HomeMy WebLinkAbout0108 HORSESHOE LANE - Health 108 HORSESHOE LN
Centerville
A = 207 — 141
S M EAD
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No. 12534
2-153LOR
SUSTAIFORE ''�`E MIN.RECYCLED
IWTIATIVE CONTENT10%
CoMed Fiber souroin0 POST-CONSUMER
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5"17e0
MADE IN USA
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No. `/ Fee to l
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: I
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplication for Migotar bp$tem Construction Vermtt
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. (p� L�6eSkoQ L q at
Owner's Name,Address,and Tel.No. f ��J/ �
CAssessor's Map/Parcel (�p . . 0 Mrs
Installer's Name,Address,and Tel.No. � Designer's Name,Address and Tel.No. C.a�a« S_#4
P..�. 3•x -r63 P 27
klV_ MM ` _,"& r39 -7%. r.
Type of Building:
Dwelling No.of Bedrooms Lot Size It Loo } sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 3`► gpd Design flow provided 3 3 1 • S gpd
Plan Date 1 2=Lra-t-c- Number of sheets / Revision Date
Title 109 la ile-3 lot
Size of Septic Tank t a O y Type of S.A.S. [ 2.) T-o �'/q/• L. G, 14-'Z b
Description of Soil _!—SQ- p,H
Nature of Repairs or Alterations(Answer when applicable) 1 So o C ro rky -,,tom _ 'n x CZ� Tvp{ C.
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.
Signed Date 2 Z Z Z o o�-
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. � Date Issued
-------------d[ ----------------- ——..�—---------- —
.� ice' � ,t. ...•,[ :..:,y...✓� ,d. ..-y �r .r.. .i ...«i.,,,. .._.
No. Fee f V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y s
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for Mis;possal *p-5tem Conotruction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. (U 2 L va Owner's Name,Address,and Tel.No. /" ,�-1 ✓�Q f4 r K
Assessor's Map/Parcel 2 0' /r�t. �/��� `� ,+''� �"&//�o``'ii '• �t-4•-a
C,npe,_ Ck, colev "'s s/�QY
Installer's Name,Address,and Tel.No. p �rt' Designer's Name,Address and Tel.No. L°,n^-,-zr ew
Ceti+u�; \le Mh 50$ f3 7`t�c.
Type of Building:
{
Dwelling No.of Bedrooms Lot Size 1 2.00 - sq. ft. Garbage Grinder ( ) ;
Other Type of Building !N 1, No.of Persons Showers( ) Cafeteria( )
Other Fixtures t
Design Flow(min.required) 3 3 gpd Design flow provided 3 3 I • S gpd
Plan Date 1 '2 Number of sheets 1 Revision Date
Title
Size of Septic Tank 1 o O 5 Al . Type of S.A.S. ( Z j- C_. /•/ - Z y
Description of Soil
'Nature of Repairs or Alterations(Answer when applicable) - 1 5-0 u �n ' (-� � � _ ��X (Z ( C•C
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 Certificatesof
Compliance has been issued by this Board of Health "
Signed 1�-\��-��Yi� !''�'_ Date Z. 0 c0(_
Application Approved by e e Date / 1J2.2—
Application Disapproved by: Date
for the following reasons
Permit No. Z� Date Issued � -
..
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 Cf Q (_,J e ,CA E✓I�-e�P�� S� S LL <_ �\
at 10 (f p e T L✓•l-� has been constructed in accordance L j
with the pr visions of Title 5 and the for Disposal System Construction Permit No. � )/� 5 4// dated I
Installer KI,U.A.Ji4.9 C'-1 Designer C n�M2vr S ljo
#bedrooms Approved design flow. = ) gpd
'The issuance of this permit shall not be construes as a guarantee that the system will functionoas designed.
Date I 1p Inspector
--------------------------------------------
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
=igpo!9al *p5tem ConsStruction Permit
Permission is hereby granted to Construct ( ) Repair ( ) Upgrade Abandon ( )
System located at D �-1 o(� S 1. t (� ._ ( ��`(t u 1 l t—
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes 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 Dermit.
