Loading...
HomeMy WebLinkAbout0030 DAVID STREET - Health 30 Dav ld :stre et Osterville A - 141-077 a MEAD No.2453LGN UPC 12134 smead.com • Made in USA N-Z 44, No. r I Fee J BOARD OF HEALTH TOWN OF BARNSTABLE 0[p plicatiou jfor Yell Con5tructton Permit Application is hereby made for a permit to Construct( Alter( ), or Repair( ) an individual well at: 3o O60 .S} ,(�s e���1� ly►1o7- Location-Address Assessors Map and Parcel D lay" 0aV;(k -M XS* v&,MA oZ�Ss Owner ii Address �2SrYwrd r`t psi 11;rq 1 rc P, 'B o i, 21 MA 42653 Installer-Driller J Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well t� Capacity Purpose of Well {`t��OAA,UV, Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed 5 Date 0 4, Application Approved By 2-1 S/ Dale Application Disapproved for the following reasons: Date Permit No. Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed 0, Altered( ), or Repaired( ) by aSIMwA Wd D ri ffinq �hc 11 ) Installer at '-)0 OW A 0 1 1k , has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector Y �I No. 4 J" d Q'��V (� Fee > BOARD OF HEALTH TOWN OF BARNSTABLE F Rpprtcatton -for Vern Congtructton Permit Application is hereby made for a permit to Construct( Alter( .), or Repair( ) an individual well at: 3a ��AJ�d ��S1zPry�,�1Q, ��I�/n71 Location-Address Assessors Map and Parcel Aya (AS6'-' 30 Dcwv A S� 105*(V�l1e_ ,P'Ulf{ 02155 Owner Address " Des, `NeA� or; 'n, Ire, P-o � 2`►�� , 0cl�,rs ' 02653 Installer-Driller J Address 6 Type of Building Dwelling Other-Type of Building No. of Persons Type of Well i S N',16 py( _ Capacity... Purpose of Well \Cf t'A U- Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Zr�--�,; y 5 Date (' ih Application Approved By 1 Ste/ 4 Date Application Disapproved for the following reasons: Date Permit No. Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the tindividual well Constructed(✓), Altered( ), or Repaired( ) by �SVY16Yx� W�� Dri��I Y�Q �hL Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL,NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE - Vell Congtructton Permit No. I)\ (.s—' 0 11 Fee Permission is hereby granted to I[)P S>-yN6yj WA G(M l a �11\� Installer to Construct(�, Alter( ), or Repair( an individual well at: No. D cAo�A � s�w Street as shown on the application for a Well Construction Permit No. ', I1' Dated Date Approved By A'I TOWN OF BARNSTABLE LOCATION SEWAGE# / VILLAGE ����rV r(14. ASSESSOR'S MAP.&PARCEX 077 INSTALLER'S NAME&PHONE NO. ees/ae'�i'w o SEPTIC TANK CAPACITY / y'DZ) 14 Za LEACHING FACILITY.(type) Z k'500 - (size) J Z/0r'X 'Z 67�Z NO.OF BEDROOMS .3 OWNER PERMIT DATE: 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 ow site or within 200 feet of leaching facility) I( Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED B}' ,�, �y I 9J L� a SJCti l I (7�O i LN � l z � �t No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: DPUBLIC HEALTH DIV#ON TOWN OF.BARNSTABLE, MIASSACHUSETTS Yes • n f brDisposal trm Construction ermit flfatlb � 8 Application for a Permit to Construct(Repair( ) Upgrade( ') Abandon( ) omplete System ❑Individual Components Location Address or Lot No. 3 O Zh ie,4 S F wner's Name,Address,and Tel N Po SOX a rya r e4 E .1.4- Assessor's Map/Parcel o Aa 7ahe 7arada ti CO T 2 Installer's Name,Address,and Tel.No. t &aW Od Desi ner's Name Address,and Tel.No. Sra r'k?k �q+ . sbl��Yz® �'3yy S o Type of Building: Dwelling No.of Bedrooms j V/�• Lot Size �j/2 sq.ft. Garbage Grinder( ) Other Type of Building RCS- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ��® gpd Design flow provided 3 417.3 gpd Plan Date !a'l� Number of sheets Revision Date Title 51 /�� /wroy eA ov 7�S Size of Septic Tank /SM G4II&rt Type of S.A.S. 2-5W Description of Soil 'Z"t�1 ^l 2•r Al0 La V f/' 312. 