receiving variance request application)
_ Four(4) copies of engineered plan submitted(e.g.septic system plans)
Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans)
Signed letter stating that the property owner authorized you to represent him/her for this request
Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
Variance request application fee collected(no fee for fireguard modification renewals,grease trap variance renewals[same ownerneasee onlyl,outside
dining variance renewals[same owner/leasee only[,and variances to repair failed sewage disposal systems[only if no ex pans ion to the building proposed])
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Susan G. Rask, R.S., Chairman
NOT APPROVED Sumner Kaufman, M.S.P.H.
REASON FOR DISAPPROVAL Ralph A. Murphy,M.D.
Q:/WP/VARIREQ
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I N S T A LLER'S NAME i ADDRESS
---At OWNER -
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED L/ l
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- TOWN WATERY A 4A LABLE Y -9y \ \EXISTED ., g`�93 A j j 6 COTUIT
(NOT IN SERVICE) \ 250 �aN 95 9 s�yoo`
�FLA CEO AS/LOT 8-2 s _ ','_TyE LoT BENCHMARK w
AS/LOT 8-1 AREA= 146,IOOfSQ.FT y� /� � 0 wv WATER VALVE `Q5►
(VACANT) 2� _ _ I M ELEV.=97. 7'(ASSUMED) ,
.�4� • 97 �98 �� 98 -�I dp1N J2o
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EX.t'TINC ° CATV
C.9 A VEL DRIVEWAY I
1 % I� e� LOCUS
a' M OF 1� 0
FOUNDATION $
�s ELEV.=100.0(ASSUMED) HSE ,¢�IOl �•
4 0' p5 rJ �' LOCUS MAP
\ �' /C.
�4 �4� / p (� ASSESSORS MAP. 15
gg I PLAN REF 11542-4, LOT 49
saxnr loan cAL 0 Q 1g.0' '2 0� ' ' %1.8' ZONING.- ,.RF"
\ \ TANK o CQ CT I ,C » "B "
CB .ry 'p � q � FLOOD ZONES: C & B
�1 \ (TO BE PUMPED, .0, p• PROPOSED `C COMMUNITY PANEL
CRUSHED & FILLED) LEACN Prr� �`� ADDITIOND 1 I 250001 0022 D
LOCAMN PER OW HOUSE - DATED.- 7102192
J /\ S/1S PLAN o C 1 �l 'O VERLA Y DISTRICT "AP"
D 04J S rOo O
\ Qv 0 ~ SAS
Rss f
8958 30"'E
Id - j�c� �t 9 10.00'
tob . SITE AND SEPTIC PLAN
99 LOCA TED A T.-
\ g 101 VINEYARD ROAD
AS LOT 8-3 g O
(VACANT) / V., o COTUIT(BARNSTABLE), MASS.
NO VEMBER 16, 2000
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\ I O WILLIAM YANKEE SURVEY CONSUL rANTS
LIE13ERMAN P.O. BOX 265
GRAPHIC SCALE IN , ����; a uNir 5, 408 INDUSTRY ROAD
so o zo 40 g0 180 \ :� �C,ST��� MARSTONS MILLS, MA. 02649
\ i E �j PH.(508)428-0055 — FAX(508)420-555J
or.AL •,
JOB NO. 525J5 `
( IN FEET )
i inch = '40 ft. _ CBI SH. I OF 2
f e
t
t,y t
1
EL. = 100 _
7VP OF FOUNDATION 20' MIN.
10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC
MIN. P77rH 118 PER FT 2 LA YER OF
99 CONCRETE COVER 1/8"-1/2"
WASHED SYONE
/ / . . . , . / / / *" A(Ax EL=99
4" CAST IRON PIPE
Pl7L^OR 1/4 PERUAQ /FT � CLEAN SAND MUM 3AX"
FLOW LINE 5 i EL=96.8'
10• 18• MAX RUN
INVERT 1 10 14" _
MIN.
