HomeMy WebLinkAbout0277 FULLER ROAD - Health 277 Fuller Road
Centerville
A = 189 - 973
S M E A D
No.2453LOR
UPC 12534
amead.com • Made In USA
A00-C-o
I
aee�us®r+naaeooaTu+c
SFI
SIXIRCING SONG
No. s 236 Feel
THE COMMONWEALTH OF MASSACHUSETTS Entered in compute
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for misposal *pstem Construction 'permit
Application for a Permit to Construct( ) Repair( ) Upgrade(M-Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. _ 77 ULL EA ZAP Owner's Name,Address,and Tel.No.
GFa,�Er�1111-c6m C;MIn ES,�/1?a aq/� 6
Assessor's Map/Parcel/9 f �G WC AXT454 L114Z4"
Installer's Name,Address,and Tel.14o. _9v?7 - Designer's Name,Address,and Tel.No.
L• s 3 s - ; (P LLFr4 Soria
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building ziDEjNo.of Persons Showers( ) Cafeteria F---�
Other Fixtures
Design Flow(min.required) �J C) gpd Design flow provided , •O gpd
Plan Date Zj/ Number of sheets; Revision Date
Title
Size of Septic Tank ype f S.A.S. J9 66 ce ,t7,k 7�Lt>r CLc
Description of Soil 2✓C lr O
Nature of Repairs or Alterations Answer when applicable) ZOIX0049 /
df7 DECIL
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 to place the system in operation until a Certificate of
Compliance has been issued by this Board o Heal
Si ed Date o�0,
Application Approved by Date 20!
Application Disapproved b Date
for the following reasons
Permit No. a i-3— Z34 Date Issued 610617-013
No.20 1 ?-Sa Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION-- TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Bisposal .pstem Construction.Permit
Application for a Permit to Construct( ) Repair( ) Upgrade V Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.o2 7 7 FvL L -a -zo. Owner's Name,Address,and Tel No. /
"0 CIM"Fl Es vk/Ylao
Assessor's Map/Parcel 2,0 r--X �Gt
Installer's Name,Address,and Tel.No. S -?d 7 . Designer's Name,Address,and Tel.No.
ulz K�`5 tJfTW6- °�`� - ,/
3 _ Jai 1 (y�7LLFr� GlQ 7
Type of Building:
Dwelling✓No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder()
Other Type of Building No.of Persons Showers( ) Cafeteria.__)
Other Fixtures r
Design Flow(min.required) gpd Design flow provided gpd _
Plan Date Number of sheets. Revision Date
Title & L
Size of Septic Tank Ott Type of S.A.S. 5-00 64 cu DR
Description of Soil �e ? r _S .r�n t
i
Nature of Repairs or Alterations(Answer when applicable) ,`C e 0U / Ti^
Vf
Date last inspected:
Agreement:
iThe 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 to place the system in operation until a Certificate of
Compliance has been issued by this Board of Heal f.
Signed Date �]
Application Approved by Date� Zol
Application Disapproved b Date
for the following reasons f
Permit No. 70111-- 7_361 Date Issued 6IZ6 17-013
�I ---------------------------------------------------------------------------------------------------------------------------------------
TH E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
k THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(4�
Abandoned( )by /lit T 7— 2 JZhP�r r/.,Il�S
at ji//_/E has been constructed in accordance
/ /
with the provisions o 't 5 and the isposal System Construction Permit No.zo►�-Z36 dated 74 1 ►-3
Installer Designer
#bedrooms Approved design flow 33 n gpd
The issuance of this permit shall not be construed as a guarantee that the systeewWill-fun ti rdesi ed.
Date !J g/l, Inspectar__ __ �-
-------------------- ------------------------------------i-----------------------------------------------------------------------------
No. _ -A Fee*10°o
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade(Abandon( )
System located at e-2 72 ��L! r,7 Z4 C 77-0/
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.
