HomeMy WebLinkAbout0380 PHINNEY'S LANE - Health 380 PHINNEYS LANE, CENTERVILLE
A = 230 - 145
No. 42101/3 ORA
ESSELTE i
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O O ° Q
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, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: Fill in please:
� � � , APPLICANT'S YOUR NAME/S: AA l C!A Z Q Jj Z.
,� �� BUSINESS YOUR HOME ADDRESS: B�� (-I 1 iu,c� 19 T;1 A .y?
ORS, � r �a 25-72 7 k E 465-
TELEPHONE # Home Telephone Number
NAME OF CORPORATION:
NAME OF NEW BUSINESS d4 1. V-\ R P Aj 7 ('O a J C' (4 fr ,-7YPE OF BUSINESS v
IS THIS A HOME OCCUPATION? YES NOS_ .
ADDRESS OF BUSINESS 48 2 tip ..(i MAP/PARCEL NUMBER a30 (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the 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 your business in this town.
1. BUILDING COM ISSION FP'S OFFI
This individu I ha b inform d o ar p rmit eq irements that pertain to this type of businAPST COMPLY WITH HOME OCCUPATION
RULES AND REGULATIONS. FAILURE TO
uth ri S gnature —_—� CC?MPl.y MAY RESULT IN FINES-
IT
I �\
)
O l' !1 ) )
2. BOARD OF AALTH}
This individual has b '-formed of the peprflit dequir �nts that pertain to this type of business.
x
" Authorized Signature** .
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
TOWN OF BARNSTABLE
LOCATION 3 JS( i?b lV NMSJ S L r%) SEWAGE# �Q���-
VILLAGE C en*o ut I�� ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. C�S
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) �'-[o ��_ (size) A-
NO.OF BEDROOMS
OWNER` _ r ej
PERMIT DATE: COMPLIANCE DATE:- 01 iih —
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 B< j �?)(ca o
I
Plot
3 -fib a
3 �
No. FEE
COMMONWEALTH OF MASSACHUSETTS
Board of Health, �%`I`*1' s ��- ,MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) - 0 Complete System (,Individual Components
Location j�(S ��wt y%n& i S I Owner's Name 6/q l ne //brf-,P-✓
Map/Parcel# Address -Ap 'S eCH4-vv-j1-e M14
Lot# (�?-/ J01a.^ �'Z Telephone# 5W-771-3WSS a'Z&3�
Installer's Name �A �fbc�l� /�L Designer's Name P-K c�nH-2 o
Address 1�0, [ l�(5 �'-en44-we 1Q Jt44 o'U3Z Address /-Z W, cerss -et Zrtll r-0 reS,7VG
Telephone# �Q•,- UO _7tSej / Telephone# a- -S3i A- OZ(n �
Type of Building ` � i�a r Lot Size 2I c d 4 C.1 sq.ft.
Dwelling-No.of Bedrooms �J Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria( )
Other Fixtures
Design Flow (min.required) d Calculated design flow 17 U Design flow provided . d
b q �3® gP g � � P �gP
Plan: Date i-rl i Number of sheets Revision Date
Title (bp y-,ed 5 ' ti Sy ky1 Uoq f-gote 4G11
Description of Soil(,) 61zi 4-ki bL SQ,lS 17-i (Q 9 - 1.57 SokAd Tj°Z; �Of� S"<c Sgvt
Soil Evaluator Form No. Name of Soil Evaluator AtWML5J-Lk Date of Evaluatio
DESCRIPTION OF REPAIRS OR ALTERATIONS AMWe &-,*s 31L- SAS uJ i l-L'.1 �S i'p wT' e('"o►txc�-t✓ 4vt
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further, not to lace the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Sign 1 Date
Inspections
No. x a .....__y.... � .. FEE �V
r
COMMONWEALTH OF ASSACHUSETTS
Board of Health, s �T' - ,MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT �
Application for a Permit to Construct( Repair( Upgrade Abandon( ❑Complete System li�lndividual Components
Location 'j 6 C) P \t h1n{. t S Owner's Name 61ci<ne Arf'$.✓
Map/Parcel# 230 ' 1 y Address ✓?o PA"nrU--! 'y (rt , o�,eH 44.-v,)1-e MIA
Lot# [Aa--/ /01a, 13k. 25'1 �g SrZ Telephone# gam'"17t—38 8S O Z b 2.
