HomeMy WebLinkAbout0199 ARROWHEAD DRIVE - Health w
1799 hA 'c'wh'ead' Dri`-�e
Hyannis ` _
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TOWN OF BARNSTABLE
LOCATION SEWAGE# Q06&143g
VILLAGE t4q com `
i 5 ASSESSOR'S MAP&PARCEL ,27(9 7S'
INSTALLERS NAME&PHONE NO. �ane �h Qd
SEPTIC TANK CAPACITY 1 S'oo 14 , U
LEACHING FACILITY: (type)SoO I'-.0 (size) 13 X a S
NO.OF BEDRbOM:v ' 3
OWNER Cpn J& Cain
or
PERMIT DATE: ` COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NdA ( Feet
Private Water Supply Well andleaeching Facility(If any wells exist
on site or within 200 feet'of.leaching facility) Feet
Edge of Wetland and Leaching'FaciIity(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
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No. 00i + Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, M'ASSACHUSETTS
01pplication for 30i!9poal *pgtem Construction Permit
Application for a Permit to Construct( . )Repair( )Upgrade(✓Abandon( ) f16omplete System El Individual Components
Location Address or Lot No. 19 q A 4Z.f4_z Ae4A d_b fl VC Ow er's Name,Address and Tel.No.
1414HniS MA oz.(oc% 1wen 6,4)Gy
Assessor's Map/Parcel i rt I�iV cl" (k -Dr,jc-
7 — 0 7(� ai i S A-t
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
7""' L''md -77�
0-9' RD-% rim
Type of Building:
Dwelling No.of Bedrooms r Lot Size /�� 2�O sq.ft. Garbage Grinder( )
Other Type of Building Svc (1 No.of Persons 7 Showers(t/) Cafeteria(�/)
Other Fixtures
Design Flow 3�� gallons per day. Calculated daily flow 35 Z. --gallons.
Plan Date 9-3 o-z,uo 5' Number of sheets I Revision Date
Title
Size of Septic Tank 15"00 �At Type of S.A.S. (?! 5b0 $61 ��• �-�►w+�•�s
Description of Soil, ► ",
Nature of Repairs or Alterations(Answer when applicable)
Q`) 11z, !�P k L e4J, C L►orwi�i KS ZS (�yC Z
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by th' oard of Health.
Signed Date f® —2-20('
Application Approved by Date 0 0& .
Application Disapproved for th ollowing reasons o - M
�Cl1ry�✓1 ca_ A/O.
Permit No. 100 C —Y 3 e Da=ssued �D
L ..:;_ °fie. ,y. _ _a-� ' •.w.�. 1.7 r�j.t';: 'SK4+f,, . 4. gw`;,i:., �y2',jr:+ ""F,."y, ... y•S
'T V� N � - •ram.
No. Fee
.\ rv\� '` Entered in computer:
.: THE COMMONWEALTH OF MASSACHUSETTS p Yes
PUBLIC HEALTH DIVISION\-TOWN OF BARNSTABLE, MASSAChU ,TTS=
..w Pam• .•s ' ZIppfication for ;MigpQ$al Opgtem Construction Permit
-A Application fora Permit to Construct( , )Repair( )Upgrade(Abandon( ) Complete System El Individual Components
Location Address or Lot No. 19 q AM" AeA '%)A t/. Owner's Name,Address and Tel.No.
"Hia�his mA 07-roQ% l�@v1 -e-yvlaRl I�jQTF/ 6
Assessor's Map/Parcel �� 0 r f f, 14ics�+ lea 17f, �lC� �`1'�Q
— j bI As, <s ✓ems
Installer's Name,Address,and Tel.No.�A Designer's Name,Address and Tel.No. <:k
wo Ru,;z ��� Sa8 ;g
CST rCi.2to�
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building 5tk%1e No.of Persons '), Showers(V) Cafeteria(L. ) M
Other Fixtures
\ Design Flow ' 3_3 0 gallons per day. Calculated daily flow -3 S;-2- gallons.
Plan Date 9--3 o- z.on Number of sheets I Revision Date
Title
Size of Septic Tank 1 Soo �A l Type of S.A.S. Z-) 9 6 S A 1 L EI.. C�w,,"s
Description of Soil _ A 1 4ti/t
Nat re of Repairs or Alterations(Answer when applicable) 1 So a p 4,< TV4.%4 -sLr
Date last inspected:• J
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 issued by this Board of Health.
Signed _12 Date 16
Application Approved by �T 0 -S. Date 6
Application Disapproved forth following reasons hi 1,,17 10G, N10.•.-C Ar , ,p/ /;x. .
Permit No. -200 6 -`/3 Date Issued /0 A k f"
THE COMMONWEALTH OF MASSACHUSETTS
- ` BARNSTABLE, MASSACHUSETTS
ce1
rtificate of Compliance
THIS IS TO CERTIFY, that the On-sit �On-site Sewage Disposal System Constructed ( ) Repaired ( )Upgraded( )
Abandoned( )by :4/ia; ):,k., On ✓0I. %et, L u C
at � _ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System onstruction Permit.No.�ro/ -y?k dated /u
Installer F7 o t ` e Designer o.n i�►</: d-4 E, r
The issuance of this permit shall }ot a construed as a guarantee that the systt m w'11 n tion as designed.
