HomeMy WebLinkAbout0013 HUCKINS NECK ROAD - Health 13 Huckins Neck
Centerville
A=251-049
e
rt
S M E A D
No. H163OR
UPC 10259
smead.com • Made in USA►
ti
I
t-
} 404te
0.4 V �J Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Zil PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
���y ZIppYication for Mi5po!6al *p5tem Construction Verna
Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) �omplete System ❑Individual Components
Location Address or Lot No. f vc J jL-s Alz:L..L.. Owner's Name,Address,and Tel.No.
GGNTL>2V 4-e SvkA kTYL,
Assessor's Map/Parcel ^ _
Installer's me,Address,and Tel.No. Designer's Name,Address and Tel.No.
LID
Type of Building: J
Dwelling No.of Bedrooms Lot Size sq.8. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures �^
Design Flow(min.required) U gpd Design flow provided ,� 7 6 gpd
Plan Date 1—2—'^I-S-0 Number of sheets Revision Date
Title 5 VW,-i
Size of Septic Tank ��1TV 10-0 Type of S.A.S.
Description of Soil
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 Health.
Sig ea Date ` 1 'b 'o
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued
t,- O
Fee
- 'THE COMMONWEALTH OF MASSACHUSETTS,.',f. -.,%red;incomputer:
3PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pprication for Migogal *Votemc Con.5truction Permit
pplication for a Permit to Construct O Repair O Upgrade�andon O AComplete System ❑Individual Components �
Location Address or Lot No. 3 I/G )� A ,,,, Owner's Name,Address,and Tel.No.
/ S /v'�—�
Assessor's Map/Parcel �^
Installer's Aamp,Address,and Tel.No. Designer's Name,Address and Tel.No.
.S I t r4
�v• o� ��S`1 c U L� - F r4
Type of Building: x
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures �-
Design Flow(min.required) U gpd Design flow provided S t0 gpd
Plan Date �" d Number of sheets Revision Date
(-
%Title �_J/1,r
Size of Septic Tank (f y c� Type of S.A.S. 1(-e vac I-e 5 �/�YrT
Description of Soil
IA v-�D
Nature of Repairs or Alterations(Answer when applicable) LC` t_
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 e�'by this Board of Health.
Sig Date ` �ro �o
r
Application Approved by r a r Date
Application Disapproved by: Date
for the following reasons
Permit No. ,'" 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( a)`by n e e� 2 6 1 (-
at 3 t t V L N S (\t-e C Y-.- G C wTe WAM C has been gorlstructed in-accordance
01
with the provisions of Tal 5 and the for Disposal System Construction Permit No. _ dated
Installer--M) y--. Designer Gv S y to
#bedrooms JV01 Approved design flow gpd
The issuance of Al permit shall not be construed as a guarantee that the system(wifilunctionnrlas designed.
Date M ,. Inspector
_____ _�fl'� i"_C./l,�.V; - �.. ti �._ ,r k"
' �//� _—��� ---------------------
No. Fee •'.'•-�'�_
THE M r CO MONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
&gogal 6pE;tem Construction Permit
Permission is hereby granted to Construct ( ) Repair ( ) Upgrade 4ii<Abandon ( )
System located at 1 V4I & N�C-�
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: Construcl n mupt be/completed within three years of the date of this errnit.
Date (,l/ Approved b
Pp Y
�.
r
Town of Barnstable
�piHETp�' Regulatory Services
Thomas F. Geiler,Director
• anaxse BLE,
MAS& 10� Public Health Division
16,39.
'OrEnrru+r► Thomas McKean,Director
k
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date:
Designer: _Shay Environmental Services, Inc. Installer:
Address: P.O. Box 627 Address S 1 t1 S�
East Falmouth, MA 02536
On r hLP , was issued a permit to install a
(date) (installer)
septic system at ICJ �(hins based on a design drawn by
(address) _\\q
Shay Environmental Services, Inc. dated a I C.9
(designer)
XX 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
certified as-built by designer to follow.
N OF Mgss�
o� CARMEN �GN
(Instal er s^ igna 0 E.
