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HomeMy WebLinkAbout0297 STRAWBERRY HILL ROAD - Health 297 STRAWBERRY HILL RD. A-248-027 M CENTERVILLE �I 1 4 i'1r'cuw.•® 3� i UPC 12543 % �a No.5.3_LOF� ��srcoe+�a HASTINGS,MN YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years).. A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form. at 200 Main St., Hyannis. . Take the completed form to the Town Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: fp # APPLICANT'S YOUR NAME/S: s . a , , USI S YOUR HOME ADD 'F ESS: I yr �' t TELEPHONE # Home Tel p�Number a e NAME OF CORPORATION. ' _ SS NAME OF;:NEWsBUSINESS �'' � RE OF BUSINESS b- 1 IS THIS A:HOME OCCUPATIO YES N / ADbRESS'OF BUSINES r s f C MAP/PARCEL NUMBER . Z � GI (Assessing) When startinga new business there are several thins you must do in or der r to be in compliance with he g y p t rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate=-g61' g61xr s Oess in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual has beenrmVorm'ed of the permit requirements that pertain to this type of business. MUST XIVIPLY WITH ALL L f' r\/[Vl 'HA?ARD0US MATERIAL S REGMI ATInrt'S Authorized Sign ture* COMMENTS: VID Vl 61(1 f '5TV�a 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: •\ V TOWN OF BA/R/NSTABLE .gyp,•-� LOCATION r9� ���PE�R SEWAGE a VILLAGE (� wr "U SSESSOR'S MAP&PARCEL�g` INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 6-3047►Pq 16M *,+l LEACHING FACILITY: e (* /4 C (10 `*X, (type)� (size) �S x�l�� 53 NO.OF BEDROOMS / OWNER I 'I ' PERMIT DATE: COMPLIANCE DATE: d 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 L aching Facility(if any wetlands exist within 300 feet of leaching:facility). feet FURNISHED BY 3 31 1 ray� ANT Rs'35� � 1 a� a 1 n O��/LIypTID BJ . No. , { Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �— Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 010plicatiou for 3Di!5po.5a1 *p-5tem Cougtructiou 'Permit Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. "1 ` �b° I tT`�I f �a Owner's Name,Address,and Tel.No. _"V' Assessor's Map/Parcel 2.4 44—t l t. Installer's Name,Address,and Tel.No.�-Jg tin �- J � Designer's Name,Address and Tel.No.Dqo_-C^ W'eq v-0 q 7`6-N 7-3- 71671 o . Wlu; o 1n ,0. �1`b1 S�.►cQ S 3C�?-29Z Type of Building: Dwelling No.of Bedrooms Lot Size 131, 7 0 sq. ft. Garbage Grinder ( ) Other Type of Building ZSr,,,,LdIc ?��,,,1�.� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min/re uired) gpd Design flow provided 3-x 0 gpd Plan Date Number of sheets Revision Date Title °r_ Size of Septic Tank /®C;-0, Type of S.A.S. �.}� {(L-2C-C.!5 Description of Soil 0" 4.0�(Q�� 01 1 le'� "1 cz, Z Z s� °1� �6a°�rl 2 Z /Oer✓n �Cizt 4e' /?Mu !'t/lea S Nature of Repairs or Alterations(Answer when applicable) IJ� � a(a� N•'f7 a.a U f e- Lti 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 it e 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by is oard of Heal Signed Date `% /Z Application Approved by Date Application Disapproved b Date for the following reasons n Permit No. 2 0 0G(- G Date Issued No.2oQ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF\BARNSTABLE, MASSACHUSETTS Yes Zippgicatiou for �Bigogar;6pgtem Congtructiou Permit Application for a Permit to Construct( ) Repair )'+.:Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components ,11 Location Address or Lot Noa Cj ` 6+04%Ub"P.(4 h' I 1 F Owner's Name,A dress,an Tel.No. A� r O i CO S'1RQWV,a -� �11 G �2v011.e Assessor's Map/.ParcelM 4 2.14 r� -4-77 ,•�(�j(A/1 �©Cb_ Li s�-5 7(� Installer's Name,Address,and Tel.No.J cam? e` J-Ae-v Designer's Name,Address and Tel.No �'- 1,s�u 7�c�e✓L. 9 4 V9 Z Z5 71 35"o I�uu•'ti S t,V. &0-wcv��lrt Type of Building: Dwelling No.of Bedrooms t� Lot Size /7te'7 O sq. ft. Garbage Grinder ( ) Other Type of Building Z5t,t--i lc No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.r, uired) gpd Design flow provided 3'Z Ca gpd Plan Date Cj�1 od� . Number of sheets G.. Revision Date �f Title I'L t Q�Qa:Jlr _ Size of Septic Tank /045101 Type of S.A.S. Description of Soil 0' �Q iU. , o1 ) 4c-, 2 Z r r .