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HomeMy WebLinkAbout0250 CASTLEWOOD CIRCLE - Health 250 CASTLEWOOD CIRCLE Hyannis A = 273 — 026 i TOWN OF BARNSTABLE LOCATION S-0 �� � WAGE VILLAGE ASSESSOR'S MAP&PARCEL ,7 3 INSTALLER'S NAME&PHONE NO. � �Q��� --,—-:�—07� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) Xa2 ,-'.XoZ NO.OF BEDROOMS oZ OWNER I-�® ®e ��zsr✓ PERMIT DATE: 1 Z -7 -'i COMPLIANCE DATE: Zl —'/OZ e Separation Distance Between the: A..- O Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 1a et Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) e,� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY In : ,d 0 No. d Ifla + Fee IWO THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpYication for Vsposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(Xfllupgrade( ) Abandon( ) ❑Complete System [individual Components Location Address or Lot No.pZ Z5"® C��TI � Owner's Name,Address,and Tel.No. Assessor's Map/Parcel r aL /� GV , �� O� ' Installer's Name,Address,and Tel.No. a Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -� gpd Design flow provided 9 gpd Plan Date �� — �3� Number of sheets Revision Date Title Size of Septic Tank��t/�/��� ®® ® Type of S.A.S. C'o'ii��i�'T4dr C Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 o lth. Signed Date Application Approved by Date — / Application Disapproved by a Date for the following reasons Permit No. :2_Q /U— H)L 9 Date Issued '— L�——_—_------------------------ 3, Fee �{ Entered in computer: THE COMMONWEALTH' 'OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for 10isp0saY 6pstem (Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System [°Individual Components Location Address or Lot No.p15-O C%4j7,_,�E'd410 o Owner's Name,Address,and Tel.No. Assessor's Map/Parcel � -7 — o"� /�i�)✓ y, r� �© Installer's Name,Address,and Tel.No. �� Designer's Name,Address,and Tel.No. Z 4,-�eD F`ri/� �'s- p�0, vie!j O"� ;'� '3 16 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage'Grinder( ) Other Type of Building �.� No.of Persons Showers( .).,,Cafeteria( ) Other Fixtures r Design Flow(min.required) -2=�O gpd Design flow provided gpd Plan Date �� "' "�3'' Number of sheets Revision Date Title • Size of Septic Tank ca")C��%��� ✓®o Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system m 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 o lth. Signed Date Application Approved by A Date 4__ Application Disapproved by Date for the following reasons Permit No. 0 /y - �0 Z -1 Date Issued 1 TIi E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(Upgraded( ) Abandoned( ')by G �• O �y/s' ��"4�1 f Jp 4-C at 9 Sip «1��G 4e-&,o G/Of has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a 1 Y- '�,2 ldated 1/ - 7` / „ Installer v Designer/+y,1id 4!r �� ✓�'`� �'� #bedrooms oZ Approved deffiign flow 2 02° gpdn The issuance of this permit s 11 not bI on tr ed s a guarantee that the system M/� etioondesigned.Date t Inspector 9/ /,r V1,11' ---------------------------------------------------------- No. O `i�C� Fee Q U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair 01� Upgrade( ) Abandon' ( ) System located at S'�o -�.r/� �Z 00 e6�.5l� 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 permit. Date 17/f 1 Approved by , NOV/13/2014/THU 07:26 AM FAX No, P, 001/001 Town of Barnstable Regulatory Services Richard V.Scali,laterim Director Public Health Division °rsanwps° Thomas McKena,Director 200 Maim Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Sewage Permit# 2 0"�- 11�'AYAssessor's MapTarcel Designer: Installer: Address: .Address: On J — 7—�� j"/ Pao�'�'{�was issued a permit to install a (date) installer) septic system at A ° based on a design drawn by ( ddress) -DIC) - 06DJ _ dated (designer)—Z, y 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. Strip out (if required) was inspected and the soils were found satisfactory. 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. Strip out(if required) was inspected and the soils / were found satisfactory, i I certify that the system referenced above was constructed o ccwith the terms of tlae I\A approval letters (if applicable) ��10!Z%S, 1-'2 .�.a /�DAVI© ��� talle 's gn ture) 0 MASON `J 0 Ito.1066 ���ra7E�';GrJ ;sq11AY1i lq (Design Signature) (Affix Desi 4 p Here) PLEASE RETURN" TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WELL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION• THANK YOU, Q:1ScpticlDasigner Certification Force Rev 8-14-13-don r Town ®f Barnstable >P a ; ll(-)3 ter , Department of Regulatory Services 1 DAMOT,v;M Public Health Division Date MAM 1, 639- �� 200 Main Street,Hyan is MA 02601 ArfU MEd h Date Sc uled Akee Pd. 1 Soil Suitability Asspssmentfor Se Dispos Performed By: V"6�k6o Witnessed By: LOCATION& GENERAL INFORMATION Location Address �"p �� � �s�® 7 Owner's Name Address Assessor's Ma /Parcel: P -.._ Engineer's Name NEW CONSTRUCTION REPAIR 3 Telephone# Land Use Slopes Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft t Drainage Way fit Property Line ft Other g SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r s" .