HomeMy WebLinkAbout0180 FAWCETT LANE - Health 180 Fawcett Lane
Hyannis
A=270.- 137
TOWN OF BARNSTABLE
2008 v 192_
LOCATION /20 7aw cc SEWAGE# 2ca1(-- 6tt2
VILLAGE 14 n r f' ASSESSOR'S MAP&PARCEL Q70 /3.`7
INSTALLERS NAME&PHONE NO.�aAe tv� �� S yd e2
SEPTIC TANK CAPACITY /-//G
LEACHING FACILITY:(type) S�o Lc Hzo (size) /Z •,f3 X ZS-
NO.OF BEDROOMS .. 3
OWNER rX a A c R P LXX `—r"' �
PERMIT DATE: 3- 1 ZC0 COMPLIANCE DATE:
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 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) l _ Feet
FURNISHED BY (`i
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JJ N '�
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N � P �i C
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Ilo. 0 01 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZIPpY%cation for 3Di.5poal *pgtem Corr.5truction Permit
Application for a Permit to Construct O Repair(Upgrade( ) Abandon O El Complete System ❑Individual Components
Location Address or Lot No. 1 g0 F4-j C_r-e Owner's Name,Address,and Tel.No. f3e4_,1 r•CC ,��ir��a�✓�
Assessor's Map/Parcel "7O /3
Installer's Name,Address,and Tel.No. tlskelm�o Designer's Name,Address and Tel.No. f�O�,d✓r e.�fJ�
R�• {3ok "7to� f73y /17t4-A STttt i
Type of Building:
Dwelling No.of Bedrooms Lot Size I�� 12 I + sq.ft. Garbage Grinder ( )
Other Type of Building /7• No.of Persons Showers( ) Cafeteria
Other Fixtures
Design Flow(min.required) :3 O gpd Design flow provided �� gpd
Plan Date :3—1 1—'Zoo1 Number of sheets Revision Date
Title
Size of Septic Tank > S_ol'� Type of S.A.S. te.
Description of Soil _ n I&w
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: 1002
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 of Health.
Signed Date 1 r 104
Application Approved by �� Date 3 — IN— 9Loo
Application Disapproved by: Date
for the following reasons
Permit No. r104—b 2- Date Issued � � �
J o � 0
Io '�b Fee
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF'BARNSTABLE, MASSACHUSETTS Yes
2pplication for �Bizpogar �&pgtem Con0truction Permit
I
Application for a Permit to Construct O Repair 04. Upgrade O Abandon O ❑.Complete System ❑Individual Components
hLocation Address or Lot No. I Ii o F4.j ct{f G„o, { Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 2?d J 3
Installer's Name,Address,and Tel.No. � i3S5 Designer's Name,Address and Tel.No. ��Otv✓� C A
Y4✓',".•-Ill /7cW r- y;.-n
Type of Building:
Dwelling No.of Bedrooms Lot Size (�! 1Z, -� sq. ft. Garbage Grinder ( )
I
Other Type of Building • No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 gpd Design flow provided ' � gpd
Plan Date —( I^2 00� Number of sheets Revision Date
Title
Size of Septic Tank / SOt� Type of S.A.S. ?i S, - �}(r (,. �. K•.
�� lc
I Description of Soil
i
Nature of Repairs or Alterations(Answer when applicable) I
Date last inspected: 1007
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 of Health.
M Signed Date O O 6
y Application Approved by Date 3 " 1,4 Q QU
r Application Disapproved by: ` Date
± for the following reasons
Permit No. 2 OG W—0 q 2• Date Issued 3
--------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the dOn-site Sewage Disposal System Constructed ( ) Repaired ( A- Upgraded ( )
Abandoned( Eby �.J,. tAt f�/1 Ki�C S
at has been constructed in accordance
with the provisions of Tittle 5 and th�lfor Disposal System Construction Permit No. o2C10 t) - 04)y dated 3_j��'o�
! Installerm!) �),l�l� �IN Q���f S Designer
#bedrooms 3 Approved design flow gpd
The issuance of this permit shall t be o trued as a guarantee that the system will(�nctionjlsgn� .
