HomeMy WebLinkAbout0038 GLEN ROAD - Health ter
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TOWN OF BARNSTABLE ' \
LOCATION %-D 0 C`I=Nti SEWAGE #
VU,LAGE °tiwvt, S DD)Z' ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO.e :� _
SEPTIC TANK CAPACITY 1 0 `` Sle6-t�i 6
LEACHING FACILITY: (size) 'X f I' X
NO. OF BEDROOMS
i
BUELDER OR OWNER
PERMUDATE: COMPLIANCE DATE:
Separation Distince Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Faciiity" Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) r - Feet -
Edge of Wetland and Leaching Facility(If any wetlands exist ! • ,
within 300 feet of leaching facility) "' Feet
Furnished by
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No. /% FEE- l
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COMMONWEALTH OF MASSACHUSETTS
Board of Health, &rrinkb/P — MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade(Jq Abandon( ) - YComplete System ❑Individual Components
Location �N����S Owner's Name l;)
Map/Parcel# Address
Lot# Telephone#
Installer's Name � r>LS Designer's Name
Address .0 15,5 Address q P
Telephone# Telephone#
Type of Building 5I-P Lot Size /0 sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures 2 2 •Design Flow(min. required) 33d gpd Calculated design flow 3 3 0 p Design flow provided 35 gpd
Plan: Date —12)—1),! Number of sheets Revision Date
Tide
Description of Soil(s) �
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS I TU /Q/Yl
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a ees t not to place ee tem in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date
//fie Date -� a
�s
No. + C .. _ f ) t FEE
COMMONWEALTH OF MASSAC14bSETTS
Board of Health, 1rn5�al� _ , I .
5
APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade(16 Abandon() - YComplete System O Individual Components
Location 1�� fid, - Owner's Name
Map/Parcel# Address
Lot# (] Telephone#
Installer's Name O � Designer's Name
Address U / 55 6260 Address �5h
Telephone# $ Telephone# - d'
Type of Building 5 Lot Size /U , sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures Design Flow (min.required) 33C� gpd Calculated design flow 3 3 [ 0p
Design flow provided 35/• gpd
Plan: Date -�J �� Number of sheets f Revision Date
Title
Description ofSoil(s)
.. r
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
1
DESCRIPTION OF REPAIRS OR ALTERATIONS Oekl
r
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a 1 ees t not to place a system in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed, '.GA /QW5 Date
lh,31m7
�Id�Speyf{3011S �l ( I i
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No FEE
COMMONWEALTH OF MASSACHUSETTS
Board of Health, L, r h/- Ml.
a .
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) yid Complete System
The undersi ed hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (�Abandoned ( )
by: kbbe,- -�l u
at _3 /,)leh
has been installed in accordance with the p ovisi ns of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application No. .�' dated Approved Design Flow (gpd)
Installer
Designer: �. .o Inspec oj: ) Date: T 0-
Y
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. - .a+ DC FEE
COMMONWEALTH OF MASSACH SETTS
Board of Health, Pm n 5 lab I _ S , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
"Permission is hereby granted to; Construct( )[[ Repair( ) Upgrade()a Abandon( ) an individual sewage disposal system
at 36 ;�•Vl K-6 G GMMl �.� �7 0 t ' � as described in the application for
Disposal System Construction Permit No. (Ji.( dated '
Provided: Construction shall be completed within Pree years of the date of thi -perm al conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health
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Town of Barnstable
Regulatory Services
i s Thomas F. Geiler,Director
ewtwsrestE
Public Health Division
Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: 1/19/05
Designer: Shay Environmental Services Inc Installer: Robert Septic Services
Address: P.O. Box 627 East Falmouth Address: 5 Trenton Street
MA 02536 Yarmouth. MA
On 1/18/05 Robert Septic Service was issued a permit to install a
(date) (instal ler)
septic system at 38 Glen Road H annis ort MA based on a design drawn by
(address)
Shay Environmental Services Inc dated 1/16/05
(designer)
XX 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 Alas
s.
CARi r 2N yGN
7tti
° SHE.
AY
No. 1181
CISTe
^'",,(TAR�Aa
(Affix Designer's S p Here)
i PLEASE RETURN TO BARNSTABLE PUBLIC IIEALTH DIVISION. CERTIFICATE
OF COMPL1rANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT C.A.RD ARE RECEIVED BY THE BARNSTAB>(,E PUBLIC HEALTH DIVISION.
THANK YOU.
Q; Hcalth/SepticMesigncr Certification Form
='a VA.