Installer's Name t v- /►'l r`CeH
�A� �ro"iA 4,L Designer's Name
Address 10. 0. 1�:C,t ILI5- C('rl fVi ���'/!/� 0�32 Address 1"Z W. cross
Telephone# 5-419-y00 -'71 5_11 Telephone# $d�-y�77-53r3 �'NA OZ4 TA
/7
Type of Building ( �3` �h G Lot Size Z��d r4 ci sq.ft.
Dwelling-No.of Bedrooms 3 Garbage grinder( )
Other-Type of Building AIlA No.of persons Showers ( ),Cafeteria( )
Other Fixtures
Design Flow (min.required) gpd Calculated design flow 3 U Design flow provided gpd
Plan: Date r-r� 1 s� Number of sheets Revision Date
Title 0-l�O f✓ ft� .sv �t✓►1 ► C� �tCcH »,
Description of Soil(s) 4-ts 4 SO:I S% 'TI'--t �.q u - 7 sQK '
b ' �s//�� � rp_2; toy' 1s� S�,K �. r��
Soil Evaluator Form No. Name of Soil Evaluator/�CW MLC,� Date of Evaluation 13 )s
.515,q+ l5-(2 ,
DESCRIPTION OF REPAIRS ORALTERATIONS )?e rtitkX 1FK1.f SAS tom!14"n J 4-,�ra qvt
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees-to not to lace the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed_ --= Date
Inspections
No. ,y,�'
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d . / FEE
Board of Health, �F�1 Sfi�41�i�.L ,MA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) 0 Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( )
by:
at 3S� �'h: •,,�evt s l,r..n,e 4��e�s���.�
has been installed in accordance with the provisions of 310 CMR 15.00 (,Title 5) and the ap roved design plans/as-built plans relating to
'application No?�� �/ dated o//5 Appr Ived Design Flow � 3�(gpd)
Installer
Designer: Inspector: Date:
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
CIO G 0 G 0000000 G 0 Go 0"0 0 a 000000,{000,O C O O 00000000000.00.0000000000000000000000.0000000000 G O 00000000 C 00 O G o co 0O O Go 000 a 0000 a 00000000('00000000.
No.0 FEE 160
COMMONWEALTH V'I'L:1 LTA OF 1` ASSA'I.LJtUSETTS
Board of Health, pt-t2-N S t�U ,MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at G tAvxl.tj1 5 �-`` ��"� _ ��LL as described in the application for
Disposal System Construction Permit NwPO) -3�� ,dated i I_
Provided: Construction shall be completed within three years of the date �this ermmi Clllolal conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Charlestown,MA Date oard of Health �.
Town of'BarnstabW
f114E i � Regulatgry Services {
Richard 'V• Scoli, Interim Direcjtor
9 STAPLE,
MASS. Public Health Division �
�'b
ra y° 'Phonmas M Keajm,Director
20. Main Street;Eyannis,MA 02b01
i
Fax: 508-790-6304
Office 508-862-4644 i
Installer & D3 signer Certification ForM
2 p — 1 +s—
Dat 11S i Sewage Permit# �OtS'-I'� 1l. Assessor l ap\Parcel_ �_—
Desi ei: I n U\YO`CU " I-X.I.nstaller:
Address: y RQ X
Ad.d ess: IZ UV' CaL�l�-F�rf CA
rat
� l/•2�3z I
�1 jP,/Ns l i (?_V.. o_vie was issued a permit to install a
On ' (da•te) (inalal]er)
(—,"'based on a design drawn by
septic system at :,�r..e J �•�
(address)
- i
✓Ic. W $ k1c dated t )s 3
(designer)
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 file
distribution box and/or septic tank. Strip out (if required) was in
and the soils
were found satisfactory.
