HomeMy WebLinkAbout0200 HIGH STREET - Health 2 U Hugh Street
West Barnstable
A 034='001 001
(4) 500 GAL.
CHAMBERS
WITH STONE
(4 BR SAS)
14. 9'
0
1500 .
DECK GAL T
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WELL Oc,
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04-333
SEPTIC A S-B UIL T
200 HIGH STREET
LOCATION (WEST) BARNSTABLE PREPARED FOR:
SCALE 1"= 40' DATE JUNE 17, 2005 JOHN 111AML®CK
REFERENCE ASSESSORS MAP 134 PCL 1-1
�A 0r M4sS9C
d HEREBY CERTIFY THAT THE SEPTIC SYSTEM � �
'SHOWN ON THIS PLAN IS LOCATED O� ARNE tiG
AS SHOWN HEREON. � H Na
OJALA Cn
off 508-362-4541
fox 508 362-9880 .,,No.26348
1 O�
down cape engineering, inc. q s a
CIVIL ENGINEERS 'ILO 0
LAND SURVEYORS
s3a main st. DATE REG. LAND SURVEYOR
yarmouth, ma
l
No. o o2�p U ^ . Fee
THE COMMONWEALTH OF MASSACHUS�ETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
Z(Pprication for Otopogal dip"t n' 'Cougtruction Permit
Application for a Permit to Construct(_ )Repair('l )Upgrade( Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. Z00 `A \ Owner's N gme,Addres and Tel.'N7
W ,I S LE 1e1�rL `�� p►. m
Assessor's Map/Parcel
t*'t 1,3Y 10 S'ci
Installer's Name,Address,and el.No.�, Desi ner's Name,Address and Tel.No.
Type of Building: - 1 /r C�
Dwelling No.of Bedrooms Lot Size I sq.ft. Garbage Grinder? ) rrry��,y,
Other Type of Building No.of Persons Showers( ) Cafeteria( ) 7,,5D rd�
Other Fixtures �66
Design.Flow gallons per day. Calculated daily flow " gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
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 Certifi-
cate of Compliance has been ' d by this Bo ealth.
Signed � --® Date G— 6 dJ
Application Approved by Date 6 z_S—
Application Disapproved for th following reasons
Permit No._ W5-- 2V Date Issued 6 r!i a
No. a400 S 'o2p fi J �: - Fee —
Entered in computer: {/
THE COMMONWEALTH-OF MASSAACHUSETTS �' Yes
PUBLIC HEALTH-DIVISION - TOWN OF BARNSTABLtiWASSACHUSETTS
ZIpprication for Mi5pogal 6pgte �Congtruction Permit
<. •'�"`X, lication for a Permit to Construct( ,)Repair( 1)Upgrade( bandon( ) D Complete System ❑Individual Components
Location Address or Lot No. ZdD kA Owner's Na e,Address d Tel.No. 1
�a�.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms_ Lot Size ' sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria r
Other Fixtures
1
Design Flow gallons per day. Calculated daily.flow -gallons.
Plan Date Number of sheets RevisionrDate
Title
Size of Septic Tank Type of S.A.S. _.:.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
a 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 Certifi-
cate of Compliance has been is' by this Boar 141th. (�
Signed c \ Date
Application Approved by 0 to Date (-
Application Disapproved for the following reasons
Permit No. 2tVE- 22 Date Issued 6 16) t
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
y r d1w A 5 Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired( )Upgraded
Abandoned( )by c sue'
at 200 has been construct d 'n accordance
with the provisions of Title 5 and t&for Disposal System Construction Pe o. Z(/ 1--e1,SlJ dated fio G -
Installer Designer
The issuance of this permit s all not be construed as a guarantee that the syf te�m'w,ill(fu ct .n designed.
Date o Inspector
No. Fee lay •
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
1wigpogal *pgtem �tCongtruc �on Permit
Permission is hereby granted to Construct( )Repair( )Upgrade( Abandon( )
System located at too S--s^ W
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of th's p it.
Date: Q�_ Approved by
TOWN OF BARNSTABLE
OCATION �IR '• SEWAGE #
VILLAGE c L ASSESSOR'S MAP & LOT1:y
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY /: Cro f
LEACHING FACILITY: (type) /1 — �N� � (size) �nre'
NO. OF BEDROOMS
BUILDER R OWNER /7 eX
PERMITDATE: ;COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
. r
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 wetl s st
within 300 feet of leaching facility) Feet
Furnished by 4
___.._ ...:--._sue;�.,�
S
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ti
� � �� � ���
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iS`� � w�'�r�
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s
Town of Barnstable
"'f' Regulatory Services
Thomas F. Geiler,Director
• swaxsrA8LZ
Public Health Division
� %639.