Q i TOWN OF BARNSTABLE : C
LOCATION D SEWAGE # ��` J
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY: 5(572 Sie6_t G
LEACHING FACILITY: V'f�- �� r--e(type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER oCiU�C. 6
PERMITDATF: 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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*NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. _
- SECTION A -A
10' min. from ALL OUTLET PIPES FROM THE -
PROFILE VIEW OF ADDITION TO LEACHING SYSTEM DISTRIBUTION Box SHALL.BE
Existing Foundation house to septic tank BET LEVEL FOR AT LEAST 2 Fr. "-72• -" CONCRETE LAVER
-D-BOX cover must be
TOP OF FOUNDATION ELEV. 100.00 (Assumed) Septic tank covers must be 3• of 1/8• - 1/2" Washed Peaston I Ayn )•
within 6 in. of finished grade within 6 in. of finished grade r. ^,.N � � ••.�La,�BQe t � a
Grade over Septic Tank - 98.00 Grade over D-Box - 96.50 ode over SAS - 96.50 3/4" to 1 1/2 Washed Crushed Stone ` KN500 ET 2 t dta4 r aChR •
- _ kit 0 : t
4' PVC CAPPED INSPECTION PORT TO BE r {ItJ• �T., .i CK
SftTIN 81 fr --
- 5.5' ^�` I 12• INLET r Asa>.rt t ....3... Itf2r
• S = 0.02 - - INSTALLED AND TO BE WTHIN 6' OF GRADE tk OUTLET
t h*dr „� r r a/ ,..SIOOAk
3jHEH-10 6 rfy� ;Y 1
3' Maximum Cover H wns a' r
OfO"
o OF System- Elev. =94.75 - f t 1y,31 a Rd
BOX �. ,' �' t „�
,g' NEW S=0.01 or Greater P Y - ._ r' .s r - 2' rPatGdfj , .a
EXIST. PIPE ` . r7 1,500 GAL s� . . . . . . . 15.5' -O 30' 0,01' per foot Effective Depth - 4" - SCH. 40 Tet.75FROM EXIST. FOUNDATION �, SEPTH-10IC TANK os Units a bzs' _ ao' - PLAN SECTION CROSS-SECTIONr. M 20'
CONCRETE FULL FOUNDA - - - _ ly rn o .83' (10 inches) A 3 ' 3' *° 4
SYSTEM PROFILE 6 In.of 3/4"-1 1/2 v d a7,2s' 3 HOLE H-10 DISTRIBUTION BOX
com compacted stone
c pO > a o ISO. Z
Not to Scale A rn Effective Length NOT TO SCALE won
� v � `
> > 4' -� 4' a SOIL ABSORPTION SYSTEM (SAS) ®roa+R�eeck> ara5 yo cv�H+wrEc
IV
1
6 in.of 3/4'-1 1/2" 0 0, 7a3 INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN GENERAL NOTES
compacted stone Q Effective Vidth
o (OR EQUIVALENT) Not to Scale
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE o 1. Contractor is responsible for Digsafe notification
Bottom of Test Hole 1 Elev.=85.30 m NOTE: OVERALL HEIGHT OF INFILTRATOR 1 EFFECTIVE HEIGHT IS 10" and protection of all underground utilities d i
Groundwater Observed O 126' = ELEV. 85.80 / p g P
-------'---- -- T R FITR R I 8" roun an es.
p
�"------"' 2. The septic tank and distri ution box shall be set
level on 6 of 3/4"-1 1/2" stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
4. This system is subject to inspection during installation
r by Carmen E. Shay - Environmental Services, Inca
5. The contractor shall install this system in accordance
P 0 q I O^I TEST
C CT with Title V of the Massachusetts state code, the approved plan
/i I V I L_J I and Local Regulations.
Date of Percolation Test: NOV. 17, 2004 6. If, during installation the contractor encounters any
soil conditions or site conditions that are different
Test Performed By. R. WILCOX - SWEETSER ENGINEERING from those shown on the soil log or in our design
Results Witnessed By. WAIVER(per Barnstable B.O.H.)
EXCAVATOR: UNKNOWN installation must halt & .immediate notification be
Percolation Rate: Less Than 2 MPI ® 27" made to Carmen E. Shay - Environmental Services, Inc.
7. No vehicle or heavy machinery shall drive over the
c9�p septic system unless noted as H-20 septic components.
8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
Test Hole \ 10. All solid piping, tees & fittings shall be 4" diameter
`No. 1
_ -- - Schedule 40 NSF PVC pipes with water tight joints.
DEPTH SOILS ELEV. 20.35' `�105.95' 11. Municipal Water is Connected to ALL OF The Residence and Abutting
0 96,301 10' Properties Within 150 Feet.
