HomeMy WebLinkAbout0039 SYLVAN LANE - Health 39, Sylvan Lane
Osterville
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TOWN OF BARNSTABLE '
LOCATION yet.39 S A vAIIJ LA,►»' SEWAGE # 0008- /53
VILLAGE 0,S=1cru;I1C- ASSESSOR'S MAP & LOT 1S/0 - /31
INSTALLER'S NAME&PHONE NO. . 1��,` E'XCA 1ZATta uJ -,MR-477-06S3
SEPTIC TANK CAPACITY 1 SocLS l Pot-
LEACHING FACILITY: (type) 41,41, (2*,p- (size) �/,( x,2 9 x a
NO.OF BEDROOMS 3
BUILDER OR OWNER Can-1A;a. }-/a►rr; S
PERMIT DATE: L -/G-01R COMPLIANCE DATE: 1-/-11- 08
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
I
At- 114"a
1 P. 93'6 " Rcar We
A3 . 0a ' to
B3- �$ Q
A y - ay'9" xnspccllcn
8y - Porgy U
Fee _
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZippYication for �Bigonl *pztem Comar ton 10ermit
Application for a Permit to Construct( ) Repair(Vupgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. 3 q S y I V Cl rN Ln n& Owner's Name,Address,and Tel.No.
05}ervllle ONr0t)ia—NarrCS 5 08 4t$ - 0509
Assessor's Map/Parcel _ fit 3 4 S y1 N an L411it t%+PX1I l 1('e.
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
"IZvb�eTLztl.�Dy- I(3t� £x�ava�lon DOC kr)vtrmmen+al -Oaviv A1ason
I
Type of Building:
Dwelling No.of Bedrooms .3 Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided gpd
Plan Date J-{�(S 109 Number of sheets Revision Date
Title
Size of Septic Tank 1500 J / ype of S.A.S. c << ,z ') 1
Description of Soil
t
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 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 y-�
Application Approved by ? Date
Application Disapproved by.(/ Date
for the following reasons
Permit No. .DDOP—fir! Date Issued "� {
' v
v
L 1-.kNo.'`!, Fee to .-
� SHE COMMONWEALTH OF MASSACHUSETTS Entered in computer:;
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
apphcatton for Digpo al by.5tem Construction Verm tt
Application for a Permit to Construct O Repair V) Upgrade O Abandon O 'U Complete System ❑Individual Components
Location Address or Lot No. 3 ci Sy 1 v CI n LCI ne— Owner's Name,Address,and Tel.No.
51ec'vlll � Gynk-h CIS - L12�j - GSv �
Assessor's Map/Parcel Rlb— 131 3 Ci y 14 C i f LA it t b5 t e r v i l le-
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
'IIZObeZT6-7 1 LlOV - N31 C3 £xCnv0 E 14)n
!'1 T 1- r r y I n, +v i es t6c,I e 5c 0)1
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(mint.required) 33 0 gpd Design flow provided gpd .
Plan Date Ai (5 U Number of sheets Revision Date
,Title
! / r }
Size,of Septic Tank � �QQ 170Iy / �� '1'�(�,tr�n�IllTypeofS.A.S. t� , _� tt
Description of Soil -T
•
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 Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this�B��oard of Health.'
isp�7V Signed u:- -e lj Date U 15
Application Approved by �, Date 1/ //,
Application Disapproved by. Date
for the following reasons
Permit No. �_pok _ul CT
Date Issued r?
ly �� fit;�r a 'Gj THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
�
_ Y/i6ry�� sQP Certificate of Corr phattce
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired.(0 ) Upgraded ( )
Abandoned( )by �71 CCIy� IO (l
at' 3 q .SN 1 yn f)l Ln(j-e aC)+P has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. C)ripkj- /S dated lI _ [l�U
Installer K04ae-P-1 G!Lrp� Designer �(�V PV/"1 n SCE fl
#bedrooms _ Approved des go flow . Ej / gpd
The issuance of this permit shall not be c tried as guaran e that the system 44 function as designed: !
Date Inspector /%s�J�/ f.�
--4---------- ------ r /-P u
i Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
wi5poe;aY �bpgtent Construction Vertu
Permission is hereby granted to Construct ( ) Repair (✓) Upgrade ( ) Abandon ( )
System located at •"4CI 5y 1 V Q r) DAL 6c,i P I \j 111 e
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this-pe it.
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Date Approved by
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Town of Barnstable
,
Regulatory Services
' Thomas F.Geiler,Director
an�xsrn,B�E,
Public Health Division
rFD: p:� Thomas McKean,Director
200 fain Street,$yannis,MA 02601 .
Office:.508-862-4644_ . -fax: 508-790-6304
Installer &Designer Certification Form
Date:
Designer: i �cu r a r �'� Installer: t
Address: . Ok L(/H Address:
On y r 1 L-oIr � was issued a permit to install a
(
(date) installer)
septic system at C based on a design drawn by
(ad ss)
dated
(designer)
I certify that the septic system referenced above was installed substautiall accbrdi 'to
the design, which may include minor approved_-changes such as laterraa� location oft he
d1kribution box and/or septic tank.
