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HomeMy WebLinkAbout0004 WEST WIND CIRCLE - Health - 4 WEST WIND CIRCLE try A = 121 - 011 - 001 ° ° F P ^ ° 1, ° d � 6 ° ^ e � 1 P ° ° n ° . - • � o .. {i:.i � �.., _- . a -...' � J " r e n u V, n : b ^ u 0 o • , S a n 0 o F , o un a •' .. ,. � a .. �. °a' " a '- ." o'� , d� o ^ <d e f. U f a ° B a ` - SEP 2 2 RECD q , . l ' BY_ `P F � . i f i i 1; i ICI 11 i 1 I r. r 3 __...._.._........_ tom' �•�-� Z uy vJ,ca VA cs . j ®R/ • fy. rl, WI .w - Fly 4 ROUTE 28 o . �y S 85433•to.f � 83.4'4-'�'"" � PROPOSED ADDITION cr► *-j LOT 16421 S.F. rarto 26.z'r �--, r off'"~��6 �,� � �b� �..: y 1� I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL TOWN OF BARNSUBLE ZONING KNOWLEDGE. INFORMATION AND BELIEF THE DWELLING ZONE RC SHOWN HEREON CONFORMS TO THE HORIZONTAL SETBACKS SETBACKS I OF THE ZONING BY-LAW FOR THE R-C DISTRICT_ FRONT - 20• SIDE - I0_' REAR 10' THE DWELLING DEPICTED ON THIS 1 R ✓ r Town of Barnstable P# 3 � a� Department of Regulatory Services BABNHPABM; Public Health Division Date f6Sq. �F 200 Main Street,Hyannis MA 02601 ' Date Scheduled 3 Time Fee Pd. /0y Soil Suitability Assessment for Sewage Isposa Performed By: Witnessed By: N V "�/•� 11 r 1;OCATION. -L_.&T`.GENER INFORMATION Location Address , le Owner's Name gnn P �S�cf-4/��c� aLGSS Address Assessor'sMap/Parcel: �a/ /0//O0� Engineer's Name �Cnj/.fta.-✓:jam/Z�p� NEW CONSTRUCTION REPAIR y Telephone# ��U��f 6-7L Land Use Pj/�rfl�/`;/ Slopes(%) C 3 /G Surface Stones Distances from: Open Water Body O G'ft Possible Wet Area ft Drinking Water Well >loo ft Drainage Way >iS ft Property Line —!�G ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Qk 2- Parent material(geologic) �!�' / Depth to Bedrock Depth to Groundwater: Standing Water in Hole: //Weeping from Pit Face Estimated Seasonal High Groundwater TyS ;DETERMINATION FOR SEASONAL,HIGII`WAT.ER TABLE Method Used: ��1.. t `' Depth Observed standing in obs.hole: in. Depth to soil mottles: / "1 C" in" Depth to weeping from side of obs.hole: in. Groundwater Adjustment Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level S�z PERCOLATION TEST Da(' / / Time ........ - •� ^µ Observation Hole# Time at 9" �� { i�' s, - � Depth of Perc 60 Time at 6" Start Pre-soak Time @ 0.►t1 Time(9"-6") � End Pre-soak 7-1h7 i� /S., i., frss h 41 Z f ;r7 Rate Min./Inch ;y Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) ,V'- 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:\SEPTIC\PERCFORM.DOC I DEEP OBSERVATION HOLE LOG.. ' Hole#11F Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C Consistency_%Graven a—j" j DEEP OBSERYATION:HOI ELOG: , Hole#! °2 .. „ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven 1o661,�sgry�i�y�+ y� t v F f DEEP!'OBSERVATION HOLESLOG',, Hole# Depth from Soil Horizon Soil Texture Sod Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven :DEEP;OBSERVATION.HI.OLE:LOG� Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Mao: Above 500 year flood boundary No Yes Al Within 500 year boundary No— Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pery material exist in all areas observed throughout the area proposed for the soil absorption system? E'f If not,what is the depth of naturally occurring pervious material? Certification I certify that on %f (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 / Z111 Q:\SEP-nC\PERCFORM.DOC LO C T ION Use // SEVIIA PERMIT NO. L61 // �/esl�ivict;olt /— 3 Ja VILLAGE u ille INSTALLER'S N ME ADDRESS Iwo Aco� y/4& So `I rmo I U I L D E R OR OWNER } CQA- v• \-/Ig1-M o of DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 9 � Lo fi 1 NOULL.........� ... ,r Fps.. ............... LTH THE.BOARD A OF FHEALTH TS ' ...OF...... .................... Appliration for Uiipniial Works Tnntrnr#iun Wrmit Application is hereby made for a Permit to Construct ( j--or Repair ( ) an Individual Sewage Disposal System at .. c ion-Address �ryorg Lot No. �',� irp; J'.......... } Owner A Address - 'Installer Address �1 •- Type of Building. Size Lot___.Aq-, 1_ ______Sq. feet Dwelling No edrooms =_______ _________________________Expansion Attic ( ) Garbage Grinder ( ) -.. a Other-i S Types E uilding _ 1, No. of persons___..