%Cc �.d�� ��u�r.i 2 Z i r -4 Nature of Repairs or Alterations(Answer when applicable) (i /�.�� D(e3• N-!� Qvtt.� U S�' �y� y 11�� Q�5 l3i��i'� �s�✓t_. k--,- a.v Un4'� S d fv.ti - Date last inspected: Agreement: ) The undersigned agrees t%.ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions ottle 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by is oard of Healt Signed Date /Z/W Application Approved by S. Date Application Disapproved b. : Date t' for the following reasons Permit No. Z ���' b Date Issued - O� �►. t-r_• iriae�+-mac:.__.., - -- ----._ --�.�:Q���:�e�::aee�e��i�=�_-- �.—.---=—===r=——��__•,,.���.�-- -. ... ,,. - - �' M�awaaiF.fa,.�r��s,�L��fi,rlr�AtiaR+pq++!�aR�.aMrMbwM++ir ►wwr +e+W�4+ri�+4wn44'lsw+s!►�NrINNs�►+.�t+►+►sA+n+ 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 -;4/va, 42 � < $�✓Glx"t4 4,1- at ')6 17 e'_11o�w\P-A1L-j fvr`\t Qc has been constructed in accordance q with the provisions of Title 5 and the for Disposal System Construction Permit No. 2,00 ' - 2 Z dated ` Installer"cgrr ur,`av7--,S fIJQ r uer�'e.4 Designer 'P`lA 1' a� ,_ M'e•_"1 g� S #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system Will fun t" i n as designed. Date -1 'O ©� Inspector ———————————————————— ——————— Fee �.w+i..�_l�.s�e,.�ar-j�..-'... . g�c'�.rr�.apr+lr.ryr•.�rrr:!ib+sir..r,..,P�r.n�.;►�r;wioa,,,,,y+lWar+�,!r.�ir�iti�t�IF+ia►,frt++.rrrwri�r'i«•+y++r�irW�l++?z�31#Mr4"r f s W 6Fes rs�1 W rwM+r+N+►�� No. 200�- 2�Z fDU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Migpogal 6p$tem Con5trUction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at 7 91-7 S` acl-4-AA-1 4,'« Q--k 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 permi . Date Z ' 0 Approved by (/ ' t s •► s • APPLICANT: ADDRESS: L DESIGN FLOW: �322 gpd REVIEWED BY: DATE: N/A OK NO Le al boundaries denoted [310 CMR 15.220(4)(a)] I x Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] �( Locus Provided 310 CMR 15.2204 t Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] )C Easements shown [310 CMR 15.220(4)(b)] X System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- i not, a variance is required 310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)],• x Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas [310 CMR 15.220(4)(e)] �( System Calculations [310 CMR 15.220(4)(f)] daily flow septic tank capacity (required andprovided) X soil absorption system (required andprovided) )( whether system designed for garbage grindel k North arrow [310 CMR 15.220(4)( )] Ix Existing and ro osed contours [310 CMR 15.220(4)( )] x Location and log of deep observation holes(existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] X Percolation test results match loading rate?-[310 CMR 15.2421 Certification statement by Soil Evaluator 310 CMR 15.220(4)0)] Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Location of every water supply,public and private, [310 CMR- 15.220(4)(k)) Address_ 2-�17 � �1 ll Jec�. Sheet 1 of 7 r within 400 feet of the proposed system location in the case of surface water supplies and rayel packed public water supply within 250 feet of the proposed system location in the case x within 150 feet of the proposed system location in the case of private water supply wells c e Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] Water lines'-and dtheF=Aubsufface utilities located [310 CMR 15.220(4}(m) (if water line cross see 310 CMR 15.211(1) 1 ) Profile of system showing invert elevations of all system components and the bottom of the SAS 310 CMR15.220(4)(o)] X Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] X Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2)or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] X Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] Test Holes adequate to cogfirm adequate groundwater separation? 