HomeMy WebLinkAbout0198 TERN LANE - Health -1918 TERN LANE
192-028 CENTERVILLE
415 J�RECYC(foco
UPC 12543
No. 5_ 3LOR -co
HASTINGS, MN
S
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No. l7d J®� s A t o Fee u�tl.r
v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:' e_
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pprication for Mi!6poga1 *pgtem Construction Permit
Application for a Permit to Construct( )Repair(-A)Upgrade( )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No. I CM �!�f`►') to , ' i U,2 Owner's Na[ne Address and Tel.No.
o�,tos �ie) .tal (r'1Q��,'.°�.,o{,n
Assessor's Map/Parcel -1'�—al t�►� "�.e ry') Ca l y�n 2Nc Oafo 3:`L
Installer's Name,Address,and Te�t�o. "33�`� Designer's Name,Address and Tel.No. (Sfl$)A.73-O W
�I 5.G G1 Lrlc
/�Q� ag5N Cmx►ybern�/,p��t
Type of Building:
Dwelling No.of Bedrooms t Lof Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons�� Showers( ) Cafeteria( )
Other Fixtures
Design Flow 24 y Q gallons per day. Calculated daily flow Ll 67. I gallons.
Plan Date kt;l I ,a�0.00� Number of sheets Revision Date
Title
Size of Septic Tank 1500M1 LOn Type of S.A.S. 600 � a.hfltrm�?r4
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) QM4. I
ISoo aabn ?tQ4ic, +1e_ tomK DPI-Ll l 4, T�o 3 oa rn vl 1e-0, LrL
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 Certifi-
cate of Compliance has been issue y t Board of Health.
Signed Date
Application Approved by lei Date
Application Disapproved for a following reasons
Permit No. .do q -30 :7 Date Issued 6/4
TOWN OF BARNSTABLE
LOCATION Z 9—'e &-Al L A&e SEWAGE #
VU,LAGE G e/vre 9 V 111e ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. J� 'M A C D 41 'Le.0 4
SEPTIC TANK CAPACITY Z—rQ 8
LEACHING FACILITY: (type) �.=/�/ Y 21�-e LLS (size) .2 S`X 12 A
NO.OF BEDROOMS
BUILDER OR OWNE 4
PERMITDATE: 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) Feet
Furnished by
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oh �,
rA
t N. 3otHE�
� �a'�` 's' ' Fee
i' COMMONWEALTH OF MASSACHUSETTS Entered in computer.
t Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
ZIppYication for Migaal 6petem Construction Permit
Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
3
Location Address or Lot No. I -TRJ'n Lok
eg 11 >AoO ae 's Na dd ss and Tel.No.
Assessor's Map/Parcel 'c�'� 1�14j 'Tern (.gil, C YtIt^;,fte.,(U, Ja to 3�
Inst er's 79
1 e,Ad essna e to �� Designer's Name,Address and Tel.&. Q� a —Q 3
E CO f Y p"' C 5 G r i ia,%Ul"' l r1 G
�_ [Z ,nu ,�a,63�: - -
Type of Building: �
Dwelling No.of Bedrooms t Lo Size sq.ft. Garbage Grinder( )
Other Type of Building Te_f 'iw\ No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 4�) 0 gallons per day. Calculated daily flow !��J7 , gallons.
Plan Date'I I , r Number of sheets Revision Date
' Title
Size of Septic Tank (5o0°,0 11 Type of S.A.S. �k_a t12G� c4 ¢ x6ex-.5
Description of Soil`'
Nature of Rggpairs or Alterations(Answer when ap licaple) flYY1, �15�w, �,5spoo(5• -L�W_ Ql) ( `
IS90 c3c.LILDn [Cv5f G frG i�� , �rsi't tbU}"WYl a( .. TaQ� !A Vl 1 Link
GSVjKb-u-6 wl Of Ty" rf G,I 0.�fUUYk = v
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 Certifi-
cate of Compliance has been is d- y t ' B-oard of Health.
Ll
Signed Date
Application Approved by Date / KA L/
Application Disapproved for the following reasons
Permit No. Vi)t_ -30 -7 Date Issued
P �
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(certificate of (Compliance
THIS IS TO CERTIFY, that the O -site Sewa a Disposal System Constructed ( ) Repaired (X )Upgraded ( )
Abandoned( _ )by S'1,. I ) "I �e" c �Yi I t
at i� t7 Q 1 YY �� has been constructed in cco dance
with the povis(ons o$Title 5 a d the for Disposal System Construction Permit No. ���f�'3�7 dated
Installer 5' 1 , cArneu 510!"I', Designer t 1 le�.r'(.UI �✓1G
O
The issuance of t 's a it shall not be construed as a guarantee that the sys will ction as I signed.