:. SHAY N
No. 1181
.p o
FQ18Tsa
SgNI WPN
Designer's Signature) (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 ' J4QCkYwS Tyrr—C'k— SEWAGE# --7 -7 :7_3
VILLAGE G�tw �U���� ASSESSOR'S MAP&PARCEL 0119
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY AQe l _
i
LEACHING FACILITY:(type) (size)
NO."OF BEDROOMS
OWNER-- 1 i3
PERMIT DATE: 'Z� ��(��" 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) —=a Feet
FURNISHED BY
t
A ,0 6 ��
y
Town of Barnstable P#_
Department of Regulatory Services
i Public Health ealth Division Date
.6Jy. quo 200 Main Street,Hyannis MA 02601
ADD MA't •
Date Scheduled
1 Time Fee Pd.
_ .. 'so uitability Assessment for Sewage A osal
Performed By: ', bu l
Witnessed By:
LQCATI N&GENERAL IlVFORMATI N
Location Address ��A p�
1� ''` ai n-S/�� Owner's Name �ni
+ ' Address 5
Assessor's Map/Parcel: -Z-.5 1
Engineer's Name
NEW CONSTRUCTION -REPAIR
Telephone#
Land Use
Slopes(%) Surface Stones
Distances from: Open Water Body�A- - R possible Wet.Area l 1 '�
( ft Drinking Water Well
Drainage Way ft Property Line 1
l g , ft Other B
SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes)
htet:
.SQL
Parent material(geologic) Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: O. S. Weeping from Pit Face
Estimated Seasonal High Groundwater _ n
DETERMINATION FOR SEASONAL HIGH'VVATEXt TABLE
Method Used:
Depth Observed standing in obs.hole: in, Depth to soil mottles:
Depth to weeping from side of obs.hole: !n.
Index Well# in, Groundwater Adjustment , ft.
Reading Date: Index Well 9evel � Adj,factor.,,,,.„- Adj.(Jroundwgter Level
PERCOLATION TEST Date 'ltne. oo
Fof
�_
911
, lime J 0Tlme at6"e
Rate Min./inch
Site Suitability Assessment: Site Passed Site-Failed: ^ t
Additional Testing Needed(Y/N)
Original: Public Health DivisionObservation'Hole
e Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conseirvation Division at least one(1)`week prior to beginning.
Q:ISEPTICIPERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#.�
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) , (Munsell) Mottling (Structure,Stones;Boulders.
Consistency, ravel
O - \�. L p v 2 3 PIA
LS
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)
Piet'S l 0 Q 3 I d �1G.
5, l0`?e6/
IM— 5 and
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color. Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
C nsistency. o Grave
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil I Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
Flood Insurance Rate Map:
Above 500 year flood boundary No_ 'Yes .-
Within SOO year boundary No✓ Yes a-�
Within 1.00 year flood boundary No Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervio s material 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?
Certi_ fication
I certify:that on (date)I have passed the soil evaluator examination approved by the
Department.of Envir ntal Protection and that the above analysis was performed by me consistent with .
the regtiired train' g,a ertise and expert ce a ed in 10 CMR 15.017.
Signature
Date— ,�L \ D kP
Q:\sppl'ICIPBRCFORM.DOC
-Moo inr
ALL OUTLET PIPES FM T1f r e4 d 2 Po r " a
'1 LAM,IRBUTION WX SHALL BE
*NOTE ALL PIPES ARE TO BE 4' SCHEDULE 40 P.V.C. SET LEVEL FOR AT LEAST 2 FT tY Ct7"t BETE COVERk
VENT PIPE (O Least 24 Indme tall)
Schedule 40 PVC w/Chorcod Odor Filter 3-5'OUll1T a d�a
NEW Foundation [house to septic tank D-B0X cover must be IaIOCKOUIS
,y
1D' min. from '✓� y ..au"Yi+Rk"-py
Septic tank covers must be tY NET
Rhin 8 in. of finished Wads
ELEV = 100.00 (Assumed) within 6 in. of finished grade OUTLET
; ? $ r
• 5.S' � ��'��-'. f`�a�r 3���✓` ,.+� �� `� ���lr � 'l x_
a Grade over Septic Tank - 98 00 Grade over D-Box - 98.00 ish G nle = Elev 98.00 to 100. { r nr r 13 t luciclns Neck Rd y
�,
"lie J
t56' 4' - SCH. 40 T
S = 0,02 3 HOLE H-10 , o,.. Top Of System = ELEV. 95.25
S-0.10 or chwer GIST. BOX S- 0.01Cr per foot Y S''
IF,� ,e PLAN SECTION CROSS-SECTION
EXIST. PIPE rc 1,500 GAL OR GREATIR t Perforated P.Y_C -'/�-'� Invert Elev=94.73 Trench1) trfrjrrfaltliu #
FROMFOUf1DAT20" rn SEPTIC TANK 15� e' = Trench 2 `� ` .� , ; •...
