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HomeMy WebLinkAbout0165 BRAGG'S LANE - Health 165 Braggs Lane Barnstable A= 298- 058 No. ©� q 6q , Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 01pplication for -Miopozaf bpotem eon!5trurtton Permit Application for a Permit to Construct( )Repair( )Upgrade(ice)Abandon( ) L?J Complete System El Individual Components Location Address or Lot No. �` Owner's Nam A ress and Tel.No. Ashes or' Map/P "L Installer's Name,Address,aV Tel �f7 - Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 19,V^o.of Persons Showers( ) Cafeteria( ) Other Fixtures 2 Design Flow D_ gallons per day. Calculated daily flow ✓ gallons. Plan Date Number of sheets Revision Date Title �T`� C� Size of Septic Tank �� Type of S.A.S. Description of Soil, fO��DX Z Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: n 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 issued by s B ar He th / Signe Date < ��— Application Approved by Date a Application Disapproved for the following reasons Permit No. aco rJ ')(( Date Issued 9 1 �— --------------------------------------- No.�ob Fee /O 0 THE COMMONWEALTH OF MASSACHUSETTSs Entered in computer: Yes �. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS RpOication for MioogaY *p6tem Conotructiow Permit Application for a Permit to Construct Repair( )Upgrade(Y)Abandon(. ) M Complete System ❑Individual Components Location Address or Lot No. /6 Owner's Nam.; dress and Tel.No.�--a/�t . Asses/syo�ry's Map/Parcel Installer's Name,Address, d Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 4/ Lot Size sq.ft. Garbage Grinder( )' Other Type of Building &&APerrNo.of Persons Showers( ) Cafeteria( ) Other Fixtures !! Design Flow gallons per day. Calculated daily flow gallons. Plan Date /7 3laci Number of sheets Revision Date Title 5 5 1 tc' Size of Septic Tank Type of S.A.S. Description of Soil. Nature of Repairs or Alterations(Answer when applicable) `4 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 issued by this B ard,1f Hea th._ Signed_ " Date Application Approved by a Date Application Disapproved for the following reasons 4 \Permit.No. \\\ Date Issued •ti 0 THE COMMONWEALTH OF MASSACHUSETTS L� ? x-� BARNSTABLE, MASSACHUSETTS Certificate of Compriance THIS IS TO CERTIFY,that thePn-site Sewa.a Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by A0! �`l''l0 / L S ' at ���� . /�lJ ✓ 4�l P has been constructed`in accordance with the provisions of Title 5 'id e for Disposal System Construction Permit No. 5 y b q dated Installer C;�s�- t�J t Designer CZ P'LA- The issuance of this permit shall of be con treed_as_a_g_uarantee that the syste will c ,o s esigried. Date �� ��� Inspector _ --- --------- No. C��5 '7 �9 --- , Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpog;ar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(✓jAbandon( ) System located at 16 ,5— t/✓ 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 must be completed within three years of the date of this p it �a-�I Date: � � Approved b '6 TOWN OF BARNSTABLE LOCATION ff.&,WJ- 41-1 SEWAGE #a?Cls= II.LAGE /..Lt+iysr�'l ASSESSOR'S MAP//& LO r-INSTALLER'S NAME&-PHONE NO. SEPTIC TANK CAPACITY /.QotJ G4 G LEACHING FACILITY: (type) Sbo Crcl 6hR.ff4-,yJ L�� (size) f0'/- NO.OF BEDROOMS BUILDER O,W 4ER Tcl PERMITDATE: 01-.41-0J- COMPLIANCE DATE: I®I 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 C s;*/ aoLe L��� e J f 6 S � FROM :down cape engineering inc '' FAX NO. :15083629880 Nov. 22 2005 09:45AM P1 Town of Barnstable Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street.Hyannis.MA 02601 Office: 508-862-4644 Fax: 508-790-6304 bgta er & Designer Certification Form Date: �5r 'Sewage Permit# f� Assessors Ma \Parcel g P Designer: . Installer 9' o- , Address: Address: T, "I 0n �/L Z` was issued a permit to install a (date) (installer) septic system at 1 based on a design drawn by (addrW dated L (desi er 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. �T'E ' 'SE�i L �l S(3�-T CPLr.