Date Inspector
-------tt'' —————————————————————————-- ——————————--
No. a D Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
'Wi5po$al 6p5tem Con5tructton Permit ,
Permission is hereby granted to Construct ( ) Repair (1>44 / -Upgrade ( ) Abandon ( )
System located at l Oro EAj&,.c e PAn vt,
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this t
Date Approved by. ,
310 CMR 15.220: Preparation of Plans`and$pecificatiorrs Effective March 19 5, Updated April
The plans and specifications for every on-site system shall be prepared.as follows:
Your A here.
(1) every system shall be designed by a Massachusetts Registered Professional Engineer or a
Massachusetts Registered Sanitar.4-rprovided that such Sanitarian shall not design a system to. t
discharge.more than 2,000.gallons per day pursuant to.310 tv'MR 15.2i13. Any other agent of
the owner.rnay prepare plans for the repair of a system designed to discharge not more.than
2;000 gallons per day pursuant to 310 C&M 15.203 provided they are reviewed by a
assachwetts Registered;Sanita-ian or Massachusetts Registered Professional Engineer and
approved by the.Approving Authority,
(2 Every plan submitted for approval`must be dated and bear the stamp and signature of"the,
esigner. At least one copysubrnitted shallbear the original starnp and signature.of the designer.
{3) Every plan for a new system 6r.,plan for the upgrade or expansion of am xisting systens
which requires a variance to a property line setback.distanco,must also reference a plan,which
Aears the stamp and signature of a Massachusetts licensed Land Surveyor in accordance with
.(i.1. c. 112.4 8 f D:
(4) cry plan for a system shall be of suitable scalene inch=40 feet or fewer for plot plans.
an one inch=20 feet or fewerfbr details of system,components)and shall include depiction of;
/�a) the legal boundaries of the facility to be served;
'' (b the holder and location of any easements appurtenant to or whicla.covld impact the
stem;_
(c the:location of all divelling(s)and btailding(s)existing and proposed on the facility and
en ic-ation of those to`be served by the system;
(d the location;of existig or proposed'impervious areas,including driveways and parking
e '
location and dimensions of the system(including reserve area);:
(f) s tern design calculations, ncluding design daily sewage flow,septic tank capacity
(_re fired and provided); soil.absorption system capacity. (Fequhred and provided); and
er system is designed for gasbags grinder;,
Al ith arrow�and�eaisting and.proposed contours;
ovation and log of deep obsetvat_ion iaole tests:including the date'of test;:e listing grade
e vations marked on each test;:and the names of the representative of flee Approving
utharity and soil evaluator;
(i percolation tests including the date of test and the�names of the
.ova ion and results of
ep atative of the Approving Authority and so' evaluator;
name and approval date of.the Soil evaluator of record;
(k) location of every water supply,public ania private,
1. Within 400 feet of he proposed system location in the case of'surf aec water.supplies
and gravel packed public wafer supply wells,
2. within 250 feet of the proposed system location in the case.of,tubular,public:water
supply wells,and
within 150 feet of tbe.proposed system location in the case of private water supply
U7/�/ wells;
(1) any surface waters of the C,nmmonwealth,ZoneAs,rivers,bordenng vegetated wetlands,
salt marshes, inland or coastal banks,regulatory floo&ay,velocity zone;:surface water
supplies,tributaries to surface water supplies,certified"vernal poots,.private water supplies
ar suction lines,..gravel packed or tubular iiub'tic water supply wells,.;and.wsubsurface drains
located up to 10,0 feet beyond the.setback'distances,in 310 CI it 15.23 i,anyleacliing catch
basins.6d dry wells located up to,25.feet Beyond the setback distances in 3.ID CMR I5.211;.
and the location of any nitrogen sensitive'area identified in 310 CMM R 15 215'within which.
y po `on of the facility-or the,prop6sed system is located as well as any nitrogen sensitive:
are o 100 feet beyond any pro perty1ine of the facility.
