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Home My WebLink About0080 LIBERTY LANE - Health 80 LIBERTY`,LANE., MAR STONS MILLS. P' A=124.004-009 l ,'No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD O OARDO F. HEALTH -' OF �M� APPLICATION FOR"ISPOSAL SYSTEM CO TRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade. ( ) Abandon ( ) Complete System ❑Individual Components oc ition Owner's Na e c� ►F, i�f� e- i�� ' Map/Parcel# Address Lot# ,, i h Tel hone# e � D Installer's Name Designer's Ime Address � -Address Telephone# Telephone# Type of Building: Lot Size ,( ,0 C Ce.Q S -€eet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow min.re u' ed) c- gpd Calculated design flow pd Design flow provided gpd Plan: Date i " 0 Number of sheets l Revision Date Title D `! AA D � t I � y n 0(4 1 L� Soil Evaluator Form No. Name of Soil Evaluator`%->< Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed ,gL iq 99 FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 i o THE COMMONWEALTH OF MASSACHUSETTS Fee D BOARD OF HEALTH . ' _ o ...:- O)F frYr" t y. APPLICATION FOR " ISPOSAL SYSTEM CON. TRUCTION PERMIT truct Applicafibn for a Permit to Cons ( Repair ( ) Upgrade ( ) Abandon ( ) - Complete System,,E Individual Components RD , Lt La yl 1 144-47 bsq a�u g) -I�JS4- )cation Owner's Name Map/Parcel# Address Lot# Tele hone# +� a Installer's Name Designer's me k i ca — Address ddress , Telephone# Telephone# y Type of Building: Lot Size ,(a0 �CJtiQiS�-feet. Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria-( ) Other fixtures Design Flow min.re u' ed) gpd' Calculated design flow pd Design flow provided gpd Plan: ate - �- Number of sheets Revision Date Title 1 r A_ y I ! _, ..,f Soil(s)�7 t � a 11 r�3(u , 56Lk lo4 " cLs"rULJ-Descriptiol Soil Evaluator Form No. Name of Soil Evaluator`?Sao cr,t rr Date of Evaluation � t 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 not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed (J� at" 99/ e FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 At No. ' THE COMMONWEALTH OF MASSACHUSETTS FEE CND f BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) I� omplete System h � t The undersigned hereby certify that the Sewage Disposal System;Constructed( Repaired( ),Upgraded( ),Abandoned( ) at qo has been installed in accordance with the provisions of 10 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. -�. dated (p " Z �- 1. proved Desi: Flow_ (gpd) Installer � � PS Designer: Inspector �r f - /�Dae The issuance of this certificate shall not be construed as a guarantee that t e ystem`ill function as designed. 1 � FORM 3 - CERTIFICATE OF COMPLIANCE - DEP APPROV//E?D FORM 5/96 # L ----°--_—_—_-----_ ------ ------_- ----- -----------�---------- � r— No. I THE COMMONWEALTH OF MASSACHUSETTS FEE _Ja�� Ns4-dole BOARD OF HEALTH DISPOSAL SYSTEM�- ONSTRUCTION PERMIT Permission is hereby ranted to Construct ( epair ( ) U grade ) Abdo/n ( ) an individual sewage disposal system at 6-e� �lo Gt c.�11. J _J /�,� -as describe sdescribed in the application for Disposal System Construction Permit No. -��O / dated `2l' Provided: Construction shall be co leted within three years of the date of this pe it. ll local co, drtion7mu Abe et Date ' Z� Board of Health tA_ - -FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARRENTM PUBLISHERS- BOSTON t TOWN OF BARNSTABLE � LOCATION �s C�, t—A`t SEWAGE# .000 VILLAGE -'% I GL rS4�03 /44 + S ASSESSOR'S MAP &LO INSTALLER'S NAME&PHONE NO. e>ii 4' r=h d4dVa".a SEPTIC TANK CAPACITY �?)