HomeMy WebLinkAbout0017 RAYMOND STREET - Health 17 Raymond Street
Centerville
A = 226 106
No. 42101/3 ORA
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NO.GLIr(-� THE COMMONWEALTH OF MASSACHUSETTS FEE bV—
BOARD OF HEALTH
- 'gala OF �LTL�2>`.ltLL��asl
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct ( ) Repair ( ) Upgrade >L) Abandon ( ) - ❑Complete System Individual Components
r 7 IL f y r`a.tia o 57- L Div 72DLv i e L-6 �/.�fce
o 0 loc0n� (�Oyvner'sName
Nlap/Parcel# �1A ddress
Lot# Telephone#
Installer's Name Designer's Name
�90.9,J)L 1�r39 C�^'TP,�tv��t_ts b'�9 ,,s}> S f'�r'T� �3 ®Sriy��<1✓
Address / \7?S » e Address
I
� ` — s 6 1/ �> �� o
Telephone# Telephone#
Type of Building: XZ7,01,r-ri-4 L Lot Size Sq.feet
Dwelling—No.of Bedrooms L'1.1( i—t /Pit Oje-'1 6 N'�-� Garbage Grinder ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.required). 41 ° gpd Calculated design flow gpd Design flow provided � gpd
Plan: Date 3 11 Number of sheets / Revision Date t ��
Title Su$S-4-F4-i-0 SLr-46-6 Qd.00V44-
Description of Soil(s) L04AJ6 4--0
Soil Evaluator Form No. Name of Soil Evaluator �l•J�1`�''1a^' Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS j4tr/C�t� �d(.Oy I��
LL'�4 c eflKCp /nth oay z) 6a4 LL-1i' �p w� G//$^ i✓L MA na.3 �� [r�(JTlnl�
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further agrees not place the s stem in operation until a Certificate of Compliance hasbeen issued by the Board of Health.
Signed Date
its 3 �C 'U2
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
No. �� " �U� THE COMMONWEALTH OF MASSACHUSETTS FEE
!{Z�STtQ� BOARD OF HEALTH --�
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby gra}ited to Construct ( ) Rep it (� ) Up rade (x) Abandon ( ) an individual sewage
disposal system at �� f`iG l_/MC �� t � I V � as described
in the application for Disposal System Construction Permit No. dated
Provided: Const uction shall be completed within three years of the date of this permit. ll local co ditions must be met.
Date �C�� / C�c Board of Health �t C �- C "-L
FORM 2 - DSCP DEP APPROVED FORM 5/96
FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON .
hMii+y..T. n -'+y`y, '"''t:j,�r'¢'SAr....:°ni.r+if";`wt'S�'S..�i�+N�—t i 'ryZ....r„r�.,<::� ,,.,..ip ,'.� �.•,. . . e.. e.-,,,.d+s {. ..V.;�. , ...�,,..-.�."`' R ��Yp���yeN...y�_. _ ,,
;lt�
No'G�(=��-1 `' THE:.COMMONWEALTH OF MASSACHUSETTS FEE
BOARD OF HEALTH
OF
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Aj pllication for a Permit to Construct ( ) Repair ( ) Upgrade >e—) Abandon ( ) . ❑Complete System :Individual Components
r
►� IL-fYAwrvp STD LeNMJLV/I.I. iYeiloy F/r-d�O
ocation Oner's Name
C o /D o �S, +e
Map/Parcel# ddress
7W - Sod
Lot# Telephone#
G+►��(A-r� /tn8�.�1a•� �oTit j�x.�tG6 �,g�/err,. Jot(�+�s�� . .