O O M 1p' O /4'-tti'IM�Ind • �, r ; ..,.;� .. <
A POLYETHYLENE ai n o Bottom of Leach Facility Elev.- 9273 (TRENCH #1) i v, `- ; - F
3 HOLE H-10 DISTRIBUTION BOX -�
H-10 _ Bottom of Leach Facility Elev s 9282 (TRENCH #2)
CONCRETE FULL FOUWOYI o A rn rn 4' TRENCH # NOT TO SCALE ;
_ a i t�
36' TRENCH #2 =I soae .euoeswveo.a.ir"ner.w" .. ° ,1
SYSTEM PROFILE 6 in.of 3/e-1 1/r o A "OK "".ear tob.eePPed at""`./1•VceP o .
compacted stone o : LEACH TRENCH Bottom of Test Hole 2 E]eY.=Bs.00
Not to scale e (2 TOTAL) LEACH TRENCHES CROSS-SECTION (2 TOTAL) GENERAL NOTES
> >
s 1. Contractor is responsible for Digsafe notification
and protection of all underground utilities and pipes.
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE V��
2. The septic tank and distribution box shall be set
level on 6" of 3/4"-1 1/2 stone.
r of 1/er-1/r 3. Backfill should be clean sand or gravel with no
stones over 3" in size.
Isar- 4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
3/r-1'WMAW dose with Title V of the Massachusetts state code, the approved plan
P E R C 0 LAT I O N TEST r perreraied P.V.Q Pipe %two and Local Regulations.
Date of Percolation Test: DECEMBER 4, 2006 NOT TiD SCALE 6. If, during installation the contractor encounters any
soil conditions or site conditions that are different
Test Performed By. CARMEN I- SHAY, R.S., C.S.E. from those shown on the soil log or in our design
Results Witnessed By. WAIVER (per BARNSTABLE B.O.H.) installation must halt & immediate notification be
EXCAVATOR: ROBERTS SEPTIC SERVICES 1R OA D
Percolation Rate: Less Than 2 MPI ® 36' mode to Carmen E. Shay - Environmental Services, Inc.
�+ CW- - 7. No vehicle or heavy machinery shall drive over the
7V l� ____ septic system unless noted as H-20 septic components.
TC'KIL - 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
v (40 FOOT RIGHT OF WAYS _ _-- ---_ ____--- 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
Test Hole Test Hole - 10. All solid piping, tees k fittings shall be 4" diameter
No. 1 No. 2 ____-- --� Schedule 40 NSF PVC pipes with water tight joints.
DEPTH SOILS ELEV DEPTH SOILS ELEV. 11. Municipal Water is Connected to ALL OF The Residence and Abutting
o 99.00 0 9a00 f Properties Within 150 Feet.
--1 I I + 5'
Loamy so ay ___------ - i i it j 1510.85 f2 THE PROPERTY LINES ARE APPROXIMATE AND
10 YR 3/7 10 YR 3/2 spi COMPILED FROM THE SURVEY PLAN GENERATED BY
0"-12' A B o0 0'-12' A 7-� i i i i NELSON BEARSE OF CENTERVILLE. MA ENTITLED
I I 1 PLAN OF LAND IN BARNSTABLE, MA' PLAN BK 134 PG 113
Loamy Loamy , i
� � DATED DATED APRIL 10, 1957
Sand Sand I I ASPHALT 1 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
10 YR 5/6 10 YR 5/b
12'-36" Bs 96.00 12'-36' Be 95.00 i I t DRIVEWAY 1' ' IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
Mod-Fine Med - Fine i i ; ; TE HOLE #1 THE SEPTIC SYSTEM INSTALLATION.
Sand Sand _
2-5 Y 6/6 25 Y 5/6 I Ico I ELEV 99'� EXISTING CESSPOOLS TO BE PUMPED OUT AND
36'-64' C, 92-00 36'-8,C G 91.00 I U- I trj ; 54'
REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
Medium Medium v i I EXISTING
Sand Sand t7� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
I °0 9$ FROM THE EXISTING CESSP00i•S TO BE DISPOSED
' 2 S Y7/L __ 7_g Y 7/4 ._.__ :. __ _.._... _._ _..... _:..i T...I -_.._ _.. ... �7 .V�l.1l011d4 _ _ ..._ _
'-144' C! 137.00 -144 .