310 CMR 15.103(3)] X Benchmark within 50-75'of system [310 CMR 15.220(4)( )] Materials specifications noted? [various sections of 310 CMR 15.000] System components not>36" deep(unless Local Upgrade Approval or LUA requested)f310 CMR 15.405(1(b) /� , 1 Address a.�l Sr H It l�- Sheet 2 of 7 i r Jr Size OK? -[310 CMR 15.223(1)] Inlet tee located ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14" or 14" +5"per foot for increase ft depth [310 CMR k 15.227(6) Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228(1)] Separation between inlet and Outlet tees (no less than liquid depth) 310 CMR 15.227(2) Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (b 7/07) [310 CMR 15.228 2)] Access to within 6 "-of grade - one port for systems< 000gpd, two fors stems>1000 gpd 310 CMR 15.228(2 All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done 310 CMR 15.221(8)] X H-20 Where appropriate? 310 CMR 15.226(3)] X Setbacks from resources [310 CMR 15.211 F Required when other than single-family dwelling or flow>1000 d [310 CMR 15.223(1)(b)] X First compartment 200%daily flow; Second compartment 100% daily flow 310 CMR 15.224(2) and (3)] "U"pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] Address 2 r 7 `��'�1/Q� y/7�LL 4. Sheet 3 of 7 Located at least ten feet from any water line? [310 CMR 15.222(2)] 1x Disposal piping at least 18"below water line (when water and sewer cross, see 310 CMR 15.211(1)[1 Cleanouts required/provided ? 310 CMR 15.222(8)] Thrust blocks specified in force mains?310 CMR 15.221(6)(c)) Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable X[310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) 310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphonproblem/ leachfield below pump chamber) Endca s or vent manifoldspecified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) " Stable compacted base [310 CMR 15.22](2) and 310 CMR 15.232(2)(a) X Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)) x Riser if deeper than 9" [310 CMR 15.232(3)( Inside minimum dimension 12" 310 CMR 15.232(2)(b)] �( Minimum sum 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] ')( Capacity(emergency storage above working=design flow)?[310 CMR 231(2)) Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE [310 CMR 15.231(5)] Service components accessible (not too deep,with piping, disconnects accessible) Alarm floats -alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [31-0,CMR 15.231(6)and (8)) Stable Corti acted Base [310 CMR 15.221(2)] Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)] Address �- l� S"� 1 YVl? p�,t/ j`�1�� �Cl✓�Yl- Sheet 4 of 7 r , rw. Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1) Required separation togroundwater? 310 CMR 15.212).] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36'! deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR x 15.240(13) Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and x Guidance Document] Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] �C Each structure with one inspection manhole(if>2000 gpd must be tograde) r310 CMR 15.253(2)] Aggregate I'minimum-4' maximum. [310 CMR 15.253(1)(b)] 2'sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet-maximum length 310 CMR 15.251 1)(a) Minimum separation 2x effective depth or width whichever eater(3x if reserve between trenches) [310 CMR 251 1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? (310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e) Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)( )] Separation between beds 10' minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only 310 CMR 15.252(2)(i) Address Sheet 5 of 7 ' r 7 Pressure Dosed System ? Provided pump and piping v calculations as re uired,. 310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems undeVmmedial approval [310 CMR 15.254(2) and UA Remedial Use Approvals] If used in gravelless system - make sure jet is directed as not to scour soil interface [Guidance Document] x Inspections once per year(systems<2000 gpd) or quarterly (>2000 dgood to note on plan [310 CMR 15.254(2)(d)] x Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? x Impervious barrier and/or retaining wall ? Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? 310 CMR 15.255(2) Breakout requirements met? [310 CMR 15.252(2) and Guidance Document x At least 5 ft. from impervious barrier to edge of SAS (10 ft. X recommended) [310 CMR 15.255 (2)(e)] b 9 Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface x Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a co y of a maintenance Are the variances listed on the plan ? [310 CMR 15.220 4 RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed - [Refer to 3 10 CMR 15.414] Address -1 SA'W Ury ll Sheet 6 of 7 r s.1" .' Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(l)] Pumping to septic tank? [ 310 CMR 15.229 Shared System [310 CMR 15.290 Address x--V S�'� � "' Sheet 7 of 7 Town of Barnstable s �TME 1pt.� Regulatory Services Thomas F. Geiler, Director • wtxarnste. � NAM Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-8624644 Fax: 503-790-6304 Installer& Designer Certification Form Date: Sewage Permit# Assessor's Map\Parcel Designer: I �r�� A ' elf/- Installer: Address: lJ 6" -J T_ Address: On was issued a permit to install a (date) (installer) septic system at a� S+y6t.w 1 based on a design drawn by (address) &- dated (designer) 1 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 (J(Instae rtified a y designer to follow. OF _114s�cy rl D E i�M `'s Signature) No 1140 NIT6 ® 11,01 (Designer's Signature) (Affix Designer's 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 Q:Health/Septic/Designer Certification Fortn 3-26-adoc .G► I own of Bknstable. Department of Relkulatory Services Public Health Division Date a U KA s$ 200 Main Street,Hyannis MA 02601 161 Date Scheduled Time-IL&M Fee Pd. 0 , Moil Suitability Assessment fop Sewage isposal DI Performed By-.1 Witnessed By: j LOCATION & GENERAL INrORMATION Location Address '7 sTmN eic-1ee-y J+I L L, P{j_ Owner's Name PNJ� Ate t-I LLI i Address Assessor's Map/Parcel: L 2-1 7 i Engineer's Name Dpt P(1�e,.^ fM e,1 e it NEW CONS i11Z Ut.nON a REPAIR X Telephone#��� -L+Z.L{ 1a Li Land Use ©�f l�Mfi 11�t Slopes(96) J Q Surface Stones Distances from: Open Water Body 2�ft Possible Wet'!Area Drinking Water Well a ft Drainage Way ft Property Unc 1 ft Other ft SKETCH:(street name.-dimensiods'of lo4 exact locations of test holes&perc tests,locate wetlands in proximity to holes) Existing Leaching (Note 10) 42 41 1 1 / -- LOT -1 � I 'AREA - .I s- i I ' � �� \. '•' ' NON b 7il sf +_ 1 1\ \\ 1 TFi \ c6 I LEACHING .'i 1 \ 1 / c \. i�• ---• CATCH NE lia DR'V WAY t 0 M o' \ r CI I I I \\\ 1 In� M U 1 I 1 W 7EP EPJE i� i in I I I� i Parent material(gedlogic) " '" I Depth to Bedrock Depth to Grouudwandr. Standing Water in Hole:' t` 'A i Weeping from Pit Face Estimated Seasonal lilgh Groundwater AL � DtTERUN TION FOR SEASONAL HIGH yyATEIt TABLE Method Used: In. Depth to snll tnotUcs: In, Depth dbserved standing in obs.hole: I in, Oroundwater Adjustment ft Depth tolweeping from side of obs.hole I A4j,factor Adj.Groundwater Laval Index Well# .. Reading Date: Index We11 level PERCOLATION TEST Observation - ` I Time at 9" C1� ...---- Hole# �_ Time at G" .....----- Depth of Perc 4 P-3 Time(91'41 Start Pre-soak Time.0 1 • End Pre-soak Rate MinJlnch ! Additional Testing Needed(Y/N) Site Suitability Assessment: Site Passed x Site Failed: Oril;m2l:.Public He$ith Division Observation Hole Data To Be Completed on Back--- ***If percolaflon test is to be conducted within 100' of wetland,,you must first notify the ,0.._v+0h10 rAtiservation Division at least one(1)week prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other (USDA) (Mansell) Mottling (Structure.Stones,Boulders. Surface in.) o vel ( nsis e c 4' O -(,E' r '-2 I f 22�_3G 131 l3V 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) A 5uetl 64y,� Log i2 3 , q Ll EP OBSERVATION HOLE LOG Hole# Depth from' Soi rizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. n 'ste c vel DEEP OBSERVATION HOLE LOG ole# Depth from Soil Ho' n Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones.Boulders. Flood Insurance Rate May: Above 500 year flood boundary No Yes• _ Within 500 year boundary No z Yes Within 100 year flood boundary No Yes Death 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? If not,what is the depth of naturally occurring pe ious material? ...