HomeMy WebLinkAbout0942 FALMOUTH ROAD/RTE 28 - Health 942 Falmouth'Road/Rte 28
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TOWN OF BARNSTABLE
LOCATION 7 l ov�, -A)SEWAGE# 2yo
VILLAGE 1 / ASSESSOR'S MAP.&PARCEL
INSTALLER'S NAME&PHONE NO. /
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) JW 6-3ffL-elt.S (size)
NO.OF BEDROOMS
OWNER o (_L
PERMIT DATE: COMPLIANCE DATE: 13
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 ori`
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
� 1
i 25r
�2 .73
07
.�
No.
�/ ^ Fee ./
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for Disposal *pstrm ConstTuttiun Vrrmit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) [:]Complete System [I Individual Components
Location Address or Lot No. I�,_
ar o,�% Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcela �D 0 �Akn j
Installer's Name,Address,and Tel.No. &4ke,y,F0164 Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms ` Lot Size sq.ft. Garbage Grinder( )
Other Type of Building w; No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) �,3 3n gpd Design flow provided �Y-4 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Zoo Type of S.A.S. (�—
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) /osf�/ ngw Loa GAL Z?
con A-D]
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 ode and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of a
Signed Date 7A0111
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 9-0 Date Issued
} Y
No. *,; Fee
Entered in computer:
THE COMMONWEALTH.QF"MASSACHUSETTS Yes
! PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
-- �r ftutication for Bisposat*, pstem Construction Permit
Application fdr a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. �{2 2� /j1A. Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel a'5 0 -d /
�� n_ e ell
Installer's Name,Address,and Tel.No. Ro (,uyF1T*?+'_ Designer's Name,Address,and Tel.No.
m64,i s7"�410�►cf- Qy- )dub-ate s SLgVeC.
Type of Building: -
Dwelling No.of Bedrooms Lot Size `sq.ftGarbage Grinder( )
Other Type of Building 40 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
r
Design Flow(min.required) 3 3n gpd Design flow provided SaZ- gpd
-Plan - Date Number of sheets Revision Date
Title w
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) } /1h►9/ Y'l�a /S�t)
con 4� i1y)w lalLj
r
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 rode and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of H,eaa
Signed Date
Date
Application Approved by Date
Application Disapproved by n Date
for the following reasons `
Permit No.
G! bate Issued
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 Q/H /�l 5e*�r,f SP2(/ (.e
at kk Iy Z 01- �� 1-t�y ^�1 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.d013" ?)"dated " f 3
Installer 1,oTTl5W(,7 i Designer ll ���() Otte
—
installer bedrooms Approved des gnjow 3 g_d
The issuance of this permit shal t b construed as a guarantee that the system i notion as designed.
/J
Date Inspector
---------------------------------------------------------------------------------------------------------------------------
No. �� � � � Fee
e%ell
1 6 -
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
disposal 6pstem/Construction Permit
Permission is hereby granted to Construct( ) Repair(� Upgrade( ) Abandon( )
System located at � I ITL Wl-a <7
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.
Date �� 2 Approved by
l
Town of Barnstable
SINE A Regulatory Services
026 Thomas F. Geiler,Director
Public Health Division
9`�Ar 6 A`�� Thomas McKean,Director
FD MA'S
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: 8 Z - '> ?(Sewage Permit#Z1013- 27,Z Assessor's Map/Parcel750 —/Z ¢i 37,
Installer& Designer Certification Form
Designer: Installer: -L7e01AaY b'(—m4 Et2 .
Address: +� v� 1'1 z9 Address: 440 NlA te-J S-r
"D KhIl-(A M 01!6 3 kC_ mck
X• On 7 6 its�i C 2 was issued a permit to install a
(date) (installer)
septic system at 1-94'e— based on a design drawn by
(address) b 1
CTL-(. _dated ~7— Z�—r 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 the
distribution box and/or septic tank. Stripout (if required) was inspected and the soils
were found satisfactory.
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
h of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Stripout (if required) was inspected and the soils
we found sa ' actory.
VSH OF A4,4
o� DAVID
N�-A
K sta s Signature) FLAN Rom,JR. N
No. 1211
0
�Fc�sTE'��
X (Designer's Signa e) X (A tamp 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.
gAoffice forms\designercertification form.doc
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Town of Barnstable P# 0
Department of Regulatory Services
��M Public Health Division Date
200 Main Street,Hyannis MA 02601
rEl► S A ..