Date (0 ' U Inspector
———— ————--————— ————
2 0 1-39 —— .�
No. U 7 �, ,.
Fee 100
_
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Dioogal *raem Con$truction Permit
Permission is hereby ranted to Construct( )Repai(�( �) pgrade( )Abandon
System located at 14 Tv n (..I�-.• cwi- 1 U f t Lo"
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: Constructi n must be completed within three years of the date of th'�p rmit r
Date: 10 L Aloved b t.�in.�
--�� PP y�
Town of Barnstable
Regulatory Services
WL Thomas F.Geiler,Director
A Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-U2-4&4 Fax: 508-79M304
Installer&Desis¢ner Certification Form
Date:
Designer: Installer: �C
Address: ��s SLAeL wY"Z— ✓ Address: C) 9 O Coco
On _5. CO was issued a permit to install a
ate Q in er
septic system at O & (-IA�'� based on a design drawn by
9._. _. ...........-- _
dated fly`L 2,00 q.
esigner
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.
OF
C r JOHN L.
X 7�� CHURCHILL m
JR.
aTtze-i SSignature), CML
No. 0807
G
signers tore (AIrsignerYWRtamp Here
P SE RETTAN TO BARNSTABLED ON. CERTIFIC TE
OF T .IS F -
B Y BARNSTABLE PUBLIC HEALTH D SION.
TBMKXUL
Q.HealtWSsoc/Dwipm CutWcadOn Form
TOWN OF BARNSTABLE
LOCATION g—�� /QA1 SEWAGE # �
VILLAGE_ G e N�"e K V Ill eQ ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.„J / ,�lil A.��'l I3.Cf/l' �' Al
,. i
SEPTIC TALK CAPACITY 1 ":r6 Z y
LEACHING FACILITY: (typek—/0 X V -f'o-e L14,C (size) 3 •9
NO.OF BEDROOMS
BUILDER OR OWNE
PERMITDATE: COMPLIANCE DATE:, 6 ZA, L01
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) Feet
Furnished by
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771-1410 f r
t LICENSE # 006653 DRAWING NUMBER
A B:U,ILDING & REMODE'LING
NEW ENGLAND REPROGRAPHICS b SUPPLY CO.
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DATE: REVISED
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■ CENTERVILLE, 02 632 SCALE: ' APPROVED BY: 0RAW7.Y I°%p�G•%t
DATE: � L O</ I.EVISED
771-1410 ��cra.c �2&ss sty>, r
LICENSE # 006653 DRAWING NUMBER
BU,ILDING & REMOLDELL N,G
' NEW ENGLAND REPROGRAPH/CS b SUPPLY CO.
TOP OF FOUNDATION PROVIDE MANHOLE EXTENSION 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS = 58.10' - 58.83' GENERAL NOTES
ELEV.= 61 .53' RISER WITH COVER TO WITHIN REMOVABLE CONCRETE COVER SLOPE @ 2% MIN. OVER SYSTEM 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
6"OF FINISH GRADE TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2"DOUBLE WASHED STONE TO CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE
FINISH GRADE OVER D-BOX= 58.83' 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES.
FINISH GRADE @ FND. EL.= 60.0' - 61 .0' FINISH GRADE OVER TANK EL.= 60.0 ' 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD
OF HEALTH AND THE DESIGN ENGINEER.
24" MIN. ACCESS MANHOLE TOP OF SAS = 55.83' PLACE RISERS ON ALL CHAMBERS 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL
EXISTING EG 4 (TYPICAL FOR 2) 36"MAX. 9"MIN. TO 6"OF FINISHED GRADE BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED.
55.00' 36" MAX. BREAKOUT EL = 55.50'
PROPOSED 4" 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
SCH.40 PVC PROVIDE WATERTIGHT ELEVATION =55.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS
A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
MIN.SLOPE@1% co 3" 2" DROP MIN. 3" � JOINTS (TYP.) �`
3" DROP MAX. o�� THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. C
L =50' - - - - 4" PVC IN FROM o
o_ SEPTIC TANK 4" PVC OUT TO O 000 O o0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
�- 5$.7$' 56.25' LEACHING FACILITY o00 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO
56.50' - 55.97' MIN. 55.80' 2' o � � � � � � � � � ocap oo � � � � � tea, INSPECTION.BACK YSTEM IS HEN NOTO BE IS ARLY BACK FOILILED WITHOUPLETE AND TFIADY FOR RST OBTAINING �
" OUTLET TEE o o0 0 0 oo APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER.