{
I certify that the septic system referenced above was installed with imajor changes (i.e,
grzatex than 1 D' 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 abo4 was constructedl in cp lance with th.e terms of
the I\A approval letters (if applicable)
{ ` •• C I.H. c,:If
er 5 l
1� e) istl� � � `ti'i05, F e•{�,
iRr,F Y
(Designer's Signature)
Affix Desxnie ' unp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC BEALTH DIVISION. CERTIFICATE
O CONiPLIAN'CE !�LL NOT BE ISSUED UNTIL B3TH TINS_FORD_AND AS-
3' T CARD ARE RECEIVE➢ BY THE BA.U,STABLE PIT]3I,IC I EALTH]31VISIflN.
T �K YOU.
-14-13.doc
Q SepticTesigner Certification Form Rev 8
i i
i
Town of Barnstable P#jf7
pti* Department of Regulatory Services
Y BARNSTABLE, : Public Health Division Date -7
y MASS.
�q i639.S � 200 Main Street,Hyannis MA 02601 ' o
rF0 MA A
Date Scheduled_ Time Fee Pd. _0
� r thief
xx
Soil Suitability Assessment for Sewage Disposal
i Ian
Performed B P�'- KJ6&-l-erg .S —t-& 4 i_S- ' n D
Y Witnessed By: "-f
LOCATION & GENERAL INFORMATION ,
Location Address (?v\,S rY►e, I S Owner's Name
y
Address —`03 9h r%v,¢-y 5 h
Ce�n,venn 1 V , "-A a z 6 T`Z-
Assessor's Map/Parcel: Z�j.�-� Engineer's Name
NEW CONSTRUCTION REPAIR ` L Telephone# -5-& 3-7-k-7Co�
f ��
Land Use 1 ** CLI Slopes(%) �� Surface Stones /00-4
i Dstances from: O enWater Bod t UC) ft Possible Wet Areal!OU 7 S
II P Y, ft Drinking Water Well �t
i Drainage Way ;>t aCJ _ft Property Line (0 +_/-eft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in prox'miry to holes)
vj
� 1
C eWLI
i
p
j Parent material.(geologic) Depth to Bedrock
I Depth to Groundwater: Standing Water in Hole: / 23
y Weeping from Pit Face ,
Estimated Seasonal High Groundwater l Q p 1 ( Z i A-cj
DETERMINATION. FOR SEASONAL HIGH WATER TABLE 16 �(
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles: 1 D O _in. _
Depth to weeping from side of obs.hole: _ _ _in. Adjos!merr. P.
-►� y� /e
Index Well f! Reading Date: Index Well level w Adj.factor Adj.Groundwater Level_ a
PERCOLATION TEST Date Time _
Observation
Hole# J_- � to Time at 9" _
/o (�1.liCr ,V
Depth of Pere _ Time at 6"
Start Pre-soak Time @ �Q�?P kd �/C t�Time(9"-6")
End Pre-soak - A Y.S
i
Rate Min./Inch �M�a I q L r0{✓ ,$'$.i—Q L 4 �{4C n{L/�
j Site Suitability Assessment: Site Passed- �� Site Failed: Additional Testing Needed(YIN) _
i
Original: Public Health Division Observation Hole Data To Be Completed on Back -- ---•--•--
1
***If percolatiott'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:\SEPTIC\PERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole# 1
pth from Soil Horizon Soil Texture .Soil Color Soil Other
urface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Conijtcrfcv. Gruel)
TO LL
8a _ Qa A ��. toY2�lz
L to yf�251 r
to ' �� C r c Sand Z.• S f`l Z %
r
DEEP OBSERVATION HOLE LOG Hole#
qepth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
iConsisteqcv.'Yo Gravel)
t0 YelY1-7 _
,Ty fly ,�-�—
f
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
S�rface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
ConsistencX,%Gravel).-
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
S,rfa,e(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders.