€ ocation of water hries anidother subsurface;utilities on fife facility;
( observed:and adjusted ground-water elevation in the vicinity bf the system`,; ,
o) complete profile of,the"system;
( a note on the plan listing all variances;to the provisions of 31f3 CbM 35,W0 sought in
onjunction with the plan;
(q) the location and elevation of one benchmark within 50 to 75 feet Of the sysYeiri- CD
�eompor:ents which is not subjeo to dislocation or:loss during construction on the facility;
j{V r t (r) when pressure distribution I dosing is proposed,complete design and specifications of
the distribution system proposed incl:rdin,g but not limited to-dosing.chamber capacity N.
(required and provided),pump curves and specifications,number cif dosing cycles and depth �.
r cycle; t
when a Recirculating Sand Filter or equivalent alternative technology is,required or
proposed,a complete plan and specifications for the system,including a hydraulic profile; a
a locus plan to show the location of the facility including the nearest existing street: c4
(u) the street number and lot number,if any,and the tax trap number and lot number,if ally,
of the facilit}};and d
v)the ma:enals:(constru, a..and the specific ions c#the system.
}
1
Richard Capen Rich@CapewideEnterprises.com
License#089273 Capewide
ENTERPRISES, LLC
J.P. MACOMBER & SON
Office:508.428.4028
P.O.Box 763 Cell:508.367.1802
Centerville,MA 02632 Fax:508.428.1928
j
• I •
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—�reci Construction Division-_
Custom Homes•Additions•Remodeling
Kitchens&Baths•Basement Finishing
Septic Division
Systems Designed Installed a Repaired
'• Title V Inspections•Pumping•Greasetraps
Excavation Division
Demolition•Clearing•Pool Excavating
Final Grading•Hydroseeding
0 o g
Container Division(10 & 15 yard)
!I F i i I EI
FROh1 :down cape engineering inc FAX NO. :15083s2gee i Apr. 04 20 8 02:33PM P1 SG
I I } �•�
+ I
r Town.'of Barnstable
, t�e�u ,story Services i
,a i i H
i I T'46mias F.:Geaer,Director; � xj
i Publ�c $'ealtb'DtVisi6u
I;
} s } ET$OmSS mcKeau,Director;
I ! I ZU4,`Ivlsiu Street, #yaIan s MA 02601
Fax' 509-790-6304 }
price: 50E-86�.aba4 i i � 1 I j ! ! ; ii
f i { i t
, stal[er & Desr<*aer Certi (cation Farm
I II ad U Oec' �1ASS sor's!MapTarcel °�' i
I Daape tA/j
te: z�e� Sea�x�ePerai>< I .. _ ;
Desi�g>aer: p� i ! I
i
j i UX �
i � � Address.
�4ddress: j .: s i I i
ii I I �I v rc 7'� f ; I
I Was issued a rmit to install a s
sl (date)
I CPUtUJC2 Gt i based.on a aesistn drav, by i
SePtiG s�'stem at y�' )
+ - I.tad1.4{HSS
ti
f i 'dated i = l(-Zc�o�
i 1
I cerdi ' that the Septic system referez�cccl above v,• litxstailed substannall}� ccordiug to
I I
which clucie'mizior a raved clzan es su6kh a5 lateral relo;,�tlan of the ;I
v�hich ma to P
P
the iaesi } ,
. i ,
' disnibunon box andior septic,
j I certify' that the septic;systcrrm referenced above w1as iiLstalled untlt ma3or an=es (i.e. t
greater than 10" lateral�eloca� on of.the .SAS of az�z' .vertical relocation af'an component
of the se zic systexn) but In i�►ecordazace vi-jth,Swa 8 Lo6al Regulations. Plan recision or
certiiled -built by designer to fallav�j G j j I ! .
ARNE M.
o : f oJAI A
! In er, gnature) i CIVIL s ��
I I I ' No;30792
• '� r �ncr icrnatu j (Af�a TDesigner S Stamp He le) .
