HomeMy WebLinkAbout1222 BUMPS RIVER ROAD - Health 1222 BUMPS RIVER ROAD
Centerville
A = 188 - 044
S M E A D
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UPC 12534
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplitation for Disposal *pstem Construction permit
Application for a Permit to Construct( ) Repair V Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 1 a., s 2v4v- Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel I kj CQ/- 14 L-1
Installer's Name,Address,and Tel.14o. Q. I Designer's Name,Address,and Tel.No.
S,
Type of Building:
Dwelling No.of Bedrooms . Lot Size ~ 013 sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date 1`U Number of sheets Revision Date
Title
Size of Septic Tank C C,L Type of S.A.S. ��(,� �`�,` j (�;^Gv
. .
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Cr_�_ �' x y S CZ S3 A?6(�
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 Health. y I
Si Date // ho N
Application Apprc ved by Date
Application Disapproved by Date
for the following reasons
Permit No. �) _ 1 J Date Issued \\ L
�of> .
J-41
No. t Fee
`FI r THE COMMONWEALT -MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for Misposal *pstem Construction permit
Application for a Permit to Construct( ) Repair V Upgrade( ) Abandon'( ) ❑Complete System ❑Individual Components
Location Address or Lot No. \a 'a S a%.V Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel J C fl V ��L V �\C^^n C,R V
Installer's Name,Address,and Tel.f4o. Designer's Name,Address,and Tel.No.
co \\3 6Lo rMo a Q J 6 S,f32
Type of Building:
Dwelling No.of Bedrooms Lot Size .�I sq.ft. Garbage Grinder(�
Other Type of Building No.of Persons f Showers( ) Cafeteria( )
Other Fixtures /�
Design Flow(min.required) c [ gpd Design flow provided gpd
Plan Date\`� Number of sheets Revision Date
Title
Size of Septic TankG1 (<�A�_ Type of S.A.S. X Gill
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 1 C., r- x to(s-f) L
d
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 Health.
Si Date ! I /f D 114
Application Approved by � Date l
Application Disapproved by Date
for the following reasons
Permit No. an) L) — Date Issued N\
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by S C o)A
at �, a ��� � a`, r ej has 4�n*t-MsActfd in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No:--QC 030 dated /11/6 X
Installer C c Designer � - C_
2
#bedrooms Approved design flow_ :::Z gpd
The issuance of this permit shall not be construed as a guarantee that the system will functio designed.
Date In � o �„-
t v
----------r----------------/�
-------------------------------------------------------------------------------------------------------------
D _
No. C IL) _4- Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS
Disposal 6pstetn Construction 3permit
Permission is hereby granted to Construct( ) Repair(L141*1 Upgrade( ) Abandon( p)
System located at���� � � 2e�,l�C�- R J �, y i \1X
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:Construction must b com leted within three years of the date of this per mit.
Date / �d Approved by M�,—I
Town bf Barnstable
Regulatory Services
Richard V. Scalf, Interim Director
BARNSTABL&
9� "& �0� Public Health Division
- Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: � ' I I Sewage Permit-4 aow r 3OAssessor's Map\Parcel K- L q
Designer: . 57z*',exS--A-- A. Installer: 5 Lo� \c CAr\�/t,
Address: 9R3 Address: 1 U\J YGs r'-t
On was issued a permit to install a
(date) (installer)
septic system at VELA I, Qyr^�PS �-��� �.� based on a design drawn by
(ad ess) c
dated
(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. Strip out (if required) was inspected and the soils
were found satisfactory.
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. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in compliance with the terms of
the I1A approval lette pplicable) nthF
3T'F.E'�s�Fl�`fn
(Ins 's Signature)
.'�ESISTEM
(Designer's Signa e) (Affix Designer s Stamp 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.
QASepticTesigner Certification Form Rev 844-13.doc
'Town of Barnstable �ak
Department of Regtdatory Services
,. t Public Health.Division hate
AlEli MAt��MAER
200 Main Street Hyannis MA 02601
ifs''
Date Scheduled #^ f' F l "
— 11 ,t T1me Fee p d.
Soil Suitahil ty Assessment for Sew � DIspo
Performed By: Witnessed By:
LOCATION& GENEW INFORMATION
Location Address ,
Q Ql .�\JC!' Owner's.Name (� 9.1 0
• C � Address CC
Assessor's Map/Parcel: / Engineer's Namc
NEW CONSTRUCTION . REPAIR !� Telephone# J b* 3�l -O 0Jq
Land Use'
Slopes(96) Surface Stones . ' V
Distances from: .Open WetecHody Cf t1`. ft Possible Wet Area rfL ft Drinking Water Well ft
Drainage Way ft Property Line ��-1 ft Other ft
SICETCH:(Street name,dimensions of lot,exact locations of test hales&pure testa,locate wetlands in proximity, to bolts)
,v
��� VIA l t 1
- V
Parent material(geologic) Depth to 9edroelq
Depth to Groundwater. Standing Water in Hole: //� Weeping il'wq Pit Flice
Estimated Seasonal.High Groundwater. ,At LA
DE
TERMINATION FOR
R SEAS
ONAL +HIGH V�A7CE '�'ABLE
' Method Used: _ .t•� �1 I
Depth Observed standing in obs.hole: In, Depth to soh mottles., In.