Date I�f! Inspector
- +No. JOUb ,/.3 c —.—.--.—._--.------•-------------`— Fee
7 n THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS zt
]Digpoga[ *pgtem Congtr coon Permit
Pernhission is hereby granted to Construct( )Repair( )Upgrade( Aband'on( )
System located at f A/111vri i j b ✓Ir ur ,en.S
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 completed within three years of the date oflhr"'s�p emit. J
Date: Approved by
Y
!LVn'JIIVl "AAJuLateIRJiG
Regalat6ry Services .
Thomas F.Geller,Director
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Forth
Date: /0 h, 106
Designer: , Ce4dP/�� Installer: C,4 IJ , Gt/h1JnJ7�r iSS
Address: Address: 4° O 7 /,}
Y4,f- L!
On �� 6 D CA JEGV , 5:7- as issued a permit to install a
( (installer)
septic system at �'7 / ��'/�� b �l' based on a design drawn by _..
(add)
• C',41�!L Lae— S dated 7L�D �S �rJ tr� 73 i%k
J 6
(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.
,��kOF
��s90
a RONALD
o JAMES �
CADLLLAC
er' Signature) #'10601
C/S-T
y SgNITAP��
(Designer' igaature) (Affix Designer's Stamp Here)
PLEASE RETURN TO $ARNSTABLE PUBLIC HEALTH Dl<VISION CERTIFICATE
OF COAU I`JANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY TBE BARNSTABLE PUBLIC EUKALTH DIVISION.
THANK YOU.
Q.HeaWSWficlDedper QrMcation Foam
1
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OCT-02-06 03 :53 PM R. J.�CADILLAC, PLS, RS 508 775 9700 P. 01
Notice: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only'
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM
i
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a bi!R
LC 4(Aereby certify that the engineered plan signed by me
dated Q ,concerning the property located at
J C rr v �►ll—
� meets all of the
following criteria:
i
• Two soil evaluations excavated for detailed examination(no hand augering)and two
percolation tests shall be conducted.
• This failed system is connected to a residential dwelling only. There are no commercial or
business uses associated with the dwelling.
• The soil is classified as CLASS I and thepercolation rate is less than or equal to 5 minutes
per inch.
r .
There is no increase in flow, and/or change in use proposed
• There are no variances requested or needed.
• The bottom of the proposed leaching facility will be located no less than five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the;
Frimptor method when applicable]
Please complete the following:
'ZI-i Z)N E P `
A) Top of Ground Surface Elevation(using GIS information) 4 8 3
d✓ 3
B) G.W. Elevation 2 6 +adjustment for high G.W. = {
DIFFERENCE ETWEEN A and B to• h
CSIGNED : DATE: 3D 4S
NOTICE
Based upon the above information.a repair permit will be issued for bedrooms
maximum. No additional bedrooms are authorized in the future without engineered septic system
plans.
q;%Septic\pme:emp.doc
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ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE.
JOB NO. B05-09 2$
_,. NOTES
.. CONLEY.DWG RpU�
0
1. LOCUS IS A.M. 270, PARCEL 78.
2. ELEVATIONS SHOWN ARE TOWN GIS f0.4'
3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. r
0) ZONING DISTRICTS: RB & WP 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED)
5.. MUNICIPAL WATER IS AVAILABLE., . LOTS WITHIN' 100' ARE ON TOWN WATER. u Q
6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. c
m
7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14".
a BENCH MARK--TOP OF STAKE INSPECTION SCHEDULE 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW o o NOT TO
SET FLUSH = 48.96 GISf0.4' CALL R.J. CADILLAC TO D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. W 4 SCALE
INSPECT PRIOR TO BACKFILL. 9. DEPTH OF 'COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. A/
M -
COVERS BUILD UP COVERS TO 6" BELOW GRADE--2 ON TANK, 1 ON D-BOX, 1 ON LEACHING N ST
10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 ,TO 1/2" PEA STONE ON TOP. LOCATION MAP
11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND,
CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC.
N/F N�F 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND; AND .UNDER LEACHING
MCBRIDE FIELD IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS-OF 310 CMR 15.255(3). TEST HOLE
13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN
Lj_j LEACH AREA; AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet)
14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. 0 48.4
A layer 10yr 3/4
BENCH MARK--CORNER OF CONC.