____ Certification I certify that on ID I C (date)I have passed the soil evaluator examination approved by the Department of Envir nmental Protection and that the above analysis was performed by me consistent with the requi im ,expertise and experience described in 3.10 CMR 15.01, Signatur ' Date �L ----•••-•• -1 ..... ....... THE COMMONWEALTH OF.MASSACHUSETTS BOARD .. O F..... _................ Aliptiration -for Utnpoiial Works Towitrurtion Prrmit Application is hereby made for a Permit to Construct ( 01"or Repair ( ) an Individual Sewage Disposal System at: _ Location-Address or Lot No. f� ..........rf :✓ Y✓G �fS� GL,rr Gf?./.._.•G vt L (L-n. C.�v✓!:--••--. Owne Address a In alley Address Q Type of Bu•, ing Size Lot./_3,F__,�_?©------Sq. feet 'yam U Dwelling /�-6�N0: ,of Bedrooms---------a_______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Ty of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q Otlier fixtures -------------•---- ---- -•--------•-----------•---------••---------------------------•--•-•---- ------------- - w Design Flow_.. _............gallons per person per day, Total daily flow-------- ----------------------------------gallons. WSeptic Tank Liquid capacitv)i gallons Length.................. Width--__ _--_._ _.. Diameter------- ........ Depth----__-_--:_... x Disposal Trench—No_ ____________________ Width_.____ We �inkk- Total leaching area----.--.__-_--____Sq. ft. Seepage Pit No..._I_______________ Diameter __. ______ ___ __ Total leaching area-....-__,________sq. it. Z Other Distribution box ( ) Dosing tank ( ) - `'— X0271-7,1. ~" Percolation Test Results Performed by__________________________________________________________________________ Date_____------------___------------------.. ,� iTest Pit No. 1..........K__::nunute's'pe`r-inch Depth of "Pest Pit____________________ Depth to ground water-_-___--_____-_---_---" Test Pit No. 2----------------minutes per.inch., Depth of Test Pit.................... Depth to ground water__-_-_-___________-_-- (yi r---------I---------- Description of Soil------1------- -`--••--2-. 1R -- _ ----- •-� ------------------------------ y ` s`- 1 a= -•-- w U Nature of_Repairs or Alterations—Answer when applicable------------------------------------------------------------------.-_.___-. --____-_-_,___---.. ------------------------------------------------- Agreement The undersigned agrees to install the aforedescribed Indiv dual'Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitary Code— Tl e undersigtiet-'further agrees not to place the 'system in operation until a Certificate of Compliance has been issued by the'board of health. Signe /j /t/ Date Application Approved BY ,/'` /��° 1�- --•-•-••--•-•. I=1 ....... � . . Date Application Disapproved for the following reasons:................................... ----------•------•---••••- -•--•--••••--•--•--•••----•-•---•-•-•----••--•--•-•-•---------•••-•--•-------•••-•-••-_.___ ------------------------ ------------------------- --------------------•- Fate Permit No......................................................... Issued.. 6 ... Da 2; No......................... FEx..... ................ THE COMMONWEALTH OF MASSACHUSETTS BOA D F 1-6 H=H. o2 f.. I 0F....... ........0" .. ........ ....... .. Apliration -for Diiipviial Works Tvw4rurtivu Pumit Al Application is hereby made for.a.Permit t6'Construct .4 I-r or,'Rep air an Individual Sewage Disposal System at: L A ................. ....YJ.�i ------------------------------------- .................................................... Locatio N w n-Address or Lot K'O ..................................... ------------------------------------ Address ... .... ................ ................................................... .............................................................................................. -- ------ ----6-� ------ ------ Installer 04, Address :Type of uildiny Size LotJ_;!/..�.2.P-----Sq. feet U 'Dwelling—No. of Bedrboms-------- ------------- ------ --------- Expansion Attic Garbage Grinder --- --- Other—Type of Building ---------------------------J No.'of persons---------------------------- Showers Cafeteria Other fixtur W-----------------­---------------­------------------------------------------------------------;Z_ ----—----------------- Design Flow ­...... gallons per person per day.. Total daily flow............................................gallons. P4 Septic Tank/01 1% ----- lame er Disposal Trench— 0---------------------- Wi Total leaching area-------------------Sq. ff": Liquid capaci . ----------gallons Length.....__ Width Di t ----------- Depth_.............. op" -, Seepage Pit No_____ ___________ Diameter. ...... ........... -1 --area------------------sq. f t. Other Distribution box ( ) , _ .., Dosing tank ( ) Percolation Test Results Performed by----------------- --------------- Date. I ...................................... Test it No. �1................minutes per inch Depth of Test Pit.._____..-- ------- Depth to ground water.-___________.___--.__. rZ Test Pit No. 2..... ......minutes per inch Depth of 'Test Pit...................... Depth to ground water-..-_-__________-____- ---------- ------------------------------------------------ -----F­ ---------------------------- ---------- ------------------*------------------------------------------ 0 ­ yt------------ Description of Soil--- ---------------------------- ------------- U ..... . . .... .... --------------------------------------- ------------­- ---------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of'l',epairs-o'r Alterations—Answer when applicable.------------------ i ----------------------- --------------------------- ­­------------------- ............. -------­--------------------------------------------------------I----------------------------4--------------------------------------------------------------------- Agreement: The undersigned agrees to install the afore described Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary 05de— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isi'sued by the board of health. iL Signed...................................................................................... ...................------------- • Application Approved By-__-- Date'- .................4� �I_ - K4---------- Application.Disapproved for the following reasons. ........... .......................................................................... ....................................................................................................................................................... ..................7............................ Date PermitNo......................................................... Issued.----....... ............ ............................ Date THE COMMONWEALTH OF MASSACHUSETTS ;L BOARD OF HEALTH OF...... . ...................... .............. 41 -SIS T ---r�Repaired CE ZZ T at... e Individual Sewage Di�pdsal System cohsfructed ( 4o .... ....... by-- .................... ......... ............. ......................... ....................................................................... slaller at.- - - -- -----_------------­- .......................................... _­ ----------------- in accordance the pi -�Slo has-le�instalfe o - rticle XI of The State'Sanitary Code as described in the application for Disposal Works Construction Permit No.-if ................. dated-._-_ ------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO I NSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION CTION, SATISFACTORY. DATE............................ . ................................................... Inspector...----......................