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HomeMy WebLinkAbout0311 ARROWHEAD DRIVE - Health 311 Arrowhead:Drive Hyannis w A=.270-066 • b TOWN OF BARNSTABLE LOCATION Oa SEWAGE# .o2 oy®®' ��✓t VILLAGE /l 4,,'wA-4f ASSESSOR'S MAP&PARCEL ,© INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(ty e) NO.OF BEDROOMS OWNER PERMIT DATE: --- a —59—./-7 COMPLIANCEDATE: Separation Distance Between the: �o wAT�4L 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 ?t_ , r� oo f 0 p Ikri . M b Y 1 33 7 � 1 Y T51 4 ! Town of Barnstable P# $ Department of Regulatory Services Public .Health Division Date 200 Main Street,Hyannis MA 02601 Date Scheduled Tiae Fee Pd. •• 'e. ;� �_, �e - . ' .. a '� . Soil Su itabiliO'Assessm nt for Sewa e c l� g sposalJ Performed By. ^ � Witnessed By:_ r� g f---------------- Location Addmss i/ LOCATION& GENERAL INFpR�TION'".'' w, Owner's Name 4/w,�� f Gf�y - Address 0WAefO Assessor's Map". .o; .7 Engineer's Name /V 4,pa,o,�r NEW CONSTRUCTION, U REPAIR Land Use Slopes(%) • Surface Stones Distances from: OPen Water Body ft Possible Wet,Area -_ -� .Drinking Water Well Drainage Way 1 ' Property Lane Other) • ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in Proximity to holes) VVD Parent material(geologic) Depth to Bedrock, Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face rr1 Estimated Seasonal High Groundwater v DETERMINATION FOR SEASONAL HIGH V�ATEIt TABU Method Used: Depth Observed standing in fobs.hole- In. ' In, Depth to sail mottles: .! Depth-to weeping from side of obs.hole: -:In. C� Index Well# ReadingDate: ft in, Groundwater Adjustment "`Y , index Well Level^ � Adj.rector Adj.t7ro6ntlwater level, 't PERCOLATION TEST bated F I _.® TWe,,_v_ .,•y Time at 9" fJ i�� ro �'J � b � Time at 6.' AA k Time @ 1 � Time(9"-6") --w_ h . Site Suitability Assessment: Site Passed Site•Failed: Additional TesiWg Needed,(Y/N) Original: Public Health Division ' Observation Hole Data To Be Comple[ed 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:SEPTICIPERCFORM.DOC t 1 DEEP•OBSERVATION HOLE LOG. Hole# i Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. Consi to c rave( r q6 ' 14 DEEP'OBSERVATION HOLE LOG 'Hole# Depth from Soil Horizon Soil Texture Soil Color ' Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION`HOL°E LOG` Depth from Soil Horizbn Soil Texture Soil Color Soil i'" Other Surface(in.) (USDA) (Mansell) Mottling+ (Structure,Stones,Boulders. r i to Gravel) A ' a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. Consistency, t AJ Flood Insurance Rate Map: ''+ Above 500 year flood boundary No_ Yes i Within 500 year boundary No Y, Yes ' ' Within 100 year flood boundary No Yes + • 'y' . Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervt m terial exist in all areas observed throughout the area proposed for the soil abs rption system? If not,what is the depth'of In uraily occurring per v.us material? ' �' ''''" •" Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Enviro iental Protection and that the above analysis was perfolmed by me consistent with the requir g,a rti a e erience described in 310 CMR 15.017. b Date Signatur �' Q:\SEvnr_\PERCFORM.DOC No. C?G` 0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for Misposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System Q Individual Components Location Address or Lot No.,5 �1_A IQ'o Owner's Name,Address,and Tel.No. Assessor's Map/Parcel = O d 6- Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 2— Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 4Z4:0'-r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) a-O gpd Design flow provided 3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank/j%��/ ��� 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 Compliance has been issued by this Board of Heath. Signed Date ,� Application Approved by Date ,2— C/ ' /0 Application Disapproved by Date r for the following reasons Permit No. aGl c - Y 0 Date Issued 11-'�i ' r d No. v G 0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in coftuter: PUBLIC HEALTH DIVISION -TOWN OF'BARNSTABLE, MASSACHUSETTS • Ye. 4phration for -Misposai 6pstetnµiEonstruction erntit Application for a Permit to Construct( ) Repair( ) ,Upgrade( ) Abandon( ) Complete System ❑Individual Components ' i Location Address or Lot No. 3��_,44-v o Owner's Name,Address,and Tel.No. Assessor's Map/Parcel >.7 p Q xf,7 fnnn, Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. � ,/I*, Al 4T .rn 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(min.required) =2- gpd Design flow provided 3 gpd r Plan Date �� /� Number of sheets / Revision Date Title > Size of Septic Tank Type of S.A.S. Description of Soil' f 'Nature of Repairs or Alterations(Answer when applicable) t i Date last inspected: r Agreement: ` t The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed" Date ,&,z Application Approved by Date Application Disapproved by Date for the following reasons 4' Permit No. .90IO — Q0 S Date Issued �� �7 ' r d THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(a Upgraded( ) Abandoned( )by at Ol.!