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HomeMy WebLinkAbout0054 LEONARD DRIVE - Health 54 Leonard Drive, Osterville A= 114-028 { TOWN OF BARNSTABLE LOCATION v 7 �L��i�lrr' �� SEWAGE # VILLAGE O5rvB ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �r C� �'CO 57` 77l" SEPTIC TANK CAPACITY 1:rb v 64 C. y 1 LEACHING FACII.TTY: (type) /taa�505 (size) NO.OF BEDROOMS BUILDER O OWNER J / 4- PERMUDATE: /�2 � COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility t Feet . Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) kehq Feet Edge of Wetland and Leaching Facility(If any wetlands exist Nip .Feet` within 300 feet of leachin faci ' ) Furnished by �39 i .Y . . V ��3�.���3�� � �'. �� O � d3-�� ,® .. .. � ��; . 9- No. 160 J ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS .ram pplicatton for Miopoml *pgtem w6trurttort Vermtt Application is hereby made for a Permit to Construct( )or Repair( an On-site Sewage Disposal System at: Location Address or Lot No.�� / ��D,r ��, Own is Name,Address and Tel.�No. Assessor's Map/Parcel 51ejrllIl e Zy leill, - Installer's Name,Address,and Tel.No. Deter's Name,Add ss FandTel.No. i Type of Building: Dwelling No.of Bedrooms Garbage Grinder(14-0 Other Type of Building 4 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 110T gallons per day. Calculated daily flow 31 r) gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Al rations Answer when ap licable 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 Certifi- cate of Compliance has been issued d of ealth. Signed Date 6411� Application Approved by Date Application Disapproved for the following reasons Permit No. 1 Date Issued No Fee' 60 1 TEE COMMONWEALTH OF MASSACHUSETTS v PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprica't on for loigooar *pmem Conztructio� Permit Application is hereby made-for a Permit to Construct( )or Repair( an On-site Sewage Disposal System at: Location Address or Lot No.eq / ��P,�,��� Owner's �Name, ,AAddress and Tel.No. Assessor's Map/Parcel (/ �/ Installer's Name,Address,and Tel,No. Designer's Name,Address and Tel.No. ­77 -4 4 A_ Type of Building: Dwelling No.of Bedrooms Garbage Grinder(14�10 Other Type of Building No. of Persons "Showers( ) Cafeteria( ) Other Fixtures 1D gallons.Design Flow ,[�� gallons per day. Calculated daily flow J� g Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alt rations Answer when applicable)"`�/1� �� h Date last inspected: ' Agreement: .'/?`7� `A The undersigned agrees to ensure the construction and maintenance'bf the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Codeland not to place the system in operation until a Certifi- cate of Compliance has been issued by • B•and of ealth. / Signed Date �` �1- Application Approved by _ Date L V . Application Disapproved for the following reasons Permit No. 9 � Date Issued .: ---- jam...,� =� T• ., "*� ,.s��...��� .:�—��--�---�� THE COMMONWEALTH OF MASSACHUSETTS l Ll 7- BARNSTABLE, MASSACHUSETTS Certificate of Compliance A THIS IS TO CERTIFY,that the On-site Sewage Dispos System installed(� )or repaired/replaced 0--�`on by Installer /l,L, l i l'�0,57—Z/G7`i l9 at U 1141 aft9 fi'✓/i / has been 66­ cteo in accordance with the provisions of Title 5 and the for Disposal System ConstructigpgermitNo. U - V1 dated P Date CZ4� . Inspector ✓ J.1' ` THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THATGTHE SYS- TEM WILL FUNCTION SATISFACTORY. /,/ —7 Q �--/ ———————————t——————— No. DG—L7 Fee G� `-7 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Bigooar bp! tem Conotruction Permit Permission is hereby granted to &Y Z?Z0 h1-) Gar1 7`�'l✓��`/®rI to construct( )repair( of aan On-site Sewage System located at No.