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0082 POWDERHORN WAY - Health
182 Powderhorn Way - Centerville A= 170-020 No, 42101/3 ®RA ESSELTE 10°l0 0 0 0 0 No. Q 1 V V V Fee (0 V c THE COMMONWEALTH OF MASSACHU§ETTS' Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2iplitation for Disposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair(/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.912,Cc-it T Awpi� ,) Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 170 -0 Z Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size err{�Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2)!:N0 gpd Design flow provided 357,'3 gpd Plan Date 612 1 h o Number of sheets L Revision Date Title Size of Septic Tank l N��,ul Type of S.A.S. sco G C k& C"�K& 12,742.01 Description of Soil Nature of Repairs or Alterations(Answer when applicable) y ire �� euC w Com jol C1"� ST� � 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 ` f Cr Application Approved by Date t 0 Application Disapproved by Date for the following reasons Permit No. Ot O ( 0 ' Li f In Date Issued t�'1 V —to TOWN OF BARNSTABLE LOCATION SEWAGE# 0 d e 1 VILLAGE Le,,)te.9Jillr° ASSESSOR'S MAP&PARCEL J',70-Q,9,0 INSTALLER'S NAME&PHONE NO. 1Da,4 s A 1 tease SEPTIC TANK CAPACITY LEACHING FACILITY:(type) es—y (size) g.S-,K 2— NO.OF BEDROOMS 3 OWNER s CC PERMIT DATE: �D COMPLIANCE DATE: i >' !/ Separation Distance Between the: GG� 5 �o Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility &C e7y�3 0�T G��c-0 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 N A AC < � t-7N G Yv JA) OUT - 3 .a Sox 1 _ / i� �. C5,U No. a O V (/ V 6 tie„ Fee too "..�.4> THE COMMONWEALTH OF MASSACHUSET S Entered incorriputer: f. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS. Yes Application.for MIsposar *pstem Construction Vermit Application for a Permit to Construct( ) Repair(t4pgrade( ) Abandon(,) ❑Complete System ❑Individual Components Location Address or Lot No. 82 vicoj UX"1 Owner's Name,Address,and Tel.No. CCNt-ClV1 We Assessor's Map/Parcel /70 `0 2 C) Installer's Name Address,and Tel.No. Designer's Name,Address,and Tel.No. s14, i rc �e t_N rNrt°rrN LAtP4c 5 � 5 S2>g-y77-57713 Type of Building: L Dwelling No.of Bedrooms 3 Lot Size 16,150 sq.ft. Garbage Grinder Other Type of Building ( ) ( V10�5 No.of Persons Showers Cafeteria Other Fixtures Design Flow(min.required) "3 3Q gpd Design flow provided S 7 'J gpd Plan Date 6 9111 U Number of sheets 2 Revision Date Title �" Size of Septic Tank 1X0 N t%J Type of S.A.S. S po 2 fe I&4 (�'k'at4,Iw b Description of Soil 'N, Nature of Repairs or Alterations(Answer when applicable) jr tp tc kl Nc w COM 10I r h p sY S�Cnn 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 aCertificate of Compliance has been issued by this Board of Health. "*- Signed OOTA Date d Application Approved by �,..c't -1-f Date l t/ Application Disapproved by Date t for the following reasons Permit No. 0 Lff 69.. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ` (Certificate of Compliance r` THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(L_ Upgraded( ) Abandoned( )by J wSA 4% A at Cj PC1w0e(1lp(n) WG y tom)e (d I r has been constructed in``accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No.