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HomeMy WebLinkAbout0125 CEDRIC ROAD - Health 125 Cedric Road A= 172- 148 Centerville SMEADdF&JI Na Z4=UMt UPC In" amuad.mm a Mods in U9A THE COMMONWEALTH OF MASSACHUSETTS FEE No 66&e 2" ;BOARD OF HEALTH �0Wn OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - []Complete System []Individual Components l z5 CCZerc 20 CP�fCevr r 'Ric herd�-Jr n to off - Ljcation Owne's Name �a.Q I,7a- �Qrcel l�� Iz5 Led21c. leD . te r Map/Parcel# jQf i ^r iZQ -k 9,3'Fdress of# nelephone# Z?l�lvnL�l�� �lne�rt�a Installer's N Address t Address Ja-Y:17-A53 Telephone# Telephone# Type of Building: n(1 .-i Lot Size Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(mi .required) 3-30 gpd Calculated design flow gpd Design flow provided gpd Plan: Date I I I Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator b 7 Date of Evaluation J 1v DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Sign Date 1 Inspections J� FORM t - APPLICATION FOR DSCP DEP APPROVED FORM S/96 No 1`7 THE COMMONWEALTH OF MASSACHUSETTS FEE -BOARD OF HEALTF1 '=.F �! a ki., OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components Lqcation Ow 's Name A; iee! /4� !,Z5 (C'd e,(c erg ner�� !,ei)'iic Map/Parcel# I Address jD� of# lephone# ak a-/ / — Installer's Nam Design Iv ' � Address �7 � � q"1 Add ess ' Telephone# Telephone# Type of Building: �I �(11.J Lot Size Sq.feet Dwelling—No.of Bedrooms , Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) .3 gpd Calculated design flow gpd Design flow provided gpd Plan: Date if III IA Number of sheets Revision Date Title Description of Soil(s) t Soil Evaluator Form No. 1 Name of SoilEvaluafor Date of Evaluation 1 IU f + / DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Date II Inspections r �a FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 j Now ^ THE COMMONWEALTH OF MASSACHUSETTS FEE ©C� r �,k� lo�P BOARD OF HEALTH CERTIFICATE OF COMPLIANCE .1 Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired('Upgraded( ),Abandoned( ) has been installed in accordance with the provisions of 310 ,MR}5.00 (Title 5) and the approved design plans/as-built plans relating to application Nam. n ��dated / -$'— . Approved Design Flow J� !,(gpd) Installer nkp 17--t 11 Designer:` r, Inspe(or Date 1,A�— The issuance of this certificate shall\ndt be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No THE COMMONWEALTH OF MASSACHUSETTS FEE /©C) dIQ �I�P BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( �/) Upgrade ( ) Abandon ( ) an individual sewage disposal system at 11 S _ - i Il as described in the application for Disposal System Construction Permit No. '—"T/ ,datedf� Provided: Construction shall be completed within three years of the date ottffi per �it/A` 'I)cal conditions must be met. Date kn Board of He/talth \� - FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM _ PUBLISHERS- BOSTON FROM :down cape engineering inc FAXyNO. :1508362138BO Nov. 14 2008 08:30AM P1 1 owlr. of Barnstable Regolatory Services M1 �. Thomas F. Gceler,W rectoir 4iARNLiC uLE, ' H_ r� g p� MANE. Public Heaaltlu Da,VISAGII 200 Mahe Street,'Fiya jm nis,MA.02601 Office: 508-862-4644 1,ax: 508-790-630/1 Installeri .1DegA�°)Ber Cabrta.ffoaantiae>ra )Wm 'hate: �/ 19 165 Sewage erm U996r)a_ �.�.� A.%serssair's maal krzrcei 1-72" 146 6 I)a sit;aoa r_ f✓ fm/ 0 F `C Address: Address: Qn. ! 