73 6r4.--e "/0 r4 Lq< Z ye t s(' `` C Z,; r 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 Enviro ental Code and not to a the system in operation until a Certificate of Compliance has been issued by this B d H It Si ed Date Application Approved by � Date Application Disapproved y Date for the following reasons e on Permit No. Date Issued No. D Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWNI-O-F;,BAR S ABLE, MASSACHUSETTS Yes ftplication for MisposAl s Prn hottruction'Permit l 1 Application for a Permit to Construct(Repair( ) Upgrade( ) Abandon(:')' omplete System 0 Individual Components A Location Address or Lot No. 3 p d S f I Owner'"§Name;Address,and Tel.No. Ao 60 X C v a r 90 r e-f E- Fiz(/'e// p 5-f-/-A Assessor's Map/Parcel �. C or oh e a O 2-f' Installer's Name,Address,and Tel.No.gt Ea Q r(� Designer's Name,Address,and Tel.No. S c,//,'„qy r'4r11�P. ,F'�/ 331y4/ Type of Building: - Dwelling No.of Bedrooms 3 Lot Size /-';P,/2 sq.ft. Garbage Grinder( ) Other Type of Building 5- No.of Persons Showers( ) Cafeteria( ) Other Fixtures <,- \ `sign Flow(min.required) 3 3 D gpd Design flow provided 3 q.3 gpd Plan`• Date /D-/ Number of sheets / Revision Date Title 5, �, P�GH 4'/a 05"r�r oy Pb,Ph 7/(S Size of Septic Tank l)`R9 Kg��a n TYPe of S.A.S. - aQ/f„�/ �� �� i/r_��� a14/►O Description of Soil 77IK� /�^/2"` � 12> /a/er / 3r12 2 ti t 711- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: w Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described -"si a sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to e the system in operation until a Certificate of _ Compliance has been issued by this Bo o e It igned / 9 Date Y Application Approved by Date � t s Application Disapproved y Date for the following reasons , {• Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired( ) Upgraded( ) Abandoned( )by at 3o L>aa r. ` has been constructed ijar apt'ce with the provisions of Title 5 and the for Disposal System Construction Permit No� ���,ated �4 Installer Designer #bedrooms 3 Approved design tow _!q / gp The issuance of this p it sh 1:no4te construed as a guarantee that the system wi nclion as desi ed Date Inspector - f Al - ----------—--- - ------- - -- --- - ------- 7 -- ------ ---- ---- No. 9 / Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS disposal *pstem Construction Permit Permission is hereby granted to Construct( �'" Repair( ) Upgrade( ) Abandon( ) System located at 262 -PG L,d J-6 _ i 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 pe Date 1 Approved by �'��- ,Zr�(�—I°� � �cQ✓U o nn.j,��� � �� �� i 1 w wi u,/,�r. .I�,�, c�•c- wP C Z g has r — I CTYPICAL ANCHOR BOLT SPACING Z 'tD D I'- I I I I 8 I I I suE:x=ra O gQe racaa�,mn Z I I I I - Z) LLO ¢a r------------ I 4 At I - __ _ ���•••l f ; i FwNYA,oN,oTEs: I___——___ _ d ,oar I I �. LCONCR iE usEo rw wAYa.RAo.._ »� 3t7o,l�- 5 I I i , NF�N6f,I�T�W.vEAfb.A,FSSNE J � am P!I wMa acrEAA L I r—_ _ I PEAwoaw,x I __ �0.�If, I I ; ! ieEawmw icuAPi�m�miu�,eur� V I GARAGE i 1� w'mom»ce@ mx9 ac°u� r . I I ., .. •mom I I A osT.NaoF,o fwmr wrolm a F I THE WOCO6iRUCIM�.S WMYL W I I e4a _ ! Eµr i 1 spmV OPFNMcaliEe ro9E00pRLw.TEo N Z ° I I -IIPIa„f eEu,Ir �';)a,f ePA„Ir I I.. GO�IRmmbEE m A) 3• III�,IIE IrII�IL� II �I, II��.IIL�I.17 J.�II�I�I,� I. I. �. ,RHA�ILbiX.E�ILW,II�➢d.L m O I I J L�f :ate `•z L----------------------------' i - e.l ui wrEnan w.unluscra.RE 'a� � peN,wWYpi I Q I Ri0Y mI1EmEA0%»LmaNcfNIFP _ ; m F" Ir N:nav'M'sA,amce,Ptro6smwL0 Z F� m o v 6aYfwmaDw d�sTwPIDOW I __�_ I aNticalcaPamlemWlmEaENM1R FRAMING NOTES: ^ ———— ——— ——————___ I.PRNME YETALJY6f NeNGOiB " iOR PFAPOCRIAARmIRGiILlG �. +e&fW�f iam!BLET.LLL lmalan O�FMA'M ANDO PERPENDICYWICOMA'CIN,6, d 1 xEARERsio as mzx,ouasas o _ OTNERWE:ENtl1® N 'i - y LEGEND N I....... (3)2X12 BEN., w Z Y lVL BEAM 'C] r• STEEL BEAM 2..FRAMING MEMBER �.......... (3)2XIO HEADER ma Al w w ui a ed f W W ¢ 8 A .0 oo.w In FOUNDATION/BASEMENT PLAN SCALE:Y.