-c�o��j 5^�ko c••� ••�G�- 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. Itk OF P. . /ARNE H. E, OJALA (Ins is Signature) CIVIL <n No. 30792 4P01 S T E\"I<. + sS/ANAL rN ` ( i er's Signature) (Affix Designer's Stamp Here) yr ct± ItFTURN TO BARNSTABLE PUBLIC HE:AI.TH DMSION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND_ AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DMSION. n% YOU. Q:HeaWSeptidDesigner Cerdtioation Form 3-26-04.doc LOCATION SEWAGE I'Vit SIT NO o VILLAGE ASSESSORS MAP N0: :5r PARCEL NO: I N S T A LLER'S NAME & ADDRESS B UILDE R OR OWNER rn4 012 DATE PERMIT ISSUED / DAT E COMPLIANCE ISSUED -i7-o1 ' F 1 V r � 4 !� 1 1 a 4 No. �./. R Fps.... ..'......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............. ........ .................O F.........................------........--------------•---------------..................... Appliration for Uiipuual Workii Tnnitrurtinn-Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: 1 5... .lj : . ..... ................................... .../... .... ..... ......................................................... Location-Wdress - or. Lot No. ---- l�r�.. ......� 120------------------------------------------- ---------------------- ------------.................---............._...-- Owner I Address a LLtS o5- C�n�Sz - Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of BuildingNo. of ersons............................ Showers — Cafeteria Otherfixtures ....................•--•-•---•-----------...-------------•-•------.......----•-•-----..-_........---•----------------•----••--•-•••-•..........•..... 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......................... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••••-•-••--•-••••••-•---•••-••••--••-••-----------------------------------•------------•-------••---•-----•------•-------••-----•---------•---•------ O Description of Soil............................. x U .---------------------------------------------.......................................................................................................................................................... W -•••-•---•------------------••-••••-•-••••-•-•••-••••---•--•-------•--•----------------•••--•--••-•-----•-------•----•------•--•----••. Ux b - Nature of Repairs or lterations—Answer when applicable_....._ ✓.__.__....�-: �_.__ Q B._.._ tA........... .......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of A ITTIZ4 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 by the board of health. Signed. ------.129�- --�................ Date ApplicationApproved By-----••--•••••••--••-••••--•-••••-•--•.....................••------...................._....... .........................--•-----•--- - -- ----•----------- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------•---•..:.-•-••-•--•••-•--•...._ ---•---•-----•----•-... --------•-•------------•----•--••----------------------•------------Dau-------------- PermitNo......................................................... Issued....................................................... Date Fxs...: ....No..fn..1........jL� y....._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................... ..............OF.......................................--------------...........---....................... ApplirFation for Biiipnsal Vorkg Tonstrttriion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �',x lJ(_f r c - _Location-Address or Lot No. .._._..... /� ._..... �..� 1,............................................. ..................••.._................... •••. ••----••-••-•-----............................ Owner Address a - c .. .^° ..---....... . - ..... . ....................... .................................................................................................. Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( )U Other—T e of Building .............. No. of persons....._._.........