HomeMy WebLinkAbout0434 SKUNKNET ROAD - Health 434 Skunknet Road
Centerville
A= 170-018-005
t.
[SMEAD
No. 2-153LOR
UPC 12534
smead.com • Made in USA
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SOU¢dNG W W W.SpiOCItMOW
TOWN OF BARNS_(TABLE
LOCATION �� 3�/\V%_ A Rv SEWAGE# I � (4172
VILLAGE ASSESSOR'S MAP&/PARCEL
��li �'� 5
INSTALLER'S NAME&PHONE NO. 's a q oc�Ofi
SEPTIC TANK CAPACITY k oU r%L jA a() 013QX
LEACHING FACILITY: (type) �14 L C- La 1�-k a O (size)
NO.OF BEDROOMS a _
OWNER�V� ]� MUCr�S
PERMIT DATE: .COMPLIANCE DATE: i Is i�i
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 facili ) ` Feet
FURNISHED BY � `��
ItA y I
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43
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No.c901 — 41'/ 7 Fee V
THE COMMONWEALTH OF MASSACHUSETTS Ent eredincomputer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0[pplication for Bisposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Li 3 LA Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel CU \`\0 �' ,Ve'�` j�{��cc4�
Installer's Name,Addr ss,and Tel.No. �� O()tD5 Designer's
Name,Address,and Tel.No.
s� �rz�'
O �.cr.c,J�,. ��
Type of Building: ee 11
Dwelling No.of Bedrooms Lot Size 1 sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) Dab gpd Design flow provided���( gpd
Plan Date Number of sheets Revision Date
Title gg��
Size of Septic Tank Type of S.A.S. L e ti.c,\^_ Gam,,,....�,�5
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) C(„ ,et.Lk,,
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 ealth. i p
igne Date // / -TIN
Application Approved by Date I
Application Disapproved by Date
for the following reasons
Permit No. �`7 �� Date Issued I-'
4/ / 7 Fee Q -
THE COMMONWEALTH OF MASSACHUSETTS ""^ Entered in computer:
PUBLIC HEALTH, DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppYication for Disposal psteut Construction Permit
Application for a Permit to Construct Re air U,.',rade Abandon pp ( ) p � pg ( ) ( ) ❑Complete System El individual Components
Location Address or Lot No., Li 3 LA �I,\"r_V.N._\ Q_' Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel ° CU a
Installer's Name,Address,and Tel.No. a�q U O b5 Designer's Name,Address,and Tel.No.
5 Cry �cz u- S-k�e ter ,s
Type of Building: A '
Dwelling No.of Bedrooms Lot Size 1 7 U 6 sq.ft. Garbage`Grinder(iv)U
Other • Type of Building No.of Persons Showers( ) Cafeteria( )
-Other Fizttires,
Design Flow(min.required) gpd Design flow provided f 3 u gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. Q.�(,` ,
P Yp ln. C ,f
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) L�L
Date last inspected:
Agreement:
i
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 € ealth.
igne Date..
Application Approved by Date l I
Application Disapproved by Date
for the following reasons
Permit No. j l/`_/ Date Issued----------------------------------------
L
t
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) RepairetG,_� Upgraded( )
Abandoned( )by C,o Vrr_, .
at c -2�c �V�u�1,C^,t_ (2 C �,g 1\� has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No '-/n dated
Installer (O �77 a Vt` Designer 3_5m,,tea ms 1
V �
#bedrooms Approved desi .. flow CY gpd
The issuance of this pe t shal not b'e construed as a guarantee that the system wall*MnC2des' ned.
Date Inspector
- - No. 10��-� _.,L� �? Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Misposat 6pstem Construction permit
Permission is hereby granted to Construct( ) Repair((J� Upgrade( ) Abandon( )
System located at t
I
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. f
i
Provided:Construction mus be cop, leted within three years of the date of this it.
Date - Approved3L� b
i
Town of Barnstable
°aTME r Regulatory Services
o�
Richard V. Scali, Interim Director
1639. `0� 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: 15_1 ly Sewage Permit#���y—�11 Assessor's Map\Parcel 7 0 — Uk.g 00S
Designer: .STz',-e- w X. H-y+-4% Installer: Sc_c>\A
Address: 523 /2,:7V-7r= 6,4 Address: k 13
On 3 Sc-o$� �rr � was issued a permit to install a
(date) (installer)
septic system at �-\3�A. SV�,v rn C: Q J C.V j\kf-based on a design drawn by
(address)
C•C 5 dated �C A a a f 1 I—A
/ (designer)
t/ 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. Strip out (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. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in compliance with the terms of
the I1A approval letters (if applicable) e,A Of
A.
WS
(Ins 's Signature) cVIL
No.354011
-
� At
(Designer's Signa e) (Affix Designers 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.