' e PLC SE RET T B RNS ABLE ` PU 3TrIC H ALT DWISION., CI RT FIC.ATI✓ E�
COMPIJIANCE WILL NOT F� ISSUE',A Q TIL BOTH THIS FORM AND AS�BU11.1i CARD ARE �I
tl
i j RECI~IV�A SY TEE BARNST_ ABLE POBLIC HEALTH DIN"ISI .N. T} A�'k 1'C>U• s ,i
j nn .�6-04'doc
ar I ' I
n• w� P.lth/Sentie/DCsiznrr Certifichtion;FO i I !
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1 e i i
FORM 30 C&W HOBBS&WARREN rrn THE COMMONWEALTH OF MASSACHUSETTS
BOARD, OF HE, TH
ITY/TOWN
W
DOARTMENT
GSM SV a�aw
ADDRESS
TELEPHONE
Address Occupant A4-IIIALILe
Floor Apartment No. No.of Occupants
No. of Habitable Rooms No.Sleeping Rooms
No. dwelling or rooming units No.$t ries
Name and address of owner
Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress: and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Li htS :
STRUCTURE INT. Hall,Stairway: — � �-
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys: —
Central ❑ Y ❑ N Equip. Repair ° v�
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line: L
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen 0
Bathroom 67a
Pantry
Den
Living Room
Bedroom(1).11-
Bedroom 2 1 (L
Bedroom 3 i�, L PIK nC�
Bedroom 4 (()Q
Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.:
Stacks, Flues,Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin, Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted
Locks on Doors: IV
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REP S SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF PERJ "
lieAA 1��
INSPECTOR TITLE
i AM
DATE I TIME
A.M.
THE NEXT SCHEDULED REINSPECTION P.M.
.., .. ..s,..... . .....: -c.r r.+� �vs:'. .:.. '.lL,.s. .s,;n. .+e1+. .yri. .,,. s n. ... _ � t s, p y � .'Y;'r•: . .;. .a
y
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410,620 state minimum requirements of fitness for
human habitation,any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to
include affect the legal obligation of the person to whom the order is issued to comply with such order.
(A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary
needs of the occupant in accordance with 165 CMR 410.180 and 410.190 for a period of 24 hours or longer.
(B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as
prohibited by 105 CMR 410.200(B)and 410.202.
(C) Shutoff and/or failure to restore electricity or gas.
(D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com-
mon area required by 105 CMR 410.254.
(E) Failure to provide a safe supply of water.
(F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR
410.150(A)(1)and 410.300.
(G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object,
including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452.
(H) Failure to comply with the security requirements of 105 CMR 410.480(D).
(1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar-
bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests
or otherwise contribute to accidents or to the creation or spread of disease.
(J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public
Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.)
(K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,
so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety.
(M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release
of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105
CMR 410.353.
(N) Failure to provide a smoke detector required by 105 CMR 410.482.
(0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or
knowledge of the owner of said condition or conditions:
(1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven
or-any defect that renders either inoperable.
(2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any
defect which renders them inoperable. '
(3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of
generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard.
(4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as
required by 105 CMR 410.503(A)and 410.503(B).
(5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550.
h r violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750 A through O shall be deemed to be a con-
dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner
to remedy said condition within the time so ordered by the Board of Health.
4 -
;Citizen Web Request Page 1 of 3
!"_.s
r GifuRequest Management : 4
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ou
Request Information
E
Request ID: 21510 Created: 1/3/2008 11:51:33 AM
I Status: Assigned To Staff Assigned To: O'Connell Timothy
Health Office
j Anonymous: No Request Category: Chapter II : Housing
� Substandard edit
Estimated 1/8/2008 Change Estimated Dec January 2008 Feb
Completion Completion Date:
Date: Sun Mon Tue Wed Thu Fri Sat
30 31 1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 1 21 1 22 1 23 1 24 25 26
27 28 29 30 31 1 2
( 3 4 5 6 7 8 9
i Created By: Fontaine, Tina Priority: Medium edit
F
Health Office
Citation Numbers: edit
'° a uestor Information
1
Requestor
Request Parcel Number I 270 137 0 0
heats not working landlord knows Map. Block. Lot. ._____w_..
about the situation
( Parcel Lo o._ ._.k..
