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HomeMy WebLinkAbout0038 GREAT BAY ROAD - Health 38 Great Bay Road W Osterville P 093015 Y a TOWN OF BARNSTABLE LOCATION 39 ar..V, A�z SEWAGE # v200t Alf'? VILLAGE ����/�'i�fe ASSESSOR'S MAP & LOT �3- /r INSTALLER'S NAME& PHONE NO._, G f 9 Z"/v SEPTIC TANK CAPACITY 004�c, T¢.,k d /0000 LEACHING FACILITY: (type) rL"PG-d (size) is kV0� NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: ,; -�0- 01/ 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) Feet Furnished by .:s� s� 1 � � ��� ��nP����fi� �� ��5� �� � �r� rr ' Gq G1(i fig",� . /�-i�'�/ G��,�a� C.�C/' No. a(DO,l — W ) 1� FEE C A6MMONW NTH 'MASSACHUSETTS�r Board of Health; \ . l.t MA. APPLICATION FOR DISPOSAL SYSHM CONSTRUCTION RMIT Application for a Permit to Construct( ) Repair(,./Upgrade(` ) Abandon( ) - 0 Complete System Individual Components Location Owner's Name vQ�-- Map/Parcel# .. l Address Lot# I Telephone# Installer's Name Ca Designer's Name STEP19EN J.DOYLE AND Address Address 42 CANTERBURY LANE Telephone# Telephone# 508/540-2534 Type of Building Lot Size a sq.ft. we ling of Bedrooms Garbage grinder ( ) t er-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (inin.required) A&V gpd Calculated design flow ( Design flow provided 14 All gpd Plan: Date Number of sheets 1 Revision Date S!h —Lo- c`. Title _ s—�-� �:> 4t Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator 11ty]1L Date of Evaluation f'�>©L DESCRIPTION OF REPAIRS OR ALTERATIONS-r i�.P1.44 S A,S The undersigned agrees o install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to t t ace the tem in op ation until a Certificate of Compliance has been issued by the Board of Health. Signed Date -v2ly OL-1 }'aalay Inspections ��} •...'S++t��•1'^...-ram-.:.;•« -. ^�rLE�r{. i.�ir.r-.C+r y,,,,`...+" , -°<cA-�.,. .. w;�.� rr: �..f'�'. �hy.`_1"rZ�,,,, ��i,n�. ,i�,- .4r ...... a. .. r.,- _� No. p do 4' } r« FEEAl " t , � /it k `�• .5� .. art C ONW LTII MASSACI-IUSLTT I` ., A a Board of Health, ; �r \S:4 1 MA. l APPLICATION FOR ➢ ISPOSAL SYSTEM CONSTRUCTION I:RMIT Application for O a Permit to Construct Repair(VJ'Upgrade(' ) Abandon( - D Complete System Individual Components Location t 2 Owner's Name j Map/Parcel# /,J .. S�.Q ; 't Address Lot# , Telephone# Installer's Name Designer's Name a • Address Address 42 CANTERBURY LANE Telephone# Telephone# EAS i FAEMOu i H, ETTS 26638 Type of Building Lot Size 1'4f 4P IP0 —sq.ft. welling .of Bedrooms Garbage grinder ( ) t er-Type of Building f No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) O gpd Calculated design flow Design flow provided gpd Plan: Date o Number of sheets— Revision Date 693 TitleArL1 Description of Soil(s) 1-:.p Soil Evaluator Form No. Name of Soil Evaluator L Date of Evaluation —8k 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 to not t �lace the to/mein operation until a Certificate of Compliance has been issued by the Board of Health. Signed %,`!�`7 G/ z Date g-a4 - —lc ti Inspecilbns + 1 No. FEE COMMONWLALT14 OF MASSACHUSETTS Board of Health, '►`�'k MA. CERTIFICATE OF COMPLIANCE Description of Work: D Individual Component(s) . ❑Complete System The underred//hereby certifythat the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( by: lie L rO at �� has been installed in accordance with the provision of.110 CMR 15.00 (Title 5)t and the approved design plans/as-built plans relating to application No. dated A prroovved Design Flow .5.:Cl(gpd) Installer \ t pector: - =Date:Designer: Ins 7 � /"=�• The issuance of.this permit shall not be construed as a'guarantee that the system will function as designed. No. Oo ti, ' L) ?, 8 FEE' /0 COMMONWEALTH OF MASSACHUSETTS Board of Health; MA. F DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) epair� ) fUpgrade(p Abandon( ) an individual sewage disposal system at �i �- Ll� _ h_J t � ' as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of t is_pe . it ,1 local conditions must be met. K Form 1255 Rev.5196 A.M.Sulkin Co.Boston,MA 'Date Board of Health t TOWN OF BARNSTABLE LOCATION SEWAGE � �� �f"'� �`*y fe ASSESSOR'S MAP & LOT �/✓�" �� VILLAG INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY_ �'�r.