22 ZABEL FILTER 6"CRUSHED STONE o 0 0 0
MODEL#A1801 HIP(GAS OVER MECHANICALLY 4, 4' - 8. ELEVATIONS BASED ON ASSUMED DATUM OF 60.00 OBTAINED
15.9' BAFFLE ON BOTTOM) COMPACTED BASE 8 5, I 4.0' 4.0' FROM A NAIL IN A TREE AS SHOWN ON PLAN.
4.9' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
5 OUTLET DISTRIBUTION BOX 33.5' (TYP•) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE
6 CRUSHED STONE
OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE , GROUND WATER ELEV.= 34.0 AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY
COMPACTED BASE C' BASE. FIRST TWO FEET OF OUTLET 53.00 12.9'
DISCREPANCIES TO THE DESIGN ENGINEER.
PIPES TO BE LAID LEVEL. 3 - 500 GAL. CHAMBERS //
PROPOSED 1500 GALLON PLASTIC SEPTIC TANK � / CHAMBER END VIEW 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE
LENGTH 140" WIDTH 64„ DEPTH CROSS SECTION VIEW Li� � J 5' MIN. STRUCTURES SHALL BE MADE WATERTIGHT.
TYPICAL CHAMBER PROFILE CHAMBER DETAILS ` ELEVATION OF POND 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR
SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL NOT TO SCALE AS PER USGS ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH
NOT TO SCALE NOT TO SCALE
TEST
FROM APPROPRIATE AUTHORITY.
- - - TEST PIT DATA 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
�5-.-- LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE
AGENT: Dave Stanton THEY SHALL WITHSTAND H-20 LOADING.
EVALUATOR: Bradley M. Bertolo 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND
1 �l• FINES.
DATE: March 18, 2004
• 14 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND
TEST PIT#: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF
�•f/'I! `' ' U • • LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN
�� • y,_Pj
ELEV TOP= 59.28 COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN
MAP 212 pP/, js� 0• . \ \� 1 'Y ELEV WATER= 34.0'± ACCORDANCE WITH 310 CMR 15.255(3).
• ` PERC RATE - <2 Min/In 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
PARCEL 20 P SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
N/F AYLMER ' • „ . p• �} l DEPTH OF PERC - 60"-78" 16. PROPOSED PROJECT IS LOCATED WITHIN:
BM (• . -
Nail In Tree •I -
* • �� • .� `�_{__,�._.___._ ASSESSORS MAP 192 PARCEL 28
Elev. =60.00' • .; • . M TEXTURAL CLASS: 1
Assumed • . ` „ • 34 - - OWNER OF RECORD: RICHARD P. GLEASON
g ' . 0 59.28' ADDRESS: 198 TERN LANE
• . �• ` a . .. + • A Loamy Sand
l� 58.45' CENTERVILLE, MA 02632
PROPOSED 33.5'x 12.9' � • :•�•• � • • � • � �„� ��i.3
Pt W15 I 10" 10YR 3/2 FEMA FLOOD ZONE C
RESERVE AREA
0 9'5 \ : i . : • : // %j AS SHOWN ON COMMUNITY PANEL# 250001 0005 C
S86 3 Q -�
PROPOSED 3-500 GALLON ' Loamy Sand
110.00+ I N ' : ` • '� • • , B 10YR 5/6 17. PLAN REFERENCE:
o I `r `t m • • s ,f • ? • 1. PLAN BOOK 88, PAGE 13.