•.......... Showers — Cafeteria a Other fixtures ----•-------•----------••------• . .. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .---•---------------------------------------------------------------------------•------------------------- ..... -.... •-•---...---------------- •--------------- ODescription of Soil---------------------••-•------•---------••-•-•---------•-------....----------••--------------------------------•-•-•----------------------•-•---....---._.._.....------ U W ---------------.......................................................................................................................................................................... I-------- U Nature of Repairs or Alterations—Answer when applicable......._.__!°__U!" t J /-' v -r f, 'r / ----------------------•------------------------••-•--•---..........---- ..---------•----------------------•-------------------•----•--......--••-•----•_----------•-....--------------•------------------------------------------------------------------------------•••...••-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.: 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 by the board of health. - 'C., Signed . ......�c f� Date ApplicationApproved By.................................................................................................. '' Date Application Disapproved for the following reasons----------------•----------------....----------------•---------•-----------•-•--•----------------...........--•-- ..----•-------•...................•----•-----------•-----------------------------......--------------•----••-•----------•-----••----•••----------•----•----•---••....-----•-•----••----••••---------•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ....O.C-QJ4......OF..........1 .�� 1,> a�ir�/1/.�11".._..........---• (Irrtif irttte of f omplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............. e,1.-T----....._.. D_.S.a...............•-•--•-----------------••---------•-•-----........--...---...----•------.....-----------.......--•--......----•--------- Installer at.............Z�5.......2R�P4 .._�.......Z-.,A............. --------------------------------•---------......---------------- has been installed in accordance with the provisions of TITL: 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._8.l_.'_1Y ............ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....................................•---......_...... -----------------•----- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF No.........................l FEE... ............... Disposal sal nrk.5 T-50no r ion rrutit -- Permission is hereby granted....................✓-...........•.......... :_.__ _....._ _ to Construct ( ) or Repair ( ) an Individual Sewage..Disposal System at No............................... � /h-'r_ - - c ---------•-• ......................-•--..............._.--••-•-----------•--•----•--•-----•----•--......-•-......---•--•--•---•-•--•--•----•-•••...•••- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... DATE_........................../�-� "board of Health i FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS S i --TOP FNDN. AT EL. 67.8' SYSTEM PROFILE TEST HOLE LOGS '-- ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) PROVIDE INSPECTION PORT WITHIN R ACCESS COVER (WATERTIGHT) TO 6' OF FINISH GRADE LISA LYONS, RS T) ENGINEER: 0' MINIMUM .75' OF COVER OVER PRECAST /` WITHIN 6 OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM D. DESMARAIS, RS WARASPIN y ? 57.0 WITNESS: P * 2" DOUBLE WASHED PEASTONE DATE: 7/6/05 & 8/19/05 �- { RUN PIPE LEVEL �,/ FOR FIRST 2' Focus BASE. SILL PROPOSED 1500 3 MAX. PERC. RATE = ASSUMED < 5 MIN/INCH C4 rr",E Ll ELEV. 60,5" GALLON SEPTIC 54.0' 1 11055 °tip 56.75 57.0 TANK (H- 10 ) GAS CLASS SOILS P# 1 ;I. _ BAFFLE 53.47' 53.30 0 0 0 C7 0 C� CI ©7 . O 7q<cr Ho �o ----- 53.17 ] C7 0 0 M 113 � CJ 0 * CJ 0 CI O C7 C 0 0 L7 �6" CRUSHED STONE OR MECHANICAL go (FADED) .; ('_,2-X SLOPE) 4, COMPACTION. (15.221 (21) 2' C7 Ca © C7 C] Ca 0 0 51.17' 4 ELEV. 1�2 r, ; DEPTH OF FLOW .