N f F �`� �• PATIO= 48.63 TOWN GIST 0.4' NO GRADE CHANGES TEST HOLE DATE: July 28, 2005 8. sandy loam
x 48.4 ARE PROPOSED PERFORMED BY' Ron Cadillac, Soil Evaluator
MORESHEAD 48 48,4 _' - WITNESSED BY: B layer 10yr 6/6
TH 1 1 N 77 PERC RATE: <2'-00" inch C layer) sandy loam
L 0 T x I 48,6 n 7 '24" x 48,4 49.37E / ( Y ) "
/ � 4 w Clean Out SOIL SURVEY(1993): Carver coarse sand
48.4 TH 2 49. 4'� Top Exist. Foundation GEOLOGIC MAP(1986): Harwich outwash plain deposits 36 45.4
1 1 2`T0- F 48,3 x 48,4
� � T�2 x 8,3 � �,,,` � � Invert 47:30 Invert 46.05 56..a C layer 2.5y 6/4
42. i -
i --__ QExist. Cast Iron 2 DRY WELLS
Use Gas Baffle medium sand
� ,40 � � � k .30
O 4 � 49.2 � � \6� �.,,_� Proposed Invert 45
� 47, Proposed 10% gravel
47.4 9•7 47.24 9 min. cover P� O x 48.9 i �� i � x 48,3 S=1/2"/ft P 46.0=To Conn
�1 J 45.7=To Peastone
N/n i J `�;� i 1 8 x 47.7 Proposed S=1 3/4 /f S=1/8"/ft P
O O � -
i O Q 8 7 47,66 PAV -'I 47,13 I Invert 46.30 1500 Got. min.
49 J N\C,0�\\ / :.:.::..::.:. .::..::.... EQ °d° �RIV 4 i Proposed Septic Tank
% v i E 1 i ----------j- 2472 132" no water
48.8 x i 49,0 37.4
.:X.. i 6 = v`s� 48, \ 47,41 j Invert 45.47 Invert 45.20 5.9, 43.2
0
Stone r compact Proposed Pro Proposed
' Bottom TEST HOLE 2
48,8� NO 47, ,l 6 t O p N
4_9,0 l full 9 O .^'� x 4/7.9 T 25 4 I I -I- -1
Z 49.2 ab bo cr _ ,� _ �y l 1 �'CD Bottom TH2=37.3 DEPTH inches
N F '1 / + 4 n 1 10 (inches) ELEV.(feet)
49,38 ss ow/ � 0 48.3
FAVOR :- �, _ rn layer 10yr 4/4
x 48.5 as - DESIGN DATA - sandy loam
♦- _ y
.
49,2 \. 2 47.40 P 7
_ = 48,5
48.5 '`' :.:.•.•` G _ BEDROOMS: - 3 min. B layer 10 '5/6
�c �� 48A�7.9 - - -_. a �� _. - - loamy sand
E 1 GARBAGE-GRINDER: No
LEACH AREA
81 REQUIRED CAPACITY. 330 GPD 34"
. 45.5
1 9 8T
CHAP OFF SEPTIC TANK: 500 GAL. USE 2 DRY WELLS WITH 4' OF STONE�2 TRIANGLES, FIRST S ��- E '
TO SAVE THE WALK--8' .X 3', 7 �2'24' E- - BOTTOM LEACHING AREA: 310 SF ALL AROUND TO MAKE A 25' LONG BY' 0 C layer 2.5y 6/4
SECOND, TO KEEP 10' FROM \ 47. 25' X 13' - 15 S.F. 13 WIDE BY 2 DEEP LEACH AREA,
SLAB--3' X 2' _ �� - [( ) ] MINUS TWO TRIANGLES, AS SHOWN. medium sand
x PA [2' X3'/2 + 3' X8%2]]
N/F 48. / SIDE LEACHING AREA: 144.4 -SF
JARZOBSKI 47 4 [72.2' PERIMETER X 2' DEEP)]
DESIGN CAPACITY: 336 GPD
[(310 SF + 144.4 SF) X .74 GPD/SF]
Sun Rm
132" no water 37.3
�3 �-• Bd Rm
c a Kit Dn Rm
a� :3
C" Bath
Lv Rm Bd Rm
FLOOR PLAN SITE PLAN
NOT TO SCALE
FOR
THIS PLAN IS A VALID COPY ONLY IF IT BEARS ^�
AN ORIGINAL RE® STAMP AND SIGNATURE. KENNETH . G. & MARY -.B E TH CONLEY
LEGEND
TH 1 TEST HOLE LOCATION, NUMBER OFM,1S� �P�CHOF SqO LOT 61 ; 199 ARROWHEAD DRIVE, HYANNIS, MA
w WATER LINE MARKINGS ��� RON D �� ��� 0 SEPTEMBER 30, 2005 SCALE: 1 "=20'
E OVERHEAD ELECTRIC WIRES (IF SHOWN) A ^'S
G GAS LINE MARKINGS U CA i� C �C ILIAC J
# 1060 p #35779
x 9.5 x 8.7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) F V- Q °FES s 0
,,-6--- EXISTING CONTOUR S�isTE N q .1°
gN�TAR�P "° SURVE RONALD J. CADILLAC, PLS, RS
$- PROPOSED CONTOUR 6 2
0 UTILITY POLE (IF SHOWN) J 6 PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN
x FENCE (IF SHOWN, NOT ALL -SHOWN) P.O. BOX 258
0 TREE (IF SHOWN, NOT ALL SHOWN) WEST YARMOUTH, MA 02673
HEALTH AGENT APPROVAL DATE (508), 775-9700
REV. 10/03/06--TO MEET CODES CHANGES. OF APRIL 2006 �2005 BY R.J. CADILLACPAGE 1 OF 1