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HomeMy WebLinkAbout0045 CHESAPEAKE BAY AVENUE - Health �A_ �6 Chesapeake Bay Ave -- 1 arstons Mills A= 098 —004 - 004 0 o a, > i O S d L m Qj 04� (U O d Y N u d D-240 d d d S d a� -N L) O) o6 N > O +' @I� O)U ai, L a, -P a, a, L LO Ln u rn LO d- o 4 L 3 1 D-242 iw��4 9� Z a o m > I I }0 2 � u M 1 o D-24 N £ ape OPer IA hol A A 01 N q h � A OL •_ pp peer }O. Pq PER C5 ° O or, cn a E o Wlih"� Fr moo/ £ i a ,�� e A�ar9 O p Sit( >, iv F d d I I A �n al D o M .4 * Cl)Lr) M4 I I o co in CO E H y 4 Q ON p . 1 Sir` I O CU o o � o d4 HQFM*� N � � � LA L ° CUSTOMER SIGNATURE DATE o Q X 3 �O a/ d 3 LL 3 O �, > 0 > ¢ i O� NI� U � i m 9 Q 4' PaN d w i�� 0) o S -C Q U aJ d g 3 i N d d ."� Ce d 0) LA i O 06 N > L u 0) 0V- o d Qj I U N p I In 3 I I '1 (4 N C Li z 00 U i 3 N E: � 4 2 .2 L d u Ln I f7 u (A A A V) w rn 0) h eh g 0 d d o � o i er7 SoU�,ed>, OP f'�ea �,.',� PER W;ae for, 5;�� 4 y�� oir ca a � Ado Da E a_ (4 ��o_ h9 Ph �a<< 0 ont C i9h� t T z WQ<< 4b�e o�g R ► wre, �o v o v L n m SIt[ Al Ivey �, o M -0 IdE -n- I I .Q � � ooLn -Q <rO � 0 c1l a S � I 0 00 co C5 d O to L (l1 CUSTOMER SIGNATURE DATE o 4 N d 3 "0 Ton, am . .� m cl-I : a Eb �OA('� � ;� ��TOWN OF BARNSTABLE � LOCATION Z SEWAGE# � ®0 D VI AGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. &/L,L/�1�77 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ,`�l 61 ��' (size) NO.OF BEDROOMS OWNER Tf � PERMIT DATE: COMPLIANCE DATE: p 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 5 FURNISHED BY 3�2- -.,,Q 5, A -3 r--3 1 13 I q�l i oc 9 (4q No. >)-7 Q717 J FEE owl�MONWLAITH OF MASSACHUSETTS Board of Health, ,in StC b le. , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application? pplication r a Permit to Construct(l� IQC Repair( ) Upgrade( ) Abandon( ) - omplete System ❑Individual Components Loc ' QS QQ, Owner's Name /Qil() �11 Map/Parcel# q e)- q , DD /rnAddress Lot# 3 Telephone# Installer's Name2. Designer's Name eyrC4, l Address Address �lt � t-�/ fiEll O Telephone# ` Telephone# Cam' Q Type of Building l.��� Lot Size 8/too-1 sq.ft. 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 Design flow provided gpd Plan: Date i �� Number of sheets �1 Re ' ion Date a©0 1 Title �2lCJI.IJ Q L ' C + Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator R . Fe v�reL" Date of Evaluation do 3 1 [1JO2— 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 t not to lace tem-in operation until a Certificate of Compliance has been issued by the Board of Health. Signed ate Inspections 'R *' ��• �`�4 ' './..