1
Email:
http://issgl2/lntemalWRS/WRequest.aspx?ID=21510 1/3/2008
:Citizen Web Request Page 2 of 3
Ed it_Requestor.Infomation.
Track Request Progress
Request Work History: Internal Note History:
System entry on 1/3/2008 11:51:33 AM:
Assigned to O'Connell,Timothy
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Time worked on request Response time
Time entries are in hog U. ExamDles of tirne e tries, 1,25, 0,5, U5 t 15, 0,25, 0A0
Response time: Measured d From the creation datUe. to your first actions on the request.
" Do not include nights, .,treekends, and holidays in response time For most departments, �
Save changes Check to notify town employee below
to review this request.
Save changes and notify
Health Office
citizen* ......
iAgostinelli Joan
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I �rnotify works if email address was given
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�M. INVOICE
f
E.EW10,),IOW 8 Reardon Circic> South Yarmouth, Massachusetts 02664
`gip"'t Plumbing ik Ho' frog 508-394-7778 e FAX 508-394-8256 a yuestions@efwinslow.ci�m �t1®ft��'0 O�� 11n `
I +8 *Due & Payable fo-pori
�e�ei�t9
'► �5 �- =�<-� time departed ® '
trs.vel start , :� -.-� time arrived ------
___ i
a�rot rformed
9
9 t
t
i14 f
,51-lel t1S: C_I Complete ❑ Incomplete/Reschedule ❑ Follow-up w/estirnE,tu
_lalantity _ description price amount
is
eot le
t
Due,glal receipt. 1.5%par IrroffM (18%per and finance charge on amounts over 30 days. Customer agrees to pay all
C011ectlon& attomsy.:; Oe;. Aa CLAims FOR CORRECTIONS OR ADJUSTWNTS MUST HE MADE WITHW THIRTY DAYS.
- hours � labor amount
_ meth nits '
_ fW 1/4.S e total materials _ -
!. total labor
total labor tax
ri ft)K
Nly--griature hereby ahptoves he Sati factcvcompletion of the above work, as well as grants Authority to use �r --
credit Card Numbers Supplied w time of Services or Credit Card Numbers already on tile.
i
TOTAL
defe completed�_-, .. 44-h-,fe PAYMENT METHOD: Ij Credit Card / Expiration Dare ❑ Cash Ch.e.ch
CUSTOMER COPY TOP COPY
: i
INVOICE
.F. insl®w 8 Reardon Circle, South Yarmouth, Massachusetcs 02664 „
Plumbing & Heating 508-394-7778 • i.Ax question
508-394-8250 ® tions@efwinslow.coin WORK ORDE Il�,
:Due & Payable upon
° Receipt'
travel start time arrived e� - 3 � - time depa;V,41
I�.wo 1 foor weed _✓ f��C �-> >/ ,p.�
i � r�r6;�?E� ,.� 4�
--- 1-
a.+maaeeev vzo�.. ,
` `; ff u`:' � Complete ❑ Incomplete/Reschedule ❑ Follow-up w/estimat€+
description price
amour;j,---------
---
70
----- --
£ Lye trlson;ecaipt. 1.55 per month (18%per annum)ttnance charge on amowts over'30 days. Customer agrees to pay all
collwdon A alfOmeyS WS. ALL CLAIMS FOR CORRECTrONS OR 40JuSTME M MUST BE MADE WITHIN THIRTY DAYS.
labor amount
apIT
f -
mechanics -
HI total mafi t ialS
total labo,::_...�
— total labor tax _ --
h.atl si�e�Freure hereby approves the atlstac ory Completion of the above work, as well as grants Authority kc u to
credit Card Numbers Supplied at time of Services or Credit Card Numbers already on file,
TOTAL
,. - --
:l��i;, completed
�_._. __....
�'fat'>`s'zEJ.� METHOD: 1Ij Credit Card / Expiration Date --
Cash Check
OFFICE COPY-BOTTOM COPY
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Balance Due
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W57ILLLER 5 IJ�►NlE_ _� .AD-DRESS _ _
BUILDER 5-. lel AD.D.RE55.---
Dh►TE PERKA T 1.55UED is y='� — — —
- DATE COMPLI &MCE ISSUED; :—_—
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No. Fi$..........�..................