Loam -36' LOT #7 p
Sandy s._. ;-y ,,.C;.:, ;, .ti. _.-�r THE PROPERTY LINES ARE APPROXIMATE AND
i �..; �..ti,y,,::..- :W:>•; ;j;;-. , fO,081 Square Feet +/-
10 YR 3/2 COMPILED FROM THE SURVEY PLAN GENERATED BY
;<: •:Y-
0"-12" A 97.75 f • s • :-` �)
10 Failed FRED A. JOYCE SURVEYING CO„ ENTITLED
Loam tt �=``:'+ h" -. >; '��' ':3 0
Cesspool PLAN OF LAND OF GLENN HAVEN VILLAGE, IN HYANNIS, MA"
Y PLAN BOOK 86, PAGE 127 DATED. DATED MARCH 1949
Sand/ i' NEW 1500 gal. AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
6w B 20 /�i Septic Tank
12"-27" 94.05 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
Medium TEST HOLE #1 i' 00 PROJECT BENCH MARK THE SEPTIC SYSTEM INSTALLATION.
Sand ELEV.= 96.30 / TOP OF FOUNDATION
2-5 Y 7/4 ,'� ELEV. = 100.00 (Assumed) EXISTING CESSPOOL TO BE PUMPED OUT AND FILLED IN PLACE OR
i27"-132' G 85.30 1 REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
f
NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
FROM THE EXISTING CESSPOOL TO BE DISPOSED
OF AS PER BOARD OF HEALTH SPECIFICATIONS.
-_- -r --' - -
EXISTING L #8
-` NO WEfLAN65RE P1EENT WITHIN 200' OF THE PROPERTY
oy� 3 BEDROOM
4 ASSESSORS MAP 288 PARCEL 20
LOT #6 �.� HOUSE
I t LEGEND
#38 i
Perc #1
Depth to Perc: 42" to 60" �� 1 /11 i 104.�1 DENOTES PROPOSED
Perc Rate= Less Than 2 MPI �\ l / w SPOT GRADE -
Groundwater Not Observed 't '
Observed Groundwater 126" X 104.46 DENOTES EXISTING
SPOT GRADE
PL PROPERTY LINE
pA L =75.00' 496P}- PROPOSED CONTOUR
\ R 455.00' - - - - - -97 EXISTING CONTOUR
9g_---------
--- -- DEEP TEST HOLE &
3-24" DIAM. ACCESS MANHOLES +�J�,1 V 1 V PERCOLATION TEST LOCATION
10' -s• - 6 FOOT STOCKADE FENCE_
(40 FOOT RIGHT OF WAY).
P LOT P LA
INLET -
INLET �.. "� OU T _
J r THE ACCESS COVERS FOR THE SEPTIC TANK,
I DISTRIBUTION BOX AND LEACHING COMPONENT
SHAM BE RAISED TO.WITHIN 6" OF
OF PROPOSED SEPTIC SYSTEM UPGRADE:
FINISHED GRADE.
STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-11TE GAS BAFFLES OR EQUALS PREPARED FOR
PLAN VIEW ON ALL OUTLET TEE ENDS
I
MADALI N E MADDEN
I �3-24•REIIO�BLE COVERS AT
I
4- r= #38 GLENN ROAD
3 min. clearance I'
INLET 6".mio_TJ2 min. inlet to outlet - 1T IHIFr
6'm1n. OUTLET -: 1
qi}'}}o
MILE - L�evel� l '
TO'mYt.
u HYANNIS , MA
d Design Calculations
1
4'-0" min.
Uqu
id depth ON
Number of Bedrooms:3 Equivalent to 330 Gal. Da 330 Gal. Da Min. �� qc PREPARED BY:
a..w.. .. , +, q / y ( / y` Per Title V) �02 A M yGd
• Garbage Grinder: No �`,
i 1 t..a..s•r..♦ ..
9
F , + - _.•:• ;.t_ Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) Qj
S Y � �• �
10-0' S' -8' Septic Tank : - 2 x 330 Gal./Day 660 USE NEW 1,500 GAL. Septic Tank., 0 20 40 50 . 1 NVIRONMENTAL SERVICES, INC.
CROSS SECTION END-SECTION SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch �o
Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons TER 1 P.O. BOX 627
Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. 58 gallons ll Sgn,ITA EAST FALMOUTH, MA 02536
TYPICAL 1500 GALLON SEPTIC TANK Providing: 331.80 gallons
TEL/FAX : 508-539-7966
NOT TO SCALE Use: (4) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, SCALE, 1"=20'
SCALE: 1 "=20' DRAWN BY: CES DATE: JANUARY 13, 2005
(H-1 O LOADING) TO BE USED WITH 4.0 OF WASHED STONE ON,THE SIDES, AND 3.5 OF WASHED STONE
ON THE ENDS. NO STONE UNDER.
PROJECT#SD678 FILENAME: SD678PP.DWG SHEET 1 OF 1
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