�FD r�a{1. s Thomas McKean, Director
200 Main Street,Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Desi--' Certification Form
Date: Sewage Permit# Assessor's Map\Parcel !3
J` -r
Designer: Installer: .
Address: 3,q Address: s--�
On - was issued a permit to install a
(date) (installer)
septic system at based on a design drawn by
(address)
�( esiper) �.
dated 1 1:i a
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.
I certify that the septic system referenced above was installed with major changes (i.e.
I
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.
o���,tr�Mass cy
9
(Installer's Signature) o ARH.
NE Gy
OJALA
No.26348
P 1A'PFSSN0,�P
(Designer's Signature) (Affix p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DMSION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNt TIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DMSION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04_doc
TOWN OF BARNSTABLE `
c/
LOCATION SEWAGE
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME dz PHONE
6
-SEPTIC TANK CAPACITY ejct/f�`'fi
LEACHING FACILITY:(type) �r l� V (size) • W f_
NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER
BUILDER OR OWNER 9G �
DATE PERMIT ISSUED: - L4
DATE .COMPLIANCE ISSUED: .'5
VARIANCE GRANTED: Yes No ✓
1
�x(c LEAcN V- w y ` BONE
0-t
,'-'Ram �N
EkKm �,�� TOWN OF BARNSTABLE
POPIS
1
i LOL:ATIONA010 SEWAGE # Sl:!
• VILLAGE_ ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. rSe�a'3_, � Lv? 31
I
SEPTIC TANK CAPACITY
LEACHING FACILITY:(eype) (size) Z__
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER O OWNE r-, S
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No �'
i
` 36�
A
Fxs.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF..............................................................................
Applir�ation for Btsvvii al Workii C oulsitra r wu eruct
Ap lication ><s hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
�Syst at
.... .................. .. . 9- ✓ �4 ................ .. . ��a ..A.._..
cation Address oNo
l_ L..S. - -=---------------. .
caner c � • Address
................... ... ....4 X1--------------------
Installer Address
Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures ---------------------------------------------- -------------------------------------
•--------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter.............._..... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
`" Percolation Test Results Performed by.......................................................................... Date........................................
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
r3, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
04 •-•-----•--•------•------------------••--•••-•------•-••--•-----------------.......---•••-•••.............-------------•--•------••-•--••-----•---------••---
0 Description of Soil........................................................................................................................................................................
x
V ...•--------•------•--•-••-••••--•--•---•--•---•-----------••---•----------------------------------•--•------------------------•------•---------...-----•-•------------•-------------•----•---•----•--••-
-------------------------------------------------------------------------------------------•••------------------ -------- ---------•----------------
V Nature of Repairs or Alterations—Answer when applicable---- . . ��._L.�___._
- , - ------s 'o ti$,
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of i i`Li:' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued the board of health.
Signed--• =•--- -- ------------------•-----•-----•--
.
. ...............
. � Date
Application Approved By................1 �,,4� �- ........................ -------- r G
Date
Application Disapproved for the following reasons:----••----------------•---------------------•---------•-----------------------...•--•-----•••-••-----••-••-•---
...................•-•----••-•----....................•---------------•----------•----••-••-••--••-------'--••-•--••------------------•------••-•--•------•-•---•-----•-••----•----------•-••-•--------•-
U Date
PermitNo........ U -• Issued_.......................................................
Date
a`r'
No..-VP._.�y . Fxs.................._......
_
THE COMMONWEALTH OF MASSACHUSETTS
'BOARD OF HEALTH
\ .........................................OF............................---------
---------------------...
i
Appliration for Uhipagal Workii Tonitrurtion "rrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
--------------� � ---- . ----
wa cation-Address �(/.tld! 6".�= o.Iof
./
G- ` ... _.... ----------- -------•----------------- ............._.... =::......./..........---------------------.....------.