� LEACHING FACILITY: (type) �.t�C 7_ (size) ,NO.OF BEDROOMS BUILDER OR OWNER d PERMTTDATE: T?4 9--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 I, L� � �} � I � 2��2.6_ �' z � � o o' 3 �' �� y � � - �� ' ��. TOWN OF BARNSTABLE j LOCATION,�^ �- I—A SEWAGE # ,�'VILLAGE /0.t-S40 M, ASSESSOR'S MAP &LO II INSTALLER'S NAME&PHONE NO. rat SEPTIC TANK CAPACITY LEACHING FACII.rIY: (size) NO.OF BEDROOMS BUILDER OR OWNER �• - ' PERMITDATE: /r2 — ??�� 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 i . rL .. - Town of Barnstable P# AqEc-.(- Department of Health,Safety,and Environmental Services ` Public Health Division Date 367 Main Street,Hyannis MA 02601 BAMSTABM Date Scheduled \Z �q Time I,0o Fee Pd. BOO 0O Soil Suitability Assessment for Sewage Disposal Performed By`�}t—? (A �la-V Vil U I,L..i/1 Witnessed By. dlti iYLA-- , LOCATION &`GENERAL INFORMATION Location Address g� (�1' �, y Owner's Name V N1 W� y tu,t Address Assessor's Map/Parcel: �Z�` 66+0C)"1 Engineer's Name NEW CONSTRUCTION REPAIR Telephone N �— Land Use r Slopes(%) Surface Stones Distances from: Open Water Body ;) I7� ft Possible Wet Area R Drinking Water Well R Drainage Way It Property Line It Other ft 1 SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ``q Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: f Weeping from Pit Face Estimated Seasonal High Groundwater bCTI NAT.ICI1 '( rt SEASONAL UGH WA'I'ER'I't1T�E Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST pate Time Observation Hole# z Time at 9" Depth of Perc 3 1 . Time at 6" Start Pre-soak Time @ 1 V l J Time(9"-6") a End Pre-soak r l 3 Rate Min./inch 2 G Site Suitability Assessment: Site Passed_V�' Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant A 1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° D`�- 364 lZo DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil"Texture Soil Color Soil Other Surface(in.) (USDA) (Munscl!) - Mottling , (Structure.Stones,Boulderes. Consistency,° Gravel) DEEP OBSERYVATION MOLE LOG ]H ie# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°o Gravel) ' i DEEP OBSERVATION VOLE LC�G Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o ravel Flood Insurance Rate Map: / Above 500 year flood boundary No_ Yes `✓ Within 500 year boundary No Yes v Within 100 year flood boundary No_ Yes ✓ 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? If not, what is the depth of naturally occurring pervious material? I Certification 1 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 15.0,17. Signature �G*w_r�l Date 41a .ram I� Up :c BATH 4'-2 1/4' 22'-3' 10'-2 3/4' j UTILITY !� Jj 2� DEN _ - O 3 ,I ECTOFl yf t WET BAR r 5QH _ ..._... UNFINISHED Q PLAYROOM ` UTILITY n LLI _ Z Z UP Q J IT-2' 3'-10' IL 2f I Al m O A co Q 14'-0' 36'-0' SWEET 1 OF 2 BASEMENT PLAN SCALE: 114" 1'-0" . i JOB: 0615 DRAWN BY KW DATE: 11/26/07 �i -'i— ..... ...r..:................. ... u- CIRID D. M. BATH BATH BEDROOM ro - -------- ----- --- � = U li S U L - ------------ -------- - BALCONY ^:- STORAGE MASTER BEDROOM ` \1. BEDROOM #3 ` BELOW EXISTING SECOND FLOOR SCALE: 1/4" 1'-0" f 62'—O° ....... .. . 00 . ..... .. ..........:...::...:.:.: :::...:. ® ® OO BA Q W � Z » KITCHEN DINING J J � 2 GARAGE W Z � Q FAMILY LI IN UP SWEET 2 OF 2 EXIS ING FIRST FLOOR[[],- 26'—O° 14'—p'' 8'_p• i4'—O" SCALE: 114" a 1'-0" Ji J08: —p° DRAWN BY: KW DATE: I I/26/07 SYSTEM PROFILE NOT TO S:-ALE" d TOP FDN. FINISH GRADE . 