• 0 Q Town A atnstable Regulatory Services �� Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Y" Sewage Permit# 2Q�41-111 s Assessor's Map\]?arcel V/ c 7 7 Designer: w�� � es�� � ^� Installer: Address: 2 0( Address: On was issued a permit to install a (date) (installer) septic system at.--20 4n d SY based on a design drawn by (address) e ,je. dated 1-10--IY (designer) , 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.. (N-7-6) 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 septic syste but in accordance with State&Local egula ' ns. an r vision certified as-built by±designer to follow. PVSH OF MAss9 JOHN C. c�J, (Installer's Signature) ODFA . Civic (Vo.48168 &GISTEP�O SWUL (D signe s Signature) (Affix Designer's Stamp Here). PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.THANK YOU. Q:Health/Septic/Desiper Certification Form 3-26-04.doc Op THE T � DATE FEE BARNSTABLE, MA-,SS. 039. Town! of Barnstable �0 REC. BY AlfO MA't A " Board of Health SCxED. DAT 200 Main Street, Hyannis MA 02601 �i31 a Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304. Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION-- Property Address: ) A t� Assessor's Map and Parcel Number; r `'V7 7 Size of Lot: Wetlands Within 300 Ft. Yes . « Business Name: No Subdivision Name: APPLICANT'S NAME: "' Phon Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: a! t Name:.(4�)ay"(Z4 C" CD i Address: '7$0 PrwY.ncaJo�j,. rjr. Address:' �( !{ Phone: Phone: 2 — a co3 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) e r � cc n�t S i✓c�r>? 5 5 JA,4 An n ^ .�06, 0M 00 :22 T o C11 :+,,f . n1 Q rr4 iipo �roeM� P't �1- s , ntg_t s 5 v I G"Ft s, NATURE OF WORK: House Addition:❑00000 House Renovation ❑ Repair,of Failed Septic System. ❑ Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans 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 lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], - outside dining variance renewals[same owner/lessee only];and variances to repair failed sewage disposal systems [only if no'expansion to the building proposed]) „ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED. Wayne Miller,Chairman NOT APPROVED ti Junichi Sawayanagi r REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D' i Q:\Application Forms\VARIREQ.DOC I- No. .1 149 THE COMMONWEALTH OF MASSACHUSETTS` FEE P BOARD Of HEALTHOF APPLICATION FOR DISPOSAL SYSTEM CONSTRIIC'Fib . M T Application for a Permit to Construct ( Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Comg. n Is Location 1 Owner'sNarfie.:,'.....a,,., :-.�...`:. ly�- Q -7 7 Map/Parcel# Address Lot# Telephone# I nstallcr's Name Designer sNipc T- I Address Ad dres Telephone P TelepAdfie# Type of Building: Lot Size `3 1 Zs Sq.feet 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 —i`ice gpd Design flow provided'-k4- gpd Plan: Date -i Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation 1 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed D,&Aa FORM t = APPLICATION FOR DSCP DEP APPROVED FORM 5/96 --- No-------------------__----------------- ---.