A S-2_
Date Scheduled_ V Time Fee Pd �D U
So S`ua b 'IityAssessment f®r ,Se is ®s �
Performed By: die Witnessed By:
LOCATION& GENERAL MORIVIAT ON
Location Address 0942 (Zf Z cru rg Owner'` s Name �341 4 /ij/f/e�/
Address (T Z
Assessor's Map/Parcel: 052�,), J 4
Engineer's Name
NEW CONSTRUCTION REPAIR �= n4A
' Telephone# `� 5 Z
Land Use �i3R ( S - e/ PQS•swvevI @�a oo, ear►.,
Slopes(i) Surface Stones &/V
Distances from: Open Water Body ft possible Wet Area--A/)Aft l Drinking Water Well
ft
_— 3 v Drainage Way �l� ft Property Line 40� ft Other (z VLj ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
z �v - 34
I 'ICe:55tx
too 41
Parent material(geologic) Or 1/V�.1��D �^ � ;1
(g g ) Depth to Bedrock N.Q,,.;...n :t.
Depth to Groundwater. Standinga_ tes in Holei Weeping from Pit Rice c.•h{
.—
Estimated Seasonal High Groundwater ( 2 �_
Method Used: DET�S �rn TION It OR SEASONAL:HIGH WATER'�'A $L E •_� :.4 �.y '�'o.�-
Depth Observed standing in obs.hole: ��Q - In, Depth to soil mottles: itt,.,,,g P
Depth tow ing from side of obs.hole: {_�l"� in, Groundwater Ad talent _f+--° r-a't
Index Well#_ Reading Date: � index Well level Adj,factor Adj.Groundwater Level 1 Z�
PERCOLATION TEST bete 1 f A-111
Observation
Hole# 'lj ( s O Time at 4"
r�
Depth of Perc �,src) Time at 6"
Start Pre-soak Time @ ��1 y //�� . Time(9"-6")
End Pre-soak 10 '� `b Z"
Rate Min./Inch I t S
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) d/
Original: Public Health Division Observation I-3ole 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:\SEPI'IC\PERCFORM-DOC ��
DEL,P.OBSERVATION HOLE LOG Bale#
Depth from Soil Horizon Soil Texture .Sdil Color Soil. Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders.
onsistency,%Gravel)
OX
I �
DEEP OBSERVATION HOLE LOG Bole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,% rav
>�ti l_ 1 r
-!E. 2"VA .� �� s I4l va✓e
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Oravell
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Cons' ten
Flood Insurance Ratelylae:
Above 500 year flood boundary No— Yes ._
Within 500 year boundary No= Yes
Within 100 year flood boundary No Yes
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? _—
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on �_(date)I have passed the soil evaluator examination approved by the
Department of Env ronmental Protection and that the above analysis was performed by me consistent with .
the required trainin ,ex a rise and exppee ie i1ped in 10 CMR 15.017.
Signature
Sig
C � 7 Date
Q:WEPTICNPERCFORM.DOC
I-
SYSTEM DESIGN
RAISE COVERS TO WITHIN 6" OF FINISH GRADE` DESIGN FLOW
ONE CHAMBER RISER
SILL ELEV. 57.98 FINISH GRADE RAISE TO WITHIN 6" 3 BEDROOMS AT 110 GPB/D 13-Q- GPD
GRADE ELEV. 56.0 ELEV. 54.9 FINISH GRADE- OF FINISH GRADE REQUIRED SEPTIC TANK
C.O. //C.� //� //C�� ELEV. 54.8 ELEV. 55.0 --- - -- _ -----
2" PVC LAUNDRY - �� GROUND ELEVATION 55.0 330 x 2 660 GAL.
TOP /�� ��///�� / �� �� �� �� �///��, SEPTIC TANK REQUIRED = 1,%0__GAL.
1 MIN.-3' MAX. COVER EXISTING S.T. TO REMAIN = 1 00_0__GAL.
20'(�S=0.027 TOP ELEV 52.75
4" PVC 32' CAS-0.63 - 2" MIN 1/8"-1/4"
- 4" PVC SCH 40 8 OS=0.01 00060 0 0 00000 DOUBLE WASHED PEA SIZE OF LEACHING FACILITY REQUIRED
C.I. SCH 40 INV.= 2 MIN-3 MAX
5 V.= 10"TEE 14"TEE INV.= N00000
0601 o c 0 O O I STONE OR FILTER CLOTH DESIGN PERC RATE <_? _-MIN./INCH
NI V.= 54,98 IN .= . O Oo000000 N 3/4" DOUBLE LONG TERM APPL. RAE_2•74_GPD/S.F.