ons'
E
i --
I
Food ins•.rrance Rate 11 az:
fAbove 500 year flood boundary No Yes ...x_
Within 500 year boundary No Yes
i
f Within 100 year flood boundary No Yes
I
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? -
IfInot, what is the depth of naturally occurring pervious material? _ . ...,.
CbiAification
ertify that on i 1 k Q4-5 (date)I have passed the soil evaluator examination approved by the
I C
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required tr Aing,expertise and experience described in�10 CNM 15.017.
Signature _
Date
Q\.E TIOPBRCFORM.DOC
I
down cape engineering, inc. SIEVE SOILS ANALYSIS 380 PHINNEYS LANE CENTERVILLE, MA
DATE OF REPORT: /28/15
JOB : GRAIN SIZE ANALYSIS-SIEVE TEST
SITE: 380 PHINNEYS LANE, SANDWICH
LOCATION: NIcENTEE TEST HOLE
SIEVE ANALYSIS Weight Sample(Grams): 159.5
SIZE :WEIGHT RETAINED % RETAINED % PASSED
(sum
--------------............... ......... ..........................:---------------------.......,.............................
1" 0.0 0.0%: 100.0%
3/4" 0.0 0.0% 100.0%
--------------:.......................................................----------------------------------------
1/2'` 0.0€ 0.0% 100.0%
-------------......................................................>---------------------s-------------------
3/8" 0.0i 0.0% 100.0%
-------------:.......................................................----------------------------------------
#4 0.0 0.0%? 100.0%
--------i......................................... :------------ - .................
#10 17.14 10.7% 89.3%
--------------:......................................................:--------------------_.....................................
#20 65.1 40.8%E 59.2%
--------------......................................................r---------------------:.....................................
#40 109.1� 68.4%i 31.6%
-------------:.......................................................---------------------......................................
#50 123.4 77.4% 22.6%
-------------!......................................................>---------------------,.....................................
#80 132.8 83.3% 16.7%
-------------:......................................................:---------------------:.....................................
#100 136.7€ 85.7%; 14.3%
-------------;......................................................>---------------------i-------------------
#200 147.8 92.7%; 7.3%
--------------:.......................................................------------------------------------
----
PAN: 157.9€ 100.0% 0.0%
----------------------------------- -
159.5s
NOTEJEST ON PASSING#4 ONLY, 9.6% RETAINED ON#4 <45% O.K.
RESULTS:
SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL &SAND) (UNCOMPACTED)
PERCENTAGE OF MATERIAL PASSING#4 SIEVE :
#4 100% (TEST ONLY MATERIAL PASSING #4) OK
#5010%-100% OK
#100 0%-20% OK
#200 0%-5% CLOSE
SAMPLE IS CLOSE TO MEETING TITLE 5 FILL SPECIFICATION
>92%SAND
RESULTS: PERMEABLE MATERIAL-CLASS I <5 MINJIN. MATERIAL (0.74
NONCOMPACTED sS
SOIL DESCRIPTION: MEDIUM SAND WITH TRACE OF SILT �o� s�O
I�ANdFl..A.