Installer's Name Designer's Name
V0,,9,;0X Iaep CF---1- L-j1LLA--T 4�Jy r "9i ST S-�iTl, (3 OSTM1fICL>✓
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Address Address
Telephone# Telephone#
Type of Building: /LGT/b@N?-(of C Lot Size Sq.feet
Dwelling—No.of Bedrooms 3 (?I,1 f T =t. (P�to1�h' <� jvi�4L-, Garbage Grinder ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
f Other fixtures
Design Flow(min.required) 4 gpd Calculated design flow gpd Design flow provided gpd ,
Plan: Date Number of sheets Revision Date 3 1;a1-3)L
Title S�gs,,,i�k�� S¢ �4(r d 06,-41,/L
Description of Soil(s) G 044W Lr S '0
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation .21191 a
DESCRIPTION OF REPAIRS OR ALTERATIONS /'<< '�' �«`� d�'1 ''''/3o�L-?��-orW
4e*f-#tt r/CL7 I000 04CCo�I �,,MP 6*f-,OeA. _,MlA C)tIjrjVd;-
•. The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further agrees not place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
2�rd
Signed ' Date J
Y . 2
s��t'ro-ns l..�C. �S 2 U
FORM t APPLICATION FOR DSCP DEP APPROVED FORM 5/96
'
No. 9t��— 5 _ �THE'COMMONWEALTH OF MASSACHUSETTS FEE '56
�eyleNSTRQLS BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( '),Upgraded ),Abandoned( )
by: n
at I �C 1 l�1 L`1�� ST' ISZfn ►VI l.l� s
has been installed in accordance with the provisions of 310 CMR 15. 0`#(Title 5) and the approved design plans/as-built
plans relating to application No dated 3/aU U 'D- . ,Approved Design Flow (gpd)
Installer Designer: Inspector 4j. Date / l)
The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
A
TOWN OF BARNSTABLE
LOCATION �~/ I���+- sip,l SEWAGE # 4"/0
j VILLAGE ASSESSOR'S MAP &LOT 2 2 J -ldl;
j INSTALLER'S NAME&PHONE NO. ;Z6 ��+-soh- `I 7,f— 7 7"7 4
SEPTIC TANK CAPACITY /Q o'
LEACHING FACII.ITY: (type) oLo 3® Z- 1` (size).A6 w 30 O
NO. OF BEDROOMS Y
BUILDER OR OWNER /�� �'/ /
PERMITDATE: �-74 �a�— COMPLIANCE DATE: �—
i
Separation Distance Between the: f
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility J Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) 'L o Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
i
within 300 feet of leaching facility) Feet
Furnished by
ILA
s
X
SM/01
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION
' FORM
I, -'Z:>Ar y Cc J` �s`'�" , hereby certify that the engineered plan signed by me
dated 316101
, concerning the property located at
aovv ST L e'Qr-eK_VI c.L-6- meets all of the
- following criteria:
• This failed system-is connected to a residential dwelling only. There are no
commercial or business uses associated with the dwelling.
• The soil is classified as.CLASS I and the percolation rate is less than or equal to 5
minutes per inch. The applicant may use historical data to conclude this fact or may
conduct preliminary tests at the site without a health agent present.
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
• The bottom of the proposed leaching facility will not be located less than fourteen
(14) feet above the maximum adjusted groundwater table elevation. (Adjust the
groundwater table using the Frimptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation (using GIS information)
B) G.W. Elevation .S +adjustment for high G.W. 16,
DIFFERENCE BETWEEN-A and B
1 f l rEiT U.4.A4-4.1Lc- ro 4-V4 UVI,-J G-j-- e7!'V4
SIGNED : Q DATE:
NOTICE
Based upon the above information, a repair permit will be issued for bedrooms
maximum. No additional bedrooms are authorized in the future without engineered
septic system plans.
q:health folder.percexmp
TOWN OF BARNSTABLE
VLOCATION 01 /�°r _ l SEWAGE #`[
VILLAGE i�fb�) �ry 11 !� ASSESSOR'S MAP & LOT 2 j
INSTALLER'S NAME&PHONE NO. 176 > h-soh- 7 2
SEPTIC TANK CAPACITY /�a
LEACHING FACILITY: (type) ot0 " 30 L- I c (size) ,Xa Ix 30 -e O
NO. OF BEDROOMS y
BUILDER OR OWNER
PERMIT DATE: • J COMPLIANCE DATE: C� f 0 2,
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 o
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) Yc-s Feet
Furnished by
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s
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60 A
i
I
1
o� o 7 d �S
TOWN OFBgRNSTABLE ��j
LOCATION /� T SEWAGE #
VILLAGE4��h�l P ASSESSOR'S MAP & LOT A v Of
INSTALLER'S NAME & PHONE NO. �LJ�(�7-�
kSEPTIC TANK CAPACITY �D
t
BLEACHING FACILITY:(ty
ydi (sue)
NO. OF BEDROOMS ,3 PRIVATE WELL OR PUBLIC WATER �
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE .COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No r/
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3°
PLAN4N p r 5 6P 1 C 5Y�,7-6� DISTRIBUTION BOX
l.. W•10
$CAJC : r " =1a�
REMOVABLE COVER 4"SCH 40 OUTLET LATERALS
TEST PIT DATA DISTRIBUTION BOX TO MEET SHALL BE SET LEVEL FOR A
REQUIREMENTS OF 310 CMR MINIMUM OF THE FIRST TWO
Performed By: Daniel B.. Johnson 15.232(WATERTIGHTNESS, FEET AND CONNECTED TO
CONSTRUCTION,ETC). 2" EACH DISTRIBUTION LINE
WITH SOLID SCH 40 PVC PIPE
Date: February 19, 2002 4"SCH 40 s''
NO.OF OUTLETS: 3
TP-1 (EL. = 96.4) o C 6"(MIN) a o o MECHANICALLY CRUSHED
�-�- ,'""`"_".._.-• ° 0 0 0 STONE(<=3/4"DIA.)