r Date � � �Z Approved by
Town of Barnstable
Regulatory Services
Thomas F. Geiler, Director
N
&MWgrABL Public Health Division
" Thomas McKean,`� Th McK Director
iOTFo ena+
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: Sewage Permit#g a 13 Assessor's Map/Parcel S r-
Installer& Designer Certification Form
Designer: Installer: G—
Address: Address: fpe
On A 6 f M S�Or It A was issued a permit to install a
date) (installer)
septic system atZ29 Fs,,7, cG,2!�r based on a design drawn by
(address)
c c c-ar -7'0254-,� 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. Stripout (if required) was inspected and the soil's
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. Stripout (if requiredd and the soils
were found satisfact
>\' p y 'C fiLTy
s
Tf 'n
,fie
(Installer' Signature) ' ` . 114
0/STS_
(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. r
gAoffice formsWesignercertification form.doc
r
TOWN OF BARNSTABLE
LOCATION 77 r- 11 LLg-_c JZ SEWAGE#0/.3 3 6
VILLAGE ("�, {FQ�/1LL E' ASSESSOR'S MAP.&PARCEIN :/q
INSTALLER'S NAME&PHONE NO. jje
SEPTIC TANK CAPACITY 1S"00
LEACHING FACILITY.(type) a 1 Scv 6-A L L6>�DZ y ) ���.r
NO.OF BEDROOMS 3
OWNER C
PERMIT DATE: d COMPLIANCE DATE:
Separation Distance Be -en th
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ! Feet
Private Water Supply Well and Leaching Facility(If any wells exist orr
site or within 200 feet of leaching facility) �r Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility). \ ` �- Feet
FURNISHED BY
NJ
r � i
" f
�t
YO
Town of Barnstable r#
Department of Health,Safety,and Environmental Services
Public Health Division Hate
�.$ 367 Main Street,Hyannis MA 02601
•ss9 . / Time Fee Pd.
��► Date Scheduled
Soil Suitability Assessment for Sewage Disposal
Witnessed By:
Performed By:
Y aCATION &'GENEPALINEORMATI.
Owner' ON
s Nwne1460je'7dP�—'�
Location Address G. /�2 4"OE5 � `�yam-
�-'/� Address 3�i/�/.vl5-Gvic c i .D.�=
r�e-4"e-� OC.c>�.y s�l� Zo$'3
CC / /7S�asr.
Engineer's Name �c:^GG�
Assessor's Map/Parcel: lam/
Telephone# <�" . `-
NEW CONSTRUCTION _ REPAIR �/ 'a.�/ }
Slopes(0/0) Surface Stones
Land Use ft i
ft Possible Wet Area ft Drinking Water Well
Distances from: Open Water Body ft Property Line
ft Other ft
Drainage Way
__—_
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
Parent material(geologic) Depth to Bedrock
Depth to Groundwater: Standing Water in Hole:
Weeping from Pit Face
Estimated Seasonal High Groundwater
_ n�R'�.,t tl ATl—GN`�"t`�l� �l; Sffi f t.' it'"� T rH'y` _ ..
Method Used: in. Depth to soil mottles: in.
Depth Observed standing in obs.hole:
�` , 1 4�°
t ..
1-Iole#
DEEP OBSERVATION HOLE LOG soil other
Soil Texture Soil Color
Depth from Soil Horizon (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
0 veil
Surface(in.)
37
1
Hti1 e'#
DEEP OOSERVATION HOLE LOG Other
P Soil Horizon Soil Texture Soil Color Soil
77:1
Depth from I __ (USDA) = (A".unsel!}_ Mcttting (&tn;ctt�re,Stones,Boulderes.
r 1 °
Surface(in? -
-------------
,i ------------
4
DEEP.6OSER'VATI'ON 1OLE I'OG I�.
Other
,n Soil Horizon Soil Texture Soil Color $Oil Structure Stones,Boulderes.
Depth from Mottling
P unsell
Surface(in.) (USDA) (M ) e ° v
a
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil
Other
USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Surface(in.)
0
N
_. ._..
Flood insurance Rate aa:
Above 500 year flood boundary No_ Yes
I
ch NINSTALL RISERS COVERS TO PIPES TO BE LAID LEVEL FOR DEEP OBSERVATION HOLE LOGS
m WITHIN G" OF FINISH GRADE 2' OUT OF DISTRIBUTION BOX INSTALL 2" LAYER OF DOUBLE WASHED PEASTONE
(SEE PLAN VIEW FOR LOCATIONS) OVER 3/4" - I X2" DOUBLE WASHED STONE ALL AROUND
w J TEST BY.4 Lu D. MEYER,ME RSICSE09
� U WATER TEST D-BOX FOR '
LEVELNESS FLOW
0- � WITNESS: D. DESMARAIS, HEALTH AGENT
< EQUALIZATION PERC RATE: < 2 MIN./ INCH
m �
DEEP OBSERVATION HOLE#I EL. 55.0
C0 EL. I G.0 - - -EL. 55.2 EL. 55.2 DEPTH
O T.O.F. @ -� e501L 501L 501L COLOR SOIL
4"SCH FROM OTHER
Q EL 57.5 4°SCH 40 PVC TOP @ EL. 52.2 SURFACE HORIZON TEXTURE (MUNSELL) MOTTLING
40 PVC 4"5CH 40 PVC
CIDI O° 14„ WORMWO 0"-G' A LOAMY SAND I OYR3/2 PERC @ 37°'-5qF"
Z to 54.50 53.25 (2) 500 GAL. PRECAST DRYWELLS G'-37` B LOAMY SAND I OYR6/8
IV INSTALL GAS BAFFLE 52. 17 52.00 BOTTOM @ EL. 49.50 37"-1 2G' C MEDIUM SAND 2.5YG/4 24 GAL:<15MIN.