---------- ------------------- �_� THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) 1 by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No: dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 —--——————-—————————————————`————————————————————————— No.kM 00VTHE COMMONWEALTH OF MASSACHUSETTS �^ FEE BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health •\ FORM 2 - DSCP DEP APPROVED FORM,5/96 l I, I A AM 1255 (REV 5/96) H&W HOBBS&WARREN rM PUBLISHERS - BOSTON i 1 i t 1 f� I• ' It P � � F � � > � i � a � t : t t � � .,� • r i _ � I � � .. � i � - t ' e � � i ' , _ ti a tI � , i � � 7 j' { y,,�. { { ! � � �.. + i � � + ' t r 4 � i � i � t � I ' i � � ! � 1 ' � { P � � . . , � . ry � �t � 4 ! 6 l � � � �� ' � 1 Town of Barnstable Geographic Information System April 2, 2010 t _ 142124 . T 142101 ,'a'Vt3i"- r #9 6s r*•t� a. Y�'� °7 2`�...��7. .R_' at�ov. 7� 141089 410 88 KT 14107 114070 yt #2 � I x 87 •X � ., � -. �i � „ate' F � a �t •=�• -+o- � .. . 141073 . `40 #52 5 v 1410 4 38 9 t. '�M . f x�. , x: L�,.` R r ° �•._k' , , a f u � 141068 ��, >� � 141080 � i f � # i y + La' £ ♦ 141087 #25 x j �� ♦ Z S � • � V141120 1 #516 13092 tea€ I...i DISCLAIMERS:This map is for planning purposes only. It is not adequate for le al Map:141 Parcel:081 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:FAASS,REGINA A TR Total Assessed Value:$509100 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map , .E are only graphic representations of Assessor's tax parcels. Thay are.not true property Co-Owner: Acreage:0.38 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:29 DAVID STREET f such as building locations. Buffer Aerial Photos Taken April 19,2008 NO.� THE COMMONWEALTH OF MASSACHUSETTS a, r FEE BOARD OX HEALTH O W O Fa-l — APPLICATION FOR DISPOSAL SYSTEM CONS T tVfib �MqqPN\N . �" `6 Application for a Permit to Construct ( � Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑[ndivldual Comp�n n s NIi' 11 Location 1 Owner's /- 077 Map/Parcel# Address Lot# Telephone# Installer's Namc Designer's ame Address _ W Telephone# Telepfidhe# c Type of Building: UL°r7 I Lot Size `3 1 Zs Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures 1 Design Flow(min.required) �—TO gpd Calculated design flow 4 40 gpd Design flow provided 44- gpd Plan: Date Z,k—el,I Number of sheets t Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator 9A. Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed FORM t APPLICATION FOR DSCP DEP APPROVED FORM 5/96 ----------%—%------- —------------------------------ -------- ---------------- NOS< `(.i''J THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 ---------------------------------------------- ------------------------ NO.kM 00VTHE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARRENTM PUBLISHERS- BOSTON Stay No.'ICe% I'�/t� F! ® THE COMMONWEALTH OF MASS�ACH,USETTS". FE6' - BOARD OF HEALTH o F VVV >. A APPLICATION FOR.DISPOSAL SYSTEWCONSTRUCTIONt PERMIT Ap1cation•for a Permit.to Construct ) Repair ( ) Upgrade Abandon ( ) - ❑Complete System ❑Individual Components Location Owner's Name 777 Map/Parcel# Address - Lot# Telephone e 21 u 10C e, Installer's Name Designer's amc Address dres Telephone# P` Telephone# , N . Type of Building: �) 1 Z �--'� ?► � ,(�e.�C�..— Lot Size 1 Sq.feet Dwelling—No.of Bedrooms �" Garbage Grinder'(. ) R, 3; Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required) 4 gpd Calculated design flow `"4 4- gpd Design flow provided'' `�a gpd "­Vlan: Date 2 q— 4 ti Number of sheets Revision Date t,) V>- ""..tr! Title � `1.4... ��t, �„ f -:�Cl+ yl� i..�i•.�./� I L! 67'1-+�i- r2t.�l�.-'!.