HomeMy WebLinkAbout1149 FALMOUTH ROAD/RTE 28 - Health �r6
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1149 Falmouth Road
Centerville
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S M E A D
KEEPING YOU ORGANIZED
No. 12534
2-153LOR
SUSTAINABLE FORESTRY MIN.RECYCLED
INITIATIVE CONTENT10%
Certified Fiber Sourcing POST-CONSUMER
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S"12Cg
MADE IN USA
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No. q4 Fee l
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
21pplication for MisposaY 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. l tj
Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel2q',— ((9�—pp'� �j �
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. j.2 Z1rcr
L.IJA _ i yea L:, r a Wj 1_5.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( Cafeteria( )
Other Fixtures T lbv 5 Z
Design Flow(min.required) 70 1
of/1/ OVA gpd Design flow provided y
' gpd
Plan . Date t Number of sheets Revision Date
Title AA''__
Size of Septic Tank,,(�o 4 g��I, OtO Type of S.A.S.
Description of Soil �)7i1.✓rj
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 Certificate of
Compliance has been issued by this Board of He�
Signed Date f
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 16 17 Date Issued �J
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitation for Disposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair( )y Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
L
Location Address or Lot No. �' O�i s Name,Address,and Tel.No. ��
Assessor'sMap/Parcel � cf-,,, I"—n 00 s � / ( 2 f t�J (
Installer's Name,Address,and Tel.No. 'f2 v g A Designer's Name,Address,and Tel.No. 1 l LA;i14 C i
J. ��,L .iJla LC1i! i �rct7xQc, �A- � r; Uj+ _)&K
Type of Building:
Dwelling No.of Bedrooms IVA Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures -Ff&.,- S ;,� 6 S
Design Flow(min.required) So y+otiS dm f( •gpd Design flow provided ' gpd
P
Plan Date Number of sheets Revision Date
Title ,,�-J _�lamJX�
Size of Septic Tank ,� 'X I, - Type of S.A.S.
Description of Soil `j�q �� /{f�q O
/�e-�f'R/vK...- V t i
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
x•
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 Env' o ental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of
Si ed Date
Application Approved by � Date ! '
Application Disapproved by Date
for the following reasons
T. n
Permit No. P-01 Date Issued 1 r-
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 /+
- at I I C'(al 1e A b Cr,,itrLh I to , has been constructed in c�cjoance
with the provisions of Title 5 and the for Disposal System Construction Permit No.�7 i4 dated
Installer Designer
#bedrooms Approved design flow C� and
The issuance of this permit shall not b e construed as a guarantee that the system will funct4d'esign d. �.
Date 7 Inspector � �� - - - -�"
-------------------------- - -- - - - - - --- -- - - - -
No. 1 ll Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby grant ed(tt Co truck( ) „ (repair . ) Upgrade( ) Abandon( )
System located at
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:C nstruction must be completed within three years of the date of this permit.
Date 1 f` �`� � '" Approved by � "
z
4
��"}F"=r
` - _-_
TOWN OF BARNSTABLE
LOCAT nm SEWAGE#
101JAZ9
VILLAG I ASSESSOR'S MAP&PARC Lar ,2
INSTALLER'S NAME&PHONE N n
�T
SEPTIC TANK CAPACITY
LEACHING FACILIT :(type 1� (size) I10
NO.OF BEDROOM
OWNER
PERMIT DATE: "2 1 COMPLIANCE DATE:
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
W- 11
rant i
L 0 CATION PERMIT NO.
11 y )C;;,
VILLAGE
i
I N S T A LLER'S AME i ESS
V
j
I! U I L D E R 0R OWNER
r. All .
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
P T.
20' 19�s�
7-//
Town of Barnstable
p..°``"E T°O Regulatory Services
Richard V.Scali,interim Director
� BARNSTABLE, �
� 0�0$ Public Health Division,
Thomas McKean,Director
200,Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fas: 108-790-6304
Installer&Designer Certification Form
Date: L, 1 l�117 Sewage Permit# :Assessor's Map\Parcel
Designer: any1neee,;n�j//Woruts, Inc_. Installer: 'Pe v IG CS.,;r. 6,15}"c4-'(,-
Address: IZ. W, f24 Address: P. aC;�C 6"z-F
To re s k olaiQ f�IFA O26�l`! i i ,.5-�ck e k. J\44 (1 Z..6 l
On �`v'was issued a permit to install a
(date) (installer)
septic system at �1 �.1I I' 124 (es�l<� based on a design drawn by
(address) t
evil Wus-lu /K C, dated l l 1 1-7 ) l
(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 anti 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 b designer to follow. Strip out(if required)was inspected and the soils
were found satis'ctory.
I certify that e system referenced above was constructs nce with the terms
of the RA a royal letters(if applicable) �v+10F
PETER T.