D
0" - 10" Fill Sandy loam STABLELEVELBASE
10" -120" Cl, 2.5Y7/3 Coarse sand
No Observed ESHWT .
84 Observed Groundwater
� �f�" /�O�S.• PERCOLATION TEST DATA
LENGTH OF LEACHING LINE: 30' LEACHING FIELD
I "END"CROSS SECTION
���A�� Date: February 19, 2002 t�
FINAL GRADE TO BE STABILIZED
ASS ^�E ELI,= 100.00 I ) 4 1
rop op ,0�)ck STvaP I Soil Class: Class, 1 (0.74 G/SF) _
� FINISHED GRADE(SLOPE=.02)
4"SCH 40 PERE PVC ' I- 1
' Perc Rate: < 2 MPI (TP-1) 12"(MIN) III '
a+7 9 � � � Depth of Perc Test• 10" - 28" NO.OFACTUAL DISTRIBUTION
`" 2"LAYER 1/8"•1/2"
9 ��� I ' LINES: 4 2'6'' 5'- - 5'-- }-5' -(D-2'6'- DOUBLE WASHED STONE
_, � ,,, „•., ..,.. -" , s-,got o f ��ISrinllr
/pie ALLA/J LEACHING FIELD DIMENSIONS: 5/8" ORIFACE DIA.
�9 t� 93t5 1 / o 7-�}/dpC SCHEDULE OF ELEVATIONS' 6
30'ILX20'WXO.5'H �� o0 3/4"•11/2"DOUBLEWASHE
E STONE
A /L �� $
Inv. Out Foundation (existing) 20
t g) 96. 9
Inv. 'in Septic Tank (existing) 96. 6 ACTUAL NO.OFDISTIBUTIONPIPESM MAY VARY LEACHING FIELD TO MEET
Inv. Out Septic Tank (existing) FROMABOVEDETAIL F( t ing) 96.4 RE ERENCE NO,OF REQUIREMENTS OF 310
Inv. In Pump Chamber DISTRIBUTION LINES AND PLAN VIEW. CMR REQUIREMENTS
ry 96.30
9g�z how lr+ __--- •_'""' / ' 1 Inv. In Pump Chamber
96. 05
atJ EWA'f e -- o 4 tL Inv. In Distribution Box 98 . 97
/o l� 4a /A Inv. Out Distribution Box 98 80 .. _-. _�.w.__M w.--..
\ .� ,_..........-,- 3n,.�-._-.-------' 3 A rlDPrs� Inv. Begin of Leaching Field 98. 65
---- ----
M Co-
` ors 8�t-°�'� Inv. End of Leaching Field 98. 50
Bottom of Leaching Field
r/E�'D, Q Adjusted GW 98 .00 NOTES
f��r► v -,�- s N 93.0
1. All construction methods shall conform to the Title V (310
orb I � LEGEND CMR 15) and the Barnstable Board of Health Regulations.
� �0 Existing.-. g Contour 98
r.4t/,�'Q XA; 2. There are no known private or
P public wells within 100
w �'�._ ._--•--- M Proposed Contour - feet/400 feet, respectively, from the proposed leaching
98 area. There are no wetlands within 100 feet of the proposed
\ �- Test Pit leaching area.