12 d� - - was issued a pernTai L to iii.gal I a (da.e) (izistaille ) W/C.Septic Syste:ni at Z � !?I Cbased on a design drawn by (address) darted (deli Mier) _ 1 wrtiiy that dic septic systen.i rel:erenced, above was uistalled substuntiially according to the design, which may include shiner approval cllaigcs such as lateral i-el.ocBtion of the distribution box and/or septic tk ilk,_ 1 certify that Lbe sep•Lic system. referenced above wFas installed with major cltanges (i.-e, greater than 10' lateral relocation ol•the SAS or any vertical re;locattion of any co.mponem of the septic system) buL 11i accordance with State & Local Regulaition5. flan rcvisiun or cer6 ied as-bu.i.lt by designer to follow. «i°r M '2objA-1 nANIELA. (installer's Signaturr,) OJALA U Ctvit_ No.46502 Q .^TEA�Ut���. F \ SS/ONAI. (Designer's Signature) (,411"x Desxl;x s Stamp Here) P;i.,EnS]F B.F,'p'TJRN TO R,rAJR-NS'Jt'iA.It7.,F PUBLIc 01EALT'AB 'DIVISION. C:ERI' b`tuyfF, OF C:O1VCC714NCE WILL NOT BE ISS1UE1) lUN•,iJ H()TH THT�d �()td� A1WI) AS-BUILT CARD tl RECEIVED BY TIE I31A)(dNSTAI3LE PUBLIC HEA LTH IVUSiC)N, THAW,YOU. n:Health/Scpti6DcsigncY Cotification Form 3-26-04.doc TOWN OF BARNSTABLE LOCATION JOS Ccdr;c Rai- SEWAGE # Ooo$- Y 7 9 VILLAGE Or-Mr-ryi 11L ASSESSOR'S MAP & LOT Q.1 - Jy8 INSTALLER'S NAME&PHONE NO. 3 B Ex cAVATT or . Sob-SI'71•DG a SEPTIC TANK CAPACITY I000 cRaa I LEACHING FACILITY: (type) Soo9a) ckam.5 (-2) (size) 13 x c7s x 7- NO.OF BEDROOMS 3 BUILDER OR OWNER R i ch arak E -Sca4 r c. A m i n* PERMITDATE:J/- l-7-OR COMPLIANCE DATE: /1 - l3-n R 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 AI- 0 ' � .61 - AZ -at 133 -,;�$ C3-AP 84-3 ' C4 35• 37. RcAR v 3 O R { T No-- 7---------------- Fes$..f. :............... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH �r Town... . .......... ..._ OF......Barnstable..-----...................--•--.--.---..........-- � '� A p iratijan for Diaposal Worko Tonstrnrtiun Prrntit Application is hereb made for a Permit to Cons ru r y Construct ( ) o Repair ( ) an Individual Sewage Disposal System at: Lot 28A Cedric Road, Centerville Mass. ...................................... .. ... ,.... ......................................................................._... ........ ...... ocation•A ress or Lot No. a.o............Normes� �omes nc. Nottingham Drive,t......Cer� Y :��,e�.... i ................... ..... ......... ............... Owner Address Jamp-s••Z�o1•la •....................plc ...srt--a g e•R°oad...............e me •�d r�S�#-L.........................._........-- � Insta er UType of Building Size Lot_-_..16000.........Sq. feet Dwelling—No. of Bedrooms.......... ...3..........................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building W��d..fsraTne. No. of persons.......6.................. Showers ( ) — Cafeteria ( ) a, Othe �ixtures •--...... -•--•---•----•--••-•-•---••-••--•••-... ,W Design Flow................................ gallons per person per day. Total daily flow......IN..............................gallons. USeptic Tank—Liquid capacity...........gallons Length................ Width---------------- Diameter................ Depth................ Disposal Trench—No. .................... idt ................. Mel Le h ................ Total leachingarea....................s ft. x Se pa e Pit No.__..__ ...... DiametW P d v . Tot leachingarea..3Oz.......sq. ft. z Other Distribution box ( ) Dosing tank ( ) — aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water•_----_--_----.---__-_-. G� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ sand••and------rave�'-----•---•-------•-------------------------------------•---•------------------...__.._...------------- ODescription of Soil........................................................................................................................................................................ U .