QASeptic\Designer Certification Form Rev 8-14-13.doc
��
Town of Barnstable
Department of Regulatory Services I �'
Public Health Division bate 1
200 Main Street,Hyannis MA 02601
' rEFI tAh't�
�t
Date Scheduled fL ' Time Fee Pd.
�.
Soil Suitability Assessment or Se a e os �
Performed By; Witnessed By: Eb
LOCATION& GENE INFORMATION
Location Address l��
' `� 3�L.[ �tYi ...Owner's Name
ZV\ `�- Address
Assessor's Map/PerceL 'VC,
Engineer'sName
NEW CONSTRUCTION REPAIR Telephone Ik i.3
Land Use' � i7 Slopes
96 L
P ( ) Zr Surface Stones Iota
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Dtaihage Way ff Property L ine fD"E- ft Other ft
SKETCH: Street name,dimensions of lot,exact locations of teat holes&pere tests,to ate wetlands.4 proximity to boles)
� Parent material(geologic)
av-w H �
Depth t4 Beciroclt
W' Depth to Groundwater. Standing Water in Hole A-C,A-$c Weeping 11'om Pit Fnea
Estimated Seasonal High Groundwater �-
IDETERWIo]ATION FOR SEASONAL-11IGH WATER TABLE
Method Used: A-Y'A-'� .
Depth Observed standing in obs.hole: In. Depth to soli mottles, In.
Depth to weeping from side of obs,hole: ln, Grtlundwater Adjustment ft.
Tndex'Well Ik Reading Date: index Well levol Adj.thetor— A41,druundwuter`Lavel,,,_,
PERCOLATION TEST bute �i. x�tna�`ti'
Observation
Hole#.: Time at 4"
ry: Depth of Perc Time At 6"
Start Pre-soak Time @ Time(9"-6" _
End Pre;soak
Rate Min.fluch
Site Suitability Assessment: Sito Passed_ Sito Failed: Additional Testing Needed(Y/N)
Origlnah,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(1)week prior to beginning.
Q:\SP-PTIC\PHRCFORM.DOC
L
i
DEEROBSER`6jATION HOLE LOG Hole#
Depth from Soli Horizon Soil Texture Sdii Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,.Stones;Boulders.
Col ilia Lency, nravel)
YA- 4/t
DEEP OBSERVATION HOLE LOG Hole# 7
Depth from Soil Horizon. Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,% a
.lV �s lv�s- 3lf
_ Z� �• LS 1 Ls/�
. o 6/
DEEP OBSERVATION HOLE LOG Hole it
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
CqjmlstendL' Q
DEEP OBSERVATION HOLE LOG Hole#
Depth from Sotl Elw'izon Soil Texture Soil Color. Soli Other
Surface(in.) (USDA)• .. `(Munsell) Mottling (Structure;Stones;Boulders,
Can ' ten •
Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes y
- "rv-itidn 500 year buundcy No Yes
Within 100 year flood boundary No,-� Yes
Depth of Naturally Occurring 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? 1►�C3
If not,what is the depth of naturally occurring pervious material?------
• Certification
'
I certify that on 41j'� (date)I have passed the soil evaluator examination approved by the
Department of Environm ntal Protection and that the above analysis was performed by me consistent with .
the required trainin p rase and experience described in�10 CMR 15.017.
Signature �--�, Date
Q:\5P-P1nC\PBRCPORM.DO C
ACCESS COVERS MUST BE WI THI N .9" MINIMUM. INVERT EL E VA T l ONS : DES l'GN CR l TER l A : GENERAL NO TES :
6" OF FINISH GRADE
3' MAXIMUM COVER
FIRST 2' TO INVERT OUT SEPTIC TANK: 94.5 DESIGN FLOW: 2 BEDROOMS, DESIGN FOR
BE LEVEL MI N 2" OF PEA 5TONE INVERT IN DI ST. BOX: 93.27 3 BEDROOMS MINIMUM AT l l0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
OR FILTER FABRIC INVERT OUT D I ST. BOX: 93. 1 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY.
4' DIAM PIPE 3/4" - I I/2' DIA. INVERT IN LEACH CHAMBER: 93.0
o� 94.5 93. 1 /2" '%6 DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 92.0 NO GARBAGE GRINDER ` 2. VERTICAL DATUM IS ASSUMED, FOR BENCH MARKS
GAS 93.2T 93.0 a) 92.0 ADJUSTED GROUND WATER: N/A SET. SEE SITE PLAN.
BAFFLE OBSERVED GROUND WATER: N/A SEPTIC TANK REQUIRED:
EXISTING 3 OUTLET 330 G.P.D. X 200% - 660 GAL.