°���5 LEACHING FACILITY p: (type)\� d (size) LS 7C°�0s NO.OF BEDROOMS BUILDER OR OWNER PERILIITDATE: �p- COMPLIANCE DATE: Separation Distance Between the: iMaximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist site or within 200 feet of leaching facility) Feet on Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) 2 Furnished by % a I - Ge �Ki t!i j e �w�a e �� Town of Barnstable �"WE" Regulatory Services Thomas F.Geiler,Director aaatvsrasi,E, Public Health Division s6;9• '1 raw+ Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Dater Sewage Permit# 10'01-'10 Assessor's MapkParcel r13 _0l,�' Designer: Installer: J STEPHEN J.DOYLE AND ASSOCIATES Address: 42 CANTER Address: fa—A-Y 3 3 9 EAST FALMOU 508 640-2634 USETIS Q�^& � �I�rs�'ahS .e% _"to Rz6 On "a 0 !�.L_ 4 `/O was issued a permit to install a (date) (installer) septic system at � based on a design drawn by address) Ar--sc L dated X-2 C2-0 (d signer 0th certify thatthe septic system referenced above was installed substantially according to e design, which may include minor approved changes such as lateral relocation of the ution box an distribd/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation-of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. �10-A A A A ad® s STEPHEN o s (Installer's Signature) ooi2E ® (Desi is Si ature) (Affix Des er's I p 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/Designer Certification Form 3-26-04.doc No.. FEs ......._............ r� TGN;PJG ENGINEER M THE COMMONWEALTH OF MASSACHUSE ' q�LgTl UST SUp ON AND EtITING BOARD OF HEALTHTHE SYSTEM CERTIFY IN WRITING 7k•1.G� -------------OF...........�PtF���� Arr'�RDANCE TO PLAN TALLED IN STRICT ,��r lir sat arks Cni ustrurturn Vrrmit A li do is her'� made for a Permit to Construct or Repair an Individual Sewage Disposal PP ( 'C 1 P ( ) g p sal System at ..i. 1. .. • --. ( -T -1 L: ..�.. ............................... ....��. .___-J_.. .... or Lot No ......_ress "..�w_...... ---- -•- •--- -------------•--._...............-._..._. i wne � �, Address a ............. .....L.........:T -::...._.......................... ...../M:_...._...:!.�--...... -......................_...._..... r Installer Address Type of Building Size Lot..._, 2.49P4__Sq. feet Dwelling—No. of Bedrooms______________ ........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria p' Other fixtures ..........................................................................................•-•=--•--....-•---•--•---....._..............._.......---••- d WW Design Flow..............1_A2....................gallons per person per day. Total daily flow................. ...........gallons. Gd Septic Tank—Liquid capacity.I�gallons Length._ �:C �. Width: !_l�?.�� Diameter:_._.- Depth.��1 �9 Disposal Trench—No. .Q...... Width......V........ Total Length.....--3.1.... Total leaching area_--_-- q.1.... ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet..................... Total leaching area.................sq. ft. Z Other Distribution box (X) Dosing tank ( ) ~" Percolation Test Results� Performed by............ .�.. ...... ____�................. Date.........4:'�__"8_�........ Test Pit No. I....__.�-:G._r�minutes per inch Depth ,of Test Pit....._.to...._._. Depth to ground water...._............. fi, Test Pit No. 2................minutes per inch Depth of Test Pit....................1 Depth to ;ground water........................ 04 ..............................................................................f3'-``-'--� • ...................................................... 0 Description of Soil.... 5 ___---��_.lC �l.... C ....`t� D V .......... •-------------------------------- •------------- •-•------ -------------- -------------•---•----------•----------------- -••••-•-•-------------- ------------•-- W ..._•-•-•••-•-•-------•------•--••-•--•-••-•••---••------•--.