--••-•••••••--•-••-•••--•-•-----------••------••••••••••-•----••••--•••••-••---••-••---••-•••-••-•-•---••-••••----•----•----•••••-•-•••-••--------•••-••••••-•-•----•-----•.............•-••----••-•••-- W VNature of Repairs or Alterations—Answer when applicable.----........................................................................................... ...:....................•--•••--•-•-•---•---•--•••------•-•••-•-------•••-••••--•••-..•------------•--•--•-•-••------•--••••••. Agreement: The undersigned agrees to install the aforedescribe ividual Sewa isposal System in accordance with the provisions of Article XI of the State Sanitary Code e under e urth.r agrees not to place the system in operation until a Certificate of Compliance has been 's by the rd he/alt . Sid....• -•--••..........•-•-•...............L ...�!- .. A • ! at j Application Approved BY ��� �- -----'----- / ."�7.;K. D to Application Disapproved for the following reasons-............................................ -------•---------------------------------......................... ...._..---•--------------------------•-------------------------------------------•--......----------••-•=••••••-•••-------•----••••-•-..._.....--•---. . •--------------------------•••---•••- Permit No. Issued. O?K Date No. .7-6_...... Fxs ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H.,;a x;�.ALT H - Tom ................. .OF.......L4ar.j .a.Uo.................................................. Appliratinn for Di4vsal lVarko Tonstrnrtion Vanfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............... .................... ......................................... Location-Address a. y� or Lot No. ...............:�Q."....... . ''�r.33l.��..�'t'-...:.��o....is.....T'".'�l;tune '32Ta...:mf 'ir!::' .....l a�c.�.a t L=.d. .e ...fA i................ Owner Address a .............. .................... Is - ew ft! ...R ad..............MM'10 .........----------# ....... oa d Type of Building Size Lot-----160.0.0........Sq. feet Dwelling—No. of Bedrooms................ ..............,............Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building E°7Q� T a —Type g :...............:....... .. \o. of persons........6................. Showers ( ) — Cafeteria ( ) Otherfixtures -•-•----•------•----•-•------•--.....--•-•-----------..........-•-----------------------•-•-•----------••-----------••--•---.........---------------- W Design Flow............................................gallons per person per day. Total daily flow--- ------------------------------gallons. Disp osal Trench—No........... :..•. gallons Length................ Width......*--------- Diameter................ Depth.............. , � - p q P 0..Width.................... Total Length...__. ___.__._.._. Total leaching area....................sq. ft. R: Septic Tank—Li uid ca acit _......... Seepage Pit No..................:.:'Diamet 4 e...pa& vAv ' .o.......... Total leaching area...] .......sq. ft. Z Other Distribution box ( ) Dosing tank Oe,/ �4 Percolation Test Results Performed by....................................................................--..... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit...........,........ Depth to ground water_-.-___---____-___--_--. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... . O Description of Soil----•---•••-•-•---••. ......Yit....�1 G4_ ------------------------------------------------------------------------------------------- x U •••-•--•------------------•---••-••--•-•-•------•---•--•---•--•-•-•....