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH sla ok ri S ............. .t 0 F......... . L ........ .. . dv� .. .t- FEE---/_90-n.......... Permission is hereby granted............................................ ..... --- ------------------------------------------------------------------------------------- to Construct or an In ivi u Sewa e Dis osal System AA atNo.. ............... . ... .... . ....... ......................................................................... 'IT C's,0 P as shown-on thA'aDDlication for spo al Works Construction P it N ---;V .......... �j � --------------------------- DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 5EW a-6�E PERMIT-U 0. V-ILL p-G►E - - - - - - - - Ij S l3 U-I L D-E R S-IJ- M E- =A-D D-R-E-SS --D IJ►`CE--P E R NIT I-55U-E-Di-_�=�-��_ _ -s DtAT}E°'CO K/l P L I-w"I CE�I �--�---,- r.. �`ei..yd.~ , hjj ��• y,r f., S LOCQTON SEWa E PERMIT MO HP INSTl1 - :€ ADDRESS 6-U-I L-D-€_R. S. . 1`! :�a• €...: A D -R E-SS. . - - - - - - - - - - - - - — __�..__- _. 7 7-4 D ArT.:�Z-----CO.OP-LI W C­E ISSUED -._ _ Oc�- 7 J D D b . � i BENC7GRATE LEGEND -�� PROPOSED CONTOUR TOP OF DRELEVATION ® PROPOSED SPOT GRADE BARNSTABL -- 98 -- EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE _ Existing Leaching W— EXISTING WATER SERVICE o (Note 10) 42 _ TEST PIT SITE 40 L - o ! ^ O� 0 V 1?0 3836 -� U J1 t0 ft 143.45 f\ _ 2'J00' • 1 1— 1 r I t.,: 71 P ''- No LEACHING LOCUS MAP N.T.S. �! LOT ,\ \\ TH t - 1 ` CATCH GENERAL NOTES: AREA = 13670 sf +— ; \\ 1 — — �� BASIN \ \\ \ 1 :�i � I T N E ; 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ \ \ \ i � \ 1 I D R V WAY. � � rn BOARD OF HEALTH AND THE DESIGN ENGINEER. \ \ \ 1I w 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS rn 1 \\ \ G GAS L I OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE 0 . rn LOCAL RULES AND REGULATIONS. rn I I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR M 0 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE \ r 0 C X n DESIGN ENGINEER. \ C - v 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING \ !I (TL (� ! m FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN m' ENGINEER BEFORE CONSTRUCTION CONTINUES. \. W �- - ! Z� / 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. t (Y 7 _ Z !, v -{ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF i 06 Z 0 _ _ _. _!. _ • \ THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF z (,� WATER LINE 1 II HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. I 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. • ! 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED " ! TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. \ I \ 1 1 + _ 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY \ 1 1 I I 1 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND REMOVED. REPLACE WITH CLEAN MEDIUM SAND. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY OF 1 \ �42 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. o�DAR N M, may✓+ \ \� + �� 14. NO WETLANDS WITHIN 150' OF PROPOSED LEACHING. M 36 �., \\ 1 \� 15. ALL PIPING TO BE 4" SCH 40 ® 1/8*/FT (UNLESS SPECIFIED) \ I ! O o. 1,,1dd4G(0 "' 38 16. PROPERTY IS WITHIN A NITROGEN SENSITIVE AREA/ZONE ii. MNI PROPOSED SEPTIC SYSTEM UPGRADE PLAN k. 297 STRAWBERRY HILL ROAD, -H�N , MA Prepared for: Blue Water Septic SURVEY REFERENCE: 1` Mom' 248 Engineering by: Surveying by: SCALE DRAWN JOB. NO. LOT.7287 DARREAIM.MEYER,R.S. Eco-Tech Environmental 1"=20' DMM SITE AND SEWAGE PLAN: BAXTER & NYE, SURVEYORS ti DEED BOOK•i&v5 PO Box gal (508) 364-0894 DATED: JUNE 14, 1974 DEED PAGE-224 FAST SANDWICH,ALA02537 DATE: CHECKED SHEET N0. 508,W-2918 09/01/09 DMM 1 Of 2 rf NOTE:. TO PREVENT BREAKOUT, THE PROPOSED DESIGN CRITERIA NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:39.39 FOR A DISTANCE OF 15' AROUND THE NUMBER OF BEDROOMS: 2 BR EXIST. / 3 BEDROOM EXIST. (PROP IS IN ZONE II) I PERIMETER OF THE S.A.S. SOIL TEXTURAL CLASS: CLASS I SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. DESIGN PERCOLATION RATE: <2 MIN/IN T.O.F. EL.