I ce that the septic system referenced above was ins a
} ep all,.d with aj r changes (Tx..
greater thy.1:0' lateral relocafion of the SAS or any vertical relosaf tin ofy componegt
of the septiE system)but in accordance with State &Local Regulations Plan revistol�.or
certified as-bit t"by designer toy fallow. ,x
- Z� 1ID^ �y
G
(Installers Signa e) cn.
'��iTARP
(I) er s Signature} Afh ,e er's Sfari� .Here
P
PLEASE RETURN TO 9MNSTAULE'PYIBLIC IMALTH DIVISION C R C . .TE
OF, CONII'�IANCE 36M 1�T�'T' , �-= SSUEI BOTH°3�5 iFQ
BUI][.T CAS ARE RECEIVED TEE B � STABILE P LI ALTO I)MR1514
Wm
T�IANK YOIT. f_
Q:Health/Septic/Designer Certification.Form
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1
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Town of Barnstable P# ZAA Z.
Department of Regulatory Services.
MUMBUB , : Public Health Division Date
,tom.
200 Main Street,Hyannis MA 02601
D ate Schedu led � t �):'ime
Fee Pd,
Soil Su' aby' Assessment for S wage Disposal
Performed By: Witnessed B 6qQ6
LOCATION& GENERAL INFORMATION
Location Address Owner's Name C y n•t-h I Ck N C f f is
3GSyivan LAn2
6s+el'Yt1It? Address 395ycyanLcin-ems
OS�vtttP M�t-o�.�
Assessor's Map/Parcel: 14 Q 13 Engineer's Name f
�nvlo MGsanr
NEW CONSTRUCTION RBppIIt
Te phone#
Land Use. /7'I l ,K_A01' =p� 61�D / . Slopes(46) tJ !� Surface Stones_-�",�t`-t
Distances from: Open Water Body%eft possible WetArea /x`i`f ft Drinking Water Well ,Drainage Way ,1' _T ft ProPertY,lane'-" �V ft Other ng �—
�' M
t SKETCH:(Street nam ,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
itz"
Parent material(geologic) D"'t w Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: `-f Weeping from Pit Fpce e�
Estimated Seasonal High Groundwater A/4
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in, Depth to soil mottles:
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj,factor.,,,,,,a,� Adj.Ciroundwater Level
Observation
PERCOLATION TEST bate—_-_. Titnn-
�
Hole# Time at 9"
Depth of Pert _ Time at 6"
4 tl
Start Pre-soak Time @ Time(9"-6")
End Pre-soak , L
Rate Min./Inch h.
} Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) g
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:ISEPTICIPERCFORM.DOC
e
DEEP-OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
l D.
DEEP OBSERVATION HOLE LOG' Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. '
Consistency,% 1
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.)- (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon. "Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
ons' en
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes V__
Within 500 year boundary No u Yes,_R
Within 1,00 year flood boundary No L/ Yes
Depth of Naturally Occurrina Pervious Material
Does at least four feet of naturally occumng pervi l exist in all areas observed throughout the
' area proposed for the soil absorption system.
— If not,what is the depth of naturally occurring pe ous material? .
Certification
I certify that on Amental
(date)I have passed the soil evaluator examination approved by the
Department of Envir Protection and that the above analysis was perfo ed by me consistent with
- the required training,expertise and experience described in 310 CMR 15.017.
0
Si nature Date 7 /
g ,
Q:WEP71WERCFORM.DOC
`II TOWN OF BARNSTABLE - .UN-,DERGR0UND'' FUEL AND CHEMICAL STORAGE REGISTRATION ;
MAP NO. �� '"':� `� ;PARCEL NO. lj>
r
ADDRESS OF TANK: <. V...I,L L_AG E: �``�
�. w
`MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) N:U; :}
4 OWNER NAME s pa °�? Y 1 S O PHONE
INSTALLATION DATES OG- ? °g�.f B`Y. _ �1C-c��,d»'d-! f_ t- y
®-� - �.�
INSTALLER ADDRESS: �# ! j'h � j1 �f y -CERT.NO.'
�`
STANK LOCATION: c'? k �t � ^� . -V S `.. roev", "C�'Y 9
c acOo" i aQ TAN,K.»LOCAT'i'ON"W"i'TH QOP,QCT TO nu I LD I Nay) t
CAPACITY a {�= TYPE OF TANK AGE YRS-:.FUEL,/CHEM I•CAL,
TESTING CERTIFICATION [ ] PASS C ..] FAIL DATE
LEAK DETECTION C ] CHECK IF N/A 'TYPE/BRAND i
REMOVEDNf H
ZONE OF CONTRIBUTION [ ] YES C ] NO DATE TO E
FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE
CONSERVATION [ ] CHECK IF N/A DATEr ;Y
1� �n
BOARD OF HEALTH TAG NO. C � �{f! f�j ] DATE V i //1 �I✓
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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Anne Driscoll
24 Summer St.
Arlington Ma. 02174
c
March 2, 1989
Board of Health
Town of Barnstable
PO Box 534
Hyannis, Ma. 02601
Dear Sirs:
I am enclosing a registration form showing the location
of outside oil .tanks for the property at 39 and 49 Sylvan
Lane, Osterville.