1id3rwneW S _•
--_-• -........................................................................................-•-•••....... •----.-•••....• .............................. ...... e �-�04
. :_.
v Installer Address
dType of Building •� Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.............................. .. .....Expansion Attic ( ) Garbage Grinder ( )
p., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ..................................
w Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width_............. Diameter................ Depth................
x Disposal Trench—No. .................... Width.............._..... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------_-_____---.-
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ------•-•----•--------------••--•--••--•------•---••-----•..........---••-•---••.........------------------••---...-•----------...... -----------------------
0 Description of Soil.................................................................................................................. .....................................................
x
w
------/------------------------------------------------------
./W.....__ S ...e�J__( ____--- __ ._._.
U Nature of Repairs or Alterations—Answer when applicable____C.)- .4r_ .......I...... :---------5.;r.................(.---------
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'T' y g g p y
of the State Sanitary Code—The undersigned further reel not to lace the system in
operation until a Certificate of Compliance has been ssued y the board of health.
Signe.................................. .....-............................................ ................................
Date
Application Approved By................ .." --- .........r----. ./--(5---- ---8..?-
Date
Application Disapproved for the following reasons-----------------------••-------•----•------------------•---•----------------•--•------------------------------
................................•-------------•-------•••••••..............-----•••------------•---•-----••--------•---------•----•-•--••-------•••-•-------•------•-•-•-•------•-•••--•---•-------•--•-
v
Date
PermitNo....... .'..(.y ------------------------- Issued.......................................................
THE COMMONWEALTH OF MASSACHUSETTS
�` BOARD OF HEALTH
..........................................OF.....................................................................................
Trdifiratr of Tontplianrr
THI NS TO CERTgY, That the Individual Sewage Di osaI System constructed ( ) or Repaired (�
b ..........�GL 1. ... A oS - C�a.vs- -. � .
--•................................................•------•--•-----•-••----•-•---..-----•-------- ---------...----------------
1 Insta er ...___ -
has been installed in accordance wit( e provisions of TITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated----------------------------------------........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
0 l /N ...OF..... ems- .5� �!..�f ............................
No... y% FEE..............'.
DispopaWork ` ,s �tr#i�oCIt rrmit
Permission is hereby granted. _ /
to Construct ( ) or Re air (V) an Individual Sewage Disposal System
at No....... ........••---.............14_'---- k ..54&.,.1........_.- 1.�z�......aA
pp p Street /j-�`�jy ry
as shown on the application for Disposal Works Construction Permit No..7_}.T_3....._._._�j ,lDated..........................................
•-•------•-------------------------------• t `�`-� .......................................
- -------
DATE. r �� rd of Health
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
1ST FLOOR AT EL. 113.3 SYSTEM PROFILE TEST HOLE LOGS
i ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) PROVIDE INSPECTION PORT WITHIN
ACCESS COVER (WATERTIGHT) TO 6" OF FINISH GRADE ENGINEER: AH OJALA, PE
107.0' MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM DAVID STANTON, RS
90.0' WITNESS:
* 2" DOUBLE WASHED PEASTONE,,. DATE; 11/12/04
I-
RUN PIPE LEVEL /
FOR FIRST 2' /r 3' MAX. PERC. RATE _ < 2 MIN/INCH q�
PROPOSED 1500 s'f
,* GALLON SEPTIC 102.75' TFF EE 99` 87.0' CLASS I SOILS P# 10,856
103.0 Lori
TANK (H- 10 ) GAS $6.27' g
BAFFLE 86.44' �� ��o , 0 0 O Ea Cho
�-- O 8 6.17 O = 0 = 0 0 ® a HIGH S7RE
* MIN = = = = o aa �� a
�6" CRUSHED STONE OR MECHANICAL go ,
2 % SLOPE o0R 0 2 a a o a (� �� 0 C_7 �� 84.17' „ IT,
ELEV. R e^
( ) COMPACTION. (15.221 [2]) MIN o0750 000 0 90.2
DEPTH FLOW = 4' ( 13 % SLOPE) ( 1 % SLOPE) 3/4" TO 1 1/2" DOUBLE WASHED STONE ��F�
TEE SIZES:
:
INLET DEPTH = 10" FILL
OUTLET DEPTH = 14" 51„ LOCATION MAP NTS
FOUNDATION 130 SEPTIC TANK 124' D' BOX 12' LEACHINGFACILITY A B ASSESSORS MAP 134 PARCEL 1 -1
50' 6.47' LS
„ 10YR 4/2
*NOTE: THERE ARE 2 INVERTS INTO EXISTING SEPTIC j 60 VARIANCE REQUESTED UNDER BARNSTABLE WELL REGULATION PART XII, SECTION 3:
TANK; ONE AT EL. 103.9', ONE AT EL. 108.2'. PROPOSED SAS TO BE 118' TO EXISTING (LOCUS) WELL (32' VARIANCE REQUESTED).
