HomeMy WebLinkAbout1379 FALMOUTH ROAD/RTE 28 - Health 1379 FALMOUTH ROAD/RTE 28
Centerville
A= 229 -087
SMEAD
KF_EPING YOU QRGANI7_EM
No. 12534
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No. ( Fee [ �✓�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppliLation for -Mispo8al *pstrm Co=stem
Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Individual Components
Location Address or Lot No.t 3'g R%RS lCr,�sY►pA A) Owner's Name,Address,and Tel.No.
Gelvterut) e
Assessor's Map/Parcel AA g —al 1_Gal/'
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
014 ,?Xf A) ,I-NG SOg Wo-ys3 y
Type of Building:
Dwelling No.of Bedrooms Lot Size -1 sq.ft. Garbage Grinder( )
Other Type of Building re51c)er, 'In 1 No.of Persons Showers( )'Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided Ll it j( gpd
Plan Date I Number of sheets / Revision Date
Title
Size of Septic Tank <tf00 Type of S.A.S. /i P/� /v V®_X
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) L. N5r~f 1/ G Atec.) .16-0 7 �ir���CnJ SAD fi�: )rrZ
()K4-A jjja ,�ra aAr) (,eQ-r 1. Stb °ate as 6 6cftl� 6M
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.
S' Date '` / _/9
Application Approved by t Date 2�0 l
Application Disapproved b Date
for the following reasons
Permit No. Date Issued oil)/aw l
"N
8,. No. 1 µ Fee
u�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes*
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Misposal ,6pstetu Construction J)ermit
Application for a Permit to Construct( ) Repair(d<Upgrade( ) Abandon eomplete System ❑Individual Components
Location Address or Lot No. g:) Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel l
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�,•'1yOWA) X&r- � rangy//A
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
1
✓' Other Type of Building �� a pna +G No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) q t/) gpd. Design flow provided Qij gpd
Plan Date .,� ,l Number of sheets Revision Date
Title
� • `` Size of Septic Tank j fC>n Type of S.A.S. ���Un S"
{„ Description of Soil
.y
r
Nature of Repairs orAlterations(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 Health.
Si ci — Date /_ f �,
v� 9
Application Approved by Date g
Application Disapproved byDate__ 1
for the following reasons
Permit No. ;7,r ( Date Issued '" ?4/q
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V< Upgraded( )
Abandoned-( )by _7,ire. ,�n1 L a)r-
at /D 77 At /,H�g,/-'. , - ���-. r,i,��o has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. -Zp1 dated I/IZp 11
Installer 4 _ ��( Designer J��y�60�5� �a,,
Ir ✓ F
#bedrooms 6/ Approved design flow L gpd
The issuance oft 's pe it shall not be construed as a guarantee that the system will ctioel,
d.
Date ►l Inspector
---------------------------------------------------------------------------------------------------------------------------------------
tc�
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Misposal 6pstent Construction Permit
Permission is hereby granted to Construct( ) Repair( Upgrade( ) _1 Abandon( )
System located at 12� i `�� �l E� �.en�Lr✓yi/�,•
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 be completed within three years of the date of this permit.
Date Approved by
x '
Town of Barnstable
.�'ME ,,� Regulatory Services
Thomas F. Geiler,Director
enxtvsreaLe, t
16 $ Public Health Division
prEo " Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: -:g/(q 1 11 Sewage Permit# o 1 -:2d l Assessor's Map\Parcel ZZ Q
Designer: DAWN GAW"1WMJI6t, IN Installer: DOZA F2UVJ
Address: AM MItIN It t"M )rF(�� Address: T,0,1k� N
YA.MOUM WTI NA 02 275 Q�3
On ��
was issued a permit to install a
(date) (installer)
i
septic system at t 3 79 (0VX Z6 'CMM IL L6 based on a design drawn by
(address)
DANIP,A. OJALA, PE, PLC dated A1)0, 22/ 201b
(designer)
_ZI 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
s 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 &Local Regulations. Plan revision or
certified as-built by designer to follow. a :
'DANIEL�A.
OJALA ;
10
;ns4tafl6r"s'5ignature) �, CIVIL
No.�ts-02 2 l
I 1
1
(Designer's Signature) (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.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
TOWN OF BARNSTABLE
LOCATION �iI& >'"CLtMgclfhSEWAGE# ';Ot"t—Z0
VILLAGE Ce, jkryl& ASSESSOR'S MAP&PARCEL ;1a c ?
INSTALLER'S NAME&PHONE NO.—�?-,q 5 bvj T_ A—r-
SEPTIC TANK CAPACITY 1
LEACHING FACILITY:(type) 1-n6 (size)
NO.OF BEDROOMS
OWNER re�i✓ Ic,
PERMIT DATE: ! / COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well 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 leachin facility) Feet
FURNISHED BY �/ �C%�✓�
'D- 211Gri r(onsT -
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oFTKE,�
Town of Barnstable P#
IS--7
Department of Regulatory Services
� BARNSTAHLE, + Public Health Division Date
MASS.