-•-••-•---••-•...-••-•---•---•--------------•--•-•••---••---•-•-•=-----....._-......_.....__...•-•..............:............••-•--•---_... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•-••-------------------•-•-•••--.......----•--•----•-••••-•-----•--•-•.._......._._._........•••-••-•._........_..------------•••••-•--••••----•-------..__.._....•••-•-•-•............................ Agreement: The undersigned agrees to install the aforedescribed-Individual Sewage Disposal System in accordance with the provisions of:I':L; 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h s been issue the�brdof I ealtSign ._ ..--• ... ....... .. /d7........ ate ' D ;�/Applicarion Approved BY __... .:... .. . ...................................................... Date Application Disapproved for the f ollowi reasons:.. :_-----..-..._..___...-.................._____....._._......____........_.. .......--•-------•-•---...-•-•-•--------------------•-------..._..---•---..................................----•--••-----•--..................__..........._..._...._..............-..................._ Date PermitNo..................................................... Issued....................................................... Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IM A , L DATA CID Fizz..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .',.e7� IN_I. OF............ I � Ft:= .................... , ppliration~forDisposal Murks Tonstrurtion--Vitmit Application is hereby-'made for a Permit to Construct 06 or Repair ( ) an Individual ,Sewage Disposal System at r. (� ���_T Location Address __ I ' \_f: ���....�- L I �__ T_- U ��U ` or Lot No. w .. •7_ Owner j ......................................................Address ......................................... ll a ...................................1..11.!mil..: ................................... i< I � l .......................................................... -== M Installer Address U Type of Building Size Lot...75-2(aQO...Sq. feet Dwelling No. of Bedrooms..............-� .....Ex anion Attic a g— •••••••••••••--•------ p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( , ) aOther fixtures ..........................•-•----•--•-••---.....---•--.......--•---------............-----...-----•------......-- W Design Flow.............. �.� ........gallons per person per day. Total daily flow.................�?..�'�?............gallons. P: Septic Tank—Liquid capacity I" gallons Length._.. f� Width 4.'.!h i' Diameter----- ~..... Disposal Trench—No. r?.... Width.....%'!.`........Total Length.....�-J.�.... Total leaching area.. ,✓ 3 Seepage Pit No...........:......... Diameter.................... Depth below inlet.................... Total leaching area.................sq. ft. Z Other Distribution box (j�)� Dosing tank ( ) Percolation Test Results Performed by............::;;...:=,&,r'�* - ................. Date........d. "`�� -••--••-_•-... M Test Pit No: I...........:..?.minutes per inch Depth of Test Pit.......). *D._...... Depth to ground water.........<!............. fs. Test Pit No. 2................minutes per inch Depth of Test Pit................ Depth to ground water........................ i O Description of Soil.... : --•-`T? r ' fit- }1, CC, F ..l( V ..............•---................. ........................_ - ._..... ...._._ ....... - ...._ - ................. W Nature of Repairs or Alterations—Answer when applicable..................................................................................:............ .....................................•---.................. .....--•-------•---•-_...-• --...--------.....-•-----•-------•••------•-- ..---•-----•----------•••-------....:. .......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLZ 5 of the State Sanitary Code.=The undersigned further agrees not to place the system in operation until a Certificate of Compliance h s been issued by the board of health. ' Date a Application Approved BY :Lht. ...................... ..