• ass CD Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_ Weeping from Pit Foce Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In, Depth to soil mottles: In. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well lever Adj.Paetor AdJ.Groundwater Level e PERCOLATION TEST bate_, Time_ Observation Hole# _ Time at h" Depth of Pero `V1 Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: 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 the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTICVERCFORM.DOC i _J::�_ DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. o isistency %' ravel) D DEEP OBSERVATION HOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistengy.9oGravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muosell) Mottling (Structure,Stones,Boulders. Consistency.%O DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten Flood Insurance Rate Map: Above 500 year flood boundary No Yes z Within 500 year boundary No=" Yes Within 100 year flood boundary No.: Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring per i aterial exist in all areas observed throughout the area proposed for the soil absorption system? � Z� If not,what is the depth of naturally occurring pe vtous material`? °T Certification I certify that on2nvElrlLental (date)I have passed the soil evaluator examination approved by the Department of Protection and that the above analysis was performed by me consistent with . the required training,ex ti n experience described in 510 CMR 15.017 ©I Signatur Date r' ` Q:\SEPTIC�PERCPORM.DOC ASSESSORS MAP : Z�3_ i _ TEST HOLE LOGS PARCEL : 2� _ _ 1) The installation shall comply with Title V allJ Town of ward of FLOOD ZONE: V I- II� ILk � SO I L EVALUATOR: 1 1c) I lealth Regulations. WITNESS : TwWn M 64A 2) The installer shall verify the location of utilities, sewer inverts and septic REFERENCE: ,PE17 . _ bq DATE: components prior to installation and setting base elevations. PERCOLATION RATE: 1M t , 3) Al( gravity septic piping to be 4 inch Sch 40 PVC at I/8" per Foot. The first 06 � V, I U� two feet out of the d-box to the ieaching shall be level. — ` , T TH- 1 TH-2 4) This plan is not to be utilized for property line determination nor any other purpose other than the proposed system installation. A ��� �►4~-t 5) All septic components must meet Title V specifications. MI)A 6) Parking shall not be constructed over H 10 septic components. -7 5A. Lb 7) The property is bounded by property corners and property lines. '� IbU 8) The property owner shall review design considerations to approve of total i �'��� t} 1 b �' b � design flow and number of bedrooms to be considered for design. Receipt LOCATION MAP J� of payment for the plan and installation based on the plan shall be deemed iVVN approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material l� V per Title V abandonment procedures. Those within the proposed SAS shall Id Q.1 �LI be removed along with contaminated soil and replaced with clean sand per Title V specs. ��i� P 10)System components to be 10 feet from water line. Sewer lines crossing the v�c ►�, ___-- ��_ � water line shall be sleeved with 4 inch SCII 40 PVC with ends grouted if applicable. The proposed SAS is being installed below the water service line. The line is to be sleeved as aforementioned and maintained in place. SEPTIC SYSTEM DES I GN 11) If a garbage grinder exists it is to be removed and is the responsibility of the j owner to ensure such. FLOW ESTIMATE 12)The installer is to take caution in excavation around the gas line if such i I exists. 1) BEDROOMS AT ILL GAL/DAY/BEDROOM -� GAL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer lines exitin¢ the dwelling"rior to the installation. I - q2��� 14)This plan is representative only that a system can fit on a property meeting SEPTIC TANK Title V requirements. Z�GAL/DAY x 2 DAYS GAL USE - GALLON SEPT 1 C TANKCEXJ 11�L� SOIL ABSO�PT'i0 S S EM 2 \ ` I S 1 DE AREA: 2-x Z5fi IZ,�3zj X Z� ��� = 111,97 �� DAVID `. I � y t �/,J� W BOTTOM AREA: Z- X 1 Z D Z 7j'7� J' n MASON1 gy�Go.106 6� Gy a �STE� IZ I SEP ! C SYSTEM SECTION I 0? U IMA ��1� 1 / t0,libIvIb IT —. n 10 I'� 2"Zvh 5 �� �_1D {� Q , rDQ GAL _ �_ _ o , �l �l � �►�t 4 )9 C� SEPTIC TA K ``I I/2 �DU1° _l v yt - SITE AND SEWAGE PLAN LOCAT I ON : �j G `JI G1�L PREPARED FOR : IVA Lt-79COUr M ICI 0 SCALE: W DAV I D B . MASON RS DATE: tI ZDl g DBC ENVIRONMENTAL DESIGNS Z EAST SANDWICH . MA W DATE HEALTH AGENT ( 508 ) 833- 2 177 Z