c OJALA
" CIVIL
c F, •a
t SAL
TOWN OF BARNSTABLE LOCATION2i30 ` M . SEWAGE# a tn- 66
VLLL•AGE- ASSESSOR'S MAP &LOT. — '5-
INSTALLER'S NAME&PHONE NO CQ���- �' �YY tJ -ni (020 4
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)�� (size) )X Z X G Z
NO.'OF BEDROOMS
BUILDER OR OWNER
PERMIT- DATE:�1 ` COMPLIANCE DATE:
Separation Distance Between the: e-�
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility r 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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TOWN OF BARNSTABLE
Li
1
LOCATION - �. � SEWAGE # `°� � �'1
VILLAGE r" ASSESSOR'S MAP & LOT
INSTALLER'S NAME PHONE N(�— � � `�, 22
SEPTIC TANK CAPACITY QM
s
LEACHING FACILITY:(type) t1 LQL (size)
NO.OF BEDROOMS PRIVATE WELL O UBL C WATE
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: /
VARIANCE GRANTED: Yes NO
a CZ
16
:'LA C'A T ION S E W A G E PERMIT NO.
VILLAGE
I N S T A LLER'S NAME A ADDRESS
BUILDER OR W R
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
P N/ a.w
I 7
9 )
No. "` Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for jDigotar *p!tem Construction Permit
Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components
Locatign A^d dres`s�or Lot No. '✓��® v Os�Nydp�sd o
Assessor's Map/Parcel x3l0,
Installer's Name,Aidikess,and Tel.No. 1 Designer's Name,Address and Tel. o.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(An wer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to a the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provi ions of Tit of th onmen and not to place the system in operation un '1 a Ce ifi-
cate of Compliance has been t b t i o d o h.
Signed % Date'1
Application Approved by NJ Date
Application Disapproved for the following reasons
Permit No.4UEt2 Date Issued
or
No. �" �-� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01pprtcation for jDigogal *pMem Congtruction Permit
Application for a Permit to Construct( hair( )Upgrade( )Abandon _ ) ❑Complete System ❑Individual Components
oca' n A�d�sslor Lot No. ��O `�.���c'S �� O 's • e,�,{r�ss and T�1„�Io.
Assessor's Map/Parcel<• C 1 C v�
Installer's Name,Address,and Tel.'No. Designer's Name,Address and Tel.,No.
Type of Building:
Dwelling No.of Bedrooms Lot Size'4 sq.ft. Garbage Grinder( )
Other Type of Building No. ofPesons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) _ yu
Q.vuC.A
Date last inspected:
` �
Agreement: �
The undersigned agrs tc ensure thei'construction and maintenance of the afore described on-site sewage disposal system
in accordance with the prove ns of Tit 5 of th e e and not to place the system in operation un •1 a Ce ifi-
cate of Compliance has been by thi oard o a th.
Signed A Date
Application Approved by Date
Application Disapproved for the following reasons
r-
Permit No. r ) Date Issued 12
THiCOMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS T T a e n-site Sewage Disposal System Constructed ( "JRepaired ( )Upgraded( )
Abandoned( ",k?
at t has been constructed in accordance
with the provisions of Title 5 and the fo isposal System Construction Permit No. r I dated�JI &
Installer Designer
The issuan e f 'is e t shall not be construed as a guarantee that the s st will function as designed.
Date �� Inspector
———A———————————————————————————————
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
30tgozai *pztem Construction Permit
Permission is he y ant to Co c )Repair( grade( )Abandon
System located at
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: Constructio mustX
com leted within three years of the date of t 's pe it.
Date: Approved by
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
I,���7g�—�-Vy ereby certify that the application for disposal works
construction permit signed by me dated E l lD concerning the
property located at � 1��4�} S' meets all of the
following criteria:
✓ There re no wetlands within 300 feet of the proposed septic system
here are no private wells within 150 feet of the proposed septic system
r✓ The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
There is no increase in flow and/or change in use proposed
te/I-here are no variances requested or needed.
i .
SIGNED: — DATE: /
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted).