�-fa............... - Date Application Disapproved for the f ollowi reasons:................................................................................................................ ...........................................................•---------•----••--•-••--••----............................---•-•-----•-•-----•-------......-•-•-•----•----•----•-•-•---.........._...._....� Date PermitNo....................•---.......---•-••-••--•---....--•-. Issued....................................................... Date --------------- COMMONWEALTH-O.F__MAS9;ACiyU.SETTS BOARD OF HEALTH .....-..... .0 +...........OFr? -. . `. .. L. .................................... Trrtif iratr of Tompliatta ' THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,�) or Repaired ( ) by.................11\ ............`t: ��' ',r., r.r .-C c, c}_A_. .. - - - .............. ......- .. ) -Z --- , J. Install ............................. ...•-•-•-••-•••-•----•. has been installed in accordance with the provisions o TITLE 5 of The State Sanitary Code as d scribed in the application for Disposal Works Construction Permit No...�U..�..99.1............... dated.....�'�.�.�. �,-:_.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... .- ._._........... Inspector.. �........................................................ ................ THE COMMONWEALTH OF MASSACHUSETTS t / r BOARD OF HEALTH .............0F.........���.-.A, �..t��..� ! .1,..�.-----......._. .........` NO FEE.. . .. Disposal Worho Tontrurtion rrmit Permission is hereby granted..............:.:. __. . to Construct ) or Repair ( ) an Individual Sewage PjD posal System ......._ / T Street as shown on the application for Disposal Works Construction Permit NF.( X9./...._._ Dated....g!_Z_��,�'(�.............. ..0 ..................../.�.1�" ......... _ / "�.V{ ���Board�of-�6alt� ..DATE.............................................................................._ (J Gv�Xr� Hyannis . j i P IQ Aia HEAVY EQUIPMENT CONTRACTORS V-617-§818 0-770 11 Jan Sebastiaan Way Sandwich, Massachusetts 02563 LOGATIov5 TAlvk //vtr-r 'o a I0 6' -PUMP Ovn-6:7 '� C = ��'6• Pur+P ounsr 6 /any n v-13UA `� U O aQoo C-AL s4Fv77< 779^*- O pump c Hg rr 6Err DAT. '50-A lam) PF�Fa,Py�n po'rs S' ON .�FivTF� SEPTIC S`/57r^ Fc.Jz %�ich��i� CF3lzauu0 y t 1 16. The work shall conforth to the following plans and special conditions: PLANS' Title Dated Signed and Stamped by: On File with: !' Rev. March 31, 1986 commission Site Plan March 20, 1986 Arne Ojala, P.E. Barnstable conservation ------------ Special Conditions (Use additional paper if necessary) 1. All areas disturbed during construction shall be revegetated immediately following completion of work at the site. No areas shall be left unvegetated or unmulched for more than 60- days. 2. This approval is contingent upon approval by ..the Board of Health of the subsurface sewage disposal system. 3. Dry wells shall be installed to handle roof runoff. 4. There shall be no disturbance of the site, including cutting of vegetation, beyond the work limit. 5. The applicant shall .submit. a Notice of Intent for the dock and wall. ..................................... (Leave Space Blank) L } 4 C,,CI ST t N G wATFa- c �. i ic:KuS SEA "A U- lam.►E S-r- J � =0UN0 i 2 SE BACKS ZONiN G RF l 1 FP--Ki '- ao' { �( SIDE ps :�r QAGE DWELLi NCr r A £ CLEAN KIP � ? p 1 � TIC �-LEANT ll -)l - - ---" / , I/ Wee MOT VAU0 0 '(�%T t3Y F FAI kaAi41< \AJ►-ru E�6: T M 2 M I W/►►j EXGAVA-(oK : R CHI APR i L 119 84 Ts+1- 3r-� C \ 1 dE�I CAN Fl-OW : i I GALE PAY x I IG = 32-c GAVT,)AY 32,( GA DAY X 15 GAYS � q9S GAI.. { S\ ` x , r kit I?FQUIR�P SEIlIC_ TAIJK slzF- IGUv GAL �� �• LEA I-I F,nL I.ITY U`,- L F--H PLLD -------- 4puc O'wx0•�� 10 x4- = 4o x 1.0= 4w clPP 2 ll lILI t J . 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N4 G ll ,&.j. -T NA, y 8,ULyWEAO e4 -.mow& lhtr- ILL ow w 7�6 AJ'f o 4 ? 