9� 0.59. 1�� 200 Main Street,Hyannis MA 02601
pTfD MPS A Vt0
Date Scheduled ` (� f 0Q. 5'
Time Fee Pd. 0
€:
y�
Soil Suitability Assessment for ge Disposal
Performed By: C�Q�QI �Ce(` Witnessed By: ,,,,`�-�
LOCATION& GENERAL INFORMATION /
Location Address / Z "�JC, /�O //�e a� Owner's Name- —�� a f—
C P� /`✓) l e Address ///���
Assessor's Map/Parcel:,� 9 8 Engineer's Na
�, ww q
NEW CONSTRUCTION REPAIR Telephone# So �v oZ
Land Use B e,5 Ae,At'oL I Slopes(%) —[( IJ�yCi,0 Surface Stones
t
Distances from: Open Water Body ft Possible Wet Area?,00ft Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
�� �S6.8Z' 6�,'��• alp`� 1
N
z
Parent material(geologic) (�LIK O: t Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: �r Weeping from Pit Face ZG
Estimated Seasonal High Groundwater n 7 b 6
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: l? in. Depth to soil mottles: in.
De th to weeping from side of Wsole: in. Groundwater Adjustment ft.
Index Well# �' Reading Date: Index Well level Adj.factor 3 r7 Adj.Groundwater Level /2P!
'PERCOLATION TEST Date Time Y
Observation
Hole# Time at 9"
bC�
Depth of Perc ripTime at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
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 Conservation Division at least one(1)week prior to beginning.
Q:\SEPTICTERCFORM.DOC
_ _ J
r
DEEP OBSERVATION HOLE LOG Hole# �-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(iri:) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
C, t Consistency.%Gravel)
LS - I
DEEP OBSERVATION HOLE LOG Hole#_
Depth from Soil Horizon. Soil Texture Soil Color ,soil Other
Surface(in.) (USDA) (Munsell) Mottling. (Structure,Stones,Boulders.
Consistency.%Gravel)
ffiqlf
is-z� L5 LoyiR6/6
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
Flood Insurance Rate May:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No 25' Yes
Within 100 year flood boundary No 2� Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pery ous�terial exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environ ental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature , ` ' Date
Q:\SEPTIC\PERCFORM.DOC
SYSTEM PROFILE
LEGEND NOTES
PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) MARK CORNERS OF Wequaquet
LEACHING FIELD W/ PROVIDE INSPECTION PORTS TO 1. DATUM IS NAVD 88 Lake
99 - EXISTING CONTOUR ACCESS COVERS TO WITHIN 6" OF FIN. GRADE WITHIN 3" OF FINISH GRADE e�
X 99.7 REBAR SET 4" BELOW
EXIST. SPOT ELEV. TOP FOUND. EL. 40.8' GRADE 27* SLOPE 2. MUNICIPAL WATER IS EXISTING occ
\ 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
17.1 ' MINIMUM .75' OF COVER OVER PRECAST FILTER
-[99]- PROPOSED CONTOUR RE-ROUTE PLUMBING TO FINISHED GRADE- 4" LOAM & SEED OR PAVE AS REQ.
FRONT OF HOUSE AS SHOWN ---- -":'- PRECAST H-10 36'-37' 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS a5
198.4] PROPOSED SPOT EL. RISERS (TYPJ
411111111116�ITTTTTTIIIII1 TO BE AASHO H-LQ
2'0 4"OSCH40 PVC CLEAN FILL
TH1 {" *38.3t 6" MIN. SUMP PIPES LEVEL 1ST 2' 5. PIPE JOINTS TO BE MADE WATERTIGHT. e J� Phinn
• 12" MIN. TNT. DIM. Grea orsh Q
TEST HOLE 4• PERFORATED PVC 3' D.C. S=0.005 KE34
Q Roy{e 28
10» 1500 GAL H-10 14" 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH
3 4"-1-1 2" DOUBLE WASHED Locu
SLOPE OF GROUND *37,8' 35.37' TEE SEPTIC TANK TEE / / 310 CMR 15.000 (TITLE 5.)
5.12 9" STONE LEACHING FIELD EPTH MIN BELOW INV. iy
00000000000o WATERTEST D'BOX , ' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TORoute 28UTILITY POLEGAS BAFFLE ::' 1°°,Q°0000°°° FOR LEVELNESS 34.75 LEVEL BOTTOM R o;
' ' ` BE USED FOR LOT LINE STAKING OR ANY OTHER Old PO
4' LIQ. LEVEL (ACME OR EQUAL) . 35.02 34.85 PURPOSE.