THE COMMONWEALTH OF MASSACHUSETTS
OARD HE TH
G 'l -.OF....... ------
Appliratiuu -fur Uhipwial Workii Tomitrurtion Vamit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
y tern at: I9
ocation•Addre s or Lot No.
�.------------- !_.e�.��! GJ ...---.... /1? i�. ................... .--------•------..._..------------••--•-...................----••------..........................
Owner Address
---•--------------- -�•h� _-----.......-1-�f9......•-••••......••.. ....•-••--•--••-------•---••-•----•--•••---
Installer Address
Q Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms.---. _Expansion Attic Garbage Grinder
( )
pa, Other—Type of Building ---------------------------- No. of persons_.._-..-..-__-_--_---___---. Showers ( ) — Cafeteria ( )
Q' Other fixtures ...... -----------------------------------------------
W Design Flow-------------------------------------"....-_gallons per person per day. Total daily flow............................................gallons.
USeptic Tank—Liquid capacity------------gallons Length________________ Width.--------------- Diameter-----:.......... Depth.-_-----__---
xDisposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter-------------------- Depth below inlet-------------------- Total leaching area..--- ------------sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by-------------............................................................. Date ground w<ttPr........................- ----- ----
a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to
44 Test Pit No. 2................minutes per inch Depth of Test Pit.--_----_.---_-__-_ Depth to ground water........................
g ----------------------------/----- ..........................................................................................................
0 Description of Soil--------- ------- ---(` [sue%r...........•s..H.....---...------------...------....------....---............------------....----------------------------------
x
U --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
W
-------------------------
U Nature of Repair or Alterations—Answer when applicable---------- -- _ �-.{���*�_... .....� �. ...
---------------------- /a. ----^._drA0/------------------------------•------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the.provisions of Article tI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has iss d by the board of healt .
tgned.. •. .. . ........ 4F•........................................... ............-•a--..............
Application Approved By........... . .. . G .... ----- ----- �" - 7'S
Date
Application Disapproved for•the following reasons:--•-----------------------------•----•--•----•--•-------...----------------------------------•-------------------
•-•--•....-••------------------------------------•------.....--•---.......----------•--•-----•------......................•-----._...............•-•----- -----------------•---------•-----•-------..----
Date
Permit No........................................................ Issued.--?/ 7 S-....—--••--......--
Date
NO.......... Y �` F�$.................... ....
��►-- -'THE COMMONWEALTH OF MASSACHUSETTS
OARD O HE TH
_. ..... J......0F........... .. . -------------------
Appliratinn -for li,ivn,ial Works Tonstrurtion Vrrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
7 --
r�--��f-----`-• =.....�.....................
Location-Address or Lot No.
........................................................... ' "......................
Owner Address
i
..................... .. .�t:..G....... .........Z------- /.......................
Installer Address
Q Type of Building Size Lot----------------------------Sq. feet
U Dwelling No. of Bedrooms___-__ ._ Expansion Attic Garbage Grinder
44 Other—Type of Building ---------------------------- No. of persons............................. Showers ( ) — Cafeteria ( )
Otherfixtures ------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacity-_---_-__-gallons Length________________ Width-----------..... Diameter....._..-------- Depth.__---____---
x Disposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area._.-.--__-._...-sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY.......................................................................... Date-------------------------------------...
Test Pit No. 1----------------minutes per inch Depth of Test Pit..........•......... Depth to ground water...-____.--.--_--.-_._.
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_.-_---._--___.____----
P4 ----------- -------- ------ -----•-----•.-... ------•--------•--•-------•-----------------------------------------------------------------------------
O Description of Soil . ----------='=""�---------•-----------------------•---•-•-•------•----•-•-------x
U -----------------------•-••----••--•---•-----------------------•-------•--•-----•--•--••---------_.-------------------------------•------------------._-------.--.--------•--------•-------------------
W
x -•--•-•-------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repair or Alterations—Answer when applicable._.-------i5ldl-- �.-.� �� ---------- ----- r�o o_6r4
--------- - -
�-oti *--_ � r k ---------------------------------------------------------------------------.