__________________ Showers ( — Cafeteria ( ) a i Other;€axe --- ----------------------------------------• _._..---._...--------- ------------••--.........---------•---- --------- W i Design low____ ___ gallons per person per flay. Total daily flow........... __ __ 1...............gallon )s. a W.. Septic Tank—Liquid capacity/$:gallons Length--- ._.... Width..... _ Diameter---------------- Depth____ ....... Disposa 'Trench— No._ Width ...... Total Length_______________._______/...._ _':Total leaching area....................sq. ft. Seepage Pit No- __/....... Diameter......... __..___ Depth below inlet......<_r. .__.____Total leaching area____„�..�?sq. ft. Z Other Distribution box ( ) Dosing tank ( ) p aPercolation Test Results Performed by.____. - !.__,�. f fr'f G Date_.-______.J, t__.�' Test:Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2........._......minutes per inch Depth of Test Pit_____ JR__ Depth to ground water_A*__W_0T67�9, p� O Description of'Soil . ------ x U ---••----•-••------------------ -------•------------------------------------------•----------------••-------=----------•-----------------•------------..._...---------••-----------•-...------•-------- W V 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'ITS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until 4ticat lop Complianc has been iss ed by the board of health. 5eg ned -- ------ ••- e Application Ap __........-•-•-----.. ateApplication Dise following reasons-----------------------------------------------•-------------------------------------•-------------._...._..... -- - ------------------ --------------------------•--•---.._._...--------- Date PermitNo......................................................... Issued....................................................... Date .F NZY................ FE$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiun for Disposal Works Tonutrurtiun ramit Application is hereby made for a Permit to Construct 4)_or Repair ( ) an Individual Sewage Disposal System at ym4j on-Address !3 ... ...... or Lot No Owner , �r J Address Installer Address Type of Building Size Lot_. ---Sq. feet �-� Dwelling—No. of Bedrooms............ _________.__---_____.__.•Expansion ttic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons. -•-•••-------- Showers — Cafeteria ( ) Other fix er. ----------------------------------- W Design Flow............:.. .....................gallons per person pertday. Total dail pow__-____--_ :.E ........--......gallons. W Septic Tank—Liquid capacity Q..gallons Length...:19....... Width----A.... ... Diameter................ Depth... x Disposal Trench No. .................... Width--- .-_--••-- Total Length......... Total leaching area... sq. ft. Seepage Pit No ..._.I-__,____ Diameter ..I Depth below inlet.....jr . Total leaching area. sq. ft. Z Other Distribution box (. ) Dosing tank ( ) Percolation Test Results Performed by: -/.iPW .. �✓_ : I l/'1� Date........ Test Pit No. 1................minutes per inch Depth of Test Pit __.. Depth to ground water ... --------- ---- fs, Test Pit No. 2................minutes per inch Depth of Test Pit 1:-•a-_.. Depth to ground water;f 10.: Y-7j ,Q a .........-•-- O Description of Soil....... v .:. t r.j" r( ......_ _ _: x U •-------------------------------------•-----------.----------------------.----•---•,----------- - W UNature 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 TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianca has been ls§ued by the board,of health Signed........ ----------- Application Ap oved B --- -•-----••---•-••-••-••--••----•.....--- Date Application Disappr r the following reasons:_-----------•----------------•-----------------------•------•---------------....-•--••-•---•--•-•---•-•------- -------------•------•-•---...