� si�/ 4'C� No. b 7 O7V ! t � EEVII J� t FEE kt� �`J sj Board of Health, rn1 C'( e, MA. " APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application fpr a Permit to Construct(y*Repair( ) Upgrade( ) Abandon( ) - aTomplete System 0 Individual Components �oc ' n e-hes c.oec B e,,, Owner's Name M -bevelup m e_tl Map/Parcel# "1 g- UD y Address Lot# 3 Telephone# Installer's Name r) Designer's Name' eyyeLrc, Associates Address Address 1 kD, � Wof a Ste_ a Fa I INOUTI Telephone# Telephone# r I Q Type of Building LV1 Cd 1 e -Fa- YVIma.L,.l�1t Lot Size 58/ sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( );4Cafeteria ( ) Other Fixtures s Design Flow (min. tmin.required) o gpd Calculated design flow Design flow provided gpd `��}Plan: Date i�l �-\1/ �'! ��� t Number off sheets Rev' ion Date Fe b,r., aQ� TtleS_Ql�)Ot�lQ 'D1sooSQJ Sld� IerV� p1 1� In\fe b(�M(� )r �EyPIl7�`y�P�4, F Decription of Soil(s) �2_Q Q_►n n `� r7 Soil Evaluator Form No. Name of Soil Evaluator R . �e�2.lYG Date of Evaluation�Cl.ln �) . �DoZ DESCRIPTION Of—REPAIRS OR ALTERATIONS r 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 to place tlfee—system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date 13 011 Inspections 4 , No. c�� - v-70 FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, q.,,If 466 , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) Xcomplete System The.undersigned her by ce tify that the ewag, Dis ssalSystem; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: _ �� r l'?� at7'"C�'r c(y I(,� h�� i GI i o — b 0 1'1 1 - has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) an t e approved design plans/as-built plans relating to application No.�Gt�'7 �f17 D, dated 21?R/d'7 Approved Design Flow (gpd) y �v�✓au.�� IVo 1 �>'hJIO��, Installer A i j v V)/ Designer: Inspector. //l I IWWA Bate: 1 m I The issuance of this permit shall not be construed as a guarantee that the s tem will function as designed. No. 10 2 ,y 70 FEE 1�) — COMMONWEALT14 ®F MASSAC14USETTS Board of Health, R�/p MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby grantedto; Construct Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at C 11-I-a-,4-, tS-L,4, &f/I O V_—�J V— 6 V as described in the application for Disposal System Construction Permit No. :�c,t) '7-o 7J, dated Provided: Construction shall be completed within three years of the date oft)ispermit. 1 local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Z� (Jl� Board of Hea ��.� !�%T 71 ow►ii of:Barnstable egulatory Services homas F.Geiter,Director � * 1 NAM Public Health Division omas McKean;Director 200 Main Street,Hyannis,MA 02601 Office:•50"62-4644 Fax; 508-790-6304 installer Designer Certification Form Date! Sewage Permi t# n6;Z�Assessor's MapiParceltgL Designer: F .,�.a Installer. J'1119/t7 2�;JIn1A<A Address: /�'iA �o..c:,, Address: 44 � , S J- X'f On D was issued a permit to install a ( ) (installer) septic system at.ZP based on a design drawn by (ad dim) ) dated .