%�-• t; i. Description of Soil(s) Soit Evaluator Form No. Name of Soil Evaluator Date of Evaluation t DESCRIPTION OF REPAIRS OR ALTERATIONSYi ', t l r>. The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of 'P TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signedr_. . M40VYI k �J SP�c ons°�s I , IIZA ; - FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96. `SI i No THE COMMONWEALTH OF MASSACHUSETT� l S FE E i BOARD OF HEALTH i CERTIFICATE OF COMPLIANCE Description of Work: Individual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) ` by at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) f Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. • FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No.(w O HE COMMONWEALTH OF MASSACHUSETTS FEE ABOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT , Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandori (:,`."'.)"an individual sewage disposal system at 1 as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 rm FORM 1255 (REV 5/96) H&W HOBBS&WARREN PUBLISHERS- BOSTON ere i /. APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS . p► 'V/ ` t No. �,OCATIQN c> v l DILLA� E p5'= ✓i �= — DATE �-' l{`- aPPLx3' ' N S ,FEE , `s �DDRE S # +� TELEPHONE NO. ( ton refundable, ENGINFE [� 'CaaA� L. �2 'j-M 1;1114 ✓r TELEPHONE NO..JTl-�x DATE SCHEDULED N ` (Applicant' s .signature O .AP 0 O O O . . • O O ..: . O O O . * O.O . . . • . : O . . O• . . . . . . . O O O O'. ..: ._. 40.41-O •,O-. .,. . O . O.• . . . 0 . ASSESSORIS_bi1�P & �.OT NO: j4_j 77 - " r .. �_ SOIL LOG SUB-D;VISION NAME /S 3, DATE TIME b0l' EXPANSION AREA: :YES.✓ NO ENGINEER rOWN� WATER ✓PRIVATE WELL I_ I> 'BOARD OF HEAM' 5:/4 Q;,-Is77 EXCAVATOR SKETClUe-.(.S.treet name,etc* ,dimensions. of lot, exact location of. test holes and percolation tests, locate wetlands in proximity to,°test holes) ' NOTES: w 7 � b ' r r 3a �Gs ti 1' t + y/: , v ?ERCOLAx :N`:RATE: LEST HOLI�.4-,NO: . ,ELEVATION: TEST HOLE NO 'ELEVATION: 2 2 7 7 3 - t 8 s 8. 9 •9 ' o to 11 ,411 12 iF 13 13 ` 14 nla if to 14 77 15 - 15 L:::1 >UITAB],E• F•OR SUB-SURFACE; SEWAGE: LEACHING FIELD BLEACHING PITS LEACHING TRENCH JNSUITABLE 'FOR SUB-SURFACE SEWAGE. REASONS: TOTE:' `' ENGINE2-RING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION >RIGINAL:. COMPLETED N ENT RET Y P . AN ETURNED TO NT BOARD OF HEALTH " RETAINED BY APPLICA N +Z 01, .nc Y ?R co - D b OQ cu Q o0 D _ z P g O c O o .• d FU1SH EARTH 0 O 23 U 4 2. m< i cE O d. y OD c Q D ----- ti c� _ I 010 D D I':° 010 O O F 1 - Z�__ �L D ® D —T J O m iq- K m m � ORY WASH i O \! p n g 's .y z-7 - 8 ' Immz- " 00„� 1 ® 9 © o.... ' w N m n ■ ' 7�mC�m N,N°5. _y� OZOr OrO rz D ■ ' ■ 0'mK Z fn N 71r CA �y m�r� Z ■ — QO� O=Dm O m rt°I rv[�1 Om NOp p�Z{8pn�c ■ , ' 1m Z_OA()f� ° ~ Q •l�l°T. �p°�V,m-°i. m - iA• .. .of. o-q, Z0. .. ■ 1 B z�z�nm0 fTl r— N (f(( Imn m O N A r..m x y m x .fill O m > N Z m m o m m � � m m 4 Progressive DATE: JUNE 20,2614 30 David Street FIRST FLOOR PLAN Designs OF PREPARED BY: DK Osterville, Massachusettes 12 FILE NAME: SCALE: me-+•-o• CONSTRUCTION SET "OM COMACT0R CR sIM �ans THE FM � a„sari tHE%MFICAnar AND COUNAMM Of ALL DRENSONS,Roue A4 ����HVAC& AL smms o + a a 12 ALL�/�•C'OISWCHON SHALL COWLY 1M1H SAL..STAN AM tch LWAL.OI IM CWS CONSTRUCT':.I OIN N 4 w7 O > m R n Z n b O CO i O X u z inl7 o 9' t Q v ra AM tl 00 7W LI 4 ro O O D rs Un e a r� Elf n D E to fi �i E" Op'2_mz�mgo.l�l�Ovm�p OCmm��O0� 0 o -1 � Nfm � .mD � o AZOlm z D 0,z, �z Om Qm 6 g�C` R oo o E; 8 - i Iz�CEi"mo�^j mz�pAm pZ�o�n z CI < v �qNPN N ,n„�Pp. rn r g �C m O X A r- m X m A O �s m > N S 0 ➢ CD m � m o m m � m m 5 Progressive OF DATE: JUNE 20,2014 30 David Street SECOND FLOOR PLAN Designs PREPARED BY: DK Osterville,Massachusettes 12 FILE NAME: sos sss s3a8 SCALE: Il -r-w CONSTRUCTION SET Now: CONTRACTOR OR SUPERMOR RESPONSGLE FOR THE THE VERIFICATION AND CORDMAM Of ALL DMEN90NS,ROUGH e n d a 1 I A5 0 , s 6 RD"OPEMNGS ELECTRICAL HVAC R STRCTURAL SYSTEMS etch ALL CDNSRUCTIDN SHALL COMPLY NITN FERERAL,STATE AND LOCH BUILDING C CONSe