LEACHING CHAMBERS I 33.5' s a \ a' ' 1 ¢ • .�
cn \
o \ \ A�` m ' • `*` • „ ' •. 18. DEED REFERENCE:
�-. • • + ; • �! ••: ` 50" 55.11' 1. BOOK 1275 PAGE 141
3) \ \ \ V
• j 1 60" 54.28' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
2 RESERVE 0 \ \ \ m " ' • + �� + �� Pere 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
\ \ • • • • + ,•: 78" _ 52.78 FOR SEPTIC SYSTEM. UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
N • �r'� �•;•; �_; M-C Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
59x28 �\ \ \ • '• • • • • • fi' f • • /=•• ••• _ 2.5Y 6/4
(4) , , \ \ 'moo MAP 212 • � ,. J- . � C-1 25% Gravel
•
- 65 � • '
11.0 \r PINE \ \ PARCEL 19 • /
�14 r
N/F CONNOR 'Cra @ ,
0 60�c0 a\i� �� \ t \ N
603- StJ \_ w m C-2 Med. Sand
PROPOSED C %� `\� 164 \ \ \ 4 ' o Z 2.5Y 6/3
DISTRIBUTION �'� ` ! \ \, �° m LOCUS PLAN
BOX C �" C) -° r 120" 49.28'
\ ` m c D No Groundwater,
6' t` ' 0 Z
n� SCALE: 1" = 1000' Weeping or Mottling
PROPOSED 1500 GALLON \ \
_R6*8Tt�SEPTIC TANK o �\, \ I I I 1 0MObserved
,ef-c,4 N ADDITION C*' TEST PIT DATA
1
I � �
26' \ \ I �� , DESIGN DATA LEGEND
I I \ I
EXISTING CESSPOOLS TO HC 1 HC 2/",////A
AGENT: Dave Stanton
1
BE PUMPED AND FILLED MAP 192 10hI EVALUATOR: Bradley M. Bertolo
WITH CLEAN SAND #98 ` DATE: March 18, 2004
C) I m EXISTING CONTOUR
C) PARCEL 28 ' \ 0 TEST PIT#: 2
w
N EXISTING 1 610 S.F. ± ' M NUMBER OF BEDROOMS (ASSESSORS) 3 50 PROPOSED SPOT GRADES
MAP 192 0 3 -BEDROOM �' ' I \ O ELEV TOP= 60.03' 0
o DWELLING 010 -n NUMBER OF BEDROOMS (DESIGN) 4
PARCEL 39-1 m I N cn -U DESIGN FLOW 110 GAUDAY/BEDROOM ELEV WATER= 34.0'± PROPOSED CONTOUR
N/F HENDERSON TOF =61.53' r ' J C) 00 \ m MAP 212 TOTAL DESIGN FLOW ° 440 GAUDAY PERC RATE -
PARCEL 19 DESIGN FLOW X 200 /o = 880 GAUDAY - EXISTING OVERHEAD UTILITIES
N/F SAURO USE PROPOSED 1500-GALLON SEPTIC TANK DEPTH OF PERC -
No EXISTING WATERLINE
TEXTURAL CLASS: 1
oa Q \ 1 ' , V TEST PIT LOCATION
MAP 192 0 \ \ 1 INSTALL 3 - 500 GAL. CHAMBERS o so.o3
m , q Loamy Sand O O PROPOSED 1500 GALLON SEPTIC TANK
PARCEL 39-2 m \ I \ 10YR 3/2 59.36'
N/F DESCHAMPS PO \ CID\ l w \
CID I I w cfl 4" SOLID SCHEDULE 40 PVC PIPE
I DISTRIBUTION BOX
°' � � � \ � � SIDEWALL CAPACITY Loam Sand O
o y
90 DEGREE LONG SWEEP 1 V , _ B 10YR 5/6
DRIVE (LENGTH +WIDTH)(2)(2HIGH) (.74 GPD/S.F.) GAUDAY
CLEANOUT TO GRADE U, W -T O 500 GAL. LEACHING CHAMBER
� \ =
\ (33.5'+ 12.9') (2)(2') (.74 GPD/S.F.)= 137.3 GAUDAY
00 \ BOTTOM CAPACITY 53" 55.61'
(LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY
(33.5'x 12.9') (.74 GPD/S.F.) = 319.8 GAUDAY
10•� 251 REV. DATE BY APP'D. DESCRIPTION
M-C Sand
s ���0126 25
TOTALS: Y6/4 PROPOSED SEPTIC SYSTEM UPGRADE
1233�4 C-1 25/° Gravel
6 PREPARED FOR:
TOTAL NUMBER OF CHAMBERS: 3 RICHARD P. GLEASON
TOTAL LEACHING AREA: 617.7 SQ.FT. 114" 50.53'
TOTAL LEACHING CAPACITY: 457.1 GAL./DAY LOCATED AT
C 2 Med. Sand
2.5Y 6/3 198 TERN LANE
DESCRIPTION HC 1 HC 2 120" 50.03' CENTERVILLE, MA 02632
No Groundwater,
MAP 212 LEACHING CORNER(1) 43.6' 56.7' Weeping or Mottling
Observed SCALE: 1 INCH = 20 FT. DATE: APRIL 2, 2004
PARCEL 17-2 LEACHING CORNER(2) 56.3' 67.3'
0 10 20 40 80 FEET
N/F PENDERGAST
LEACHING CORNER(3) 60.4' 57.1' RESERVED FOR BOARD OF HEALTH USE
'°HN�. PREPARED BY:
LEACHING CORNER(4)
48.8' 44.3' C��RCHl�� v JC ENGINEERING, INC.
cfVfL
418 2854 CRANBERRY HIGHWAY
" NOTE:SUBJECT PROPERTY NOT LOCATED NO +1ao�
WITHIN A DEP APPROVED ZONE II EAST WAREHAM, MA 02538
SITE PLAN 508.273.0377
SCALE: 1" =20' L 1 y Drawn By: MLP Designed By:MLP Checked By: JLC JOB No.635