EL.= 97 cas INVERT LEVEL °°°° o 0 0 0 0 0 0 °°'°° °
INVERT BAFFLE EL.=96.55" INVERT 6 UM /NVER7• o�4 ° o 0 0 0 0 0 0 °°°08° = 94.0
EL.= 9_6.8 EL.= 96.45 EL.= 9_6.2 _ 4
EL- ,
(>n BE PLACED ON �R. BASE) DISTRIBUTION 4 - CHAMBERS es" LONG X 4• t0" WIDE
WrBANICALLY COMPACFED OR 6' OF S70NE BOX BY 34" HIGH ( 2' EFF. DEPTH) -�
LQ2__GALLONS 719 BE WATER TESTED / 12.83' X 53.9' X 2' TRENCH FORMA TIO
SEPTIC TANK IF MORE THAN ONE OUTLET
PLACE ON 6" S7ONE 3A4SH D S7t-NE" SOIL ABSORPTION
h
PROFILE OF SYSTEM (SAS
SEWAGE DISPOSAL SYSTEM BOTTOM of TEST HOLE ELEV=_-_B0'
NOT TO SCALE NO OBSERVED WATER
OBSERVATION HOLE_,f1 ELEV.=_9B OBSERVATION HOLE 12 ELEV.=_93 _
y PERCOLATION RATE. t2- ARN./ INCH AT 48__I8"INCHES PERCOLATION RATE S?_ MIN./ INCH
DEPTH TEXTURE DEPTH TEXTURE `` 'L eD
0-2, LOAM AND SUBSOIL O_2• LOAM AND SUBSOIL
2•-g• CLEAN MEDIUM SAND CLEAN MEDIUM SAND y ���N OF
GENERAL NOTES 13' NO WATER.�FNCOUNrE'RED O EL 85• 13' NO WATER ENCOUNTERED 0 EL 80•
- . : WILLIAM
Div LIFOERMAN tiI
P.1) ALL WORKMANSHIP AND MA TERIALS SHALL CONFORM TO D.E. "9
TE
TITLE 5 AND THE TOWN OF -BARNST,4BLE___- RULES AND `�sG'
\ S
2 8/0IYAL Ft
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 4085
2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO P NUMBER_____________ '�• -
WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 3/06185 SOIL TEST DONE BY P. SULLIVAN (BAXTER & NYE)
3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED BY: JAMES CONLON• B.B.0.H.
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CALCULA TIONS.'
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. NUMBER OF BEDROOMS . . . . . . . . 6
4) ANY MASONARY UNITS USED TO BRING COVERS TO CRADE SHALL GARBAGE DISPOSAL . . . . . . . . . NO
BE MORTERED IN PLACE. TOTAL ESTIMATED FLOW
5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH USE 4- 500 GALLON LEACHING CHAMBERS ( 110__GAL/BR/DA Y x — BR) 660 GAL/DA Y
DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO 4' APART #77H 4' OF STONE SIDES AND ENDS REQUIRED SEPTIC TANK CAPACITY 1500 GAL
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. AND 4' BETWEEN A:!VD 2' EFFECTIVE DEPTH
6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR (53.9' LONG X 12 83' WIDE X 2' DEEP) SOIL CLASSIFICA TION . . . . . . . . 1
IS TO CALL "DIC— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS DESIGN PERCOLATION R9TE 2 _MIN./IN.
PRIOR TO COMMENCING WORK ON SITE. EFFLUENT LOADING RATE . . . . . . • 74 GAL/DA Y/S.F.
7) CONTRACTOR IS 710 VERIFY GRADES AND ELEVATIONS AS WELL AS LEACHING CAPACITY (AREA X RATE) 716 CAL/DAY
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. RESERVE LEACHING CAPACITY . . . 716 CAL/DAY
8 PARCEL IS IN FLOOD ZONE____C" &_B"_. B077VM 53t 9• X 12. )83 X .74 = 511 GAL/DAY
) AS PARCEL 8-2 LOT IS SHOWN ON ASSESSORS MAP _15 _ TOWN WATER A G.AILABLE (
_ _ __ • SIDES (53 9 X 12.83) X 2 X 2 .74 = 205 GAL/DA Y
-- (NOT IN SERVICE) 7177AL = 716 GAL/ DAY JOB 52535