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HomeMy WebLinkAbout0042 PRINCE AVENUE - Health 42 Prince Ave h u o Marstons Mills A= 077-042 No. 7 '' 4 Fee Z00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for his osaY 6pstem Construction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. Ow"�nfer's Name,Address,and Tel.No. Assessor's Map/Parcel '771 V.2, Y�z ..-e ,yjG/ f fvH r /fills i✓/,g a2Gy Islaller''s Name, 7 e,Address,and Tel.No Sobs a`�`�- 74 2 Dee/$igner's Name,,Address,and Tel.No. J. A4 //J-7 4 16 1,9002 S� !/d! r�7o✓/ter /r/J Oo?ly 73 pe of Building: " + S��y w�y Dwelling No.of Bedrooms �j e Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) 1 Other Fixtures 4 Design Flow(min.required) 330 gpd Design flow provided 3 6 a G gpd r_ j t, Plan Date I g'zoj0 Number of sheets Revision Date Title Size of Septic Tank � P aC�J `n�l d d G.lwd� Type of S.A.S. In ru f t U-( r Description of Soil -f91M 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 ea h. SigK N Date "7 "- A lication Approved b , _ 5 Application pp y Date Application Disapproved by Date for the following reasons Permit No. 6 1 — Date Issued 9- c-o s /,,U _ No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTSt '"Yes application for B18 DBat6pBtrin (Construction i3ertnit Application for a Permit to Construct( ) Repair( ,Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No./' Owner's Name,Address,and Tel.No. Oi•II 702 ,vte ✓ �grS7r^r/ Assessor's Map/Parcel '7-7 y.2, `1�� /�. � ,p /�a�rf/H{/Ll A �/► O�Gy Installer's Name,Address,,,and Tel.No(6-0Z)a y`�- �7 71,E? De igner's N�+ame� dress,and Tel.No. ~� A e A4 /77 C'On i- / /�ov+4/� C pO(i�� G/S y7H -I1 f /VA a4 a s9 6�/ ✓�+a,•��,/�A O�G 73 pe of Building: } ' D ' Ord"Uml 4 5tvo�/ W/y C4 = �nGrftn�n, �C.j�in Dwelling No.of Bedrooms 'jj Y, Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other FixturesY Design Flow(min.required) 33 0 gpd Design flow provided 36u & gpd 00 t Plan Date I I ' t$`Z o(� Number of sheets Revision Date I� % Title ; Size of Septic Tank - rJ '/Uu d q,//ve7 Type of S.A.S. (2& -14r- f 4-rr,.,c�tr /d- 4;r4m / fv�/T0 Description of Soil Nature of Repairs or Alterations(Answer when applicable) .Se_ p�Q 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 ea th. ty Sign L- , "✓ Date' Application Approved by Date Application Disapproved by Date b for the following reasons Permit No. a G (( — 3 Date Issued --------- ------------------------------- ---------------------------------------------------------- --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) u�r Abandoned( )by ,{`(� (i f�- C crr�Try C at qg- pk I. Gy C•.e- Aq /;?4 'has been constructed in accordance r with the provisions of Title 55 and the for Disposal System Construction Permit No. 6 / d 3ydated Installer )OA n Designer #bedrooms 3 Approved design flo 3 0 and The issuance of this perm't shall not be construed as a guarantee that the system wi fun t•on as design d. a Date I I Inspector -------------------- ------------------------------------------------------------------------------------------------- --/------------- - No. Do I I - 3 t/ t Fee ' (QU— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction i3ermit Permission is hereby granted to Const ct( ) Repair( ) Upgrade( ) Abandon( ) System located at /Z//1/C e_ /V'" and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons uction ust be completed within three years of the date of this pe it. (� Date is Approved by o TOWN OF BARNSTABLE o a. LOCATION �oZ /Ors"n c e kVe- SEWAGE# 9 0l 1 " 03 n; VI LAGE ✓d«r ASSESSOR'S MAP&PARCEL 0771 oYA INSTALLER'S NAME&PHONE NO. j, C, �Gt �✓ SEPTIC TANK CAPACITY __/0001 LEACHING FACILITY:(type) (size) NO.OF BEDROOMS 3 OWNER e PERMIT DATE: -/S// COMPLIANCE DATE: /7 1 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 6 [a�.ti•�>yd7 Mai/�j �. Town of Barnstable °FTHE r Regulatory Services P� ti Thomas F. Geiler, Director BARNSTABLE. * Public Health Division �$ 163 prFnMA'�A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: a'!8- /( Sewage Permit# a 0//-03Y Assessor's Map/Parcel 77 Installer & Designer Certification Form Designer: Z ,CA D lL 9; PC. Installer: ML to 611,011 ON Address: Pig& Address: P•0.Soi339� Q Mars W=48 l�, YYl,4 ©2j6 On %S=/J C, A. A/0 was issued a permit to install a (date) (installer) septic system at Q 14ye based on a design drawn by (address) / dated %l`/8la y iD q,, (designer) �I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. 5 I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. S.tripout (if required) was inspected and the soils ti were found satisfactory. RONALD JAMES (Installer's Signature) CADILLAC t#1060 0 �' T AP�� (Designer's > ature) (Affix Deice tamp Here), PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\office fonns\designercertification foim.doc I i11 ... ac t 'I �• h JA !t , __ -- 'Ev f i VA I VVV I F: A _ I h 0 N _ 7 _ d Cast o�oerS r _ G xeA- Per�.TO — i LI L '• - 2 ��lb 0 rat + .S I + I , i 71, fit -- i' -� - } -- ---- - CA , v)OM yICQ �� Co sl of t C-+ `�t li I r� ti S• { ' . 3 r m P4 i Ka. - 4� 1' a TOWN OF BARNSTABLE •i LOCATION t P ye SEWAGE # d VILLAGE AA, ASSESSOR'S MAP & LOT INSTALLER'S NAME C PHONE NO. J4 A h SEPTIC TANK CAPACITY /00 U LEACHING FACILITY:(type)-1;,! 141 "r4?Or5 (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE / G BUILDER OR OWNER DATE PERMIT ISSUED: DATE COLiPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� i ,�. � d� �� '�. . n�� t ,, �y .�. �` � �� �,�� dl �� 0 a, ��;- `'`� ��ve oF� Town of Barnstable P#_ 13// Departinent of Regulatory Services • Public Health Division Date 1 i 200 Main Street,Hyannis MA 02601 Date Scheduled D (d Time Fee Pd. Soil Suitabili Assessment for Sew ge Disposal Performed By: C Witnessed BY: LOCATION& GENERAL INFORMATION 71=ationddress > Z r••JBU� /�v� Owner's Name �Fh'I/B��// v P74I/6 Address �Z _'/NG� � Assessor's Map/Parcel /�o�Z �fJt/S1�JN ��j / Engineer's Name / / OZ NEW CONSTRUCTION )1� J ®J�� REPAIR Telephone# �j 0 — 777<--0,; [Land Use , Slopes(%),` Z �O Surface Stones Distances from: Open Water Bod f! 7�L,, ! L j Y__ ft Possible Wet Area ft Drinking Water Well 19 Drainage Wayft Property Line _ I ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) J A6q N � Tp 1 (� To b I�oN Ply �Nd��,eld 17, Parent material(geologic) i4 � �/Wep Depth to Bedrock Depth to Groundwater. Standing Water in Hole: //Weeping from Pit Pace Estimated Seasonal High Groundwater Q4ie! G��GL/ �o —4 — i '� 7'C rout,�� i9�� fp Sfii�P.