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EXISTING S.A.S. Wequaquet
STRIPOUT BOUNDARY TO BE REMOVED
40 MIL POLY LINER (SEE NOTE 1 1) 41.07 (SEE NOTE 1 1) N
Lake
PROPOSED S.A.S. PROPOSED S.A.S. I 40 83
TOP,- EL. 39.0 GS❑41.03
=
BOTT., EL.=34.0
a L
N 40.80 R0 ( 39•F39 oe`
EXISTING SC TANK � `3.4�� / BENCHMARK SET
(TO REMAIN)
.0
TOP OF TANK, EL. 40.9f TP-1 ^p MAGNETIC NAIL SET ' 2
8
INV.(DUT)=39.57t(VER/FY) �,� �
EL.=38.72(NGVD) Greot Marsh Rd eke c� �P Roue
y 40,20 .41,
Route 28 Qr
I S PART west Mom St
• O LOCUS
ent •' 40,89
a,Ie�'�' OLD ��`�\ �� .75 : : AG. NAIL y LOCUS MAP
1 f P P/�( rt J C �\� ♦�� 9,01 38J2 { NOT TO SCALE
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0 41.29 38,14 \ o G EXISTING GAS SERVICE
40.27 x, 41,52` '1.24
U UNDERGROUND WIRES
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No. 35109
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0 1v! \ 35,34 o,�`F,A � �( l�(�
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\ 35.34 ��`� PULE WETLAND CONSULTANT
\ LOT 1 MARSH MATTERS ENVIRONMENTAL
o \ P.O. BOX 554
`m \\ MBLU 230- 145 35,25 + 010 E �• FORESTDALE, MA 02644
1 0 \ 21,000±S.F. N �5 O' f 978-434-1228
�94. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
1 380 PHINNEY S LANE, CENTERVILLE, MA
\ Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
DORRER, ELAINE H Engineering Works, Inc. 1"=20' P.T.M. 197-15
FLOOD ZONE DESIGNATION 380 PHINNEY'S LANE 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
NON-HAZARD CENTERVILLE, MA 02632 (508) 477-5313 9/15/15 P.T.M. 1 Of 2
NOTE: TO PREVENT BREAKOUT, INSTALL A 40 MIL. POLY LINER GENERAL NOTES:
}- TOP OF LINER, EL.=39.0
BOTTOM OF LINER, EL.=34.0 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
• PROPOSED D-BOX PROPOSED S.A.S. BOARD OF HEALTH AND THE DESIGN ENGINEER.
SEPTIC TANK 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
INSTALL RISERS & COVERS OVER INLET & :INSTALL RISER AND COVER INSTALL RISER & COVER OVER ONE CHAMBER(MIN.) OF THE STATE' ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
OUTLET AND SET TO 6" OF FINISH GRADE SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE LOCAL RULES AND REGULATIONS.
T.O.F.=43.0t GRADE AS AN INSPECTION MANHOLE. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
EXISTING F.G. EL.=41.Ot F.G. EL.=41.0t TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
F.G. EL.=41.2t /- " DESIGN ENGINEER.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
ENGINEER BEFORE CONSTRUCTION CONTINUES.
' L = 27' L = 21'(nlAx) 5. ALL ELEVATIONS BASED ON N.G.V.D..
Q SCH4 (MIN.) ® SC (MIN.)
" 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
6: - 4scH4o PVC 4"scH4H4 o PVC __ 2" LAYI�R OF 1/8" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
�o„I E3 O® TO 1/2 DOUBLE HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
ia" 6' 12" WASHED STONE 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
EXISTING 48" LIQUID (OR APPROVED FILTER FABRIC)
EM
INV.=39.57 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
LEVEL INV.=38.40 4' 3' 4'
1 PROPOSED 3/4"-1 1/2" 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
GAS BAFFLE D EFFECTIVE WIDTH = 11' DOUBLE WASHED
• .... . .. •• ,•• INV.=38.57 INV.=38.10 STONE AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
H-10 RATED DIRECTED BY THE APPROVING AUTHORITIES.
EXISTING SEPTIC TANK USE 5 LC-6 LEACHING CHAMBERS IN SERIES 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
WITH DOUBLE WASHED STONE-ALL SIDES THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
CONSTRUCTION.