The,tank at 39 Sylvan Lane was put in, I,believes' about
October of 1984. They didn't send me a bill for some-
time and I had to.ask for it but the bill didn't show
details, i.e. , size etc. I believe they are all 200 or
250 but I may be wrong.
I don't know the age of the' tank at 49 Sylvan Lane. It
was therewhen I bought the property!
Yours truly,
Anne E. Driscoll
i
I
ORS MAP.. /
ASSESS (JJ
O TEST HO LE LOGS
ail NOTES.
PARCEL:
G
FLOOD ZONE.
SOIL EVALUATOR : \1
WITNESS : .
THE 1 The installation shall
. ) all comply-with 1 wrth Title V and Town of Barn
�._, P Y stable Board of
i-�-� REFERENCE:
REFER ___ _,._. _ . A
(/ D TE: Health Regulations.
PERCOLATION RATE:
Z
I 2 The ins
taller shall verify the location of utilities sewer inverts and
t
L
septic
tic
3 components prior to installation and setting baseelevations.
3 All gravity septic
t piping to be 4 inch
h Sch 40 PVC at 1/
_ _ Y P P P g 8 r foot. The first
TH I TH 2
Pe
two fee
t ou
t of the d box to the le
aching sh
all be leve
l.
Mh-
—�1
�
�A A 4 This plan is not
to be utilized
utlze d for
pro
perty line deter
mination rmination nor an o
P I� Y other
3 Y
u ose other than the pr
oposed
ose ds sy
stem in
stallation.
stallatro 9 purpose n.
P P Y
L.t�t
6
d •
v b
5 A11 se
ptic tic comp
onents
is must me
et
t Title V sp
ecifications.
ification
Y
Po s.
•
P�
b
6 Parkin shall not g be constructed over H 10 septic
components.
V
7 The property is bounded
b property P P Y corners and property lines.
Y P P Y
P P
M
I Y
LO
CATION
CAT ! N AP
W 8 Th
e he pro
perty ow
ner shall re
view e� ) design co� P P consideratio
ns stoa r./ 1�'I approve of
� � total
W PP
design flow ;and number of bedrooms to be� considered for de
sign. Receipt
1��b P
G of a 'ent for the plan and installation,based
� payment P aced on the plan shall be deemed
C
t
approval
7 of the d� -7) design flow b
the.owner.
� Y
t 9) The existing leaching or cesspools shall be
and filled with material
pumped
r Title V t abandonment� per procedures. Those within the
l P proposed SAS shall
P Po
be removed�! ed along with con 1 g contaminated soft and replaced with clean
O
� p washed
>r� W
O _ and Title V specs.
Pecs.
lO System
tem comp
onents
�2 to be 10f feet from.wa
ter ater line.. Se___ •—��'��• � J P Sewer lines crossing
l _ the
water li
ne ine shall be 1 s eeved with 4 inch SCH 40 PVC with ends grouted if
SEPTIC SYSTEM DESIGN applica
ble.
' 11 If •
a garba
ge under exists rt is
g g to be removed and is g the responsibility of the
P tY
FLOW ESTIMATE ATE
owner to
ensure such.
L E
12 The '•
e installer i s to take caution.in excavation around the as line
.
N K t
g
BENCH MAR
33
l3 T ,
The installer
e sha
ll verify the location,
t n uan i t t t and
elevation of
0 A fY the sewer
,, BEDROOMS AT I GAL/DAY/BEDROOM OM �j G L/DAY quantity YELLOW SPOT ON `�J
�, lines exitingthe dwelling prior to the installation.
CONC STEP ' x /� - 8 P n.
ELEVATION 33.64 SEPTIC TANK
E � �
BARNSTABLE GIS DATUM 2 00�'
2��
LOT
WoGAL/QAY x 2 DAYSGAL
AREA 1,1021
USE 6DOGALION SEPTIC TANK ;
33
I�
� -S01C ABSORPTION SYSTEM.
IC
Im a- (q) I�-VIUMAlbVI-*
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LiSIDE AREA: Z-A, ( 7,1 + 10% 2-X
Z
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m
Z
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o z BOTTOM AREA: Z X O `.1 ��✓ ,
t + Z
- SEPTIC SYSTEM SECTION
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STONE -,
I R DRI VEWA Y I
20 Ft
m PGR
m
T P
t i 0
q 31�a lb 1�}-
,./ z�' P Sraw FI 6T c. �i'w e,
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5N A.m o 0 2 ,61
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,�� N SEPTIC TANK Z��Iv 1 '
.. SCfi L E. 1 �n - 20 _F�. il
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140. 10 S I TE AND SEWAGE PLAN
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LOCATION . 3 Ym 4�� � 44E.
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PREPARED FOR . '�3
SCALE:
6 • 5
W DAV ( D B . MASON 'r _DATE.
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DBC ENVIRONMENTAL� DESIGNS
EAST SANDWICH . MA
W DATE HEALTH .AGENT
W ( 508 ) 833_ 2177
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