�d -q I� dated Installer DMl c 5 A ICJ lUwro INC. Designer Y iy S I Nr Y.";^,% (,t�y✓�C S #bedrooms -17 Approved design flow l i 35 7,'3 gpd The issuance if tss qermit shall not be construed as a guarantee that the system will func '"r} s designee,. Q Date Inspector v -------- -- -----------/-----j--/------------------------------------------------------ ---------=------------ -,--D - -------------- No. )01 D- `I -( 1(/ Fee 16 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Misposai tipster Construction 'ermit Permission is hereby granted to Construct( ) Repair(✓) Upgrade( ) Abandon( ) System located at 6 2 RoyiUf i ho;l y Wv y r 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. C Date _ l V Approved by Town of Barnstable P# ' Department of Regulatory Services s' zap j Public Health Division Date s 16 659.��� 200 Main Street,Hyannis MA 02601 Mitt . 1.v Date Scheduled `` Time Fee Pd. 0 Soil Suitability Assessment for Sewage D'os'al Performed By: {�� I"`L�"�{ �� Witnessed By: LOCATION& GENERAL INFORMATION Location Address 9 2 (Po"i CUL r _. _e\ LAJ" Owner's Name i PQr0A - A Address Assessor's Map/Parcel: t t� ® ZJJ� Engineer's Name f�C Ell- NEW CONST R U CTION -- REPAIR Telephone# e --7 & Land Use s'�-Sl CJ`��G\ Slopes(%) Z — Surface Stones yl Distances from: Open Water Body ft Possible Wet Area 7�S ft Drinking Water We11�ft Drainage Way -7 rd ft Property Line �-�ft Other _ ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) Ccs s l I F. . Pd. �t ov Vt Cl) 7 Parent material(geologic) ©J Qe r''1 Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Race Estimated Seasonal High Groundwater 7i3'zr' ` DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index.Well# Reading Date: Index Well level_.a e-., Adj.factor _ Adj.Groundwater Level.— PERCOLATION TESL' Ditto Time Observation Hole# Time at h" .�....-...a Depth of Pere 36 a 44 4 Time at 6" Start Pre-soak Time 2Y @ Time(9"•6") - -- y4�l��rs End Pre-soak Rate Min./Inch. Site Suitability Assessment:,Site Passed X 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(l)week prior to beginning. Q:ISEPTIMERCFORM.DOC - DEEP.OBSERVATION HOLE LOG Hole.# _` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in,) (USDA) (Mansell) Mottling (Structure;_Stones;Boulders.. Gravel) a 60 C Z —SaK Z�SY4(� c�.r DEEP OBSERVATION HOLE LOG Hole# �— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) ">- - "(USDA)" � (Munlseli). Mottling- (Structure;Stoaes,.Buulde-rs. Consistency.,% "Gravel) 0.— SL 2 = (00 M-GS ? r4, 5 ,rwnS DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other )Surface(in. (USDA) (Munsell) Mottling (Structure,Stones,Boulders. i to e DEEP OBSERVATION.HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color 5011 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Flood Insurance Rate Map: Above 500 year,tlood boundary ,No_ Yes 4. Within 500 year-boundary No-1-6 Yes Within l00 year flood boundary No X Yes Death of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout.the area proposed for the soil absorption system?. not;what.is the depth.of naturally occurring pervl us material'? ._.._...-. Certification I certify that.on �� L (date)I have passed the soil evaluator examination approved by the., Department of Environmental 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 f �O -� { Q:\4EPTi0PBRCPORM.DOC Town of Barnstable Regulatory Services Thomas F.Geller,Director l i Public Health Division ' Thomas rdWean,Director 200 Mak Street, Hyannis,MA 02601 price: 5M$62.4644 Fax: 508-790-6304 Date: b vc� ` Sewage Perm!W Awmes Map/Paroel ZD er dt RMWML ertrtication F rm Designer: ft+e-✓—r" F9 Iistaner: Address: �q!