O IN OUTLET TEE 53.00 .50
Ln 5 I
t N DB-5
N Lu
T) INSTALL TANK#D-BOX
1- ON G" LAYER OF CRUSHED 5' DEEP OBSERVATION HOLE#2 EL. 55.0
DEPTH
O Q 1 500 GALLON PRECAST STONE FROM SOIL 501L 501L COLOR SOIL OTHER
J
SEPTIC TANK BOTTOM OF TEST HOLE SURFACE HORIZON TEXTURE (MUNSELL) MOTTLING
@ EL. 44.5 0"-7" A LOAMY SAND I 0YR3/2
7"-3G" B LOAMY SAND I OYRG/8
37"-1 2G" C MEDIUM SAND 2.5YG/4
NOTE: NO GROUNI?WATER ENCOUNTERED IN ANY OBSERVATION HOLE
56
/ DESIGN DATA
55.0 l' / 54 DAILY FLOW: (3) BEDROOMS x I 10 GPD = 330 GPD
SEPTIC TANK: 330 GPD x 200% = GGO GPD
+5G.8 / o 1 , USE: 1 500 GALLON PRECAST SEPTIC TANK
TH TH 1 1 .5' , D15TRIBUTION BOX:
1 + - - I ; USE: (5) OUTLET DB-5
lW �� i 501L A55ORPTION 5Y5TEM:
I�� I W 0 I I� i USE: (2) 500 GALLON PRECAST DRYWELLS w/4' OF
L _ _ _ _ -- .I i DOUBLE WASHED STONE ALL AROUND
CAPACITY:
o I , 51DEWALL: 7G x 2 x 0.74 = 1 12.5 GPD
BOTTOM: 13 x 25x 0.74 = 240.5 GPD
TOTAL: 353.0 GPD
i It i 11 It
1 / i '
I
I
Fv TBM = EL. 57.5 / i '
u / ► '
N
TOP OF FOUND. / '
I
O I \
I I I i
D i 52
it
1 rn�I;
1 I
R= 1 1 .30'
/ A= I G.37
' T= 1 0.00' ', 50 -0 OF Mq,i
It
___ 0. 1114 0
10 5 00'
/I / TL �Q
jTs
'Ni
I
-Il l
GENERAL NOTES SITE �J' SWAGE PLAN
fop,
i I . SEPTIC SYSTEM IS TO BE INSTALLED IN ACCORDANCE WITH 277 FULLER RD. CENTERVI� _ 1 LLE, MA
\' 3 10 CMR 1 5.00: TITLE V '
52 50 k 2. THI5 SEPTIC 5Y5TEM 15 NOT DESIGNED FOR THE U5E OF A PREPARED FOR
I GARBAGE DISPOSAL. CH'ARLE5 * MARY AN N TOLL
I 3. TH15 PLAN 15 NOT TO BE U5ED FOR PROPERTY LINE DETERMINATION. SCALE:/
t 20' 04-09-20I3 DATE: DRAWhkSY: TMW
4. CONTRACTOR SHALL PROVIDE 48 HOUR NOTICE TO DESIGN
=
54 ENGINEER FOR ANY REQUIRED INSPECTIONS. JOB NUMBER: REVISION: SHEET NUMBER:
3-008 5P_ I
5. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ANY
UTILITY, ABOVE OR UNDERGROUND, PRIOR TO ANY EXCAVATION WELLER A550CIATE5
OR CON5TRUCTION. I G45 FALMOUTH RD., SUITE F9 P.O. BOX 417 CENTERVILLE, MA 02G32
2 WINDY WAY, #232 NANTUCKET, MA 02554
TELEPHONE: (508) 328-4G92
EMAIL: trlsweller@comcast.net
REGISTERED LAND SURVEYORS ENVIRONMENTAL CONSULTANTS
Traverse PC