H-20 RATED 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
NOTES: TOP CONC. ELEV.=39.9 -- _ -BREAKOUT REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=38.10 MEftFE3 ER®0 ER®® ELEV.=38.6 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
INVERTS, PRIOR TO INSTALLATION.
INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=37.10 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
GRADE ON A MECHANICALLY COMPACTED SIX 4' 6' 4' IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY,
INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING
310 CMR 15.221(2). PERVIOUS MATERIAL EFF. LENGTH-REFER TO SKETCH
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 4' (MIN.) ABOVE G.W. -- -----
I -
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION r a" KNOCKOUT
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W./BOTTOM OF TP„ EL=32.1 z I 20• ow. COVER
I I
SEPTICSYSTEM PROFILE I KNOCKOUT 4" KNOCKOUT I M
I I
N.T.S. - I-_-_ --_ 4'KNOCKOUT
18.¢' SOIL LOG
-------. Q r 72"
N't.�, DATE: AUGUST 13, 2015 (REF#14,784)
BOTT. AREA ♦ SOIL EVALUATOR: PETER McENTEE PE(SE#1542) PLAN VIEW
= 374.3 SF III WITNESS: DAVID STANTON R.S. HEALTH AGENT
4' �t
DESIGN CRITERIA L 1 , I ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH ----
r I 41.2 0„ 41.1 0.1 ® ® ® 0 ® ® ® 2 2^ ® 0
NUMBER OF BEDROOMS: 3 BEDROOMS L 1 11_J 34.5 FILL 80„ 34.6 FILL 78„ INVERT I ® ® ® ® ® ® ® I I
SOIL TEXTURAL CLASS: CLASS I A A
PERIMETER=90.1' SANDY LOAM SANDY LOAM r 72. - I r 36" I
DESIGN PERCOLATION RATE: <5 MIN/IN SAS DIMENSIONS 33.7 10YR 4/2 10YR 4/2
go.,
DAILY FLOW: 330 GPD B gp" 33.6 B SIDE VIEW END VIEW
DESIGN FLOW: 330 GPD SKETCH SANDY LOAM SANDY LOAM
WIGGIN LC-6, H-20 LOADING
10YR 5/8 10YR 5/8
GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN LEACHING CHAMBER
EXISTING SEPTIC TANK: 1500 GALLON CAPACITY ESTIMATED 32.1 C AOT G.W. a 109" 32 1 C(MOTTLING)
4 108"
(ESTIMATED) (MOTTLING)
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF F-C SAND F-C SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN
.74 GPD/SF 2.5Y 6/4 , 2.5Y 6/4 ,
USE 5 LC-6 LEACHING CHAMBERS IN SERIES SURROUNDED (sampled) (sampled) 380 PHINNEY S LANE, CENTERVILLE, MA
WITH DOUBLE WASHED STONE-ALL SIDES AS SHOWN ON PLAN 30.1 STG. G.W. - 133" 30.1 STG. G.W. - 132" Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
SIDEWALL AREA: 90.1'(PERIMETER) x 1'(EFF. DEPTH) = 90.1 SF Engineering by: SCALE DRAWN JOB. NO.
BOTTOM AREA: 374.3 SF(BOTTOM AREA) = 374.3 SF 90.2 157' 28.1 1 156" Engineering Works, Inc. N.T.S. P.T.M. 197-15
TOTAL AREA:........................................................... 464.4 SF STANDING G.W. AT EL.=30.0O.
SOIL MOTTLING 108"-114", 7.5YR 5/8 (EL:=32.1) 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET
DESIGN FLOW PROVIDED: 0.74 GPD/SF(464.4 SF) = 343.6 GPD PERC RATE <5 MIN/IN. PER SIEVE ANALYSIS ("C" HORIZON) (508) 477-5313 9/15/15 P.T.M. 2 of 2
2