±f- WdAS rx C, Address: T `d • 5 0 X on 6? o c- was issued a permit to install a (date) (installer) r septic system at g Z To � `''� !L%�based on a design drawn by (address) G�G✓^ ,J eL dated (o -Z" 1 O rgnor) I certify that the septic system referenced above was installed substantiallyaccording to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic taA. Stnpout (if required) was inspected and 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 by designer to follow. "Stripout(if re uzspected and the soils were found satisfactory. OFS _ PE-MR T. McENfEE uInIaller Signature) "� l�0.9fi1Q9 C NAL (Designer's fie) ( tamp Hem) TO BARNSTABL H IVI OPT. CERIMCATE OF COMPLIANCE WELL T ISSUED UNTIL. BOTH THIS FORM AND A REC D BY THE B STA L P HEALTH DIVISION. $;roaioe�mmw�ca¢ian t6rm.doa TO 39Vd SMOM 9NId33NIJN3 ETCSLLb809 EE:60 TTOZ/90/T0 m N ® F N V Nouset Ln v Tomahawk Or LOCUS 3 FENCE LINE__ _ S 86'59'30" W Powderhorn oa Way �a 98.42 100.00' x 98.42 G� Dee wood skane3 X 98,85 Cir . v� 2N� glrahlll o z LOT 28 18,980±S.F. Rote 28 � ! � AP N 170-02�; SHED x 98,32 LOCUS MAP ! 0 98,42 NOT TO SCALE x 98,44 —— 98 —— EXISTING CONTOUR x 98.82 06" X 100.98 EXISTING SPOT GRADE 27' *P-2 __ 25' _ gg PROPOSED CONTOUR ��♦ � —yy EXISTING WATER SERVICE 1Ir, 8" T F S.A. ;48" —U UNDERGROUND WIRES //II/[�J `� I�•�• 0 ®9 " .• I w —O.-H.-W.—OVERHEAD WIRESPROPOSED SEPTIC Y J TANK TEST PIT PROPOSED SEWER I BENCHMARK I CONNECTION o 8" J TIE IN AT, OR ABOVE, LEGEND I N V.=97.37 4 LA P ` EXISTING CESSPOOLS 14" 98+--�, , BENCHMARK SET TO BE PUMPED, FILLED wiTH �= 99 29"—,\ - - ���5 9,06 OUTSIDE BULKHEAD CORNER SAND AND ABANDONED cn J: + EL.=99.87 (ASSUMED DATUM) 0 w I---25_0_--) W bo , C) 0 ... ..+ 98.88 fo N i� + 99.30 I z rn PROP. S.A.S. = 98,72 �•...- • • 99.52 + edge%of I wn 99.31 �� w _ 1 i ao ' 1' ------------ ' . 0i 99.48 NG 1 w o I x 98.90 *+..9. ,53......... PATIO plantings 99, 4 j Ishr. 98,51 . x 99 1 I -� EXISTING o 99----- ---� 9 7:o HOUSE(#82) Q O.F.=99.87± o, N a1 SI o X 99,24 2 x � x 98: 5 99,30 ?% \ 19 � 0 x 99,,45 •• z /J W \ � 99,12 -07 •• i + 9 8.6 4 BACK OF HOUSE Fq o 40.0' SHELL a DRIVEWAY S.A.S. LAYOUT 3 + 98.52 �� J8.37 24" \0 �� _ 4/ 98,87 100. ' I N 86'59'30" E } 98---x--98,0.5------98,07 OHW,00 --g6— _ 97.39 97,62 98,01 edge of pavement 98,67 PO WDERHORN WA Y GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS Of THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE .`� OF k4ss DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING G FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o PETER T. ENGINEER BEFORE CONSTRUCTION CONTINUES. V MCENTEE 5. ALL ELEVATIONS BASED ON ASSUMED. CZ) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF No. 35109 OWNER OF RECORD THE HEALTH FOR CPROPTOR ER INSPECTIONS DR OWNER TO URING CONSTRUCTION.IFY THE LOCAL BOARD OF 9oF R£GSTFR`�� Paradise, Richard H 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. Nk , & Roberta M 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 82 Powderhorn Way 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS Z�l Centerville, MA 02632 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 82 POWDERHORN WAY, �CENTERVILLE MA 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). Engineering by: SCALE DRAWN JOB. NO. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE Engineering Works, Inc. 1„=20' P.T.M. 154-10 INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. (508) 477-5313 6/21/10 P.T.M. 1 Of 2 �• NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:95.5 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" INSTALL RISERS & COVERS OVER INLET INSTALL WATERTIGHT RISER & OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F. AND SET TO 6" OF FINISH GRADE. COVER SET TO 6" OF GRADE PROVIDE ACCESS TO GRADE OVER OUTLET COVER EXISTING F.G. EL.=99.3t F.G. EL: 98.6t F.G. EL: 98.8(MAX.) f f /MAINTAIN 2% GRADE (MIN.) OVER S.A.S. 3NN . . .V . w. L = 20(MAX.)' L = 36' L = 5'(MAX.) ® S=1% (MIN.) ® S=1% (MIN.) S=1% (MIN.) 4"SCH40 PVC • ' 4"SCH40 PVC 4"SCH40 PVC 10"I n as as 14" 6 9Ba�BBB INV.=96.95 48" LIQUIDLEVEL aaaaaaa ADD GAS BAFFLE INV.=96.17 PROPOSED INV.=96.00 4' 5.2' 4' INV.=96.70 D-BOX EFFECTIVE WIDTH = 13.2' INV.=95.00 PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN TIE IN TO EXISTING SEWER H-10 RATED AT, OR ABOVE, INV.=97.37 TOP CONC. ELEV.=95.8t BREAKOUT ELEV.=95.5 imffm INV. ELEV.=95.00 ease aBBaB aaaaa ease eases NOTES: BOTTOM ELEV.=93.00 m fl 4' 2 X 8.5'=17.0' 4' 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS, PRIOR TO INSTALLATION. 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 25.0' 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO T.P. EXCAVATION OR G.W. GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED LEACHING SYSTEM SECTION NO GROUNDWATER, EL.=82.0 STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). - 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" TO 1-1/2" DOUBLE OUTLET TEE AND REPLACE IF NECESSARY. WASHED STONE SEPTIC, SYSTEM PROFILE 3" LAYER OF 1/8" TO 1/2" N.T.S. DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) (3) 5" DIA.OUTLETS 15.5" 16" �2.. SOIL LOG DATE: MAY 18, 2010 (REF. P#12946) ut ., 12" SOIL EVALUATOR: PETER McENTEE PE, (SE#1542) 15.5"WITNESS: DAVID STANTON R.S. 6" 8.. HEALTH AGENT ELEV. T P- 1 DEPTH ELEV. T P-2 DEPTH 2 98.5 A 0" 98.6 A 0" H-10 LOADING LOAMY SAND LOAMY SAND �/ 97.8 10YR 4/2 $„ 97.9 10YR 4/2 8„ D-BOX B B N.T.S. SANDY LOAM SANDY LOAM 10YR 5/8 10YR 5/8 95.5 �36" 95.1 42" C1 PERC C1 M-C SAND 36"/48" M-C SAND 2.5Y 5/4- 2.5Y 5/4 ®®F ® ®®® >20% GRAVEL >20% GRAVEL 93.5 60" 93.6 60" H. ®®®®®® ® ®®®® 33" C2 C2 w ®®®®®® ® ®®®® MED. SAND MED. SAND N Z ®�® 2.5Y 6/4 2.5Y 6/4 - 5% GRAVEL 5% GRAVEL 87.5 132" 87.6 132" 102" NO GROUNDWATER, PERC RATE: <2 MIN./IN. 4" KNOCKOUT 20" DIA. COVER. DESIGN CRITERIA 4" KNOCKOUT / 4" KNOCKOUT 62" NUMBER OF BEDROOMS: 3 BEDROOMS SOIL TEXTURAL CLASS: CLASS I 4" KNOCKOUT DESIGN PERCOLATION RATE: <2 MIN/IN DAILY FLOW: 330 G.P.D. DESIGN FLOW: 330 G.P.D. 500 GALLON CAPACITY, H-10 LOADING GARBAGE GRINDER: NO PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY CHAMBERS LEACHING AREA REQUIRED: (330) = 445.9 S.F. � N.T.S. .74 USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 82 POWDERHORN WAY, CENTERVILLE, MA SIDEWALL AREA: 2(13.2' + 25.0') X 2 = 152.8 S.F. BOTTOM AREA: 13.2' x 25.0' = 330.0 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 TOTAL AREA:........................ Engineering by: SCALE DRAWN JOB. NO. ......................................482.8 S.F. Engineering Works, Inc. NTS P.T.M. 154-10 DESIGN FLOW PROVIDED: 0.74(482.8) = 357.3 G.P.D. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 6/21/10 P.T.M. 2 Of 2