6" �00000
GAS BAFFLE H-10 D83 WASHED STONE
t: PROPOSED 4 BAND 4'-1" LIQUID LEVEL D-BOX 52.08 IV=
4'-10"x8'-6"x2'-9" CHAMBERSSIZE OF LEACHING SYSTEM PROVIDED:
STAINLESS SEEL INV.=52.25 VI52.00 S.A.S. (13' x 25.0') o' 330 + 0.74 SF/GPD = 446 S.F. MIN. REQ.
CONNECTOR „T" REQ• t aL 50.00 USING 2 CHAMBERS WITH 4' STONE AROUND
� •.t: OO
Vl SIDEWALL = 2(13'+25.0') x 2 = 152 S.F.
TES
DATUM: PROP SET ON LEV GALLON VEL STABLE EPTIC BASETANK ELEV 43.0T PT #1 GiWAER ENCOUNTERED BOTTOM = 13' x 25.0' = 4725 S.F.
VERTICAL DATUM: BARN. GIS - MSL± CONSTRUCTION NOTES: 477 S.F x 0.74 = 352 GPD
BENCH MARK USED: CONCRETE BOUND AT 352 GPD PROV > 330 GPD REQ. = 22 GPD RES.
SOUTHEAST CORNER. EL=56.27 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND
ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING WORK ON THE SITE. NO (GARBAGE DISPOSAL / GRINDER ALLOWED)
2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE
SITE & SEWAGE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT VARIANCE REQUESTED
REPAIR PLAN 3. IVEHIOCULLAR OBTAIN
TRA F C, PARKING OF DETERMINATION
VEHICLLES AND APPROPRIATE
PLAC NGAUTHORITY.
NONE
�942 (R T. 28� MATERIALS OVER THE SEPTIC TANK IS PROHIBITED. P 14072
GENERAL NOTES:
FALMOUTH ROAD 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. D.T.H. #1 D.T.H. #2
TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS DATE: 7-19-2013 DATE: 7-19-2013
N FOR SUBSURFACE DISPOSAL OF SEWERAGE. GROUND ELEV. 55.0 GROUND ELEV. 55.0
H YA N N I S, B A R N S TA B LE 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE NO GROUNDWATER NO GROUNDWATER
ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING I CERTIFY THAT I AM CURRENTLY APPROVED BY THE
ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT
DATE: 7/25/2013 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL
CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE ". EVALUATION:-ARE ACCURAT AND CORDANCE WITH 310 A A
UNDER OR WITHIN 10 OF DRIVES OR PARKING AREAS THEY C MR 15.1 HRO GH 15. 7. LOAMY SAND LOAMY SAND
10YR 5/2 „ 10YR 5/2
MUST WITHSTAND H-20 LOADING. --
APPLICANT: s ___ _ __ _ ___ __ ___
6 8
4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION ,, _ _ _ __ ____ B B
J 0 H N FA R R E LL OF ALL UTILITIES PRIOR TO ANY EXCAVATION. EDWA D A. S NE, ERTIFIED SOIL VALUATOR LOAMY SAND LOAMY SAND
5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 10YR 6/6 10YR 6/6
#38 CAPTAIN ELLI S LANE OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. GROUNDWATER ADJUSTMENT
6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER
H YAN N I S, MA 02601 FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. NO OBSERVED GROUNDWATER 24" 28"
7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF DEPTH TO BOTTOM OF HOLE 12.0' ELEV =53.0 ELEV =52.7
SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE
THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND C C
LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. COARSE SAND COARSE SAND
SHEET 3 OF 3 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN 2.5Y 7/6 2.5Y 7/6 60"
2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT 10% GRAVEL 10% GRAVEL
ELEVATION OF THE OUTLET PIPE.
PREPARED BY: 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES" NO G. WATER 144" NO G. WATER 144"
jµ OF htqSSg ELEV =43.0' ELEV =43.0
E A S SURVEY, INC. 10 BAFFLE, 4 EINC ES INRDI METER RAND CONSTRUCTED I OF 4"GPVC, 02��� AVI c 11 PIPES ALL SHALL BE SCHEDULE 40 PVC ET FOR THE DTH1
PIPE AND
'� �� �� # ITESITAHTES OLEDEEP B.O.H.
141 R T. 6 A SHALL BE SLOPED 11/4 NCH PER FOOT MIN. DONNA MIORANDI
FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL r o 12 1 SOIL EVALUATOR
P. O. B 0 X 1729 BE LEVEL F P-260" PERCINDICTES EST BACKD. STONE
HOE OPERATOR.