49 x, .4 -T ar� 2 DECK GALi LAG l A*rC I,-( r,v Af rX X4 it Fe AW-( -f x, 4" rf- lJ el' ji4\/AfWAJ A�)pljjj 104 I6k Ai,t, oL vr?1\16 To y AWA'Y rf7(,,O Wff�-AWV- 14M. 7-1 t rylL W-ft C� llfo(LA ikV - r T w -7 2;�' �fz fsL'�j C K-11 Q 5A,. G-1 r/l CA IkJAL',l F- TtCO04 Ot:� LAA? i� YJA-,14 e .�� 1%7 91 �4^F 24, Ot i,W lz -1 ) Q W�un Came 7 r V�j pig/ 7. r -it I For 2' class 150 4" Schedule 40 PVC with 4" Speed Reduction Tee at Inlet 1 Pressure Pipe (Pim"we Tested) rMish Grade - 8.0t Pine Is] v, r r r rrrrrrrr�rrrrrrrr .'. 18 w .1 )lashed Stove ®2" ThickArm 6" 16 Inv sump Inn Inv d d d' 9 4 1 .a d. a ,od.• (A7ev 6.3) NORTH BAY r a'd, Q 1 " 1/d 1f'ashed aStane•'Q�• Mow 6.8' 6.6 (Elev. 6.5) L7 (Elev 5.8) h»m sztstlitg• . . . . . . . . •. �. LOCUS Pomp DISTRIBUTION BOX 40' Great Bay Rd [Member j LEACH FIELD PROFILE VIEW b pezwow SOB -L nay• �a i' a An • a.. 'a. N.T.S. as aa° PRECAST REINFORCED CONCRETE DISTRIBUTION BOX 6-�I s• •y5 n p Install on a level base I -- " �v�t Minimum..wall .thickness = 2" observed Gil? (El. o.B) 15'0 f �.[I -- y Minimum inside dimension = 12" Use (sJ nistriGution Lines at 0.005 scope Outlet inverts shall be equal to each other and at 2" minimum Lem or L►IstrlbuUon Lines - ss'e" below inlet invert PROPOSED LEACH FIELD EXPANSION The distribution lines from the distribution box shall all have equal inverts as determined by flooding the distribution box to END VIEW - N.T.S. the height of the distribution line invert after all lines have been sealed in place. Invert adjustments shall be made by filling with durable and nondeformable material permanently fastened to the line or -- reconstructing the lines until all inverts are of equal elevation. z �= GENERAL NOTES E'x7stir7g Porh c I. All the__workmanship and materials shall conform to R E.P Title 5 3p and the Town, of Barnstable rules and regulations for the subsurface disposal of sewage. - 2. At least one access port over tank tees shall be accessible P : Eistizig Dwelling f38 �. 3 z, 6,0 s U within 6" of finish grade, with any remaining access ports brought Y to within 12" of finish grade. ZR. . 3. All components of the sanitary system shall be capable of . withstanding H-10 loading unless they are under or within 10 ft of drives or parking. H-20 loading shall be used under or within 10 ft of drives or parking unless noted Plastic equals may be >. - used in lieu of all precast units 4 r N 8 Plan data compiled from Site Plan prepared for Richard Card ullo Dated Jan. 14, 1987 and Rev. April 6, 1987 6 ?Existing 2000 5 .... 5. Sewer pipes shall be 4'** Schedule 40 PVC laid at 0.02 slope. 7 Gallon Tank, •� �i,iSK of .� ►'', 6. Any masonry units used to bring covers to grade shall be Proposed ; : Existing =: �N_~ To Remain o�� p Contour ; g X` i W►W11M mortared in lace. Garage o �� LIEBERM,w 7. ► ; Finish grade shall have a minimum slope of 0. 02 ft per foot. _ _ 5t U i ►vo.2 ,T y o j. Edsting 1000 + �, Gallon PC 90� •` ,- a To Remain �►sJ' wAt E .�. ; . : .- + ' -Y. r• a � :• e DAB � ` i � 0� ti + Soil Log 15 + _ 103', ! ' •y GRAPHIC SCALE 1 Test Date: 04-01-86 ,_' .�'� :. :• i ! - 0 13 30 so 120 Existing 10 x 40 Leach Field Siol Evalua tor. F� Fairbank , �T �� Perfroa ted at 5' O.C. ; ,. Health Agent: T. Mckean ���' 7 IN FEET 10'0 { Perc Rate: Less than 2 fin/Inch ��-' Props AS Field i inch = 30 f AO 1 40'x 15 l ' , TP - El 6 8 x p Number of Bedrooms' Four Sewage System Repair Plan Top and Sub 18" Total Bedrooms = 4 X 110 gpd = 440 gpd Required Flow ' ,i _ ;� 4 r W Pmpwvd For 38 GREAT BAY ROAD Use.- Leach Field 40.0 I. x 15.O'W x 6" Eff/Depth 77 6 [40.0 x 15.0] x 0. 74 444 gpd Total Design Floww 5 in Osterville, Massachusetts CLEAN COARSE ale 1- - 30, Dater Aft 19, 2004 Prepared Itr SAND Stephen r Dbyte and Assoclates Adj. CF (EI. 2.3) Assessors Data: 42 canter=Laves s tkhnouta, xA o, Map 93 Parcel 15 7W phone: ti08/540INN - FEMA Zone "A13" (EleP 11.0) F2aao ofrsIvra .8z4=>c3--c• Ob ery wa ter 72"(EL 0.8) 120"j El. (-3.2) i 8-20-04 Revise SAS No. I DATE DESCRIPTION