Loading...
HomeMy WebLinkAbout0153 POINT OF PINES AVENUE - Health 153 Point of Pines Centerville A=230-071 [ /// ISMIEAD® Na 2-153LOR UPC 12834 snM MLOOM • Made In USA TOWN OF BARNSTABLE LOCATION -4"`- SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL o a 0 INSTALLER'S NAME&PHONE NO. e-- Jr- ®a o 7 SEPTIC TANK CAPACITY Aso 0 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS OWNER .J�i�li40Z G PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: -Jo- a Gv�TD'mL 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 �coe o,r j � - 3A s 0 �-� JR, % s C No. 2DI O - 1q b Fe*00 ov THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es ftplitation for Bisposal .pstem CouslTurtion i3Prmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) �<omplete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel -;k ?cv Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. O Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 'F� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -3® gpd Design flow provided gpd Plan Date Jam-—/ /O Number of sheets Revision Date Title Size of Septic Tank �� `��®� t Z Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 i Compliance has been issued by this Board of ealM. _ Si Date JaS—Jy/O Application Approved by - Date D Application Disapproved y Date for the following reasons Permit No. �iOl `� t s Date Issued I L 1 Zoi t7 No. FeA/0() 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS applitation-for-Mispo8a1 *pstrm Construction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) kromplete System ❑Individual Components M ' Location Address or Lot No. ,e Owner's Name,Address,and Tel.No. G c��,-1= ip�i� •O Ei,�i�'sb°�oi—y%�,G_sy eZ Assessor's Map/Parcel,2 30 ® 9 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Q.Z. 4"'C) A& .4;FoO '4;OA- JT j Type of Building: Dwelling No.of Bedrooms .3� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building aAe e.—P No.of Persons Showers( ) Cafeteria( ) Other Fixtures ~ Design Flow(min.required) .k 14> gpd Design flow provided _3� O gpd Plan Date / ,—/ 3 —*�'© Number of sheets Revision Date Title Size of Septic Tank Jd/�`'� /�"OG+ t Z. Type of S.A.S. -dA41' Description of Soil Nature of Repairs or Alterations(Answer when applicable) �t 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 thefnvironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed # Date 1 Application Approved by Date Application Disapproved Date for the following reasons Permit No. 7 Date Issued JZT 17n' b 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 at /1" 3 .4lis�has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. p p_yc($ dated JZ,111 l O Installer Designer ®A j-,W #bedrooms 3' Approved design flow gpd The issuance of this permit shall not a const ye as a guarantee that the system func ' s es' ed. Date Inspector, p ------------Fee ------------ No. 3f U.-r t7 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal bpstrm Construction 3permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at /S �o n.�' .�' �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. Provided:Construction must be completed within three years of the date of this permit. r L \ Date 2_l� ,o J!7 Approved by J 1y ti-� Tawas of Barnstable' Regulatory Serdees Thomas IF.Wler,Vector blic•.Health Division ��. Thoums M cXean,lDirector . 200 Main Street,HyaYmis,MA 02601 Gffice:.508-862.4644. ;hex: 509-790-6304 lwgHer 8c_Ndaner Cgtgci ion Form Date: ZD10 Designer: l installer:. •�IN " Address: . � ;�lil.)1Ck� Address: t4 k.11 was issued a p to install a (date) {*nstaIlet) septic system aY .� � i'1�J '� c.�Yl-based on a design drawn by 4 y�(address). dated ( gaer) pertify that-the septic system refemc,6d above was installed substano� ►11*Ce rd&11,D `'the dveign, wbprieh may include nmor approved'changes such as W4 61.�slacat�vn of the &strriuiou box and/or septic tank-.. I cextX3qhat the septic syst= refm=ced above was iu*WW'wi#0 a�}oi':chaff (i:e. ,eatertbaA'YQ' lateral reIN46n-of the SAS orgy vmacc.Lj'"* ��i�'of Ei eo �. Y 'ant of the.septiVgys�z}but is accordance with State& ,oeal:Reg ab`ans. flan rmsigq oX cerfted as-bi t'by de ep't"6�foruaw. {installer's Signa#nre) A ,F ]E PS't"W TO B' �PUBLIC;WAL -I W O C. TF a C �ulv�•- �: .4 � T-AM XaLJOY QDP Q:i4oaltiAeptidlDek ner CeMeatp'Ftn•• �V 1,_'"::;i,�, 'Yi, ,•"•;`';; :+ 1 .r fit. Town of Barns table P# ' c Department of Regulatory Services • � Public Health Division �. Hate 200 Main Street,Hyannis NIA 02601 Date Scheduled DTime Fee Pd. Soil Suitability Assess ent for Sewage pisposal Performed By: 2>9-Yid _, m4c-5 p� Witnessed By: DALItyll", f iw1 LOCATION& GENERAL INFORIA ION Location Address 153 O r P 11 Opp,p e!C &6 Owner's Name Ct o1� d ti_4 Address Assessor's Map/Parcel: a 3 V`,—(J!� - Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well _ ft Drainage Way fit Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 1 1 � Parent material(geologic) Depth to Bedrock I 0 Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERARNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment Index Well# Reading Date: Index Well level.�,,,,,,�a Adj,factor— Adj.(Groundwater level Observation PERCOLATION TEST bete Thne,,M,__ Hole# Time at 9" Depth of Perc 0 Time at 6" Start Pre-soak Time @ 42 oK Time(9"-6") End Pre-soak G p, M 1 t Rate MinJInch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: 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:\SEPTICVERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil'Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) ,� Mottling (Structure,Stones;Boulders. o i tency %Gravel) G042A c �40 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi ten % ravel ' 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) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. Consistency,%3mveI Flood Insurance Rate Man: Above 500 year flood boundary No` Yes Within 500 year boundary No IX Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring per v'oupaprial exist in all areas observed throughout the area proposed for the soil absorption system? •/I 11 If not,what is the depth of ha roll occurring ervi us material? IA P Y gP Certification I certify that on ID (date)I have passed the soil evaluator examination approved by the Department of Environ en 1 Protection and that the above analysis was perfo ed by me consistent with . the req ' 'ng,ex d x e 'ence described in 310 CMR 15.017. Signature Date Q:\,SBP'nC\PERCFORM.DOC ASSESSORS MAP : TEST HOLE LOGS PARCEL : W--71 -._. FLOOD ZONE: SOIL EVALUATOR : i p NOTES: ITN DATE: cat � PERCOLATION RATE: ,.---- ��I I 1) The installation shall comply with Title V and Town of a� Board of Health Regulations. Pt 2) The installer shall verify the location of utilities,sewer inverts and septic components prior to installation and setting base elevations. TH— I TH-2 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot.The first two feet out of the d-box to the leaching shall be level. A4) This plan is not to be utilized for property line determination nor any other 't purpose other than the proposed system installation. 5) All septic components must meet Title V specifications. 6) Parking shall not be constructed over H10 septic components. 7) The property is bounded by property corners and property lines. LOCATION MAP 8) The property owner shall review design considerations to approve of total design flow and number of bedrooms to be considered for design. Receipt ` of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall 'G be removed along with contaminated soil and replaced with clean sand per t A'I ; Title V specs. �( 10)System components to be 10 feet from water line. Sewer lines crossing the �O` :✓ 'T"\ water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if applicable. The proposed SAS is being installed below the water service line. The line is to be sleeved as aforementioned and maintained in place. 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. SEPT] C SYSTEM DESIGN 12)The installer is to take caution in excavation around the gas line if such exists. - 13)The installer shall verify the location,quantity and elevation of the sewer ,, lines exiting the dwelling prior to the installation. ---_ , �- FLOW ESTIMATE 152 BEDROOMS AT 10 GAL/DAY/BEDROOM GAL/DAY 4�9 SEPTIC TANK - {�? , 6 AL/DAY x 2 DAYS GAL •.>. �;� USE GALLON SEPTIC TANK _ 4p •Idp.fO96 y' SO I L' ABSORPTION SYSTEM 41 lip Nj Dl- LA N SIDE AREA: � 1�a -X �,, f ,� I� �57- O M BOTTOM AREA: [ 0t� 10 N a _-- --. _ S E P T IC SYSTEM SECTION nAf(or 4 .. Zo ' - _ _ Q Tt GAL 42'q ,, �o ._ wwu / .. 4DIGO SEPTIC TANK r. SITE AND SEWAGE PLAN LOCATION : d 1441 Cf TI q 6 k 5 _ � ---� �_ PREPARED FOR : 'Ipi 0 l C� a SCALE• W DAV I D B . MASONIR5 DATE: !Z 1 a Z DBC ENVIRONMENTAL DESIGNS Z DATE HEALTH AGENT EAST SANDWICH MA 3 z ( 508 ) 833- 21/77 -