12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION �'
SANDWICH , MA 02563. TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW S T 0' FISHER EXCAVATION (MIKE)
AND APPROVAL. S4,kt RtiP NO MOTTLING SOIL TYPE: __
PH. (508) 888-3619 13. MAGNETIC TAPE OVER ALL COMPONENTS. ' NO WEEPING PERC RATE: <2 MIN. PER INCH
LOADING RATE: 0_74 GAL/SF/MIN
CELL (508) 527-3600 144" INDICATES ADJ. GROUNDWATER
1
LOCUS DATA
"14 N �v 4
CURRENT OWNER RUTH CARLSON
- v Q
PLAN REFERENCE 293-27 / LOCUS
\ N 77'?3'301, w STONE ROUTE 28
DEED REFERENCE 797427 FOUND = WO
161. Sr �'Q
M 38, S 76-15,19„ E tiiq Q
ZONING DISTRICT RC-1 Q 388 e, -- `S7,p �y
N W / 3—
FFr o z
OVERLAY DISTRICT ZONE II - GP o / / N LOCUS MAP
i� l 7672 '1p�� NOT TO SCALE:
FLOOD ZONE "C" 250001 0 CO l ��eX/s Nc
JOB # 13-0118
_ _ E
ASSESSORS MAP 250
PARCEL 123, 34, 32
FOU
LOT AREA 44,020t S.F. SHED
SHED $1
SITE BC SEWAGE
492Lu
REPAIR PLAN s 9p.4! -.w. _ _ — _ a ^ , — EXISTING e y, I "'
� � o z
Poo, o / DWELLING \ \
/T 42 (/? T. 28> FARM E FARM � ( � — --
HYDRANT HYDRANTrI I i \ PROPOSED NEW \ /�
FALMOUTH 1?0A0 LEACHING SYSTEM j�� \ /o W
N OSHED 11 13' x 25.0
Hof
_ HYANNIS, BARNSTABLE EDWARDA.
DATE: 7/25/2013 STONE I I I `b \ a
P No. 80 I I// — � I ` D.T.H. #2 I
,p � D.T.H. #1
APPLICANT: o��ssF /ST 3 W I j 3� �1 o a
L LA o I a I I �, o _
JOHN FARRELL 1 �� I �11 2,
2 6- - -
#38 CAPTAIN ELLIS LANE h�, COa I
HYANNIS, MA 02601 Z I I , o ��' � 30 -5� _ _
SHEET 1 OF 3 r I _ Q
'7 45,30„ TE Q
. E 125 00� s -59� \ 1_� 1 \
ou
PREPARED BY; N ► L .L �UTH ROA
EAS SURVEY, INC. LM
141 RT. 6A
P . O. BOX 1729 0 40 60 80
_ BENCHMARK
OF
SANDWICH , MA 02563 TOP BOUND.
CONCRETE
EL=56.27
PH. 508 888-3619 GRAPHIC SCALE:
CELL )508) 527-3600 1 INCH = 40 FEET
t
F
W 54 \ N
SS \ 26.26 101,
EXISTjAic FEN \` W
a co / CEE 55\ \
V) / \ \ \ 235.4 7'
N OF MA8S9 56\
o' EDWARD
A.
STONE N \
No. 28 sue/ i
0
53—
0 20 30 40 SHED
GRAPHIC SCALE:
1 INCH = 20 FEET / SHED 5� \
EXISTING CESSPOOL TO BE
o /_ +i PUMPED, CRUSHED AND
SITE 8c SEWAGE �<o o w #492 ABANDONED IN ACCORDANCE
o o / EXISTING DWELLING PROPOSED WITH TITLE 5. �,`'
REPAIR PLAN k,2 4—BAND
942 R T. 2S FARM I CONNECT R-^
HYDRANT I \
FA L MOU TH ROAD ( 5
IN LLo
o - \
HYANNIS BARNSTABLE 1 i 0�
f c.0.
DATE: 7/25/2013 I �� cp �55�
APPLICANT: I I
JOHN FARRELL I \ i PROPOSED 1500
#38 CAPTAIN ELLIS LANE \
I I GALLON SEPTIC_ \ _ + D.T.H. #2
HYANNIS, MA 02601 — ,O .-
— -L— — D.T.H. #1 OBS
� / TANK�
SHEET 2 OF 3 WI NI O
I I I ,Ln
0 71.85
PREPARED BY: �oI
C. o 56__
E A S SURVEY, INC —56 � \ — — —57-----
141 RT. 6A Z
P. O. BOX 1729 ���' L ��� �55--
SANDWICH , MA 02563 o / N L _ 1
PH. (508) 888-3619 U TE 28
CELL )508) 527-3600 �� I ____ —58 — R
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