Date /2/Z / Approved by
c
Town of Barnstable
°FWE'n Regulatory Services
Thomas F. Geiler,Director
BARNSTABLE. •
9� MASS. Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: i C)
U
QDesigner: Sha Environmental Services, Inc. Installer: W I'
Address: P.O. Box 627 Address:
East Falmouth, MA 02536
On Ca &T, LL( was issued a permit to install a
(date) (installer)
septic system at I OV Mac�, based on a design drawn by
(address)Shay Environmental Services, Inc. dated_ 6-;L @ In ca
(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.
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
ified as-built by designer to follow.
N OF MAssq
CARMEN
E.
(Installers Signature) $ SHAY
No. 1181
0
\. GISTS
SANITAIMP
(Designer'sSignature) (Affix Desi p 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
TOWN OF BARNSTABLE
LOCATION ��� i��d - ��` SEWAGE #
VILLAGE Erl 'L/L ASSESSOR'S MAP & LOT GJ
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY i C H 1
LEACHING FACILrTY: (type) 4 /,f IQ .SZ`6 (size) t X
NO.OF BEDROOMS _
BUU.DER OR OWNER , _.�O S Cr
PERMTTDATE: /,`3 SOMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Ne) !Z Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) 4 Feet
Edge of Wetland and Leaching Facility(If any wetlands exist /
within 300 feet of leaching facility) / S Feet
Furnished by
cl
i7' a
k). 3 a s,
it
�`VIV�'!T�'�'ll�ii+}��IISY�.'�;�be'YteY'lllfirtb : �. . ••"�• � 1�11���1�' �.�t
VENT POPE_ ��
(0 Least 24 feehes tall ' K
Schedule 400 PVC w/Charcoal Odor FAter �' a .+ a a� � Y JvLyry
10' min. from *NOTE.- ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C.
EXISTING Foundation [house to septic tank mud be IE3alrr1tas1ta11biss �p
n 8* covers
munt
r M thin BOeorfGRADE SAS ewsr awfR be ,
e SECTION A A ,1oB s-aorsastsoAm Ln
' Grodt over Swft Tank- MW Qods over 0-Barr-9600 wRlrir► 8' d GRADE over SAS-9&00 *;
PROFILE VIEW OF LEACHING SYSTEM k
S- 0.02 3 HOLE TOP OF SAS 9C75 s f f/!'srwd and awe. y#Ar'-fAr�s Aerr"r
n 72' S'0Df -�) BOX INSpEClION cover rrMrst Oe Frei r ,. rf § iq
FIMNEV PIPE Fa9mATM NEW 1,500 G �, solo' toot / 4w.`.arm eR1An a in of tkrielred grade # A r#r pWd" r t` ' x .z� •,�.SEPTIC TANK
r
H-10 N 20' o o
A •.err •
CONCREVE�1 0 0 + Y l 4 V µ4e
S. .�.�� t� 0 @S m.w.r .. .Jfe.�.. T[�.aF.. :sF..YwQ. ...:aQT. D-.ia t.
SYSTEM PROFILE o a r 9 4, z L 9 = 17 4, GENERAL NOTES
Effective Nldth
Not to Scab i , 1. Contractor is responsible for Digsafe notification, Verification of Utilities
NOTE: PIPE TO BE RE-ROtM TO FRONT OF HOUSE BY A LICENSED PLUMBER c c z Effect��L.ergth and protection Of all underground utilities and pipes.
0 In.ot 3/4'-1 1/'r .9 2. The septic tank an1� distn cation box shall be set
CO Kai
3/ m SOIL ABSORPTION SYSTEM (SAS) level On 6" Of 3/4 -1 1/2" stone.
NOTE: PLUMBING PERMIT REQUIRED TO RELOCATE INTERIOR PIPING AND SEWER LINE Bottom of Test Hole 1 Elev= 87.00 3. BOckfill should be clean sand or gravel with no
500 - C H-20 LEACHING UNITS / WIGGINS PRECAST stones over 3" in size.