Depth to weeping from aide of obs.hole: In, Groundwater Adjustment fr {
Index-Well i< - Reading Date: Index Weil level emu_ Ad{,ihetor A�,drauitdwuter Laval
PERCOLATION TEST bolts
Observation '
Hole# Tinto at 4"
U- Z
Depth of Pero 2
Time at 6"
Start Pre-soak Time @
Time(9 '
End Pre-soak
Rate Min./inch
Site Suitability Assessment: Site Passed t/ Sup 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 ConseIrvation Division at least one(1) week prior to beginning.
Q:IS EPTICIPERCFO RM.DOC
]DEEROJBS1+IiVA.TIONMOLE LOG Hole#
Depth from Soil Horizon Soil Texture Shcl Color Soil Other
Surface(in;) (USDA) (Mansell) Mottling
(Stnucture,.Stones;Boulders.
0115151ency %aravel)
LIS
M-5 viz
DEEP OBSERVATION HOLE LOG Hole It '2..
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsisten % a
(DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Sail Color Sall Other
Surface(in.) (USDA) (Munsell) Mottling (S"Utura,Stones,Boulders.
ConsiatenoLG
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Moil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders,
Consistency, 6
Flood Insurance Bate Mats:
Above 500 year flood boundary No--M-':� Yes t/
'Within 500 year boundary
\ Within 100 year flood boundary No._-"' Yes es
Depth of Naturagy.Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all ttreas observed thrpughout the
area proposed for the soil absorption system? �
If not, what is the depth of naturally occurring pervious material?
Cea tifieation
I certify that on �� •�� S (date)1 have passed the soil evaluator examination approved by the
Department of Env' onmental Protection and that the above analysis was performed by me consistent with .
the required trainin x ertise and experience described in�10 C-N M 15.017.
Signature 1/�
..._.`�j Datb
Q:\SRPTIC\PI3RCP0RM.D0C
TOWN'OF BARN�STABL
LOCATION (J s'') ��`(� AGE# �-(� A�
VILLAGE C`el�. �[F' ASSESSOR'S MAP&PARCEL
INSTALLER'S.NAME&PHONE NO. �O !�
SEPTIC TANK CAPACITY S-0 0 GcL VA a.U 6 Y
U
LEACHING FACILITY: (type) � q a ram—
NO.OF BEDROOMS
OWNER CLC <
PERMIT DATE: CO PLIANCE DATE: 1
Separation Distance Between the: g
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ,A Ct /F t
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) [�.Q� _ "Feet '.
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) �' 'r-CJL,'A( Feet
FURNISHED BY ,� �� y,.
Eli,
3
A 2
/A 3 3.3
P
,. ....
' ACCESS COVERS MUST-BE WITHIN - -< .
INSPECTION 4- PERF PIPE 9- MINIMUM.
6- OF FINISH GRADE
PORT V3/8- MIN. 5/8- MAX 3 MAXIMUM COVER INVERT ELEVATIONS DES I GN CR I TER I A .- GENERAL NO TES :
101.98 FIRST 2'- TO HOLES FACING DOWN END CAP INVERT AT BUILDING: 97.0 DESIGN FLOW:
BE LEVEL 'INVERT IN SEPTIC TANK: 96.5 3 BEDROOMS AT 1/0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
2x--� MIN 2' of PEASTONE !NVERT OUT SEPTIC TANK: 96.25 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY.
4' DIAM PIPE
96.3 OR FILTER FABRIC INVERT IN DIST. BOX: 96. 17
$_ `4
o � . . INVERT OUT DIST. BOX: 96.0 NO GARBAGE GRINDER 2. VERTICAL DATUM 1S ASSUMED, FOR BENCH MARKS
97.0 / 96.25 96.0 00 000000 o 0 0 0 0 0 0 314" - l tie` DIA. SET. SEE Sl TE PLAN.
GA
96-5 eaFFLEJ 96- 17 ��� 95.8 95 5 DOUBLE WASHED STONE 'INVERT IN LEACH FIELD: 95.8
3 OUTLET 95 p INVERT END LEACH FIELD: 95.5
SEPTIC TANK REQUIRED:
!8'x 25' LEACH FIELD 330 G.P.D. X 20OX - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND
D-BOX BOTTOM LEACH FIELD: 95 O SEPTIC TANK PROVIDED: 1500 GAL. MIN. MAINTENANCE OF THE SEPTIC SYSTEM SHALL
7500 GAL //-20 'ADJUSTED GROUND WATER: N/A CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL
1 V ' SEPTIC TANK 6" CRUSHED STONE OR "OBSERVED GROUND WATER: N/A SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
COMPACTED BASE
BOTTOM OF TEST HOLE #2: 88.0 DESIGN PERC RATE ! 5 MIN/INCH
PROFILE •. NOT TO SCALE SOIL TEXTURAL CLASS I 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
330 GPD / 0.74 GPDJSF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH-
- j STANDING H-20 WHEEL LOADS.