FIRE HYDRANT ::•`,.. ':. .. . .._•.:..,•• . _ 40.0' V
Y J°O ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
. ° ° o ° ° o ° ° ° ° ° ° ° ° ° ° ° o ° ° o 0
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING °o°o°o°o°o°o°o°o°o° ° ° °o°o°o°o°o°o°o°o°o°o° 34.0' 9
1,o,o„o.,n_n_n?n-n 0000000 n n.n_n_n_n_o.o o
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 6" CRUSHED STONE OR MECHANICAL 5.0' - WITHOUT INSPECTION BY BOARD OF HEALTH AND
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM COMPACTION. (15.221 [2]) PERMISSION OBTAINED FROM BOARD OF HEALTH.
( 3 % SLOPE) ADJUSTED GROUNDWATER 29.0' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING
FOUNDATION 92' ( 2 % SLOPE) ( 2 % SLOPE) DIGSAFE (1-888-344-7233) AND VERIFYING THE
LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP
' SEPTIC TANK 5' D' BOX 5' LEACHING PRIOR TO COMMENCEMENT OF WORK.
FOUNDATION 32 FACILITY SCALE 1"=2000't
11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
(7.5 % SLOPE)
REMOVED BENEATH AND 5' AROUND THE PROPOSED ASSESSORS MAP 229 PARCEL 87
SYSTEM DESIGN:
V" LEACHING FACILITY.
12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND
GARBAGE DISPOSER IS NOT ALLOWED
REMOVED OR PUMPED AND FILLED WITH CLEAN SAND.
/
3� 35 �38 46J
EXISTING 4 BEDROOM DWELLING Z
DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440 GPD _
USE A 440 GPD DESIGN FLOW 41
SEPTIC TANK: 440 GPD (2) = 880 m
USE A 1500 GAL. SEPTIC TANK o g 3 33
-c
3g
LEACHING:
428 GPD (.74) = 579 SF REQUIRED TEST .HOLE LOGS
15' X 40' = 600 SF OK0-3
\ m
600 SF X .74 = 444 GPD OK
USE A 15' X 40' PIPE AND STONE LEACHING FIELD I 00 G CRAIG J. FERRARI, SE 13871
ENGINEER: #
= TH1 TH2 WITNESS: DONALD DESMARAIS
0 3 3� 246 �_3 DATE: 8/15/18
MA \ PERC. RATE _ < 2 MIN/INCH
APPROVED DATE BOARD OF HEALTH 4
o CLASS I SOILS P# 15747
0
ELEV. ELEV.
W p" 33.5' p>, 33.5'
0 38
41 0 0
STAKED SILT LS LS
FENCES WORK 3» 10YR 3/3 3" 10YR 3/3
LIMIT LIN
--
00 36 SLEEVE S WE o
E WHER A A
p c� o
C° 8 WITHI T OcoLS LS
WATER SER O Ri 10YR 4/4 32, 10YR 4/4 32'
10
LOT AREA c,, 18 18
83,873 S.F. o B B
•� � LS LS
� •c9+ 10YR 6/6 10YR 6/6
30" 31 ' 28" 31.2'
F
TION �� / 3' CRAWL \
RGROUN pF% 'I 8 C 2 3
F ELECTRIC 00 �� �, 6 C C
`E 0PERC
MS MS
o E G-W ADJ. DATA:
BENCHMARK: FULL
o ARE-ROUTE BASE. � WELL: M I W 29
GARAGE SLAB �o c/o PLUMBING \�\G , / ZONE: D 120" 2.5Y 7/4 23.5' X» 2.5Y 7/4 X
=40.5 NAVD88 \ G �Oa 3 ADJ: 3.5' '
\�\ �. j JULY 2018
/ E�oP Flo / cn GROUNDWATER ENCOUNTERED AT 96" EL. 25.5'
\�J 3 CRAWL / 0_
00
0. / / / G�
GARAGE QOR O� TITLE 5 SITE PLAN
/ l COVER . ' �g �,1 �� / OF
z :41079 ROUTE 2`8 (FALM%,._juTH ROAD" )
0
2
o � •� 6
3CENTERVILLE,
PREPARED FOR
37 �k ES TE `F lw_�RANCE " FERN ki
36 j
20A
DATE: AUGUST 22, 2018
Scaler 1"= 20'
\ pGE P/ 0 10 20 30 40 50 FEET
E/
off 508-362-4541
��t{OF Mgss � sq fax 508-362-9880
c� / � 9Oy low DANIEL yN� downcope.com
DANIELA. A
OJALA OJALA � down cope engineering, MC.
/ LONG POND No,40980
„ 502 civil engineers
c� E�� o� Ss�o'
\. F ST -� land surveyors
939 Main Street ( Rte 6A)
DCE 5-246 �� DATE DANIEL: A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
# i
15-246