=43.50 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" 'DIAMETER INSPECTION PORT OVER DAILY FLOW: 110 G.P.D./BR OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. DESIGN FLOW: 330 G.P.D. F.G. EL.=42.Of F.G. EL.=42.0f F.G. EL: 41.50t F.G. EL: 42.25(MAX.) GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) PROPOSED SEPTIC'TANK: USE EXISTING 1.000 GALLON CAPACITY LEACHING AREA REQUIRED: (330) - 445.94 S.F. .74 L = 1O• ± t36* AIX OVER/ DISTRIBUTION BOX: 5 OUTLETS (MINIMUM) COVER L = 10' L. = 10'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) ® S=1X (MIN.) A S-iX (MIN.) ® S-IX (MIN.) PRIMARY S.A.S. 4"SCH40 PVC 4"SCH40 PVC 4 SCH40 PVC USE 4 ROWS OF 4 - 11" ADS BIODIFFUSER H-20 UNITS-NO STONE 1 6.35" TO 14' INVERT BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF.OF BIODUFUSER) \IN = 40.30 VID INV.=40.?53 (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.70 SF/LF = 470 SF L POSED INV.=39.75 DESIGN FLOW PROVIDED: 0.740PD/SF(470.0 SF) = 347.80 GPD > 330 GPD req'd GAS BAFFLE) 4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25'/ROW BOX�� INV.=39.95�}I-10) INV.= 39.00 SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1,000 GALLON SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING SEWER OUTLET BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS -75" NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING "•`' ;::= ::' PLACE FILTER FABRIC PIPE INVERTS PRIOR TO CONSTRUCTION -:~'' ' ''''' _.•': OVER ALL UNITS BREAKOUT=TOP ELEV.=39.39 w 2) TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 39.0 GRADE ON A MECHANICALL COMPACTED SIX BOTTOM ELEV.= 38.47 INCH CRUSHED STONE BASE, AS SPECIFIED IN EXISTING SUITABLE 310 CMR 15.221(2) 1 2.83' MATERIAL _I 3) REPLACE EXISTING 1.000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF r• 76" TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECT. WIDTH = 4 x 2.83 11.32' IF FAILED, DAMAGED, OR UNDERSIZED. (7.37 PROVIDED) USE 4 ROWS OF 4-HIGH CAPACITY PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM OF TESTHOLE EL.=31.10 _ ADS BIODIFFUSER UNITS-NO STONE SEPTIC SYSTEM PROFILE TYPICAL SECTION � 11" � N.T.S. N.TA 6.±5 SOIL LOGS I I h�34"�1 Elev. TH-1 Depth Elev. TH-2 Depth SECTION END CAP 42.10 o" 42.20 o" ����Z� Of FILL FILL sf9� 11"" HIGH CAPACITY (H-20) BIODIFFUSER UNIT 93.25 A 16' 93.25 A 16" I DA MODEL 11" HICAP SANDY LOAM SANDY LOAM Y 10YR 3/1 10YR 3/1 " NO. 1140 C^ LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABIUTY SUBJECT 91.67 22" 91.67 22" B e EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY SANDY LOAM SANDY LOAMc� E SIDE WALL HEIGHT 6.35" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. IOYR 5/8 10YR 5/8 44NITAA%p 39.10 OVERALL HEIGHT 11" Ci W. 39.20 36"C1 d/ 0 �'J OVERALL WIDTH 34" 4640 TRL/EMAN BEND MEDIUM MEDIUM - ` 9.21 CIF lime H/LUARD. OH/O 43026 SAND PERC 0 37.60 SAND CAPACITY (68.4 GAL) AWN CED DRN1ucE SYSTM& INC. 2.5 Y 7/4 2.5 Y 7/4 PROPOSED SEPTIC SYSTEM/SITE PLAN 297 STRAWBERRY HILL ROAD, HYANNIS, MA 31.10 132" 31.20 132" Prepared for: Blue Water Septic PERC RATE <2 MIN/IN. ("Cl" HORIZON) Engineering by: Surveying by: SCALE DRAWN JOB. NO. NO GROUNDWATER OBSERVED DARRENM.MEYER,R.S. Bco-Tech BfnvlronmenW NITS D.M.M. DATE: AUGUST 13, 2009 P#: 12665 • I, Darren M. Meyer. R.S., CSE, hereby certify that.I am:currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX&B1 (508) 364-0894 SOIL EVALUATOR: DARREN MEYER, R.S., CSE # 1614 to conduct soil evaluations and that the above analysis hoe been performed by me consistent with the E4STSWIP RCIt AM0207 DATE CHECKED SHEET NO. h WITNESS: DAVID STANTON BARNSTABLE BOH requirements of 3/0 CMR 15.017. I further certify that 1 have poeeed the Soil Ewl. Exam in october, 1999. 508.3B-VM 09/01/09 D.M.M. 2 of 2 to oPoleo f I r OF � �4�{r�7t9�`�r�LE.aC!•A !p!T LA 644, +� E�ya A,'srUA.J ! llzn IV '7-e 4Trc J a 1.1 t OJE r ! i 1�-,,( `f'14A I- -n4a Peoposatz) PLAO POP CXX-W kAA ,1 eCEA L-oe-art oQ W I L.L.. ao/%A PL..S{ w try "-o w 14 1 TG vb rip C.- 7 7� ° VA4 - _