McENnEE
CIVIL
1 aller's Signature) NO.35109
NrSiER010
(Designer's Signature) (Affix Designers tamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL N01' BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Scpiic\Dcsigiicr Certification Form Rev 3-14-13.doc
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BENCHMARK SET
MAGNETIC NAIL SE FA LMO UT H (Route 28) ROAD
EL.=52.68
53:61 edge of pavement 55.63 56.33
53.34 J ----------5 —-----------
�•.
SIDEWALK 54 SIDEWALK
SIDEWAL :.,.:.:•. '... /56.03
/ A
HEADWALL w o i:oa 2�k-3381 .39' OLE
/ —— L=243.24 .
I 2 STORM WA TCB
ERM 53.69
Cx a9s� �l DETENTION AREA -s0--.LOT 4
\ h
49,19 1 O •O
4 1 OS'.52:86 5
53.03 \ / • x 50.19
29 100 0
PARCEL ID. 2 0�_ �
-- 54.4
WATER SERVICE PROVIDED 2—
FROM FALMOUTH ROA � �'. .,...;s��/ canlsc
52.38
/
229 100 003
53,57
PA VED
•
PARKING LOT: ''': 2.99
Ja
N
1�, ...
r \' _---
52-- 8
/.. :.. :�'\ �� out 2
\.
52.00
\. . a
/.:.... ..:. �(/ GJ WALK LIGHPOLE f Nd1 R x
/ d
r / E 11
Btu eT
J CANOPY x / ,_----5t�----- 250-049eb� c a
V O
52,30
LIGHTPOLE DUMP TER l LOCUS
a
1EX/STING
Q BUILDING(#1149) x s2:o1 /i • �o ,o°�
52.72 X /SLAB EL.=53.5f �:� �`� •�i �\\ `1'�'��/
s3.64` CONVENIENCE STORE /� / / \ 1' ` �� jN OF nigssy�/r '
I % xsR. X'2.6o . { o v: LOCUS MAP
/:... 53.48 / o�`s PETER T.
r NOT TO SCALE
_ ......;.. . • VENT5240
" McENTEE
— x sza�a\ CIVIL
—52 ——EXISTING CONTOUR
\:. y.. �• 53.14 53:14 COVER 5275 / \\ BENCHMARK-2 NO.35109 x 50.98 EXISTING SPOT GRADE
\\ �•:' �ry 52,91 • SEPTIC TANK COVER
ev
R \ —W—EXISTING WATER SVC.
:. 54.33\• \\ ttr • pp.�/ e \ EL.=52.91 :.'.`?.
,i.� ® 2.74 �G `\ —$H. bb`—OVERHEAD WIRES
�q .r.; o o \e • � , 1 Er TEST PIT
9
52. 3 p�• \ EXISTING SEPTIC TANK BENCHMARK
t \ (SEE NO TE 14)
\� TP-2 �TP TOP OF TANK, EL.=50.94 �� LEGEND
•�1/14 0 0 ' INV.(OUT)=49.60f(VERIFY)
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
• . 4." EXISTING GREASE TRAP 4 F UTH ROAD CENTERVILLE MA
N 84'44g4 n .53,ea.:.. • � 1 1 9 ALM 0
229-121 �� E': TO REMAIN IN PLACE
OWNER OF RECORD Prepared for: Bevilacqua Construction, P.O. Box 628, Forestdale, MA 02644
SOUTHLAND CORP
TAX DEPT 255942464 EXISTING LEACH CHAMBER Engineering by: SCALE DRAWN JOB. N0.
P.O. BOX 711 TO BE ABANDONED OR CONNECTED Engineering Works, Inc. 1 -30' P.T.M. 289-�7
DALLAS, TX 75221—071 1 WITH BULL RUN VALE FOR FUTURE 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
C/O 7—ELEVEN, INC. USE. (508) 477-5313 11/17/17 P.T.M. 1 Of 2
i
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
SEPTIC TANK FOR A GRADE
STD SHALL NOT BE
< THE 0
INSTALL RISERS & COVERS OVER INLET & PERIMETER AN THE S.A.S.
OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D-BOX
INSTALL RISER & COVER PROPOSED S.A.S. ,EXISTING
SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND BUILDING(#1149)
SLF.GEL.53.1
SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT N) SLAB EL.=53.5f
t F.G. EL.=52.9t F.G. EL.=53.Ot F.G. EL.=53.0t VENT �' h°�` -CONVENIENCE STORE
MAINTAIN 29� SLOPE OVER S.A.S.
L = 50' L o 5' 22 8'
® S=1% (MIN.) ® S=1% (MIN.) 2" LAYER OF 1/8" TO 1/2" 00 ��
4 SCH VC 4.0'
" 40 PVC 4"SCH40 PVC DOUBLE WASHED STONE ,�N 2. 0
1p�I as $ as (OR APPROVED FILTER FABRIC)
14" 6" aaa aaa �/ S /�o•
aaaaBaa
EXISTING 48" UaUID aaaaaaa -3/4" TO 1-1/2" DOUBLE
LEVEL WASHED STONE
ADD INV.=48.77 PROPOSED INV.=48.60 4' S.2' 4'
GAS BAFFLE D-BOX EFFECTIVE WIDTH = 12.8'
INV.=49.60t SEPTIC LAYOUT
3 OUTLETS
(EXISTING-VERIFY) INV.=48.50
EXISTING SEPTIC TANK 1-500 GALLON LEACHING CHAMBERS
SURROUNDED WITH STONE AS SHOWN GENERAL NOTES:
H-20 RATED
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
TOP CONC. ELEV.=49.6t BOARD OF HEALTH AND THE DESIGN ENGINEER.