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 hem issued by the board ofhealth.
Date
Application Approved BY. rft� .--•-•------ -- 1�• -
Date
Application Disapproved for the following reasons---------------------------------•----- ----•------•-----------------•-•-•--•--•-----•--••------------•----
---------------------------•--- ......................-..................................................-------•-•--------------•-•---------------------.-----.-----•---•-----------------_------------
_ Date
PermitNo......................................................... Issued..... 1 --------- --------------. ...............
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF (HEALTH
OF................... .. - -, .:...�.�.............. .---.......
W.Utifirate of f�lampliaurr
THIS I TO CERTITha Individual e g Disposal System constructed ( ) or Repaired
by......- .l r lam/ •-•---------
__
Installer
at. -------- --- -------,�;- `-- ----- --•-------- - ---- -•-----•---__e-------- --- ..................................
has be installed in accordance with the provisions of _<V
X��The State Sanita Code as described in the
application for Disposal Works Construction Permit No.
_-. ---------- dated__-_/:___-��.............................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ,l-. - . Inspector--- -- ---------- C�
/// f
THE COMMONWEALTH OF MASSACHUSETTS
�.S BOARD Qf HEAL
/ �1�............O F....... . �...................... .:.----..................
No.------ ` -.- FEE-2.............
Bisigni nrk,_q 4n trur it rmit
Permission is LrRjeir
by grante ' ....... -- ---- -• =-------- ...........................................
to Construct, Individual'Se geX-0...
sal Syste
Dr
at No.. .��,�E' er- - ----•----•----
Syreet -�
as shown on the application for Disposal Works Construction rty4itN :__ __j_... ___ Dated... l_.'. �: 7 ............
-_- _.l1 --- -------- _ ..........
7 S� � Board of Health
DATE----- - -------------------- ------------------------ Board
1255 HOBBS & WARREN. INC.. PUBLISHERS
SYSTEM PROFILE NOTES
TOP FNDN. AT EL. 40.95'
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE (NOT To SCALE) APPROXIMATE NGVD Route 28
ACCESS COVER TO WITHIN 3" OF FIN. GRADE 1. DATUM IS
ACCESS COVER (WATERTIGHT) TO �o
Fr40.09MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 2. MUNICIPAL WATER IS EXISTING s�
4o.a' lb
I!pmmm
RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. o
OR GEOTE)MLE FABRIC a o
*37.37 _ FOR FIRST 2 ° ¢ E
PROPOSED 15Q0FL 3' MAX. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS TO �° o
BE AASHO H-20, EXCEPT SEPTIC TANK WHICH WILL BE a c
37.09' GALLON SEPTIC 36.84' 37.27' H-10 (PROVIDED THAT NO TRAFFIC IS ALLOWED OVER
=AZ
TANK (FT- 10 ) � ,
�� 36.56 TANK. IF TRAFFIC IS ANTICIPATED, THEN SEPTIC TANK MUST c s
BAFFLE 36.73 E3 ED p p 0 p 0 0 0 <� rtegen
0 36.47' DOLT O OOOO BEH-20.)
Mitchells
( 2.5% SLOPE) �6 CRUSHED STONE OR MECHANICAL
0
coMPACT1oN. (15.221 [2]) 2' p O p p ED p p E3 O -A 34.47' 5. PIPE JOINTS TO BE MADE WATERTIGHT.
DEPTH OF FLOW = 4 Q
TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH m aL/MOIn
INLET DEPTH - �a" MASS. ENVIRONMENTAL CODE TITLE V.
LOCUS West Main St. St.
OUTLET DEPTH = 14" ( 1 % SLOPE) ( 1 % SLOPE) 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO cOdde(
BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE.