Groundwater observed - NONE OBSERVED 4. This system is subject to inspection during installation
P E R C 0 LATI 0 N TEST P 11468 Not to Scale by Carmen E. Shay - Environmental Services, Inc.
# 5. The contractor shall install this system in accordance
Date of Percolation Test: OCTOBER 18. 2006
NOTE ALL COMPONENTS Muse HAVE RISERS TO WITHIN 6" BELOW GRADE with Title V of the Massachusetts state code. the approved plan
Test Performed By. CARMEN E. SHAY. R.S.. C.S.E. and Local Regulations.
Results Witnessed By. DESMARAIS (BARNSTABLE BOH) 6. If, during installation the contractor encounters any
EXCAVATOR: SHAY ENVIRONMENTAL SERVICES, INC. Au.OunET FM RM THE soil conditions or site conditions that are different
Percolation Rate: Less Than 2 MPI ® 48" ® TP1 asnaelnlON Box SHAM 11E f2 _ OovER from those shown on the soil log or in our design
SET LE1k1 FOR AT LEAST 2 Fr, installation must halt do immediate notification be
R•- j %�Test Hole Test Hole 3-r ounu 7vt made to Carmen E. Shay - Environmental Services. Inc.
loaacaurs
No. 1 No. 2 = 7. No vehicle or heavy machinery shall drive over the
DEPTH SOILS ELEV DEPTH SOILS ELEV - as ou1LET 1r MET septic system unless noted as H-20 septic components.
r : r 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
0 98 00 0 94.00
9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes.
Lo�ady , SOH. 40 T 1.7r 10. All solid piping, tees dt fittings shall be 4" diameter
FILL 10 YR 3/2 43.00 82 PLAN SECTION CROSS-SECTION Schedule 40 NSF PVC pipes with water tight joints.
95.17 0._6. A. 93.50 11. Municipal Water is Connected to ALL OF The Residence and Abutting
Amy sandy Properties Within 150 Feet.
10 YR 3/'2 10 YR s/s 84 3 HOLE H-10T DISTRIBUTION BOX
THE PROPERTY LINES ARE APPROXIMATE AND
36"- 36 A4 95.00 6"- 2r B■ 92-00 COMPILED FROM THE PLAN BY CHARLES SAVARY, ENTITLED
�y lb VARIANCES REQUESTED: SUBDIVISION
BBDDIVISIO S"TP3 PLAN OF
OF LAND972. INBOCEEN 2 0 PAGE 78
10 YR 5/k 25 Y 7/4 ADS . AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
36'- 4g• Be 9400 2r- 120 G 84.00 EDGE -f 1. Request a Variance to install an SAS 5 From a Full Foundation. IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
Coarse ps -_ a 40 mil Polyethylene Liner Has been Proposed. THE SEPTIC SYSTEM INSTALLATION.
Sand
7/2,S 4 $EDGE F- ' 2. Request a Variance to install an SEPTIC TANK 6' From a Full
$6 46'- 13 87.00 Polyethylene FOUNDATION. A 40 mil Pol eth l Lineras been Proposed.H b P osed. EXISTING CESSPOOLS TO BE PUMPED OUT AND FILLED IN PLACE
� �
3. Request a Variance to install an SAS within 10' of a Water Line NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