BREAKOUT ELEV.=49.0 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
NOTES: INV. ELEV.=48.50 eases OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & aaaaaaaaBaa LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. BOTTOM ELEV.=46.50 -310 CMR 15.405(1)(b):
2 SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 4'
) 4' OF NATURALLY OCCURRING 1) A 3' variance to the 3' maximum cover requirement, for up to
TRUE TO GRADE ON A MECHANICALLY COMPACTED PERVIOUS MATERIAL EFFECTIVE LENGTH = 16.5' 6' of max. cover. S.A.S. shall be H-20 and vented.
SIX INCH CRUSHED STONE BASE, AS SPECIFIED 5' (MIN.) ABOVE G.W. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
IN CMR 15.221(2). LEACHING SYSTEM SECTION TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
3) INSTAL
L INLET & OUTLET TEES AS REQUIRED. BOTTOM OF TEST PIT, EL.=40.8 = i DESIGN ENGINEER.
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
AS MANUFACTURED BYY TUF-TIUF-TITE, ZABEL OR EQUAL. FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
ENGINEER BEFORE CONSTRUCTION CONTINUES.
SEPTIC SYSTEM PROFILE 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
DESIGN CRITERIA SOIL LOG SOIL LOG HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE
BUILDING USAGE: RETAIL - CONVIENCE STORE DATE: NOVEMBER 15, 2017 (REF#15,535) DATE: JANUARY 14, 2005 8. THERE ARE NO POTABLE WELLS WITHIN 150' OF THE PROPOSED S.A.S.
FLOOR AREA = 2688 SF SOIL EVALUATOR: PETER McENTEE PE(SE#1542) SOIL EVALUATOR: DAVE MASON 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT WITNESS: DAVID STANTON R.S. AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH ELEV. TP-2 DEPTH DIRECTED BY THE APPROVING AUTHORITIES.
DESIGN PERCOLATION RATE: <2 MIN/IN 53.0 53 0" 0" 0" 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
.0 52.8 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
DAILY FLOW: 50 GPD/1000 SF x 2688 SF = 134.4 GPD FILL FILL I FILL CONSTRUCTION.
DESIGN FLOW: 200 GPD (MINIMUM) 52.0 A 12" 52.0 A 12^ 51.6 A 14"
SANDY LOAM SANDY LOAM SANDY LOAM 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
GARBAGE GRINDER: NO-not allowed with design 10YR 3/3 10YR 3/3 10YR 3/3 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
51.7 16" 51.5 18 50.1 20" REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
LEACHING AREA REQUIRED: (200 GPD) = 270.3 SF B SANDY LOAM SANDY LOAM SANDY LOAM
B B 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
�
.74 GPD/SF 10YR 5/4 10YR 5/4 10YR 5/4 INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL.
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 50.0 36' 50.1 35" 49.8 36" 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH PERMIT
EXISTING GREASE TRAP: 1000 GALLON CAPACITY C1 C1 t C1 FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING PERFORMED.
PERC
PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED M-C SAND 36"/54" M-C SAND M-C SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 1-500 GALLON LEACHING CHAMBER SURROUNDED 2.5Y 6/4 2.5Y 6/4 2.5Y 6/4
4 FT. OF DOUBLE WASHED STONE ON ALL SIDES 10% GRAVEL 10% GRAVEL 10% GRAVEL 1149 FALMOUTH ROAD, CENTERVILLE, MA
SIDEWALL AREA: 2(12.8' + 16.5') X 2 = 117.2 S.F. 1 Prepared for: Bevilacqua Construction, P.O. Box 628, Forestdale, MA 02644
BOTTOM AREA: 12.8' x 16.5' = 211.2 S.F. 1" 40 8 144" Engineering by: SCALE DRAWN JOB. N0.
42.0 132" 42.0 132
TOTAL AREA:................... ....... .... 328.4 S.F. PERC RATE <2 MIN/IN. "C" HORIZON PERC RATE 2 MIN/IN Engineering Works, Inc. N.T.S. P.T.M. 289-17
PERC REFERENCE: P-2470, 10/25/83 C" HORIZON
DESIGN FLOW PROVIDED: 0.74 GPD/SF(328.4 SF) = 243.0 GPD NO GROUNDWATER ENCOUNTERED NO GROUNDWATER 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET ENCOUNTERED (508) 477-5313 11/17/17 P.T.M. 2 Of 2
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