---••-••--••--.........-•-•--•--•----••-•---•••-•-•----...-------•----•-----•-•...---------•--•••------.....----•-----••......-- :.',t U Nature of Repairs or Alterations—Answer when applicable.................................._.....__..........._.._._..._... ............................ ..... ------------------------------------------ -----------....................................... Agreement: The undersigned agrees to install the aforedescribed4fid vidual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code � ue undergned.furth�er agrees not to place the system in, operation until a Certificate of Compliance has beenxssued by the bgardd f health. Sign Id � .rri"� ( !�._. PP Y ----------------- a Application-A roved B - / w- _••-•- Date Application Disapproved for th ij'ollowi4reason : - --------------------------------------------------------------------------- =- - - ---•---------- ---------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...TAm+l.?�..........................OF...........Barn-stable.......................................... f�rrtiftr�te of �.n�t�rti�nrP THIS �Qa CxgTx �, hat the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by. '<;.-•--- •--- ....•-• .-_... ..•-- -•--•-•-• --•--- ------ -------•---•-•---- -•--•--•••-•---•----•-•-•-----------•--••............................ er at. Lot 28A Cedric Road. Centei �a�e,.._ �sr�f has been installed in accordance with the provisions of Article NI of The State Sanitary Code as escribed in the application for Disposal Works Construction Perlillt"No............... :. ___ -__- dated.:--.--._ KAN �/- THE ISSUANCE OF: THIS CERTIFICATE SHALL NOT B C NSTRUED AS A GUATES A�T�E SYSTEM WILL FU CTIION ATISFACTORY DATE , Inspector ... Tk'E COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ...........I..............................OF...................................................................................... No.......... .� FEE.......... .... Ma olia1 nrk� Cann trnrt�urranit Permissionis hereby granted------ ---------------------------------------...-----------•--------•---------------...........-•----........................;..........----- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No..........................Lot 2$A Ce.dr p .i�C�O..d_ L...... .-ente 'villG-�-..-�`11as.s.*...................--- ..... .a .. ... ... ... Street. as shown on the application for Disposal Works Constrrtdction Permit o............ ...... Dated._...._._.... ...i�. ...7�� t DATE ;;. ----------•------------ -------- y k FORM 1255 O S & WARREN, INC.. PUBLISHERS - I ALL SYSTEM LL SYSTEM PROFILE MARKED WITH CMAGNETIC TTAPE A R BE NOTES Oak S (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROXIMATE NGVD ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE o Three Ponds / TOP FOUND. EL. 69.3' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING as 2% SLOPE REQUIRED OVER SYSTEM 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. MINIMUM .75 OF COVER OVER PRECAST a PRECAST H-10 BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST . PRECAST RISERS UNITS TO BE AASHO H-1_Q RISERS (TYP.) a\ ..a 4"SCH40 PVC 67.4' 4"OSCH40 PVC MORTAR ALL r° 2'0 H-10 T Y L. 65.8' z F PIPES LEVEL 1 ST 2' 5. PIPE JOINTS TO BE MADE WATERTIGHT. z 4' COMPONENTS 4' Locus c #*EXISTING 1000 GAL ENDS (TYP.) SIDES *EXISTING 1 p" SEPTIC TANK 14" o o. o a o 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 0 TEE ? °°°°°°°° ®®®® ®®®® ®®®®- -���� >0000000o WITH 310 CMR 15.000 (TITLE V.) a o EXISTING TEE *66.0'f )°O°O°°°°O ®®®®®®®®®®® ®®®®®®®®®®® o°o°o°o°o°o