--e,,9 jw5 �' isEo j�pg 2Q�? (designer) 41- I certify that the septic system referenced above was installed substantially according to the design, which may ini lode minor approved changes such as lateral relocation of the distribution box and/or mptic tank Stripout (if required) was inspected and the soils were found satisfactory- I certify that the septic systern referenced above was installed with-major changes (i.e. greater than 10' lateral rel Dcati4of the SAS or any vertical relocation of any component of the septic system)but'i acc rdance with State&Local Regulations. Plan revision or certified as-built by desi er to follow. Stripout(if required)was inspected and the soils were found satisfactwry. (Instal er s igna WCHAW FERWRA I - _ -s (Designers Signahtre) , is Stamp Here) i PLEASE TO BARNA -PUBLIC HEALTH DIVISION. CERTIFICATE OF COAiPLIANCE WILL NOT E ISSUED UNTIL BOTH THIS :FORM AND AS- BUILT CARD ARE RECEIVED B THE BARI��STABLE I�UBLIC HEALTH DI`V_IS1012 . PRANK YOU i j 'd ZZOZOi�StOS eaiaijaj paeyaia d6S=i0 La so unr i � • t ' S 8'- o� 22'- o• B- N C—QFQEr.Glt 4- 1 1 —71 Q i I .. -- — — --- o.rS--aoa*L;. -- ------ -- —�--- ------ — -- ------ — — — -- --- — — — — .t -_>���'Cd_•_:_CnN'G.tC�_�c[Ai.:LS —.- — .__I ! -��:- 1 I ...(b---I-— - ( l d L ► J I l E j ;J :.0"EAYA-Pc�G1Cf.T.:EAGH_'.IrNCS-......_.... ..:... __ cZ'•+_..�:E-dH .::C-OLa�itii.if:--- ...... ._ C SLAG E .. ..� i _ O U -7U "-n�rr-crrr�+--n{'y—n-rs-�n-fi►.::fj=_->--_-__ _ ! _ i�. I � � `I- - j ! 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I � i it 4; .� j j I + r I : _ � .i i ► . 1 �� �� I - _ � f t c - - - -- lb _ -t_Li3.F'TeTL--t':�/ar► zyfo:�-:1r+_..lZ.�t2 �tTc.Ft_..-._.. . _ _ - - _------ . _..._....__....._...---.. ..... _IY.:B' FA:SCaA: $ tt,,> . 1�4.._.i:o wrrwwmor. '. 22-p•' . ( =2pFTe1z :PL-Ate'. .._.: : overt: Sec:o...n_'f`-L-oorc-;::c:ml L-I ., ..'F x.,d- z • 8 0�-8 � a SYSTEM PROFILE �Q 0 NOTES." NOT TO SCALE 1. ELE0ATIONSBASED ONM.S.L. F/N/SHG'QaoE 2. FLOODZONE C'KNON-HAZARDS �- soo' 601, OtE9FINISI GRADE 3. TOWN WATER ON S/TE ^': i Oi�ER TANK OILER T OCHES 60 0' 0U7E TOPFND. LOCUS Q� O�/\�� SCH40PVC TEES '� J\ = L 58.00' 57.40' -57 `r2 Qo O �Q 57.77' qo � of 57.52' 15W GAL. 5724' SOUTH O SSMTFLR REINFORCED EQUALIZERS Co 5, µ I CONCRETE ': GAS DIST. BOX O� BAFFLE PRECASTL C 110 CHA.4fBERS 2� � L OVERA E .� .s :�_` TOBE/NSTALLEDONA / uu (LOT 3-58,609 S.F.) { :., r LEVEL STABLEBASE OTRENCH LENGTH EXISTING FOUNDATION-2025 S.F. =3.5% SEPT/C TANA' 3011-0" L OCA //O!Y MAP TO BEINSTALLED ONA 5'tif/N H00117 TOTAL EXISTING COVERAGE-3.5% LEVEL STABLEBASE ABOMEADIVSrED GROUND WATER SOIL AND PERCOLATIONDATA PERC" RATE <5 M/N/7N LOT 7 TAKENBY R/CHARD FERRE/RA W/TNESSEOBY OAMESTANTON - 50301 BARNSTABLEBOARO OFHEAL TH 159.93 N36°10'08"E DATE ✓ANUARY31, 2002 .49 TESTP/TELEV WR/ES 29.5' f 31,1' 170.07 F rESTHOLE 1 ELEV. 60 f rESTHOLE2 ELEV 60.2 W I 33.61 J 0" 01" 29,5' ►�� I r' y __ O/A - SANDYLOAti 10YR� O/A - SANDYLOAM IOYR313 114.87 B" Lu Lu 61" B B \ I^ o W LOT 3 j, ` I SANDYL OAAf 10YR 5/6 S4NDYLOA6f f0YR5.6 EXISTING GARAGE proposed O >- h e. " N W } I Zp6s "°� , R=34.42 3s"FOUNDATION FOUNDATION drive uj N I58,609 S.F. O vI co I N L=54.87 SAW 25Y5/6 v v- C1 Y.F01 -COARSESA ND47,4' 376' SAND 2.5Y&F 40 °o GRXVEL Z ``\ to p r ,� (o APED/UiNSAND-COBBLES 1500 gal _O SAW 2.5Y6V . I \ N I CA C2 sophc tank O O 26.8' \ �� 13.0' � 60" MED/UM � SAND-COBBLES 58.1' d-box `rW. 248' \ y. W I 10 1b GR4VE1 I 4 C22 84" 4' o 0 0 o 0 4' `1' 1 67,6, 4' N N '39,46�W i °�a`3 SAND 2.5Y6/4 �� to S�5 0 proposed leaching trench 38' ��`4 a I Uj / , $6 41 OO �Q`3 CLEANiLfEDU/iL1 SAND SANG C32.5Yfi/4 with(5)LC 110leaching I T CLEANA1EDU/MSANO \ chambersall with 'stone Reserve Area ?, �"° I G��e$EMEN I MINA 6 S.F.` 120" >aa" X �4`\29�5 13.8' 1 l to D 3$5 / f t/'�►K ¢ NOGROUNOWATER .00 134.93 \ 25.00 -- "--- I� ,1�188 `r"` MICHAELJ. ---, 170.00 S34°38'03"W .162 gp �' �oRSEui DESIGNDATA 329.93 `� R" / u CIVIL N - -� - _ d No 35854 NO. OFBEOROOMS_4 BENCH MARK le t) r- �v '��Q DISPOSAL NO top of hydrant CHESAPEAKE BAY (40.00 WIDE) AVENUE �`�� elev.63.18 EST. TOTAL DA/L YEFFLf/ENT 440 GALS. SEPTIC TANK >5OO GAL. NOTE.•DO NOTRIIIVIIEAVYEQU/PMENT 0!/ER SYSTEiL1 GENERAL NOTES • - 190. S.F. SIDEWALL AREA .7W GALS/SF 145 GALS. NUMBER OF TRENCHES 1 >. ALL SYSTEMCOMPONENTS SHALL BE/NSTALLED IN 4'f S.F. BOTTOMAREA .74' GALS/SF 909 GALS LEACHING CLAMBERS SECTION. ACCORDANCEW/THT/TLE50FTHESTATESAN/TARYCODE NOT M SCALE NUMBER OF CRAM, ERS 5 614 S•F TOTAL AREA 4 674 GALS. L7ATE0 MgRCH 1995AN0ANYt OCAL RULESAPPL/CABLE 2. ANYCHAVGE/NTh'/SPLANMUSTBEAPPROI/ED " '"---- -� BYTHEBOARDOFHEALTHANDFERREIRAASSOC. FORFrNrsvcMoE 3. kWENCONSTRIICTlON/SCOrL1PLETED, PR/ORTOBACKFILL/NG SEESYSTFMPF{t�F/LE ,mNr-fps-frr LEGEND NOT/FYFERREIRAASSOC/.4TESFORINSPECT/ON A wASHEosravE FND. ELEI/. MUSTBECIIECAED WHENCOLIPLETEO (fr oW) / - THESEELEt%/L!C/STNOTBEChrANGED WITHOUT REt//SED. "AY9 2007Sf/OIWY/NGEX/ST/NG ,. .:. .. .;:. :. ,.._ .. :. .. EBOARD OFHEW THAPPROVAL OCATED SEPTIC - -so'_ Exrsr. G�urvoELEv. FOUNDAT/ON, RSEPTIC SYS TEMS 6. ARD OFHEAL THINSPECT/ONREOD WHENEXC4114 M0 4'OLQ PIPE O F l FINISH GROU'vo EL EV. REVISED. FEB. 2 2007RELOCATED HO,YS1=GARAGE NA7Z RAL SO/L (` a a a r EFFEcrrlvE 5B 00' P/PE/N1�ERTELEV. ` L7EPTN 7FSTPITLOCA71ON SEWAGE DISPOSAL SYSTEM PLAN Yd'-f fit• WASh'ED STONE C7 NK E,�EcraErs'onv PREPARED FOR IXL�ALL >1'-�- D. DEI/EL OPMEN T CORP. 000 sEPricrl S o D/S>R,BV�ONBOX M.A LOT 3 CHESAPEAKE BA Y A VENUE AREA PLAN r°� �N BA RNS TA BL E - MA SS. PROPEWYL/NES RtCNARD c, FERREJRae _ 'en- IND,31.109 , , ES7GNED.• SAP DA lE: MA Y 9, 20a5 FERREYRA ASSOCIA TES , BRAWN.• MVB SCALE: 1" _ 30# 161A WgR6rS7E7? COURT 98 MAP SEC PCL LOT HSE" ` ' CHECKED. GS DWG NAME CADD FALMOUTH - MASS 02540 00