-------------------••---..............................-•-•--... ....... Date PermitNo......................................................... Issued....................................................... Date .j THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r a ! !!I.....OF.......�'i� ....ag""° " " ... R .- �...... , Tntifiratr of Tompliaana THIS IS TOT CERTIFY, That tthe-Individual Sewage Disposal System constructed - or Repaired ( ) by .... - ............................ .............................................. at. I � : . _.. +'�!fk..__--11�s - -- `-- ------ .: __ .... has been installed in accordance with the provisions of TIT F 5 e State Sanitary C s es ribeedd-in the application for Disposal Works_Construction Permit No.... .. '........................... dated_...____. ........................ THE ISSUANCE OF THIS' ERTIFICATE SHAL NOT BE CONST UE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTI N SAT FACTORY. . DATE.....-----•................. .. ............................ -•-• Inspector.....--_......-•----..... ..................................................... THE COMMONWEALTH OF MASSACHUSETTS x BOARD. OF HEALTH ,w Il ..'... �'f •-~ .. . ....OF..... ... .�'a� - FEE........................ Disposal urki Tung�� iurcRrmitPermission is hereby granted...___.. ,. ..._. '2 .... Vl..,__ °. �. to Construct 411 or�Repair ( )) anf Individual Sewage Disposal System ell Street as shown on the appl•ca.tio r Disposal Works Construction Permit Nq ............ Dated...........................:.............. .................... ........ „_ ............................................................ Board of Health DATE..----. ••• .•----•--•................................................. FORM 1255r A.;?31?A'` SULKIN, INC.. BOSTON ' Qi:4 ". ELgV= 5 2'Yo LL,E\/• - _i:7 __�7 I � �i - a�� E�f�B. gNc► r.— M/A3 A✓2 F M E c.a P SEA L.P L 7o - - �— + .5 U������ -r PIV--14 AL.L L►dES A MIkI,MU"A OF %/e,"/1 ClC7T _2' - I 07, A,L.L- 'P'1PfcS TO Awl> Oki`SJ 0 ® ALL- S6P 11C T�r5, v,�r2,��rr�4.� Box, A►�U n! l.,E�C►-1,.JE, Pfc'�, S+-�aLL �?E �EStiG�..JEO F=c�f�. -- _ �l a © o J Q; N 2a • -~ � �.'Er••�to.iE Au_. UrJSLJ+rA3�.E MATE,21At- UE►JE•>TLI 7 Z � -- s O 00 C) Q' ® D - THE ,►��lE.s�r ELE✓AT,o.JS of L EtaCH,.JE� PrTS F'-o� - i .�� ._ _ h A �a0S of Ador��LL ITN C�a.y FG1E F/A/ -�- -'�- -- �T t E o a o c Co ��11 f^� �1SA.JO ► .�D C�2Aa,1E� C i o lJ C) I to > NCSTI C-:,FE W NE_&j T+4 '5y ITEM iS N EAK CC-Mr�E-T-ioaJ A.,,o PQ,o2 To C5, ,C-41 STET- . o Go C) (0 0". 0 IQ�GC92 Gn.JL w'rsl-+ -T I T l_E _T� G F= T�+� I c 7\/PIC4L DIST2lbJ-F10 J Pox- i o 0 0 C TOTE _ � � '►J�T T® SC A L_ l� -r..- - a 1clN 1 G t� M�i A 0►t`/' i ,yy T✓,trL,�llT,n.� 13[Dr, v..la I x�c ��ot_ W-, .��y >:� C�^d- �ep-e r..1� C SAGM I�1Ca el Q�,�VAT/OAl/ 0/T5 >I�i.:Foer .v ���►T ,c zr. ,uc ey arEe,C.?�,J Pe�cr.sr CAZ 64:4L)Al. 4.-,W�Wz,* //7c/1 i.,i,s►1 e.��cr��c �uE�vEa vs, ""..--- _.. ,.:... , Qt Wa'rH - � OTI�-A.GC,�'y9 �Li�W,�„iL4 tr OBSE c'Y/IT/Oisl5 6y' �c>r!d�1 _7�4C lkf. f�E,9L r!/ AGENT 24 - `,!l" �MeenOED s L ebr�s ,.J �• - . _ - Sev-nc rrMc ar+ - . •_. BO,•ALl� QF .9LT/ t,o•TTcr�1. c4otx. it, 4000 r%a. -Tp-�T - p��,LT OF TO ,�Rktc r4 'roe rao#4DATrbw� �EL�Val F��,5►+ cr? s ��. a p1,hL15�1 QitADf r t►Jr'Sw+ G��.tX F 1"154 6,e�► o+r cv>c7L FmUS i GCA.tE• W 6 R TAJ-4 r[. tw,Efr`C3' x I Banc r+•�rG ... 1�•GKFIt_a. ? 9 0 00 0) et,►1 Fa[tC+D cn."K• D1ST a. e* Q ® O ® �,��•gxt LEAc'1�1_3�, cjEP(IC p 6 K t ("') ? ' S TYP1C?�.L �EwwtsE SV'ST>EM PptTFrtrE " _� ELF-ACl•11NG ►�rT T C: 1A/l S� MAP SECTION P,gRCEI✓ O T ADDRESS 5o ►'r- j' GEC Ertl1� PA EL LOCATION PESfGI'V C�/9-Eels gp Kati �7er9R�av �.aowTd6K. ,�.a'�_ - Al(IM A4f� pF �FE.r�.¢Gk�MS �_• �•�16 �Xl'9T �+OGt�E�Y �'� = ROntt{T S(E MGE PISPOSAI SYSTEM wq,,� 'to r �E,�f0/✓S /�fsC QfOE00M •! ` " RAY fv10ND F•..,+ o l � j � "ir/j�. ;� J P��PClXrllhx� � ,'Va. 8� c€,ILLr�t/S A - /+��I�/Ib116 IeFrQr'/�1�� _ IJOJd°.C. 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