/ Q ZIZ has been constructed in accordance , with the provisions of Title 5`and the for Disposal System Construction Permit No..2 010—4�S dated r v Installer ���17j G Er��!!r Uf Designer 4e�T4 y/O #bedrooms Approved design flyi ,d o�-�O gpd The issuance of thispe it shall not be construed as a guarantee that the system will ncesi ed. Date Inspector . . -------- - - ------------:----------------- :------ ------ No. 010— S Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS �Misposal *pstem Construction J)ermlt Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at J// /4��OAS, 'o -A6e. /Yy 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. l Date "' �`(a Approved by 1 i 1 Town of Barnstable r. Regulatory'Services ,}t r' # Thomas F.Geiler,Director �. . ftbfir Health wbion Tboumas McKean,Rector. 200 Main Street,Hyaunes,MA,02601 O£ ce::508-862-4644 Fax: 508-79M344 Installer&Dedener Certefication Form Date: , I)eeigner: Ij SURer:• t�'�, t 0�.t. . � r.4ddress: . Address_ VAX � th1 i on s was issued a perldt to install a (date) {�izzstaTlex) . septic system at based on a design drawn by ( ) � dated /� -- — ✓O :d��er) ' . certify that the septic system zefetp ced aiiave was installed sub stauvia acdordi�tg to "the design, which may mclnde minor approved c$agages such as late a{relocation of the lx ution box au&or septic tack... T.cetat the septic system xe£eZ exzced above was instil with'taar, l `1 V' lateral zelocatiatr of the SAS or any.vea cak= t• • r�n'o€a#y comppt of 1 e.septie,system)but aecordance with State & - cexti fled as-b t de A' T=.ocal;Re lions. Plan revlsipn y `ta`follow. •' - � 1�4 dr r ' or's Si f 8'f'6 (Dhigieff's Sigiature} _(Affix PL AS3E RIE T B t. ,r., C••EMALTH D�ION, �F.. CE I33 vo AmR 'RR .f' :B T P �S E3 Q:Ueaitil se*/DesignerCe iCa 1Cp Fjorrb ASSESSORS MAP : _*0 7 LOGS TEST HOLE PARCEL: E� FLOOD ZONE: ate„ 6f�jflGL� WITNESS : > �j '\ NOTES: SOIL EVALUATOR: wREFERENCE: DATE: C� �i 1 The installation shall comply with Title V and Town of ) p Y WW3oard of PERGOLA ION RATE: ., Z,.� t I 1 Health Regulations. .....-_,_, _. _..a...a.....,.....,,a...,...:...r...,..«....« a.,,... ......>.b.,._...a..a..,w..—......«.a..-.._..a.,......,�....._,..._.._ .....�...�..,,.. ,............,,.......,.;..».J �/ yI ` Gj, _ 2) The installer shall verify the location of utilities,sewer inverts and septic '�f 'y1\\\w(//f W a components prior to installation and setting base elevations. TH- 1 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. —`-''—' 4) This plan is not to be utilized for property line determination nor any other lb L purpose other than the proposed system installation. �p 5) All septic components must meet Title V specifications. 5 6) Parking shall not be constructed over H10 septic components. 7) The property is bounded by property corners and property lines. C 'w l 8) The property owner shall review design considerations to approve of total LOCATION MAP 2 'A �� 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 iper Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per Title V specs. 1`� q " �a 10)System components to be 10 feet from water line. Sewer lines crossing the ,�� �( Ww /i7\ l7 ull� R '�� 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. 12)The installer is to take caution in excavation around the gas line if such 41 S E P T C SYSTEM DESIGN exists. 13)The installer shall verify the location,quantity and elevation of the sewer lines exiting the dwelling prior to the installation. FLOW ESTIMATE r` EDROOMS AT IC� GAL/DAY/BEDROOM GAL/DAY � , —IPTANK GAL/DAY x 2 DAYS GAL USE �50 GALLON SEPTIC TANK' ' WID y .., 0 o SOIL L'-. --ABSi?RPT 1 ON SYSTEM 67 � - 1 tom' It . i Q � ^ a�, , _._... ....�..� , ........� _. .. _. �.�. ,._. . . . it) �S I DE AREA: Z'� � BO'1F.T0M AREA: N - �-nw —' SEPTIC SYSTEM SECTION — � . 10 7 �LI-4 GAL a- lh -- — SEPTIC TANK .�.l..� 1 ,00 — �y x 0 IOU x1 SITE AND SEWAGE PLAN LOCAT ION : PREPARED FOR : P O, T SCALE: iLlity W DAV I D B . MASON DATE: I '� z DBC ENVIRONMEN AL DESIGNS W EAST SANDWICH . MA W DATE HEALTH AGENT Z ( 508 ) 833- 2177