INSTALLER TO ENSURE GRAVITY FLOW FROM �f B NOTE: EXISTING WELL IS 112' TO EXISTING FAILED LEACH PIT.
RE-DIRECTED PIPING TO NEW SEPTIC TANK FOR LS
N
BOTH LINES.
10YR 5/6
74" 84.0'
C
E IS CS
94.51+ .88 RE-GRADE AS
4.68 NECESSARY TO
MAINTAIN MIN. 2' OVER 2.5Y 6/6
VACANT \ +9 .96 PIPING 150" 77.7'
94.67
+9 .3 5' REMOVAL OF UNSUITABLE SOIL REQUIRED NGWE NOTES:
AROUND PERIMETER OF LEACHING FACILITY,
DOWN TO SUITABLE SOIL LAYER. REPLACE
+94.80 +93.13 WITH CLEAN MED. SAND. SEPTIC DESIGN: NOT ALLOWED 1 . DATUM IS APPROX. NGVD
(GARBAGE DISPOSER IS )
+ 0 s PROVIDE APPROX. DESIGN FLOW: 4 BEDROOMS ( 110 GPD) = 440 GPD 2. MUNICIPAL WATER IS NOT AVAILABLE
� ,.
+1os,12 +94.49 65' of 40 MIL USE A 440 GPD DESIGN FLOW , 3. MINIMUM PIPE PITCH TO BE 1/8 PER F00T.
+ 06.3
-10Fj°Jh /� 2 LINER, TOP AT EL. 440 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AAbHO H- 10
PROVIDE R -DIRECT E IT 87.0', BOTTOM AT SEPTIC TANK: GPD ( 4.5) = 880
LONG-RADIUS BENDS p PING C•o o EL. 83.0' 5. PIPE JOINTS TO BE MADE WATERTIGHT.
llo.
+109, • 14. 9' USE A 1500- GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
LEACHING: ENVIRONMENTAL CODE TITLE V.
i11.41 , VACANT 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT
EXIST. 111,46 +93,63
BOTTOM AREA: 455-SF x 0.74' = 3,36 GPD TO BE USED FOR ANY OTHER PURPOSE.
1500 �� DECK PERIMETER = 105' x 2 x 0.74 = 155 GPD 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
GAL
SEPTIC - 1 ,4 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
TANK F+ ' o TOTAL: 664 S F 491 GPD
PUMP do REMOVE �`O s 113.32 O- INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
-� USE 4 500 GAL. LEACHING CHAMBERS IN
� ) FROM BOARD OF HEALTH.
CONFIGURATION SHOWN: 3' STONE AT SIDES AND 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING SEPTIC SYSTEM
PROVIDE 111. 9 2.5' AT ENDS
CLEANOUTS AT N
BENDS. USE LONG
RADIUS PIPING // ® �®
WHERE POSSIBLE o TI TL 5 I T ® L / V
LEGEND REPAIR ` OF FAILED SYSTEM
\� 06, 2 °° 9� 9s PROPOSED SPOT ELEVATION OF
E
EXIST. FAILED LEACH WELL �o ° 200 HIGH STREET
PIT (SEE NOTE 10) J > �' J 1 doxo EXISTING SPOT ELEVATION
IN THE TOWN OF:
o 10o PROPOSED CONTOUR ( WEST) B A R N S TA B LE
rG� so LL 100 EXISTING CONTOUR PREPARED FOR: JOH N AND LAU REN M AM LOCK
I a
40 0 40 80 120
BOARD OF HEALTH
MA SCALE: 1" = 40' DATE: NOVEMBER 13, 2004
EXISTING APPROVED DATE
WELL -
off 508-362-4541
fax 508 362-9880
0'vH
down cape engineering,, inc. �� ARNE H. ERNES
OJALA H
CIVIL Cn
CIVIL ENGINEERS No° 30792 ®JAB
LAND SURVEYORS ��°�� 15TE�
04-333 939 main st. yarmouth, ma 02675
AR ' . OJALA, P.E., DATE