# TStreet and as described in the above Application for Disposal System Construction Permit. G - �- NO. vate The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. l� Date: /2 /, q C Approved by e 224 `x t 7� Board of Health 'r: • SOIL EVALUATOR& PERCOLATION TEST FORMS ) / P O*IHE Tp�O Page 1 of 4 Town of Barnstable 9BARNSTABLE. Department of Health, Safety, and Environmental Services `b79 �0 Public Health Division HIED MAr A 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 FAX: 508-775-3344 Soil 5'ulta�,&t �lssesslrlent for Sen e Dls -)oral ASSESSORS MAP NO' 1 14 PARCEL NO• Z 8 NO. -- 2 Date: Performed By: /� �`� T� Date: " 3 Witnessed By: 't �'��/ Location Address / Owner's Name 13 uJ 7 ham,r-4 t Lot#: Address,and S'F L eO�-► a+-c�D�" o is t cp V,//C/MA . 0 2 C,SS Assessor's Map/Parcel: Telephone# NF-W CONSTRUCTION RETAIR Office Review Published Soil Survey Available: No Yes Year Published 19 1-3Publication Scale ! ?see e Soil map unit Celrq- Drainage Class V // S Soil Limitations <X e e.S.S e/Y r'a c q e dC Surficial Geological Report Available: No Yes Year Published J 79/ Publication Scale 1-3/4 o Geologic Material (Map Unit) C dak r' ✓<0- 8 Landform C*3 ( --L c c ( a .,r C Lr as /i Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Wetland Area: National Wetland Inventory Map(map unit) N o Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month -T-IX Range: Above Normal Normal Below Normal X Other References Reviewed: DLP APPROVED DORM- 12/07/95 II` r RNI FORM 11 - SOIL ENAIXA71 a1; )r,2t►f 4 Location Address or Lot No. SQ Ora-site Review Deep Hole Number Date: -71 Time: / / Weather G c a r Location (identify on site plan) Land Use ]Z esr J�ti Zip I Slope 1%) / o Surface Stones Vegetation b -ems h -s Landform Position on landscape (sketch on the back) Distances from: Drainage way / oa T feet Open Water Body /oo tfeet g Possible Wet Area /oa"f' feet Property Line 2S 1t feet Drinking Water Well / a•t feet Other DEEP OBSERVATION HOLE LOG oil color Soil Other Depth from Soil Horizon soil Texture re Mu sell) Mottling (Structure,Stones.Gravleljrs, Consistency, Surface (Inches) Sgndy 7.SYA L.c 0--.y 7.S Y2 j e2 = Z o r' IQ .S a.1 CA .f" 6 !Metcf►V." 2'sY rl fr d o a rSc (e C j 4$ 4o,r C a sang s/� ,✓a. �! /n Y/R rh c ac i•� / / 4-r�--/3-Z" Cob 6 le s DepthtoBedrock: ,: �-f-- — Parent.Material (geologic) G'1G G/C Weeping from Pit Face: Depth to Groundwater: Standing Water in the Hole: .u/jq Estimated Seasonal High Ground Water: DEP APPROVED FORA)- 12/07/95 FORM 11 - SOIL LVALLIATOIZ F0101 Page 3 of 4 Location Address or Lot No. S<( L.co.-� Q �( �•� �s �P•--vi��� Determination for Seasonal High Water Table Method Used: Z- o' ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole .. inches ❑ Depth to soil mottles inches ❑ Ground water adjustment ........ ...... feet Index Well Number .... Reading Date ............... Index well level Adjustment factor Adjusted ground water level ... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all, areas observed throughout the area proposed for the soil absorption system? y� 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 Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date 7 DFP APPROVED FORM- 12/07/95 FORM 12 - PERCOLATION TEST Page 4 of 4 1 Location Address or Lot No. S� L P�►� Q r cl�� d��c.