R eC T`I[N T.O.F. AT EL43. LEGEND ON)S POND r ACCESS COVER WITHIN 6" TO FIN. GRADE ACCESS COVER (WATERTIGHT) �So WATER SHUTOFF VALVE WITHIN 6" TO FIN. GRADE 2" DOUBLE WASHED PEASTONE O PROPOSED LOCATION L41 of EL,38_0t 2% SLOPE REQUIRED OVER SYSTEM EXISTING WATER LINE MINIMUM .75' OF COVER OVER PRECAST EL34,0t '-tro APPROXIMATE LOCATION TL 3PROPOSED WATER LINE L3 .3 - PROPOSED LOCATION RUN PIPE LEVEL PROPOSED 1,500 FOR FIRST 2' "s GAS SHUT OFF VALVE LOCUS GALLON SEPTIC I TEE TO BE LOCATED ( --_-) GAS H-1�EL.30.52 EL.31.0 TANK H- 10 �� � EXISTING GAS LINEBAFFLE EL30.69 �« o FLOW LINE ao APPROXIMATE LOCATION - PROPOSED GAS LINE 6"-CRUSHED STONE OR MECHANICAL - t6" TO BE LOCATED COMPACTION. (15.221 [21) 4; O SIDES 10 4; o SIDES PROPOSED PHONE LINE DEPTH OF FLOW = 4' 3 O ENDS 3 O ENDS EL29.67 TO BE LOCATED �C, REQUIRED TEE SIZES: INLET DEPTH = 10" MIN. BELOW FLOW LINE H-20 �, PROPOSED ELECTRIC LINE OSTERVILLE OUTLET DEPTH = 14" MIN. BELOW THE FLOW LINE 14 14w TO BE LOCATED EAST BAY o0o L.2$.5 -- � PROPOSED CABLE T.V. LINE 0o TO BE LOCATED T T ( . MIN. SLOPE) (21,3t� SLOPE) (. MIN. SLOPE) 3/4"" TO 1 1/2" DOUBLE WASHED ST-,NE LO C LJ S MAP `"'emu-_FOUNDATION 13' SEPTIC TANK 24' D' BOX -2' 2' LEACHING FACILITY LOW OVER HEAD WIRES SCALE 1" = 1000' ELECTRIC CABLE T.V. & PHONE SYSTEM PROFILE -34- EXISTING CONTOUR ASSESSORS MAP 141, PARCEL 77, LOT 28 (NOT TO SCALE) --f-K PROPOSED CONTOUR FLOODZONE: C, BARNSTABLE PANEL # 16 X425 PROPOSED SPOT GRADE *ZONING DISTRICT: RC & AP 6' FRONT: 20' UTILITY POLE SIDE: 10 REAR: 10, TH1 *TO BE CONFIRMED BY BUILDING COMMISSIONER SOIL TEST HOLE 4; SEE TEST HOLE LOG(S) O \\ O \� BOTTOM OF TH1 do TH2 EL22.5 NOTES: lot 28 43_ 1 SEE SOIL LOGS 1. THE LOCATION OF EXISTING UNDERGROUND UTILITIES SHOWN ON THIS PLAN IS • 13,125 Sff lot 27 APPROXIMATE. PRIOR TO ANY EXCAVATION ON THIS SITE, THE EXCAVATING - - Q CONTRACTOR SHALL MAKE THE REQUIRED 72 HOUR NOTIFICATION TO DIG SAFE 42.5 �� (1-888-344-7233) AND ANY OTHER UTILITIES WHICH MAY HAVE CABLE, PIPE OR PEE 9 EQUIPMENT IN THE CONSTRUCTION AREA FOR VERIFICATION OF LOCATIONS. l 2. ALL SEPTIC WORK AND MATERIALS TO CONFORM TO 310 CMR 15.00 TITLE 5 - AND BARNSTABLE HEALTH REGULATIONS. 11f01.� ArtWADE A5 .SOWN 3. VERTICAL, DATUM IS NGVD, ELEVATION ASSUMED FROM QUAD ® EL.30.0. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHTO-H10. PROPOSED 5. THIS PLAN IS FOR A PROPOSED SEWAGE DISPOSAL SYSTEM ONLY AND IS NOT TO 41. 4 BEDROOM .0 5. pRpppS�p BE USED FOR ANY OTHER PURPOSE. DWELLING �� � 1,SQ� CAL. Sl�AAC TANK �'J.vi!' V( HIMU hLV11-1 1'l rILL Vl'i 'rt ;AND ANY (XiSIINI I tJSI IUUL(5). T.F.=EL43.2 7. ALL SEPTIC PIPING SCH-40-4" PVC UNLESS NOTED. 8. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED BASEMENT \ �� �O0� t FROM BOARD OF HEALTH. 10 9. MINIMUM 'PIPE PITCH TO BE 1/8" PER FOOT. T.S.=EL.35.2 10. PIPE JOINTS TO BE MADE WATERTIGHT. 11. WATER TEST D-BOX FOR LEVELNESS. GARAGE / r'p O�b SO(L ASSa?P77aV SYS7E1/` 5 HIGH CART LYTY INFIL 7RA'7wa H=20 T.S.=EL34.5 EP 9' Gig'STGW£SAWAF AL6WG 1'4C SIQIES, AND 14a Or S&WE QEYOW. DEPTH (in.) TH1 ELEVATION 10 0. A 35.5 SAND LOAM SOIL CLASS: I (SANDS, LOAMY SANDS) �5 BENCHMARK 10 YR 3 2 PERC RATE: < 2 MPI (5 MPI DESIGN) NAIL IN 12- UN IT 34.5 PRESOAK: 9:28:30-9:34:00 �o N0 �� / �L UTILITY POLE LOAMY SA D (24 GAL. < 15 MIN.) EL.32.66 10 YR 5 8 9": 9:34:00 �� D I� �� / ASSUMED 24wSOITA IF 33.5 BOTTOM PERC: AT 48" EL.31.5 lot 29 �� ��4 d', gyp/ M/F SAND NO MOTTLING OBSERVED 2.5 Y 7 6 NO WATER OBSERVED 156' RATIFI 22.5 SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED) �¢ f .NUMBER OF BEDROOMS: 4 DEPTH (in.) TH2 ELEVATION DESIGN FLOW: 4 BR x 110 G/D/BR = 440 G/D 0" 0 A 35.5 EXIST to 0 USE A 440 G/P REQUIRED