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HomeMy WebLinkAbout0020 SKATING RINK ROAD - Health i 20 Skating Rink Road Hyannis A=291 — 120 i n ViE Town of Barnstable P# ' Department of Regulatory Services �._ Public Health Division Date I MASS. p 039. �e� 200 Main Street,Hyannis MA 02661 01 Date Scheduled_ i'me Fee Pd. So ' Sultabilit�;Assessment,f®�° Sera e I��sp®,s � p Performed By: :/°r"V Cr/' Witnessed By: , LOCATION& GENERAL INFORMATION Location Address 20 �/��l l 1rc ,nik CD, Owner's Name �/[�eQj(i� �L�� r�✓f'q���S �/�• Yl Address Assessor's Map/Parcel:Af 4P I q I PA(lCelt- I Z'J Engineer's Name D, 1/16 cx* NEW CONSTRUCTION REPAIR Telephone# i [ Land Use �(�P.L t � Slopes(�o) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SIMTCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock, Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL MGH 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 level ._ �. Adj.Factor- Adj.(Groundwater level e ,,.� PERCOLATION TEST Date Thne Observation 4 1 Hole# Time at 9" Depth of Perc ` _ Time at 6" Start Pre-soak Time Q V' '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:XS EPTIC\PERCPOR M.DOC DEEP—OBSERVATION HOLE LOG Bale# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsi_stency,%Oravel) _ 1b g6 cp , 4 J , DEEP OBSERVATION DOLE LOG Bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten % ravel DEEP OBSERVATION HOLE LOG ' Mole-# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.'Yo Gravel) r (DEEP OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Cons' ten e Flood Insurance Rate Man: / Above 500 year flood boundary No— Yes!�____ Within 500 year boundary No'r Yes Within 100 year flood boundary No..; Yes Depth of Naturally occurring Pervious Material Does at least four feet of naturally occurring pervioys}n trial 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 on �� ` (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with . the required training,expertise d rie a described in 310 CMR 15.0^-1�7. Signatur ' Date / Zola Q:WEPTICVERCFORM.DOC TOWN OF BARNSTABLE ry LLOCATION � ��/� j&EIS SEWAGE# 0 L3" VILLAGE �,(I�I��(<, ASSESSOR'S MAP_&PARCUN j / A.2./ O i INSTALLER'S NAME&PHONE NO..&n�� � (S G� (0,S SEPTIC TANK CAPACITYGb �+G LEACHING FACILITY:(type) r00 44 L C, (size) NO.OF BEDROOMS yr ;OWNER PERMIT DATE: ' I " 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 ori` site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachiin-g�facility) Feet FURNISHED BY r ' _ l G G . r / !• �Ili 0 . s —31 ti• c No. 1. � � ` } Fee (I(J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS RppliLation for ioisposai 6pstem ConstCULtion permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.,(�-Zo S KA r/w xlx/v ro Owner's Name,Address,and Tel No. A Z p S KA i 1 PlAl k 4yp W#15 � `R,,,NAV_0 n c�G9R�-eq � ,e � Assessor's Ma /Parcel /{,A P T 9 AR crib I Z4 W N 1 40 Innss aln>'s ew'SamCe, ess,and Tel.No. S'Q� 63)—5gq l Designer's Name,Address,and Tel.No. I �. R w c Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building DFl e L L ) No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow(min.required) 330 gpd Design flow provided 330 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /s_ 0 Type of S.A.S. 2' �J Description of Soil 41 Nature of pairs or Alterations(Answer w t applicab v / VVJAI y' IPYL �. 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 the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this B and o Health. Signed Date Application Approved by Date j'— Application Disapproved by U Date for the following reasons Permit No. P-U (5 Date Issued r % t � � �O 1 S'�>,�.:'� .r`� a:•>�/;s'�-�"",� q� �No. Fee (`'4 T E COMMONWEALTH'OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION --`.TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Bisposal *pstem tonstruttion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ElIndividual Components Location Address or Lot No.-i+20 S KA T/#b kl Ni v D O�wner's Name,Address,and Te�l/.No. � Z u S�&TI W lM Assessor's Map/Parcel /??A P 2 C) AR crL !1—J J Installer'se Name �1���,and Tel.No. S'Q�. (�3+—5 9��] Designer's� Name,Address,and Tel.No. 1 'L R A Qw U/t* MA- .!!