�7 DETEXMNATION FOR SEASONAL HIGH WATER TABLE Method Used Depth Observed standing in obs.hole: _ G �� �q.. �O`��u n��/'� ✓"�t',�9 Depth to weeping from side of obs.hole: �n, Dffpth to soil mottles: Index Well# In. Groundwater Adjustment ft. Reading Date: index Wetl levcl'-._;,�,,,�r, Adl.factor Adj.f3raundwater level , PERCOLATION TES Date II �' T Observation hna� � Hole# � - '" Time at h" Depth of Pero Time at 6" Start Pre-soak Time @ i Time(9"-6") End Pre-soak Rate Minllnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) 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:\SEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. on istencv,%Gravel) U- /D ii A .S 75 Yr 2 190 ID 7. ✓ 4 f?D 25%o &wve 2 ZDff C (o f2SF 2, 6 no r a v DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C nsis en %Gravel) 32 — 114h7�t4X411.1 -7,-5vjr- h 0 0a 6r"el 37-' 13Z C S 2 h Ave 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. t Consistency. 1 Flood Insurance Rate Man: Above 500 year flood boundary No— Yes 40-5c- Within 500 year boundary No_ Yes WitiJ ui 100 year flood boundary No— Yes /AJ ✓a� �/ Depth of Natitrally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed.for ti;e soil absorption system? If not,what is the depth of naturally occurring pervious material? Certificatio=.i I certify that on N (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 tra' ' expertise and exper' ce described in 310 CMR 15.017. Signature Date Z a Q:\.SEPTIC\I=ERCFORM.DOC ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE. JOB No. B-10-05 TEST HOLE 2 NOTES Sullivan7.dwg Zg 1. LOCUS IS A.M. 77, PARCEL 42. DEPTH, (inches) ELEV.(feet) 2 ELEVATIONS SHOWN ARE CLOSE TO NGVD! BASED UPON TOWN G.I.S. 0 0 20.0 3. LOCUS IS IN FLOOD ZONES C AND All(EIL.11) ON FIRM DATED AUGUST 19, 1985. ston A layer 7.5yr 2/2 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) sandy loam 5. MUNICIPAL WATER IS. AVAILABLE.. LOTS_ WITHIN 150' ARE ON TOWN WATER. �+ 'a 14" 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. s layer �.5yr 44/6 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14"_ _4'z loamy sand 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW rn a 207. gravel D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. 32 17.3 9, DEPTH OF COMPONENTS NOT TO EXCEED 3'., OR VENTING MUST BE PROVIDED,. NOT TO C layer 2.5yr 6/4 COVERS: BUILD UP COVERS TO 6" BELOW GRADE-ADD 1 ON TANK, 1 ON D-BOX, 2 ON LEACHING. SCALE CD poorse sand �, 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LOCATION MAP 25% gravel 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. 12. IF AN OVERDIG IS CALLED. FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING N jF IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). TEST HOLE 1 SEARS __ 13. PUMP AND FILL ANY EXISTING CESSPOOL,/LEACHPIT. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet) -� 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. _ 132" 9:II 0 A layer 7.5yr 2/2 19.7 BENCH MARK--TOP &-eEN M OF no water sandy loam GONC:' D=22:05 ASSIGNED SEMEN_--� BENCH MARK-TOP, BACK, CENTER SST HOLE DATE'. November 2, 2010 T ENTER ELECTRIC EA SEPTIC TANK=19.38 ASSIGNED PERFORMED BY: Ron Cadillac, Soil Evacuator 10" E- E WITNESSED BY: David W. Stanton, inspector B Iayer 7.5yr 4/6 _ PERC RATE: <2 -00 /inch (C layer) sandy loam I 22. 