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HomeMy WebLinkAbout0074 HAMBLIN'S HAYWAY - Health �i /4 Hamblins Hayway - - - - - - -- - — - - --- _ - - - Marstons Mills A = 045 022 i M t i Y'/ TOWN IO�F/BAR�N/STABLE LOCATION ! 4b A)L Wr4 W#/ SEWAGE# "-t ILLAGE Jqfi aST" M I( I ASSESSOR'S MAP&'LOT INSTALLER'S NAME&PHONE NO. 64A)C® '7?T-a2,660 SEPTIC TANK CAPACITY f 40 �Al LEACHING FACILITY.(type)15'lNAI1 f gUr- 30 60's (size) i(,?, /Z.,J(a" NO.OF BEDROOMS BUILDER OR OWNER h i m gKi p S PERMIT DATE: a O COMPLIANCE DATE: ' 1 C'VLCI Separation Distance Between the:Maximum Adjusted Groundwater Table and Bottom of Leaching Facility ?P 1461/Feet Private Water Supply well and Leaching Facility (If any wells exist J on site or within 200 feet of leaching facility) /'v Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I 0° Ai= 3� 6. �. L)ec-K 3 I TO O'F'rBARNSTABLE LOCknON�/ k �t�S W SEWAGE # VILLAGE MA"2sz r d12� ASSESSOR'S MAP & LOT�yS� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILrTY: (type) (size). NO.OF BEDROOMS BUILDER OR OWNER- PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 s �4[ i � ' f �,i. i �� � � � � � .> �; i ,. :�.- .. C 'I � I e. I I I hereby agrp a to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construc ion. tom. s. � No. � ��� � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Mioogal *pg;tem Cow6tructfon Permit Application for a Permit to Construct( ) Repair( ) Upgrade K Abandon( Complete System ❑Individual Components Location Address or Lot No.7y A/" /j rl 3 /-�,"4yw�Qy Owner's Name,Address,and Tel.No. J 0a n 5,S, �pk�S Assessor's Map/parcel y�— �,a.. Installer's Name,AdQfLAS TGAWCO Designer's Name,Address and Tel.No. 350 Main Street / �n W. Yarmout yje c� Type of Building: Dwelling No.of Bedrooms .S Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.require ) S S� gpd Design flow provided S^,�(j l- gpd Plan Date as Number of sheets I Revision Date Al/ A Title Lre _ Size of Septic Tank /Sl,D lype of S.A. TX, Description of Soil Q— 114 Nature of Repairs or Alterations(Answer when applicable) _ P 16-41 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 He lth. Signed Date 5 /C1 Application Approved by Date � /� /11NJ h Application Disapproved by: Date for the following reasons Permit No. pD 6 " a0 Date Issued (, is l No. (n 2 Q/ i _ � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABJLE,MASSACHUSETTS Yes TIPPrication for Bitpogaf 6p5te'm Con5trUction Permit Application for a Permit to Construct O Repair O Upgrade Abandon O Complete System ❑Individual Components Location Address or Lot No.7/-/ An )U 1 i') 4A 1/f zl Owner's Name,Address,and Tel.No. ij Assessors Map/parcel L/S— Q a 0( Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. rneel ` �� 5��� 3�� -asda Type of Building: Dwelling No.of Bedrooms S Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) OtherFixtures res to Design Flow(min.required) .S Sr� gpd Design flow provided 5 S�6 ��J gpd Plan Date 5/�, - Number of sheets I Revision Date Al/ A Title f(f - Jt A u � Size of Septic Tank /SUI� 1 yp/Ie of S.A. �� 3 ySbl 7.3• S Description of Soil / Nature of Repairs,or Alterations(Answer when applicable) Date last inspected: _ f Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i 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 He Ith. Signed (/1 A 0 Date �^ Application Approved by r1 r/tnZ Date 15- Application Disapproved by: Date for the following reasons r - Permit No. Date Issued S 3 A ——————————————————————————————/————————————-- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS �t Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded X) Abandoned( )by CJ at ?7 11A b I i 1 414 (vt,44-V �'• S has been constructed in accordance i with the provisions of Title and the for Disposal System Construction Permit No. 2006— o?U 3 dated 0 6 Installer ./�� Designer #bedrooms Approved/d�sig ow gpd The issuance of this 1e�rmit hall not be construed as a guarantee that the systefn will functi s de ig d. Date U � � lP Inspector -------------------------------------------- No. (G - 2 V Fee Ao THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Misspont,,*p!6tem Con5trUCtton Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade (x) Abandon ( ) / System located at A t L,J V 1 ,2 5 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: Constructio m t be completed within three years of the date of t`s e it. �Q Date _ 2 Approved by Town of Barnstable ;taE rti Regulatory Services , Thomas F.Geiler,Director aAM-.. ILL, qQ Public Health Division Fop° Thomas McKean,Director 200 Main.Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 0(, !' 0 C. Designer: DWV) 61"_ 9,S Installer: Q C A WW- Address: . Address: 350 Main Street Wk Yarmouth, MA�, ��i,✓1 G�VV 1 L L-� � I 3 On C a was issued a permit to install a dat ) (installer) II septic system at � 9 H XM FPt4 N S H k�T based on a design drawn by (address) _ MeU al dated (designer) .1 -certify that the septic system referenced above was installed substantial) according g to the design, which may include minor approved changes such as lateral relocation of the 'j distribution box and/or septic tank. 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&I;ocal, egultions.-Plti revision or certified as-built by designer to follow. - �N OF As (Installer's Signature) 0. 1140 FG�STE?� 4tVl'P,R,��..,. (Designer's Signature) (A fix Designer's Stamp Here) PLEASE RETURN TO BARI�r.LEPUBLIC HEALTH'DMSION. "CEIkTIFICATE OF COMPLIANCE MU NOT BE ISSUED UNTII, BOTHTHIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEAL ... `DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form I Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I,�-/� �'"t YVe �iI/ ,hereby certify that the engineered plan signed by me dated �.� �� ,concerning the property located at 74 HAM 6l N5 HAyW Ay meets all of the following criteria: • Two soil evaluations excavated for detailed examination(no hand augering) and two percolation tests shall be conducted. • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. 0 The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) -7(O . / W rJ 0 �'!, B) G.W. Elevation S 2 •b+adjustment for high G.W. ` r DIFFERENCE BETWEEN A and B hI ZO SIGNED : l DATE: Q • ?�lo •OS� NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.doc 45�22 OF C o� EN M. MEYER No. 1140 o SgNITAR\P� tj• JD 069 l OT yW A)I I� �S � i o NHS« ASSESSORS MAP NOTES, �EDa TEST HOLEF LOGS o" S ROSE M�+- - " cD 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH PARCEL t [Ato ZZ Y v�' ST eI THIS PLAN 1995 MASSACHUSETTS TITLE V & TOWN OF wA Z 0 �Op h 1"� Ot� f P ZA-fL SOIL EVALUATOR . ( f l.Is BOARD OF HEALTH REGULATIONS. des H 11 D te rn FLOOD ZONE . N + WITNESS �D VI:C.p 'mot 00 - r LOCATION OF UTILITIES REFERENCE . � - D 2) THE INSTALLER SHALL VERIFY THE L , �S o.� �► y_ 1 ATE � 2'a � v► S COMPONENTS PRIOR TO .L rrt SEWER INVERTS AND SEPTIC 012 PERCOLATION RATE M NGt} INSTALLATION. A y t? LASS 0(L Lcl ` THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION C �.. � _ I _ 3) . o V � � TH _ : 81 5 �r SNORE o © t 0 TH �2 Vi% ONLY, AND SHALL NOT BE USED : FOR PROPERTY LINE v G mac, 0 SPc*;1ra DETERMINATION. ' TLPco f1f, VNYP � �v u r ►� tR� I , ZS 4 ALL PIPING TO BE 4 SCHEDULE 40 @ 1/8 / FOOT. (UNLESS - _ A�n1 SPECIFIED OTHERWISE) _ 5 :f e S _ A o 3 � p I y� - 8 `I (� R / Z LOAM ALLOW FOR THE USE OF A _, ,r _ 5) THE DESIGN OF THIS SYSTEM DOES NOT A LO O i ON MAP T, d.�? �2• Z : L CAT ( N S Za 31 y GARBAGE DISPOSAL. ID (Z R L4f BOXES WHEN INSTALLED� 6) SEPTIC TANKS AND DISTRIBUTION ( ) S G SDI �7 MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON v A BASE OF G OF CRUSHED STONE. `I ` N OF 1 Mqs C 2,5 yo '� �� 7- D R N ►� a � `7 / to, 7 .� 'IS `l ov+E� l OPT i1 v (�GtJ o. 1140 p v� �sE tJt:. ? I: UI f Q� . Goy , 5776/ F0 ti f na a --- VI TAR, S P1 I C. SYSTEM DES. i GN t - FLOW ESTIMATE �-- r 5 BEDROOMS AT ; GAL/DAY/BEDROOM : SSO GALIDAY \ \. SEPTIC SANK - . .�� GAS/DAY x 2 DAYS iloC� GAL USE ISOO GALLON SEPTIC TANK Ehl \ \ \ SOIL ABSORPTION SYSTEM t L Ta 3oS� VatT�5 � 3 SrUNE 0>J 0 r i � � Q �-os �.� sTvn,>�•_ n,� , ,�JF,�,.Y�4 �,:..�_ 1?-..►G\�,x2._n1 CD h`' \ S'DE AREA:L('4j3S)-44- xZ X 0,74 ( (��{ •7 — BOTTOM AREA: •S x 1z-Ho k o:? �. 43 '� 31 � .43 - P Y,e G ' SEPTIC SYSTEM SECTION X 0F .. Fo o X TQ 0 P Q r a \ _ to< \ + u-s ' ur o BRI Cov TU V�I rJ ��k m 's M r� ,� � w . �' t0 6� #a�2 �I:E !f�} Fs Ins a t .r, r �, a P P ,. _ N I S ojuz 1 LL1 O J Q .. Q p \ cv I o �• � P \.w UQ GAL 75. aft �Sf' . \ es5 7S SEPT I C TANK `�(v. \ M r 7S �F if SITE AND SEWAGE PLAN \d - LOCATION -7 q Hnm6 aw s /a -�K- / _l d v \ EDGE OF PAVEMENT E W PREPARED FOR S C&"60 - 49 m z9 SCALE: DARREN M. MEYER, R.S. \ 4 DATE : 03-25- W r� P.O. BOX 981 Z EAST SANDWICH, MA 02537 Z - DATE HEALTH AGENT Ph: 508 362-2922 -- ) w , w Z E, - t T