6 4" PVC DOUBLE SLEEVE Has been Proposed. FROM THE EXISTING CESSPOOLS TO BE DISPOSED
88 OF AS PER BOARD OF HEALTH SPECIFICATIONS.
Perc J1 LOT # THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
Depth to Perc: 48" - 66" $$ 11„Z00 Square Fsst f/-
Perc Rate= CL MPI ASSESSORS MAP 207 PARCEL 141
Groundwater Not Observed 0132" -TP1 ji0 LEGEND
No Observed ESHWT
ADJUSTED H2O Elev. = None a
va
--11 DENOTES PROPOSED
3-24'our.NZEW MAIMM o, 104X
;I SPOT GRADE
1v 90 No Failed- 92 X 104.46 DENOTES EXISTING
ft I
N b 0TEST - 11
. Cesspool SPOT GRADE
r ^1 ^1 E s4.00 94
• PL PROPERTY LINE
.kET ;
THE ACCESS COVERS FOR THE SEPTIC TANK, 96 PROPOSED CONTOUR
DISIRIBUTKIN BOX AND LEACHING COMPONENT Cesspool
_ ,�,,.,r FI ALL BE NtSINEDADs�o TO "THIN s- OF aJ� 96 NOTE: WATER LINE TO BE DOUBLE SLEEVES FROM - ---97 EXISTING CONTOUR
STEEL REINFORCED PRECAST CONORM INSTAL- nW-MW GAS BAFFLES OR EQUALS ) STREET TO HOUSE WITH
PLAN VIEW ON ALL OUTLET TEE ENDS `�/
3-2 REhIOr,RX oaWIM� 9 DECK too k FROM w DS 4" SCH 40 PVC & PLUGGED AT EACH END. DEEP TEST HOLE &
PERCOLATION TEST LOCATION
_ _ __ 6 FOOT STOCKADE FENCE
V.3•mn.d.Qarc. '>..� .:-• 4 1r ..Er f 96 IM tJDs
"LET-
NOWr aarT r errr rw.t to ee0.t s•er. � FRO
--� oulm � 100
I EET
s-r . 1 �T Lrww M y 's•-r PROJECT BENCH MARK 3 Season Room
e • i*nft
� TOP OF FOUNDATION PLOT P LAN
�s6.2.0ft ELEV. = 100.00 (Assumed) EXISTING
3 BEDROOM 9 gorrsE TEST HOLE �1
OF PROPOSED SEPTIC SYSTEM UPGRADE
,a,�. �a•�- �•� �
CROSS SECTION END-SECTION 40 POLYETHYLENE LINER FROM ELEV. #108
� ELEV = 98.00 PREPARED FOR
96.00 to 92.25 AND TO EXTEND 96 PA M E LA L. M 0 S E R
TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK 10' BEYOND SAS & FND AS SHOWN is' AT
NOT TO SCALE , # 108 HORSESHOE LANE
May Substitute with 1500 gallon H-10 Polyethylene Tank-George O'Brien Co. = • 4- PVC
o o ,. j :j ; VENT C ENTERVI LLE, MA
�. :� •>
NEW
Design Calculations 500 gal. e� �L p_-Box+ ° r
Septic Tank 3 f.00 PREPARED BY: SHAY
Number of Bedrooms: 3 Equivalent to 330 Gol./Day (330 Gal./Day Min, per Title V) - 4 f.37' o C1 Y R�Yl�'N E.Al
Garbage Grinder. No `. •
Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) 0
i
Septic Tank : - 2 x 330 Gal./boy = 660 USE NEW 1,500 GAL Septic Tank! a " ENVIRONMENTAL SERVICES, INC.
'L
N a..
2
SOIL ABSORPTION AREA: Using percolation rate of < min./inch ` ..--- "---`- ----- ---- ----------------- �
Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. - 222.00 gallons 6 -"' � ,, , r P.O. BOX 627
"- C, EAST FALMOUTH, MA 02536
Sidewall Area: 0.74 gal./sq. ft. x 148 sq. ft. = 109.50 gallons tiNITA0
Providing: = 331.50 gallons ��•- '° TEL/FAX 508-539-7966
Use- (2) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH, , 9 FOR f57.1Y0E LA NE SCALE: 1"=20' DRAWN BY: CES DATE: DEC. 20, !1:::d
00TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES AND (40 FOOT RIGHT OF WAY)
4' OF WASHED STONE oN THE ENDS. PROJECT#SD979 FILENAME: SD979PP.DWG SHEET 1 OF