6 189't <D REAII OF STREAM) x 13 f 9.4 NO GRADE CHANGES SOIL SURVEY(1993): Carver loamy coarse sand 28" 20% gravel 17.4 x _- I ARE PROPOSED GEOLOGIC MAP(1986): Mashpee pitted plain deposits 20.3 �-- " --� m C layer 2.5 6 4 2 -L ---- -Pl,�----------i 20,5 A 20.27 � coarse sand / A-1 -}-S F._ r 22:1 Invert 18:10 10 HI-CAP INFILTRATORS 42"" 25% gravel ---y"'- ) Exist.Top Found. Use Gas Baffle z EXISTING SHELL _ - l x 21.9 ' Existing Invert 17.33 I , � Z Top:.,Units=]7.7 PARKING I ... ... 22,1 rProp7osed w ....................... x � a - Use Filter Cloth I o v `_ 21,7 11,1 S a), t-- _-_- -- -- 1--- __ x. r�l 3" Max. rn iv \N__ -V�1 I x 20,9�� p = / { _! W �� =.: N , � `H Existing � S-1�"/ftf S 1/4" ft Inspection Port ----- 20,6 �� Q 1000 Gal. I min. �/�\ ; p �ti ( "--- I ; EXISTING HOUSE *.* O i i Septic Tank N 0. 42 21,3 --------- .> x 1 8 1 ' 11 120" no 'water 9.7 x 20.8 : 22,05 I 16.33 --{ Invert,17.50 Invert 17.25 , :.......... ......:::::::::::. ::::::... ::::::. :. x 21.6 D r' .. Bottom ............... I'd .0 17- 6 Stone or compact Proposed Proposed 7.3 0.0 x 21.5 16 �© i i I i 4' i _ } F- x 20.4 x 15. 1 i _ Bottom TH2=9:0 b.3 EXISTING 0UTILITY .0 l p 9, < 4 2 51 + ab Q � '/� 2 ` �'0 7BUILDING x 16,2 y l ' I o 6.56 DE.S1.GN DATA `� LEAjCH AREA 22 G°-�ZG I :::: x 208 x 12.9 1 BEDROOMS 3 MIN. �SU MOOMM CERTIFICATION FOR GENERAL USE--REv -6/3Df10)- 16.0 TH v 2L2114 t GARBAGE GRINDER: No EXCAVATE TWO 2'-10" BY 31'-3" TRENCHS. USE 10 x ' 19.7 23-6" 0, .6 REQUIRED CAPACITY: 330 GPD HI-CAP H-20 INFILTRATORS, AS SHOWN. FILTER CLOTH IS I m ,10 _ T---, __1__ x 15.5 RECOMMENDED OVER UNITS.. BACKFILL. TO TOP OF UNITS I � 1�_J_-/-� o Co � EXISTING SEPTIC TANK. 1000 GAL.co RESERVE ____J 20. ,, WITH CLEAN SAND FROM A GRAVEL PIT, OR VIRGIN C LAYER --_ o -- k �, 2 EFFECTIVE TRENCH LEACHING AREA: 486.8 SIF 20.0 / 25` q, I 6,8 FROM SITE MAY BE USED IF IT CAN BE KEPT CLEAN AND 10 _ __ r -- r-_ ^1p 1_}B-B ]1, 7.79 SF/LF X 6.25'/UNIT=48.69 S.F/UNIT FREE OF TOP AND SUBSOIL. - lj x 1 ,3 X i 10 UNITS X 48.69 SF/UNIT=486.8 SF(EFFECTIVE) I 21.22 F __ RESERVE x -___-- .. � DESIGN CAPACITY: 360 GPtl 21. [(486.8 SF) -X 74 GPD/SF] I TH 2 -? x 4 m TO THREAD OF STREAM x 20,1 -F 132 I x 21,3 \ x x 17.1 x 13.9 x 12.7 IRON PIPE \ x 21,5 21,12 FND x 20,5 . CHICKEN COOP INSPECTION SCHEDULE CALL R..J, CADILLAC TO REMOVE OLD LEACHING BENCH MARK-TOP, BACK, CENTER _ INSPECT PRIOR TO BACKFILL. AND CLOGGED STONE AND TALK=19_38 ASSIGNED WITHIN' 5' OF NEW NSF ABREU LEACHING AND REPLACE WITH TITLE 5 SAND SITE PLAN y FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN ORIGINAL RED STAMP AND SIGNATURE. DANIEL P . JR . & MARY Q U . SULLIVAN -' M �j-FMgss 42 PRINCE AVENUE, MARSTONS MILLS, MA TH 1 TEST HOLE LOCATION, NUMBERyG {{�� / r� /-� r� W WATER LINE MARKINGS E . a . g j N V MEMBER 18, 201 0 TALE: 1 20 rS R JAL N a g° R A D GN '� E OVERHEAD: ELECTRIC WIRES (IF SHOWN) c co ° o < , U_ A G GAS LINE MARKINGS d� # 1060 357 x 9.5 x8,7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) , <gocFss\° Je �-6-- EXISTING CONTOUR SANITAR\PN tioSUR\10 RON ALD J. CADILLAC, PLS RS P.C. __.-. t t r g- PROPOSED CONTOUR ��� ) PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN � UTILITY POLE (IF SHOWN):. ® EXISTING DRAINAGE CATCH BASIN P.O. BOX 258 x - FENCE (IF SHOWN, NOT ALL SHOWN) WEST YARMOUTH, MA 02673 0 TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE C 2010 BY R.J. 'CADILLAC (508) 775-9700 PAGE 1 OF 1 REV. 2 15 11--APPROVAL DATE, INVERT, NOTE 5