__. 6 SLOPE) ( 1 9: SLOPE " " 091, 60.0' 0" TEE slzEs: ( ) 3/4 TO 1 1/2 DOUBLE WASHED STONE INLET DEPTH = 10 FILL f UNSUIT 25" FILL UNSu1T. 3 OUTLET DEPTH 1 4" 25" B LOCATION MAP NTS I b . I ' LEACHING B FOUNDATION 35' SEPTIC TANK 54' D' BOX 15' LS UNsuIT. FACILITY i ASSESSORS MAP 298 PARCEL 58 i FOUNDATION 120't 7.87 LS 44" 10YR 5/6 UNSUIT. C1 •, 10YR- 5/6 SILT CLAY **SIEVE SAMPLE TAKEN IN C4 ' *THE INSTALLER SHALL VERIFY THE !V2' LOCATIONS OF ALL` UTILITIES AND ALL 60H LOAM uNsulT INDICATED MED/COARSE SAND BUILDING SEWER OUTLETS AND ELEVATIONS „ 113 1OYR 6/3 WITH VERY FEW FINES (PERC PRIOR TO INSTALLING ANY PORTION OF WATER ELEV. IN SILT CLAY C2 RATE OF < 5 MIN/INCH) SEPTIC SYSTEM LOAM LAYER 433' C1 , LOWER SEPTIC TANK ELEVATION AS NECESSARY TO UNSUIT 5 REMOVAL OF UNSUITABLE SOIL .REQUIRED �MS uNsulT. ALLOW FOR MIN.=2% PIPE PITCH FROM DWELLING FOR AROUND PERIMETER OF LEACHING FACILITY, SILT CLAY 2.5Y 6 4 ALL SEWER LINES DOWN TO SUITABLE SOIL LAYER (DOWN /// 130" / APPROX 16'). REPLACE WITH CLEAN MED. LOAM/ 3 +57.16 SAND. ENGINEER TO INSPECT REMOVAL 154" / , SILT CLAY OBS WATER EL. 43.3' 5"4 +67,10 .LOAM UNSUIT. `\ 1 10YR 6/3 192" 2.5Y 5/1 40.2' ,1k56,$B' 58.1 •"' 7 \ e 11 M/CS I b to �, 67,88 22C7" \ 1 41.0' 240" 1OYR 4/6 36.2' p' `y, I L T 5 67.94 �,'-•\ / �s .12 2 ,913 SFt NGWE NOTES: 2•-•' o� �� s 7. 4 ��� APPROX. NGVD 1. DATUM 1S I .+. 'S. SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) j 116� �7 �T, <EXIS I NC O' 2 67.44 " . ' ,.!" �: n-.. � . b..�,r+.n��...... r<i �..._. UUE$ A3 _. - _ L. IV U ko l V"PAL VtiN1S 5686 TE 66.6�` 1\ G� DESIGN `FLOW: 4_ BEDROOMS (110 GPD) _ 440 GPD I W 67.57 (,� 3. MINIMUM PIPE PITCH TO BE 1/8 PER FOOT. ti ,( )•�_JF5713 / rn J USE A 4t40 GPD DESIGN FLOW i +57.61 ; ,j 61 cA ; C!) 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 \s y % N '11 �, SEPTIC TANK: 440 GPD 2 e 8 O++� +i O.o1 (_) 880 5. PIPE JOINTS TO BE MADE WATERTIGHT. " 57�94 9 %xk 1 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. USE A 500 GALLON SEPTIC TANK --:- osl 11 ENVIRONMENTAL CODE TITLE V. I \6as7 ELAEVE=60 51' o e 06 (� LEACHING: 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT TH1 ; coNc. 1� 2(40.5 + 9.83 2 74 = 149 {s9.50 ;PATIO y �Ir" ( ) ( ) TO BE USED FOR ANY OTHER PURPOSE. ,+veto EXISTING .93 „p SIDES: I coNcN60.73 17 DWELLING -'' '�m 40.5 x 9.83 (.74) = 294 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. '6CONC TF=67.8' �se4 BOTTOM: 00 ke0.74 0 . 3 DR VE o v 598 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT *" z 1 TOTAL: S.F. 443 GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 43 ,�*61.47 9 ' ,+ A710 •58 ,1•�i 7+iZ USE (3) 500 GAL. H--10 CHAMBERS (ACME OR FROM BOARD OF HEALTH. 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING SEPTIC SYSTEM 23 67,44EQUAL) WITH 2.5' STONE AT SIDES, 3.5' AT ENDS I 64 1 17 11 .0e ' 7z4 ii AND 4' BETWEEN UNITS .- +65.79 6 .08 7. CO F 4160 �4i 72.33 6 .. WR 66 4 66 13 P T R VED . ,./ 11 +72.68 _ .88 I�EW ,� LEGEND TITLE 5 SITE PLAN j ".'ll"4r, .an 65.46 �- B MAR I J0.0 PROPOSED SPOT ELEVATION �s OR BR PATIO e, 7431 OF 165 B R AG G'S LANE • bg b •4¢ ;. ELE 7.23' ^ y I 100x0 EXISTING SPOT ELEVATION I IN THE TOWN OF: +65.3 PROPOSED CONTOUR � BARNSTABLE ( VILLAGE)7s.e7 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI CONSTRUCTION/TODD Y-7718. k NOTE: THIS IS AN ,ASSUMED LINE - 4� ,,,���,, �s-, OUT OF DWELLING. LINES TO `x t" CESSPOOLS MUST BE EXCAVATED 30 0 30 60 90 n r FOR LOCATION AND TIED INTO BOARD OF HEALTH PROPOSED SEPTIC TANK AT MIN. 29� I PITCH (INACCESSIBLE WITHOUT HEAVY MACHINERY NO ACCESS TO , MA 1" = 30' AUGUST 23, 2005 ' PIPING INSIDE DWELLING) APPROVED DATE SCALE: DATE; A Off 508-362-4541 fox 508 362-9880 .IH OF/yf,gS p down cape engineering, inc. ARNE H OF down OJALA �' `'� ARNE CIVIL H CIVIL ENGINEERS NO 30792 O y - LAND SURVEYORS Is 939 . main st. Yarmouth, ma 02675 ARNE, O.�ALA, DATE 05- >40 SCR