DESIGN FLOW SAND LOAM SOIL CLASS: I (SANDS, LOAMY SANDS) HOUSE 3 SEPTIC TANK; 10 YR 3 2 PERC RATE: < 2 MPI (5 MPI DESIGN) •440 G/D (2) = 880 G/D 12w N 9 34.5 PRESOAK: 9:45:00-9:51:00 OHO USE PROPOSED 1,500 GALLON SEPTIC TANK LOAMY SA D (24 GAL. < 15 MIN.) ^� 1 LEACHING: 10 YR 5 8 9": 9:51:00 / N ITA BOTTOM PERC: AT 52" EL.31.17 SIDE AREA: 2 x 2' x (10.83't37.25') = 192.32 SF 24 33.5 BOTTOM AREA: 10.83' x 37.25' = 403.42 SF 2.5 SAND NO MOTTLING OBSERVED SIDES: 192.32 SF ST Y 7 6 NO WATER OBSERV -5 �� + BOTTOM: 403.42 SF 156w T IF 22 5 P#: 9606 / TOTAL: 595.74 SF KEY M: MEDIUM DATE: 11/16/99 �. �O PROPOSED CAPACITY: 595.74 SF x 0.74 G/D/SF = 440.84 G/D O.K. F: FINE ENGINEER: MICHAEL S. FARIA, SE STRATIFIED; STRATIFIED LAYERS (DOWN CAPE ENGINEERING) �, OP OF FINE & MEDIUM SAND WITNESS: DONNA MIORANDI �'P�C SYSTEM DESIGN DATA XCAVATOR: BORTOLOTTI CONSTRUCTION . / 1 TEST _HOLE LOG NOT TO SCALE TITLE 5 SITE PLAN off. 508-362-4541 SITE PLAN OF LAND IN I fax 508-362-9880 SCALE: 1 "=20' OSTERVILLE , MA down cape engineering, Inc. '' PREPARED FOR DAN & MARGARET FARRELL ofOF CIVIL ENGINEERS ARNF'�1JNCs oG LOCATED AT LOT 28 DAVID STREET LAND SURVEYORS CD NE OSTERVILLE, MA 02655 OJALA N pvtL BOARD OF HEALTH No.26346 SCALE: 1 "=20' DATE: 11-29-99 Na.9a79 2 REVISED: 939 main St. yarmouth, ma 02675 °'.��_, �fc, lta�`' 4��� o ------ MA 3 sS 20 0 20 40 60 Feet 199-3271 APPROVED DATE DATE ARNE H. OJALA, P.E., P.L.S. SEPTIC NOTES 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours Prior to Any Excavation For This Project the Contractor Shall Make the Required Notification to Dig Safe(1-888-344-7233). 2.The Contractor is Required to Secure Appropriate Permits From Town ASSESSORS REF: Sin le Famil DESIGN DATA Agencies For Construction Defined by This Plan. Map 141, Parcel 077 g y 3 Bedroom @ 110 GPD 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall , Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to OVERLAY DISTRICT. No Garbage Grinder Assure Watertightness. In General,Water Lines Shall be Constructed in AP - Aquifer Protection District Total Daily Flow=330 GPD Saltwater Estuary Protection Use a 1500 Gat Septic Tank Coordination With COMM Water,and Shall be in Accordance With 248 CMR 1.00-7.00&310 CMR 15.00. FLOOD ZONE. 4.A Minimum of 9"of Cover is Required for All Components. Zone C • Lawn LEACHING AREA Community Panel No. All Structures Buried Three Feet or More or Subject Lawn Lawn Lawn #250001 0018 D 330 GPD 0.74(LTAR)=446 SF Required July 2, 1992 to Vehicular Traffic to be H-20 Loading.It is the Engineers Used.that H-70 tip;n Mways be Used. A Recommenk Sidewall 2(12.83'+2552"= 151.3 SF!, 6.Install Watertight Risers and Covers to Within 611 of Finished Grade 105.00 Bottom Area=(12.831 x 25')=320.75 SF Over Septic Tank Inlet and Outlet,D-Box,and One Leaching Chamber. REFERENCES: S57* 50' 40"W Total Provided=472.05 SF 7.Septic System to be Installed in Accordance With 310 CMR 15.00& LOCATION MAP 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable Deed C 150840 LEACHING CHAMBER DESIGN Board of Health Regulations. Plan LCP 18366E SHEET 2 0 All Pipes to be Schedule 40. Use 8.All Piping to be Sch.40 PVC. quildinS Se ac 2-500 Gal.Leaching Chambers in a _-9.D-Box Shall Have a Minimurn Inside Dimension of 12",and a Minimum 12.83'x 25'Washed Stone Field as Shown. Sump of 6". b ZONE.10.The Separation Distance Between the Septic Tank Inlets and, RC (RPOD) Area (min.) 87,120 SF Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend Frontage (min) 20' P a Minimum of 10"Below the Flow Line.Outlet Tees Shall Extend 14" Width (min) 100' Below the Flow Line,and Shall be Equiped With a Gas Baffle. Setbacks: Fron t 20' F Side 10' L o t 28 Rear 10' 13112 5 S. F. 38 Lawny PERC TEST: 9,606 C PERFORMED BY:MICHAEL S.FARIA,SE DOWNCAPE ENGINEERING CN Q WITNESSED BY:DONNA WORANDI,R.S.