/� SAWI?Lt/1c1� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building J AIe L L 1 W b No.of Persons (i Showers( ) Cafeteria( ) Other Fixtures 7 Design Flow(min.required) 330 gpd Design flow provided 33 U gpd Plan Date Number of sheets Revision Date ti Title) 44 /! /? - Size of Septic Tank /5 V 1 Type of S.A.S. Description of Soil Nature of pairs or Alterations(Answer w applicab ��U v � z �vv w y' %2 1 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 the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this B and o Health. Signed Date Application Approved by =-. Date �" 2 Application Disapproved by Date for the following reasons Permit No. a`0 % Date Issued 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )Lbyqq �at Z TN t JW� l�/ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2 013 —2�) dated f Installer Designer 2 /i #bedrooms rr Approved des}gn flow / v ,'1/ gpd . The issuance of this permit s all not be c pstrued as a guarantee that the system wi nct on asIdeesi/gned.-I / l Date � ) Inspector \i ----- -- ---- - - - - - - - - - No. go � ' ge� Fee �""' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction 3permit Permission is hereby granted to Construcctt.,( ) Repair( ) Upgrade( ) Abandon( ) System located at Z 1 � 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:Co tructio(must be completed within three years of the date of this perm��tt� ^45 / Date J Approved by Town of Barnstable „ Regulatory Services Thomas F.Geiler,Director �ysTMAse ABL& = Public Health Division Thomas McKean,Director i0r6D MA'S° 200 Main Street, Hyannis,MA 02601 Office: 509 62 44 Fax: '08-790-6304 Date: Sewage PerAait# ,Assessor's Map/Pareel2l1 (Zo Installer&Designer Certification.Form LkDesigner: v � �'/� InstaU.er: 4 �' Address: A,ddrass. On T&14 � was issued a permit to install a (date) (instaa�ex) �n,� septic system at'q � YWI P4� W% based on a design drawn by �(ja�ddress) �'C�J dated 4 (designer) —` certify ttaat the septic system referenced above was installed substantially aCcotdi.ng to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout if required) was inspected and the �soiils wereLt?found �a-tis£ac��r t f� l,�j l ! `��U-[ OLO G . wl 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 R- '-rions. flan revision or certified as-built by designer to follow. Stripout(if r-- -cteci and the soils Wer satisfactory. ��,OFryj �'a4 �z DAVID ' (Installer's ignature) MASON D N0,1�86 o 0) SST � ql � esia er s Signature) J PLEASE RETURN TO BARNSTABLE PUBLx_ fE OF COMPLIANCE WILL NOT BE ISSUED UN i iL by i ri i mi6 r ORM AND AS- BUILT CARD ARE DECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THAINK YOU. q:lotTice fonns''*09ftetcertlFicatzon fonh.doc f 00 'd •011 Xdd WV 5E I : I dd%0 I06!60/�fit� TOWN OF BARNSTABLE LOCATION p2- k�//i(� OP112 J: A2 SEWAGE # VELLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ��/i/ � Cyi�if/ SEPTIC TANK CAPACITY o ei iP /�L w LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER O .OWNE C ti PERMITDATE: COMPLIANCE DATE: Vol Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 wetland_s exist within 300 feet of leaching facility) Feet Furnished by ^s No. l Fee U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 3pprication for Dizpo!5al fppztem Cron.5truction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System L`Individual Components Location Address or Lot No. J/� A"���d %/�/� Owner's Name,Address,and Tel.No. Assessor'sMap/parcel �� (' ��© -0 'Ir-4 //�t,4, ,fm4r- Insta e'sNamePdress,nd el No. 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 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) C 141 k/ E 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 of Health. - Signe Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ).Gd-7— I Date Issued / r No. 7" z: Fee Uo . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYtcatton far Digonl 6p5tem Congtructton Permit Application for a Permit to Construct O Repair(Upgrade( ) Abandon O ❑ Complete System E4 ndividual Components Location Address or Lot No. Owner's Name,Address,and Tel No. Assessor's Map/parcel s^a 7P'- '7 3'•�' Phu Installer's Name, ddress,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: e, Dwel'lirrg -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 gpd Plan Date . Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when"applicable) - �. ��/ c Z & 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 Certificate of Compliance has been issued by this Board of Health. Signed Date 'sue / 7 o r Application Approved by Date Application Disapproved by:, Date for the following reasoris Permit No. D rid-7- f Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS " BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( 4--Upgraded ( ) Abandoned( )by// A 1 ,6 04 xv �c o 3 OZ' Aw ST' 4-1`� k W,4_ at U 'a; h A 72"Az (- /F/4/4 At has been constructed in accordance with the provisions of Title 5 and the for Di posal System Construction Permit No. -2d)-? III ( dated _ Installer _ . ,2L�•-- Designer #bedroas R^ Approved design flow �J/� ��" k f gpd The issuance of this permit shall not-be.&nstru6d as a guarantee that the system with unction as desrgn�d.l Date J .-� I � Inspector ' ,l -------------------------------------------- No. r) O0-? 'r O 7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS 1=tgogat 6p5tem Construction Permit Permission is hereby granted to Construct ( . ) Repair (4- T Upgrade ( ) Abandon ( ) System located at - ! �&e 4 ORJA, �(' �? 1� /�/ 9" 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 thi rermit. Date il i Approved by ✓ KN_ S ASSESSORS tifAP_ NOTES:TEST 1-10 L E L 0 G S PARCEL : # _- FLOOD ZONE: �� �PPG1(f4 SOIL EVALUATOR: 1 � 1) The installation shall comply with "rifle V and 'Town of� Board of -REFERENCE: WITNESS : - In health Regulations. > 0 _.p�-�/ C'vU� C� /9z�77 DATE: � 2) The installer shall verify the location of utilities, sewer inverts and septic �.0 6 PERCOLAT I Oil IRATE:', L _21RAN, I , components prior to installation and setting base elevations. q-) 1 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first O f TI(- 1 �� TN-2 two lest out of the d-box to the leaching shall he level. 4) This plan is not to be utilized for property line determination nor any other A -_PDNN � � ��,✓� purpose other than the proposed system installation. i' 3 I d I f 5) All septic components must meet"title V specifications. (� , 6 �,, / 6) Parking shall not be constructed over 1110 septic components. '/�► 0 / �, � l� 7) The property is bounded by property corners and property lines. LOCATION MAP � � � 8) The property owner shall review design considerations to approve of total fp,6POD ,S design flow and number of bedrooms to be considered for design. Receipt h11� of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material f per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per- , l � Title V specs. - }LJ� 10)System components to be 10 feet from water line. Sewer lines crossing the - - / % ---- water line shall be sleeved with 4 inch SCII 40 PVC with ends grouted if applicable. The proposed SAS is being installed below the wafer service SEPT IC SYSTEM DES I G N line. The line is to be sleeved as aforementioned and maintained in place. t 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. FLOW EST 1 MATE 12)The installer is to take caution in excavation around the gas line if such exists. • , BEDfi00MS AT �n GAL/DAY/13EDR001�1 -�GAL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer i yo `� y I , r lines exiting the dwelling brior to the installation. � SEPTIC TANK 14)This plan is representative only that a system can fit on a property meeting "fide V requirements. GAL/DAY x 2 DAYS - UL GAL I (.p USE 1570D GALLON SEPTIC TANK t ; SOIL ABSORPTION SYSTEM VCD SIDE AREA: Z• '� czlj+ 9Zj� X 7 � D►�� % � ���7 r. _6X1`04 — �� of o o IAA , BOTTOM AREA: ) 2t �r� O�1 �.�� �NOFM,gss -r I I _�2�✓�u°� 10 q in • J �� DAVID MASON �j J �. SEPTIC SYSTEM . SECTION �too.166 1 or A-AT2. - - /,1L—m►,I1 &f,9� 3 r oe � � c, �3t' � I 00 UAL -}� SEPT I C TANK '�2- tZ 9 � �-� All - 64121 e ) SITE AND SEWAGE PLAN ___ _-- 1�2u 1�►�f1�� r?�_ _v_ iW LOCA'r I ON i k4tj 'RINK, 00 L PRE-PARED FOR P O, O ' NQ�q . ,- SCALE : W DAV I D B . 1AA301\1 DATE : -1 6, DBC ENV I RONMEN�TA _ DES I GHS w ` DATE HEALTH AGENT (_AST SANDWICH . MA z ( 508 ) 833- 2177