-�, //. COMMONWEALTH OF MASSACHUSETTS B ,q 2ws rq j3L,x7, Massachusetts Percolation Test* Date: (,. 9 4 Time:, Observation Hole #! Depth of Perc G G o Start Pre-soak / % :30 End Pre-soak 2+' 9� is Time at 12" 2 m : 3 a Time at 9" Time at 6 2 r . Z o ir = Time (9"-6") 2 a e -c . Rate Min./Inch z. -►, •714117 Minimum of i percolation test must be performed in both the primary area AND reserve area. Site Passed ® Site Failed ❑ Performed By: `' /2 • d �' Witnessed By: C'( f Comments: : ....., .. :�....,.. . ....._:. .. ... DEP APPROVED FORM-12/07/95 PROFESSIONAL CIVIL ENGINEER, CUSTOM DESIGNER P,O: Box 781 Dennis,Massachusetts 02638 Telephony(506).3z}5.6530 July 05, 1996 Mr. Edward F. Barry Health Inspector TOWN OF BARNSTABLE Health Department 367 Main Street Hyannis, MA 02601 Dear Mr. Barry: Enclosed herewith is a check for $100.00 to be applied to the following test hole: 54 Leonard Drive,- Osterville Assessors Map 114,. Parcel 28 Owner's Name: B.urghardt Test Hole Date: July 16, 1996, Tuesday. Time: 11:00 AM Backhoe Operator: Mr. William Robinson Thank you. Very truly yours, Claire. Wagn -Kimbal Research Assistant CWK/ t BVNCHMARK — — ---- _ TOP OF fOUNOATtON 20 T�MIHI8d4rfA fTE4f6 L1.AR ID FT wM IJu.Fkou I E1g i,;wAxa;- .Acs 501E TEST fLEV, /�Q Q 40 FT. M{►11MWd. — DATE OF (A58UN�j ETE t l - (S..EAN SAND �E:Ti'37_ 9 4 �S t'� LI�z r rsr N7TTJE93ED FHB-BY' f SAD OBSERVATION HOLE 1 ELEv.. 9 O P 6 3r _�..�_ MCM ION. HOLE 2 ELHv.- d �, a PERCOLATION RATE ��_brN/uraT AT UYGFEB(r oPj o ERQN AIION'IRATE ^, ►tW A 5 t j 1 1- i HaF"a+'a, - 5•!h rry•:`i(! c.1 k•� :I' ��'Ifl r a!' - &"T I J09fGhl T IN%a ! C:L 4 ` �,�e' . 5 9(D s'I I _ �Q7: r , 6#J7$ rZPSf .tl ! OTTREQUIRED p WTYDi T/4,:dER F is C,i t -• r �d 'a 3y �a v � �rS.'1+11 r rJii.��I ' �v��7ur �L -51 . - ! -...t�.�I �rv'�k'.`5 -{'I`e. t`4 .! J5 .1 ° ' j/t(rr h}'• '.t! I CU. Fr. OF Gov.,. 7•S{/,y to' I I P rr -t'r 10.�✓ ANCHOR . 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(1{ iJ32 T}fatyw 1bfiA 4tP�l� - L_ HttS�f _ENQ1 fi ( I d2 5an a( 69 ¢ ' :r•�''-$ p r in. ..� LkCED '; 1a� 1 , 'LS I',i� ; IV IA - L On' �y� WELL /f7 HA7H9 EJPOOUN']£AED AT "L ,, t I sdJ 4 .L NO WATER ENIfpIJWERED AT—._ :..-" IEV. . - , "'�yY;_'t_iai ,_ `bau� ,�.:e '-;tll 1� I# i !�" 1 LONE /d.. 6 Y" r J fI S�!I ra N3DFD( s7r N Yyy Z AP� 'rC1F�M ^a1 yF} rg t [ I�n til ^r `tTr I d L S r I i I i F AD.4ST iF F ti`E nl5'p!I 5 .'' 2� I}n If J v't•r< F d YfK- — rzL 4.+v.-.FP-r 'k-A..[t,-'--' c h�gi ,+t, TE How :. LEGEND: Q SIGN CALCULATIONS _ I� Ty t ! oB5EiS4'ftl'i(MTER TLCD , ..}!'r1I '. } ,p,- EXIMNC!iP•RT'ELEVATION t90&@-: PA/YBER�OF-9CDRiS01T9 k°h'ry •} ;k�r}Y Q*. 1- •aJ -1AS:^tx Y�Ps-�4', I-0 T� jjpGu '1 �.//.. 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" ------------ ---FA3-i;IJER'J AT AI-L- So:Br FASCIA / IxA SEb,.',J0 MEMBER aA—.-ER / TOP PLATE CONTINUOUS VENTING SOFFi'' JUNC'-IONS Ty.. -.Q (� e Ixa FR<EXE LiD, l^V 6L-U I`IOJLDINCa � \� TYP EXTERIOR LNAU_ z E><'r. 'STUDS 0 16" O.C./ '" R13 F.G. INSU-./ W ` / 1/2' RI_YIN(X,D S"F.ATNING! �. u' /) TYVEK- WRAP/W.C. %IINGi_iM _ a 3 1/2' :C*,ICRETE 5L.A>? E 6 klL VAPOR °J'ARRi 6R / Ln =r SHEET 2 OF 3 .--=.P FOUNI''ATICAJ ltit\_L � _ � - �7 . P.T. 5Y L AN:FGRCZ) 4'•,Ou 0.C. r 8"x9-4" KtETE FROST WALL ( - IG"x; " CON�'INUCUS FOOTI`C. -C)a =GT I QP� $ r�l_=: ✓4" 1`—o" JOB: 0723 DRANN BY: KW DATE: *1/24/07