PROVIDED: 18•x 25' LEACH FIELD. 6" DEEP
AREA - 450 S.F. x 0.74 - 333 G.P.D. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
-94--- APPROVED EQUAL.
I
95 --_ \ I 6. SEPTIC TANK AND D-BOX SHALL BE REl NFORCED
+ _ SO I L TES T P I T DA TA S PRECAST CONCRETE OR APPROVED POLYETHYLENE.
82'08 �9� �� �� BOTH SHALL BE WATERTIGHT. D BOX SHALL BE WATER
101 •95 INDICATES INDICATES
PERCOLATION = OBSERVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE
TEST - GROUNDWATER OUTLET.
98.5 - \\ �+ LEACH
UP �� \ FIELD 9l :. +96.� I `� ` TP #1 P#l45/7 TP #2
I � __,\ 7. BEFORE CONS TRUCT l ON CALL "D l G-SAFE". '
1-888-DIG-SAFE AND THE LOCAL WATER DEPT.
HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR
b 0" 100.0 0" 98.0
PANE FOR LOCATION OF UNDERGROUND UTILITIES.
i2-OAx I sal �� LOAMY IDYR LOAMY IDYR
SAND 3/4 SAND 3/4
8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
l5" - - - - - - - - _ _ _ _ 98. 7 12- _ _ _ _ - - - - - - - - - - - - 97.0
DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
j 99.2 � ::::::::::• -,�. � � � � LOAMY l OYR LOAMY IDYR +.
i I I i IRRIGATION POND B B OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
_-- 110' i SAND
- - - - - _ 5/$ - - - - - - - -SAND
- - - - - 5/8
- - -
_ / t
... ....... ..
CONSTRUCTION INSPECTIONS.
j � � �--� '.. '•"- - - 6-BOX 1500 GALLON �� � � 24' 98.0 24" 96.0
SEPTIC TANK _\ I « C/ MED I UM IDYR Cl MEDIUM IDYR 1.
24-°AK 00 - SAND 6/6 SAND 6/6 9. EXISTING CESSPOOLS TO BE PUMPED DRY AND;
o 100'
\ \ BACKFILLED.
f 4'PINE -- TP#1 \ BM CORNER BH I 3
a
N \ EL-l00.49 y 11 W I
!0. ALL UNSUITABLE MATED/AL IA 3 8 HORIZONS) -
42- ENCOUNTERED BELOW THE INVERT OF THE LEACHING
OHW \ 1 P
�y � - FACILITY TO BE REMOVED FOR A DISTANCE OF 5'
1 1 AROUND AND REPLACED WITH SAND IN ACCORDANCE
K c WITH TITLE
,
� G � I I \
CESSPOOL EX t ss 1 NG �\ i �1 NO WATER NO WATER 1
�\ 0wE�1 I I I \\ ( I20" 90.0 120' 88.0
,
H 1 tf 1 Il DATE: OCTOBER 16. 2014
\I 100.9 TEST BY: STEPHEN HAAS
Wl TNESSED BY: DONNA MI ORAND
PERC RATE: C 2 MIN/INCH
G
\ _ GARAGE
LOT 63
� 1
15. 934+ S.F. _.
a
SEPT l C SYSTEM LIES I ON
l 222 BUMPS R l VER ROACO . MAP 188 . PARCEL 44
E3 .4 NS ! ABLE CCENTERVILLB• ) MA
W
�<
RooTE2B � � PREPARED FOR
L EGEND
N MAR / A NNE R / CG / O
o
L OCUS �� CB CONCRETE BOUND
4 -W ATER LINE SCALE- : I 20 ' OCTOBER 0 / 20 / 4
b HYDRANT
BUMPS RIVER G GAS L I NE
{
OHW- MHT
R HEAD WIRES E P E N A H A A
UP Posr ENGINEERING , INC
-E- UNDERGROUND EL ECTR l C L l NE , P . O . Box 16
-T- ONDERGROUND TELEPHONE L I NE South D e n n i s MA 02660
--CTV- UNDERGROUND CABLEVISION LINE / � � >'�r��� ( SOB ) 362-B 1 32
j� +40.4 SPOT ELEVATION
40 EXISTING CONTOUR
0 /0 20 40 40 �kOPOSED CONTOUR
LOCUS MAP JOB N0: 14-075
r _