(( 3. Existing leaching area to be pumped and removed prior to
Finished Floor Elevation FIFE installing the new leaching field.
it 9$ \ Basement Floor Elevation BFE 4 . No changes are to be made in the field without th
P7 \
Water Tine -�--- W ....._,._
of the Board of Health and the design engineer, e approval
9b ' ------ - -- - - .-- -�. 5. Proposed leaching field is not designed for use w'
N. � 96` WAIN �A i 1s r \�y�o �.._ ,�o- �,� y� g p
4
ye- t',
garbage disposal.
g with
t� l m PP,Nf. R` Ro � 6.` Contractor to notif Di Safe 72 hours rior to
�REL C�RLuiT Av N° EWL�P �' 3 GUNWHAL,- yg pp -• �b Y o„or m r G t� Ro - RP P ( ),^N „P AV A� Rya.: RooFidconstruction. 800 344-7233.
� V• e ' � PUTTER LA ppIPER o ENNED" g�N
AN z � r_ 7 . Property line 'information taken from Site Plan of se+�pic.
AORFjyA qv 5 i A ZCAR FDy
APPIZ�?4. vtl� t OP.E. /
� Q. Py.eN� sT r � system, prepared by Down Cape Engineering, Arne Oj ala, RLS
(F of JeO,4 . JPyr,->'t"�:': Plan n i.1 •F' t:'v1 '1 n property
•t
^-. --M.--- e< LAKE•:. qr. v L �9t F `' c; `� i oREy o the used as a property ., ine ,;-:ve .
os a e 4 a 0 SH RD C k
WINOS 4t
ON �aTf�. �-•�•- :. ey a 8 . Remove 5 feet horizontally around the
{ proposed leaching area'
l� �Y DR R M < Q� CHNowICK
1 `oL�s Y Av CRRwV/L16 B��cH and verticall • approximately 1 foot (fill, existing failed
ryb CRAIGVlLLE HEACN RO y/j h 2 W Nt RF y/
_ 1 leaching area and all leachate impacted soil)and replace
• \`��` ' °�� ° A Z a A dE�P = s v c " NYAN N 15 with Title V fill [Reference 310 CMR 15.255 for
•. ''��'`��� a = o o A' ��ks� MAPLE ST f specifications of fill (sand) ] . The total amount of fill
' y A .a ,� 4 "'+ PORT required is approximatelyI9
CE.vrR �a T �' ; sr GOLF
o CUb1C yards.
{� d AV D �c v V� PrNE <. 4 CLUB •..---.- •o^------- ..-.._ ._ - ...
CFN Cy ti fORES•f ST OAK
ST
-o�ILC Y?F SEY771 L 5 `/ST E e - CRST
5e•4 L tr ; A S 5 o�°'^/ t Be ' t•�v� CALCULATIONS
3 Bedrooms (Existing) + 1 Bedroom (Proposed)
-._..-____�_.__ _ -___._.. l=a 110 GPD/Bedroom X 4 Bedrooms = 440 GPD
lation Rate - <
�o,� SoiloClass: Class I (0?74PG/SFp-1J
�(�oP�SED Gl�t>aE 1000GALLONPUMPCHAMBER
• � MODEL:TK•1000(SHEA CONCRETE) PROPOSED LEACHING AREA
(OR EQUIVALENT) •
rFr= roo,,rr �X►ST'ING• �R�4QE FINISHED GRADE
tp0 f.3 `- 24"DIA - 24"DIA. g�� (MIN) 24"DIA = Leaching Field: 30'L x 20'W x 0. 5'H
r�Oxo SEE"PUMP CALCULATIONS"AND - -- - HARDWIRE.CONTROLS Bottom Area: 600 SF X 0.74 G/SF = 444 GPD,
/0 0 "FLOAT SWITCHES"FOR TO COMPLY WITH
FURTHER DETAILS. 3�� FLOAT RAIL MANUFACTURERS Total Leaching Capacity: 444 GPD
SPECIFICATIONS
p' d"SCH 40 .611
4'Su a S-.a1 �„ - ! 3 _ PUMP CHAMBER TO MEET 3"SCH 40 FORCEMAIN
. i WATER TIGHTNESS
,6,eo q�:Cft qo PEttr, FCC ( AND PUMP TO HAVE OVERLOAD 10' HIGH y 1/8"DIA. WEEP HOLE PUMP CALCULATIONS