1/
� �n ; SOUSE� OF AS PER BOARD OF HEALTH`SPECIFICATIONS
>+ ' NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
~O EXIST. GARAGE ipf3 1 00
POLYETHYL NE ASSESSORS MAP 251 PARCEL 049
l 1 . �� Slab Fnd. f SEPTIC TA,W
0 I DECK
' .. LEGEND
. I 4 PVC O 0 O 0.5'
1 I i Cleanout
Perk
DECK D-Box DENOTES PROPOSED
Depth to Perm 36" to 54' I I 104X 1
Perc Rate= Less Than 2 MPI I LOT J47 Failed 4 - SPOT GRADE
Groundwater Not Observed I I 1,2,f50 Square Feet +/- Cesspool 8' 0.5'
No Observed ESHWT , , f Failed X DENOTES EXISTING
104.46
Cesspool ADJUSTED H2O Elev. = None I I SPOT GRADE
f 50.00
TEST HOLE #2 PL PROPERTY LINE
SIB ELEV = 98.00
9�15 PROPOSED CONTOUR
PROJECT BENCH MARK -____
i TOP OF FOUNDATION -97 EXISTING CONTOUR
ELEV. = 100.00 (Assumed)
DEEP TEST HOLE &
TYPICAL 1500 GALLON SEPTIC TANK
40 POLYETHYLENE LINER PERCOLATION TEST LOCATION
NOT To SCALE I 6 FOOT STOCKADE FENCE
3-24 IXML ACCESS MA"NaLS (H-10 LOADING) IAND TO EXTEND
10 FT. BEYOND TANK FND.
-<r.i.;' -�=��..t- .-_..-.�,a�� _+-•: 1. ``� - ...b_....,..._,.,„,.„,, ���a�4 P LOT P LAN
MET
NLET ,: ' �.VAiANCE REQUESTED: OF PROPOSED SEPTIC SYSTEM UPGRADE
THE ACCESS COVERS FOR THE SEPTIC TANK,
DISTRIBUTION BOX AND LEACHING COMPON PREPARED FOR
s� 3. REQUEST AVARIANCE TO INSTALL AN SAS 17.5 FEET FROM_,
x�X�� ,,`.sue: SHALL BE RAISED To WITHIN 6" OF A FOUNDATION (40 MIL RUBBER LINER PROVIDED_,.-'
FINISHED GRADE. HENRY SMITH J R .
STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAILEM OR ALS
PLAN VIEW ON ALL OUTLET TEE ENDS `'� Design:. Calculations~ AT
3-2,C REMOVABLE COMMBedrooms-
Number of Bedrms- 5 Equivalent to 550 Gal./Day # 13 H U C K I N S NECK ROAD
/- Garbage Grinder Na CENTERVILLE, MA
Leaching Capacity Proposed: 550 Gal./Day Minimum (Min. Per Title �)
"*L cLekrame r Kcr = Septic Tank : 2 x 550 Gal./Day = 1100 INSTALL NEW 1,500 GA- POLYETHYLENE Septic Tank. s A
L"LEr 6-mr,T I r in.idat to outlet e1,, SOIL ABSORPTION AREA: Using percolation rate of f2 min./inch ��� �S
Li3T.r.i - PREPARED BY:
10� �` 6._T. Proposed Leaching Trench Dimensions TRENCH #1 -4' Wide b 54! Long by 2 Depth . � '4✓ F
5INL -r CARHEN E. ,SHA Y
e _ 4'-0'mik Bottom Area: 0.74 gat/sq. ft. x 216 sq. ft. s 159.84 gallon. o I<
`M' '� depth Sidewoll Area: 0.74 goL/sq. ft. x 232 sq. ft. 171.68 gallons mi
UIPM
o Providing: = 331.52 gallons O 20 40 50 0. NVIRONMENTAL SERVICES, INC.
,. :�. -a•- -.- -, - ' -" `-- =' J TRENCH #2 -4' Wide by 36' Long by 2' Depth . �F P.O. BOX 627
Bottom Area: 0.74 gal/sq. ft x 144 sq. ft. = 106.56 gallons s A?, � EAST FALMOUTH MA 02536
CROSS SECTION END-SECTION Sidewall Area: 0.74 gal./sq. ft. x 160 sq. ft. 118.40 gallons �nrlraR�P '
TEL/FAX 508-539-7966
Providing: = 224.96 gallons SCALE: 1"=20'
MAY BE SUBSTITUTED FOR 1500 GALLON POLYETHYLENE TANK - GEORGE OBRIEN CO. TRENCH #1 + TRENCH #2 = 331.52 + 224.96: = 556.48 gallons SCALE: 1"=20' DRAWN BY: CES DATE: DEC. 15, 2oos
PROJECT#SD1001 FILENAME: SD1001 PP.DWG SHEET 1 OF 1