O °°°°°°°o °o°o°o°o GAS BAFFLE::` °°°°°°°°°°°° °°000000 °0°0°000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND ° ° ° ° ° ° ®�®®® ®®®®® ®®E�J®®®�®®®® ° ° ° ° °°°°°°°° o°o°°°°° NOT TO BE USED FOR LOT LINE STAKING OR ANY 65.27 65.1 >°°°°°°°° 0 0°°°0 OTHER PURPOSE. �01 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. het 49 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. H-10 500 GAL. LEACHING UNITS BERS BY REQUIRED ME PRECAST RSEQUAL) DEPTH OF FLOW = 9. COMPONENTS NOT TO BE BACKFILLED OR ALL AROUND PRECAST STRUCTURES CONCEALED WITHOUT INSPECTION BY BOARD OF TEE SIZES: 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83, o HEALTH AND PERMISSION OBTAINED FROM BOARD INLET DEPTH = 10„ COMPACTION. (15.221 [2]) `O OF HEALTH. OUTLET DEPTH = 14" 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING ( ) AND 58.0' BOTTOM TH-1 VERIFYING IGSAFE THE LOCATION OF ALL233 UNDERGROUND & LOCUS MAP (2.2 % SLOPE) ( 1 9. SLOPE) NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. SCALE 1"=2000'f FOUNDATION EXISTING SEPTIC TANK 33' D' BOX 12' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED FACILITY SHALL BE REMOVED 5' BENEATH AND AROUND THE ASSESSORS MAP 172 PARCEL 148 *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **THE INSTALLER SHALL CONFIRM MIN. PROPOSED LEACHING FACILITY. UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS SEPTIC TANK SIZE AT 1000 GALLONS 12. EXISTING LEACHING FACILITY SHALL BE PUMPED LOCUS IS WITHIN GP OVERLAY PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM AND ITS SUITABILITY FOR RE-USE AND REMOVED OR PUMPED AND FILLED WITH CLEAN DISTRICT AND ESTUARINE WATERSHED SAND. PROTECTION OVERLAY DISTRICT LEGEN D 99- EXISTING CONTOUR -� X 99.1 \ EXIST. SPOT ELEV. / \ 99 PROPOSED CONTOUR / `�5.64' 198.41 PROPOSED SPOT EL. , R30.0001 ' \ TEST HOLE SYSTEM DESIGN: 2� SLOPE of GROUND GARBAGE DISPOSER IS NOT ALLOWED UTILITY POLE FIRE.HYDRANT * G / - 68 ) DESIGN FLOW: 3 BEDROOMS @ 110 CPD = 330 GPD NOTE NOT ALL S1IABOLS MAY AQPEAR w oRAwM USE A 330 GPD DESIGN FLOW T 28 SEPTIC TANK: 330 GPD (2) = 660 TEST HOLE LOGS / 16�57f SF PAVED \ **RE-USE EXISTING 1000 GAL. SEPTIC TANK / 0.4f AC. DRIVE ENGINEER: DAVID FLAHERTY, R.S., SE2755 � 6�\ LEACHING: WITNESS: DONNA MIORANDI, R.S. 6g � SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD / �`L DATE: NOVEMBER 10, 2008 GARGE BOTTOM 25 x 12.83 (.74) = 237 GPD � PERC. RATE _ < 2 MIN/INCH / (SLAB) .71 TH-2 TOTAL: 472 S.F. 349 GPD CLASS I SOILS P# 12416 �� ::'.:• TH-1 USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) \ / WITH 4 STONE ALL AROUND ELEV. ELEV. \� EXISTING 3 \ BR DWELLING 680' 68 pOtt ". p .0' TOP OF FN DN \ EL. 69.3' �...: r` ,.`,: / MA A A c \ APPROVED DATE BOARD OF HEALTH LS LS \ �' .O' APPROX. AREA OF 10YR 3/2 10YR 3/2 ;� O EXISTING LEACHING TITLE 5 SITE PLAN 12 12 c�_ o�G O / (NO AS-BUILT ON FILE) OF B B � LS Ls 68 �� 125 CEDRIC RD. 10YR 5/8 65.7' 10YR 5/8 66 27 , 26" 65.8' CENTERVILLE, MA BENCH MARK - COR. OF CONCRETE WALK EL. = 68.5 PREPARED FOR PERC C C 77 LP ABANDONED?) B & B EXCAVATION/ MCS MCs o RICHARD & JOYCE AMIOTT z S�� DATE: NOVEMBER 11, 2008 2.5Y 6/4 2.5Y 6/4 off 508-362-4541 jH OFAjgsS9e fax 508-362-9880 �AOFAfgSS I downcape.com 5% COBBLES 5% COBBLES o�o� D AI` L yG�. �� DANIELA. �� /� • No JA 80 � o OJALA 90WO Cope eagineeringl MC. CIVIL 120 58.0 120 58.0 �:� ,0 No.4 502 civil engineers Scale: 1"= 20' �O �qN�s SN'�o� P SSc, - � `� land surveyors NO GROUNDWATER ENCOUNTERED �'h ZONAL E 939 Main Street ( Rte 6A) LICE #�8-2�� 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 08-270 B&B-AMIOTT.DWG (DDF)