I I 5••, o $so PROTECTION WATER
yaG 4 SCH 40 TEE
9 S ""-•--. y 8.65 � �� CHECK VALUE
%,54b I z lzefLAC PUMP CHAMBER TO Static Head: 98. 97 - 92. 05 = 6. 92'
EXlsr t o �""`i�(57"lL18 uTIO� 30/L a`W 1"ID, e•no PUMP ON MEET REQUIREMENTS
�� Ew S -• I PUMP OFF OF 310 CMR 15.231 Dynamic Head: 211L X 2.87 FT/10OFT = 0. 60'
t ".rcff o •1�0� --- -.....'•" -------�... -- H-10
6,9 3 sctlQa J �, o a Total Dynamic Head: 7 .52 FT at 115 GPM
96 c�•><1 srint! } � s•/ 6 (MIN.) _ o � COMPACTED
LY y
�ORGE�4/N
g,USr-�,�Gr X30 �6.OS LIFTING CKAIN SECURED TO
96,6t �'� �`,%p �r�Lk FLOAT RAILAND PUMP,[ACCESS STABLE LEVEL BASE CRUSHED STONE Pump Specifications: Hydromatic SP 40M1 (or Equivalent)
FROM MANHOLE). ALLVALVES 4/10 HP, 1 Phase, l lVolts
� PJ~p C���� � OUTFITTED TO BE REMOVED. TIGHT TANK DIMENSIONS:8'LX 5'2"W X 5'8"H �-3/4"DIA "
S,S't ,_,_,••,,,,_, 1 1/4 S o l i d s
PUMP SHALL BE INSTALLED IN STRICT CONFORMANCE WITH -FLOAT SWITCHES REF,
MANUFACTURERS SPECIFICATIONS AND SHALL BE EQUIPPED
9q FROM BOTTOM OF `
WITH AN ALARM POWERED BYACIRCUIT SEPERATE FROM PUMP CHAMBER 10 1zG4, 311ijoz l,vcl�. re-o 544 1'o 4 BED/Loom� , r"1 pAlr/�'� s '¢'y��c�, ��"D'Q!c-s 1"�• ,
PUMP. ALARM TO BE LOCATED WITHIN BUILDING.
~--' Ri7Ju$rtrt?GWCCl.=93.a� jZCti', 311,610� , Q!`� J p�+^�f Gfl�{va&L� T4 r�A ltu l+� S' F� paw ,lET ro ItdO'dSS"L'Ei('j O�k
9�,o+ ftAT6 7uS Ole mcmePILgAIL' ArC4,= 9$ 0`;•
91 Zrt&EE ,�ll.r�2 $DUO 6-R��a� !?ion^ a� w►EMB�Nt;RrE�,=94.ot FLOAT SWITCHES -
32
CMoA�L Pr•l$�o� � _ _
flu�tF' C�fR.�tidP',�• Sr;t; p� .►,�'w FoR. (,ocR-�foN .t �
-per t3E• />,J7A1-tE4 � OP 4C,''�b11•a+Nr- 3•G� High Water Alarm: 17" (El,= 93.5)
W
1ctF4o Pump On: 12" (El.= 93 0) ru 2a --
A�� our4er rg*C. _ --�- --
� 4/10 HP
UJ
Pump Off: 6" E _ SUBSURFACE SEWAGE DISPOSAL
o x,SriArlr P ( 1. 92. 5) SYSTEM
/�aG cf-�4L(.o� - 216
a -
�F� o B S ��+� �E4, ' •�` � Bottom of Tank: (E1.= 92. 0) Z `:'r` IDA
17 Raymond Street, Centerville
3FNIJ�6NIN
TP'I F - �JOSO(� , SCALE: as Sho APPROVED BY DRAWN BY
- -- Cui:
- Distances referenced from bottom of pump chamber a � 1r377 DATE: 3/11/02 Daniel B Johnson D.H. Johnsen
_ _ _ _ ___ •$�� �� Prepared Lynn Field (508) 771 - 0078
24 Hr. storage volume: 897 gallons + �t�' 01/ �� For: 17 Raymond Street, Centerville, Xh 01632
$ r ..__..__ ._..1_. ._.._r....._ I ._� . _.�. »..� 1._ A (7 . 5'L X 4 .71W X 3.41H) X 7 .48 G/CF - -
0+00 d+10 ataa o-t-3o t7•!•`1q OrS�o pl bo o+>o t)fgo 0•r90 14•00 1+10 1a-xa Includes Back flow from force main °0 20 ao so so 100 120 4.t� M,t,
A tPrepared DOMESTIC SEPTIC DESIGN, INC. (508) 420-1904 DRAWING NUMBER
- Dosed at 4 times per day at 110 Gal/Dose CAPACITY-U.S. n ^/1 �^�t11�� By: 804 Main Street, Suite B, Osterville, H& 02655 J-755