, LEACHING 6.47' LOCUS - MAP
FOUNDATION 11 SEPTIC TANK 11 D BOX 11 FACILITY 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED SCALE: 1" = 2,000't
WITHOUT INSPECTION BY BOARD OF HEALTH AND
*THE INSTALLER SHALL VERIFY THE ALL SYSTEM COMPONENTS SHALL BE PERMISSION OBTAINED FROM BOARD OF HEALTH. ASSESSORS MAP 270 PARCEL 137
LOCATIONS OF ALL UTILITIES AND ALL MARKED WITH MAGNETIC TAPE OR BOTTOM TH-1 EL. 28.0
BUILDING SEWER OUTLETS AND ELEVATIONS COMPARABLE MEANS FOR FUTURE LOCATION. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCUS IS WITHIN WP OVERLAY DISTRICT
PRIOR TO INSTALLING ANY PORTION OF DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION
SEPTIC SYSTEM OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO
COMMENCEMENT OF WORK.
11. EXISTING SEPTIC SYSTEM SHALL BE PUMPED AND
REMOVED OR PUMPED AND FILLED WITH CLEAN SAND.
LEGEND 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
\ REMOVED 5' BENEATH AND AROUND THE PROPOSED
�100.0 LEACHING FACILITY:PROPOSED SPOT ELEVATION \ SYSTEM DESIGN:
+100.00 EXISTING SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED
100 PROPOSED CONTOUR I DESIGN FLOW- 3 BEDROOMS ® 110 GPD = 330 GPD
00,
100 EXISTING CONTOUR \ USE A 330 GPD DESIGN FLOW
SEPTIC TANK: 330 GPD` (2)` - 660
f LOT 74 USE A 1.500 GAL SEPTIC TANK
11,121E SF
TEST HOLE LOOS / \ LEACHING:
\ SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD
ENGINEER: DAVID FLAHERTY, R.S., SE2755 I
-G_G BOTTOM 25 x 12.83 (.74) = 237 GPD
WITNESS. DONNA MIORANDI, R.S. _G G f� TOTAL: 472 S.F. 349 GPD _
DATE: MARCH 10, 2008 4� USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
PERC. RATE _ < 2 MIN/INCH V
o LP WITH 4 STONE ALL AROUND
P SOILS 12130 U 0
CLASS # cn
o MA
ELEV. ELEV. 3 S ' APPROVED DATE. BOARD OF HEALTH
�} o
0" v 40.0' 0" 39.5' PAVED DRIVE 1Q, 0
1
0
LS Ls •� Q0.6' 10.0' TITLE 5 SITE PLAN
" 10YR 4/2 " 10YR 4/2 �FITI
� \` • _.'.t:£' OF
12 16 3acM / ;t
B B BENCH MARK - CENTER OF r \�` �� - � ._��� /` � '�
180 FAWCETT LANE
LS LS CATCH BASIN ELEV. = 35.1
DIRT DRIVE P (HYANNIS) BARNSTABLE MA
POSSIBLE 5' REMOVAL OF ,
" 10YR 5/6 37.2' " 10YR 5/6 ' �8 \- -' - TH 2 j: TH-1 THIS REQUIRED
E UI EFACILITY,
34 33 36.7 I PREPARED FOR
DOWN TO SUITABLE SOIL LAYER.
p z'p REPLACE WITH CLEAN MED. SAND. CAPEWIDE ENTERPRISES/
I q�-.J 3j X---114.44'X 38 �- 39 BERNICE PHILLPS
C PERC C 'S`Yo X X X X X X
X X_ X
MS MS DATE MARCH 11, 2008
1OYR 7/4 1OYR 7/4
LZH OF MAS
yam Sq�, ITN OF Mqs� off 508-362-4541
DANIEL yGN ��� q0y fax 508.362-9880
A. DANIELA.
OJALA OJALA `-+,
No.40980 d CIVIL down cape engineering, inc.
144" 28:0' 120" 29.5' o \o� �Q �No.46502
o
NO GROUNDWATER ENCOUNTERED Scale:I"= 20' �o"URv ° �� G' T G�� C/1//L ENGINEERS
,���I(GS i0 E� ;.� LAND SURVEYORS
0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. 939 Main Street - YARMOUTHPORT, MASS.
DCE #08-044 08-044 CAPEWIDE-PHILLIPS.DWG (DDF)