-TOWN OF BARNSTABLE 36 - NOVEMBER 16, 1999 SITE PASSED I EST HOLE - 2 Lawn, TEST HOLE EL.30.5 EL.30.7! OALAYERJ0YR*3/2- - .'.'OALAYER'I0YR'3/2.' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . SH BROWN. . 'VERY.DARKGRAYISH'BROWN.'.- - WRY.DARK.GRAYISH. . . . . . . . . . I . . . . . . . . . . . . . .. . . . . . . . . . . ..SANDY LOAM: 12" -'SANDy-'LOAM-', 29.5 121 29.75 -5/8 B LAYER.l0Y.R.5/8'-'.'.'-*. . . . . . . . . . B LAYERJOYR . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . YELLOWISH,BROWN-.-.-.-.-,-.,. .-. .....Iq��OWISHBROWN.'.'.. . . . . . . . . . . . . . . . . .24" §AND-*�­-'-'. .'-. .*-'-'-.. 28.5 2411 t 6 '.SAND 28.75 C LAYER 2.5Y 7/6 C LAYER 2.5Y 7/6 0.9 YELLOW YELLOW STRATIFIED FINE&M.SAND STRATIFIED FINE&M. SAND POSED 48" PERC TEST 26.5 5211 PERC TEST 26.4 f PRO ___&W LLING , 25 GALLONS GONE IN 10 MIN. 25 GALLONS GONE IN 10 MIN. / ., :.-. PERC RATE<2 MINIIN(LTAR=0.74) 17.5 PERC RATE<2 MIN/IN(LTAR=0.74) 17.75 156"_ NO GROUNDWATER ENCOUNTERED 156" _<_ NO GROUNDWATER ENCOUNTERED ti F.F. EL. Q t. O 1--Finish Grade -35L-A8LZL"' 3 -5 FIN E�=H' �.J� Max. min compacted Fill 4 Fit t' Lawn Fat sr�c rd Anc lor T 2 118 f12" Pea St,?ne . .......... 34 31 314 1 112 LEACHING PROPOSED Double Washed CHAMBER Stone SEPTIC TANK PROPO�E-0 - 10" -DRIVE-WA-y- L 12'-10" C). ri PROPOSED J 1 0 - CROSS SECTION OF CHAMBER D BOX NOT TO SCALE L 44. 1 12'- 10 5 See Note 6 (typ. All Structures) F.F. El. 33.00.... ......... 15' -2- TH-1 2 F.,G. EL. 32.00* *Final ,Foundation "Gra�ding To Be F.G. EL. 3 1.00 F.G. EL. 30.00 Min. MIN. 0 RESIE-2-VI�__ Coordinated ffith, Landscape Plan Rom .S. Complies '-Zr X 25' L. 6' With 12'- 1 'V ("' )5 ri Flow Equilizers 1, Breakout 9 )'trj As Required EL. 30.25 Installer To 10 MIN. Confirm Prior EL. 29.00 1500 Gallon To Any Work Septic Tank EL. 28.75 J . Top Ch am b er EL. 28.00 N57* 50' 40"E (See Note 5) 28.50 D-Box E L. 2 8 E . -�J 6n 27.00 Leaching ...... To Be Installed On Bedding,"T"s, Chamber e a Compacted &ose L Bot. EL. 25.00 Inspection Port, ......... .... ............. --26 - -26 - - - Utility Pole ....... .............................................................................. ........... . ....... ... ...... ... ...... 10, & Boffels .......... ...... ............. . ...... ...I-.-_... .. 'eP Min. as Per Title 5 ...... ....... .. .. Edge of Pave Edge of Pave 10' Min. Slob Lr) ................ .. .... ....... 20' Min. Foundation ....... 'Th.....S.... ............I........ ... ................................. ...... ........................ ...... . ..... . . .. ............ . . . . .. .. ... ............... IiA OF A4,qOo EL. 17.5 JOHN C. No Groundwater David 40' Wide Street Per Test Hole 1 11 .4 63 Cn DEVELOPED PROFILE OF SYQTEM EL. 5 �oF /sTE�� ���Groundwater /0 At NOT TO SCALE Per T.O.B.B. Standard Edge of Pave on REVISION: Update Building Footprint 06123114 TEMPORARY NOTES: PREPARED FOR: PREPARED BY: T/TL E. Site Plan BENCH MARK MAG NAIL 1.) The structures shown were located on the ground Sullivan Engineering, Inc. Proposed lmprovements EL. 24. 90 by conventional survey methods on or between Kendall & Welch PO Box 659 211MAR114 and 281MAR114. Osterville, MA 02655 At 2.) The property line information shown hereon was (508)428-3344 (508)428-9617 fax compiled from available record information. 30 David Street 3.) The datum used is an assumed datum from TOB GIS Maps. Bamstable (ostervii1e) Mass. 10 0 5 10 20 40 Dro ft: JOD Field: CRIWK Z EMM Review:- PS Comp.: CR DATE:TE. April 10., 2014 SCALE: 1 11=101 Project: 31016 ----------