7 y, o FINISH GRADE OVER EL. . E y .�- FINISH GRADE OVER • .a..o •;' FINISH GRADE OVER w7IST. BOX • SEPTIC TANK �''y LEACHING TRENCH p 'o•p a. o:4.,0 4 •e .v'•,' d FIISEt S TO 12" BELOW MUDE - 'V•'Q' ..'. 'y :.9•C• '!" V:'.b ••p' V' .D..Q: .o .p,.'°.'p' 'p:'. ♦ .OQ o:o,0 : TOTAL TRENCH LENGTH = �•, OUTLET PIPE LEVEL 3 �► s• af= 1/B•-1/2" o. ° FOR 2 FT. MIN. DOUBLE WASHED PEASTONE j V 0. .4 . . . . . . . . . . . . '• ' 72,8 S ..o •,A'• .4• 7Z. •7 2'G! •.°u•:o:••e:•a.e. o °•.:'o. '° 4 Z. 7/. 3 7 �7Z CAP END INLETS CAP EN A '" C. I. OR PVC TEES—/ 24~ �/!p M9 �j 4S .3.� L'�/c_ T4,70 7/, 3/4" - 1-1/2" DOUBLE WASHED .o. . . BSMT. FLR.. c:'o"a: ° o GALLON CRUSHED STONE e,'. . 10-- DI.3 TRIBU TION BOX EL GS•c� o'° ' o *° PRECAST CONCRETE Iivs TA L ON LEVEL BA SE 0. ° ° •Q TRENCH SIDE SECTION O a H- / O REINFORCED pR J a,./ r o.Q,a`p •op.o':o o. q•a 'q:o a a '.4:a'•'U:'y:4 0: 'v•:o•'� "o e•'a' d..O•p..�.e':C.:°'A;;O:A.'.4 e'b'.0.0 .O•Q'.:°,'0:4', O O. 1D:'+b' o::0 TRENCH END SEC TION sy SEPTIC TANK INSTAL L ON LEVEL BASE NOTE.• ' EXCA VA TE- TO EL EV V. >t%1,� OR � � -•�'""'°" L OWER TO REMO VE AL L IMPERVIOUS ,f MA TERIAL BENEATH TH THE L EA CHING AREA 9' MIN.DIAM. 3" OF ! B"-1 2" / " / " 3 REPLACE -EXCA VA TED MA TERIAL WI TH DOUBLE WASHED � •' • DOUBLE WASHED o CLEAN, CLAY FREE SAND CRUSHED STONE ASTONE j ivr� 4Y r G N M G,q 7"ea GL i TRENCH WIDTH GENERAL NO TES 1. ALL ELEVA TIONS SHOWN ARE BASED ON ASSUMED 2. AL L PIPES IN TIE S YS TEM MUS T BE CAS T IRON s, 7 '..,._,,.� ._w...._.,,_.-•-- __..�.�,_. ..r....,�••--`..�' � ,�^°'�� ' � � R SCHEDULE 40 PVC. O OBSER VA TION PIT 4 3 ° 3. THE BOARD OF HEAL TH MUS T BE NO TIFIED WHEN CONSTPJCT TON IS COMPLETE PRIOR PERCOLA TION RATE.' ��,,„.,� •��'� . " TO BA CKFIL L ING <2 MIN./IN� , l � �, � f�- 4. ANY CHANGES IN, THIS PLAN MUST BE APPROVED /yl'TNESSED BY* + ti ��"�' �.�..... . BY THE BOARD Or HEAL TH AND CAPE 6 ISLANDS o . � ENGINEERING DONNA MIORANDI vrl MATERIALS AND INSTALLATION SHALL BE IN ?z_ I ^,'' COMPL IANCE WI TH THE S TA TE SANI TARY BARNSTABL�1RD. OF HEAL TH DESIGN DA TA . • "'' '" DA TE.' MAY 28, 1999 CODE - TITLE V - AND LOCAL APPLICABLE E NAr: i ✓�� es...'t N RULES AND REGULA TIONS NUMBER OF BEDROOMS 4 6. NORTH APRON IS FROM RECORD PLANS AND z Z s 4-r 3 �� o GARBAGE DISPOSAL NO IS NOT TO BE USED-FOR SOLAR PURPOSES C. vpf4Nr! y. — . zi 7. FLOOD HAZARD ZONE NON-HAZARD �zy .�-_��A��._-- !by'� � DAIL Y FL ON 4�?0 GAL` c� o . a S t w M,{ 8. WA TER SUPPL Y._ . TOWN WA TER a M..y s "^d SEP TIC TANK REG 'D. 1500 GAL . r °r2 SEPTIC TANK PROVIDED 1500 GAL . o �7y c LEA CHING REQUIRED 440 GPD. ,a f A��Gf IV P" .Set A44 SIDEWALL AREA 312 S.F. \ ld rR "+' 312S.F.X 0. 74G/S.F. - 230 GPD. N t �Lo ' \ ph p� BOTTOM AREA = 296 S.F. LEGEND 296 S.F.X 0 74G/S.F. = 219 GPD L EA CHING PRO VIDED s 449 GPD PROPOSED ELEVA TION F ——— —=EXISTING coNrouR SINGLE FA MIL Y RESIDENCE C ! ®d OBSE+RVA TION PIT � 1. ❑ 2 DISTRIBUTION BOX . .. PROPOSED SEWAGE DISPOSAL S YS TEM PLAN --- L('.ACHING TRENCH .T PREPARED FOR 0o .7y N 16'00•'0p�k, A• j { ' `_ / ,�� sf=Prrc TANK <� �F �� ' RESOURCES TRUST So HSE. NO. (LOT 3) LIBERTY LANE 1BERrY LANE \ 1-_--l RESERVE AREA MAPS TONS MIL L S — MASS. - M PIPE INVERT ELEVATION ' QAVID y Q CHARLES � DA TE.':✓v. .L 17_ 099`� Top p,�' GB SAN!CKI CAPE G ISLANDS ENGINEERING SCALE.' A S NOTED` PLOT PLAN ,Zy _9 � �,o � 2�oa � 800 FALMOUTH ROAD SUITE 301 SCALE: 1 "= 30 PLAN NO MASHPEE, MASS. � N: MAP SEC PCL LOT HSE Qi LA _s ,