4 LC-6 LEACHING CHAMBERS J. ALL CONSTRUCTION METHODS AND MATERIALS AND
D-BOX W/3.5' STONE AROUND. IO'w x 36'1 x 12"d BOTTOM OF TEST HOLE #1: $5. 1 SEPTIC TANK PROVIDED: 1000 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL
1000 GAL CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL
SEPTIC TANK 6" CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
COMPACTED BASE
DESIGN PERC RATE C 5 MIN/INCH
PROF l L E : NOT TO SCALE SOIL TEXTURAL CLASS - 1 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH-
STANDING H-20 WHEEL LOADS.
PROVIDED: 4 LC-6 LEACHING CHAMBERS
W/3.5' STONE AROUND. A-452 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
_ a 452 S.F. x 0.74 - 334 G.P.D. APPROVED EQUAL.
6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED
SOIL TEST P I T DA TAB+ PRECAST CONCRETE OR APPROVED POLYETHYLENE.
O rNDtcATES INDICATES BOTH SHALL BE WATERTIGHT, D-BOX SHALL BE WATER
PERCOLATION _ OBSERVED
Qv TEST _ GROUNDWATER TESTED FOR LEVEL WHEN THERE I S MORE THAN ONE
C 11 TP #1 Pwt4516 TP #2 OUTLET.
METERPIT
® 0" HORIZON TEXTURE COLOR 95.6 0' HOR 1 ZON TEXTURE COLOR 96.0 7. BEFORE CONSTRUCTION CALL DIG-SAFE".
A LOAMY IOYR A LOAMY IOYR
O� $AND 3/4 SAND 3/4 1-888-D!G-SAFE AND THE LOCAL WATER DEP T.
�O 9" - - - - - - - - - - - - - - - 94.9 I0 - - - - - - - - - - - - - - - 95.2 FOR LOCATION OF UNDERGROUND UTILITIES.
B LOAMY IOYR B LOAMY IOYR
SAND 5/6 SAND 5/6
24" - - - - - - - - - - - - - - - 93.6 24' _ - - - _ _ - - - _ - - _ _ _ 94.0 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
SAND AND 6/144 C MEDIUM I SAND AND 6/194
t qy C MEDIUM I DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
_1
42" GRAVEL GRAVEL OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
FIRM FIRM CONSTRUCTION INSPECTIONS.
72' - - - - - - - - - - - - - - - 89.6 76- - - - - - - - - - - - - - 89.7
C2 MEDI(AII IOYR C2 MEDIUM IOYR 9. EXISTING LEACH PIT TO BE PUMPED DRY AND
SAND 7/4 SAND 7/4
UP-278 BACKFILLED.
NO WATER NO WATER
� 3 `32•38� 126" 85.! 120' 86.0
DATE: OCTOBER 9. 2014
/ TEST BY: STEPHEN HAAS
/ WI1`NESSED BY: DONNA MIORANDI
PERC.RATE:_uf_2_MIN/INC14.-
LOT 26
a ti i - - - - - - i�- - - - - - - 17. 906f S. F. �
1i � / I % 94.8 a
4
\ f O €XISTING / EXISTING �
0EPTIC TANK m PIT
BM. CORNER BH I ...:: ,73.y'AZ
EL-98.7B �7. ,- 62�A S E P T I C S Y S T E M D E S I G N
12-OAK 12'OAK ��
✓ ' -434 SKUNKNET ROAD MAP ! 70 PARCEL 0 1 8 - COS
7. 1
..... .�
TP#2 ��•-•h• :..:::... •- 'ice
36*95// 46 BARNS TABLE . ( CENTERV l LLE ) MA
o / ✓ ... _ 6-Box i
�Q / /✓ TP#I /
4 LC-6 CHAMBERS PRE-PARE-0 F 0 R
Af 6
2
LEGEND '�' �3^3`3S O / W/3.5' STONE AROUND
2S0.� NE l L MORR l S
■ CB CONCRETE BOUND � l
a LOCHS -py WATER L INE SPIKE FND/+95-0
+ 4 HYDRANT SCALE : l 20 ' OCTOBE`R 22 , 2014
9�Fs -G GAS L 1 NE
OHW- OVER HEAD WIRES S T E P H E N A . H A A S
4- LIGHT POST ENGINEERING , INC
-E- UNDERGROUND ELECTRIC LINE P . O . B o x 16
2$ -Y--T- UNDERGROUND TELEPHONE LINE South L) e n n i s M A 02660
ROUtE -CTV- UNDERGROUND CABLEVISION LINE / ��i/�,�/ 11/�;1�
+40.4 SPOT ELEVATION �`''`"� /�I�1� �\ 508 � 362-8 1 ,32
--------40--- _ EXISTING CONTOUR
LOCUS MAP 40 PROPOSED CONTOUR 0 /0 20 40
JOB NO: 14-074