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HomeMy WebLinkAbout0071 CLAMSHELL COVE ROAD - Health 71^Clamshell Cove Road v . I Cotuit A = 006 054 - - - .� 9 a Nqy� FEE THE COMMONWEALTH OF MASSACHUSETTS BOARD OF WEALTH OF b(1AA'lQ-6btJ-- APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (�/) Upgrade (") Abandon ( ) - D/omplete System ❑Individual Components Location Owner's Name; m ' o b(e cA h 54 �-�- "I MapMap/� Address MA dw3-D l � phone�# m ' Installer's Nae Designer's Name Address ddress Telephone# Telephone# Type of Building: Lot Size �� � r7 Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other Of Design Flow(min. equ,�red) 5t) gpd Calculated design flow�3'✓�O gpd Design flow provided 3 5�pd Plan: Date T I Number of sheets Revision Date Title nj;l c 1p( � Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Sri Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The un a signed es to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 an er rt� snot to tem in operation until a Certificate of Compliance has been issued by the Board'of Health. Signed D Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 t , 4 ;`Na� �TH'E"COMMONWEALTH OF MAS ACHUSETTS'"`" FEE' wr f TO .,, BOARD OF iHtEALTH 'L OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (Upgrade (�Abandon ( ) - [ Complete System El Individual Components Location Owner's N e mpD�p Qc'� a�� '� c � �ifyr- id-- Map/Parcel# IY A ��il�Ad c ��S t J 7 T lephone# G,fJP CA F-n�l Installer's Name Designer's Name Address Z_7,.,,!fress ((,, Telephone# Telephone# Type of Building: Lot Size 49e_:;0 Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow( in. equ,�red) 5-3 gpdCalculated design flow,3?�o gpd Design flow provided 35'5pd Plan: Date Q Number of sheets _I Revision Date TitleSa�� ►np/vla de T J l h��1�►rr� A &Ox- �„6 A.t� c". 0 Description of Soil(s) "-�I`•`uaw ''-3lr" 3�"-� -N4,A ]r-jzo, kd sc" Soil Evaluator Form No. Name of Soif Evaluator Date of Evaluation I DESCRIPTION OF REPAIRS OR ALTERATIONS ' a The underlsigned agrees to install the above described Individual Sewage Disposal System in-accordance with the provisions of TITLE 5 and further agrlees not to ace e. tern in operation until a Certificate of Compliance has been issued by the Bogard of Health. Sighed w D 9 Inspections FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 NO.-/� THE C M NWE LTH OF MASSACHUSETTS FEE f 6 .- I BOARD OF HEALTH CERTIFICATE OF CO PLIANCE Description of Work: ❑ Individual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed(y)!Repaired( ),Upgraded( ),Abandoned( ) by: at 7/ C sy!S has been installed in accordance with the provisionsof 10 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated o JAAroved Design Flow (gpd) Installer ��Designer: Inspector . Y IM1-Date 3 1S The issuance of this certificate shall not be construed as a guar intee that the system will function as designe . FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 1 No THE OMMO W ALTH OF MASSACHUSETTS FEE OARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct (�epair ( ) Upgrade ( ) andon ( ) an indiviidual sewage disposal system at Cd(/� o e? / as described in the application for Disposal System Construction Permit No. © r�O dated Provided: Co str ction s bll be completed within three years of the date of this p t.�1YINonditio must be met. Date .Board of Health �/ r FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON TOWN OFBARNSTABLE C. LOCATION '" "� j � '`� SEWAGE # ® ASSESSOR'S MAP &�L T VILLAGE -_'_— INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 bo jr LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER •PERMIT DATE: 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet leac fac' ' ) s Furnished by .. M .I it y V z0' ZIP e� , ' �`' ° Z 3 �y ' d ' q� yql \` .� TOWN (�OFBARNSTABLE LOCATION 77/ r "l�T Yx SEWAG0,7g ! VILLAGE t� ic�C ASSESSOR'S MAP & LT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I GbQ LEACHING FACILITY: (type) (size) _ NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: ct 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 feetA leac fac li Feet Furnished by O L0 i ZJ 7/-7 � 3 3q ` v6 1 yL `� Town of 13arnstable P# D j-� ✓ DeparOucnt of health,Safety,and Environmental Set-vices �THE 1 Public Health Division Date (a- Si 367 Main Street,I lyannis MA 02601 BARNBTABM MAS& "rF16yg. Date Scheduled it ! / ®3 Time_ Fee Pd. \bCD, Soil Suitability Assessment for Sewage Disposal �� d S ' 54c Ala �S Performed By: t a�-C-� Witnessed By: - LOCATION & GENERAL INFORMATION Location Address GGrv\Sk1t1\ (ou Owner's Name Address 1 Assessor's Map/Parcel: M,P UO(G PLC 5L' Engineer's Name NEW CONSTRUCTION REPAIR Telephone H Land Use Slopes(%) Q / Surface Stones Distances from: Open Water Body it Possible Wet Area Il Drinking Water Well (t Drainage Way R Property Line ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) Parent material(geologic) a fWIt S'It Depth to Bedrock Depth to Groundwater: Standing Water in I lole: Weeping from Pit Face Estimated Seasonal Fligh Groundwater yy�� ,�� 1)ETLftrrllltiTAT10i�1 r V 1 SEAS0N i7 AL, WATER TABLE Method Used: _ Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment R. Index Well N Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Bale X a Thitc Observation lole 0 Time at 9" Depth of Pere G Time at 6" Start Pre-soak Time G / Z Time(9"-6") End Pre-soak / 9 Rate Min./Inch Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public health Division Observation Hole Data To Be Completed on Back Copy: Applicant DEEP OBSERVATION HOLE LOG Ilole # Depth From Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,lloulderes. Consistency,° I , oLow »� /oY2 '/a- L m• .,.7 -5',* / s'� .3G- 7z C S.o y loy,� ��5,. 72 -r 2..v CZ S /oT2 z�y 'Vo G�...ol.../lr. DEEP OBSERVATION HOLE LOG Hole# _— Depth from Soil I lorizon I Soil I exture Soil Color Soil Other Surface(in.) (USDA) (ti9rmsell) Mottling, (Slruclure,Stones,Boulderes. Consistency,° Gravel) 6 --2 6 4..a... ea A f S 7� 72-/za, C ' b 7/ s /aYA 41, 4e r ac�c✓t DEEP OBSERVATION HOLE LOG Hole # Depth From Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA; (Munsell) Mottling (Structure,Stones,Iloulderes. Consistency.°°Gravel) i i I DEEP OBSERVATION HOLE LOG Hole # Depth from Soil I lorizon Soil TCxlUre Soil Color Soil Other Surface(in.) (USDA)J: (Munsell) Mottling (Structure,Stones,lloulderes. Consistent ° ravel I I ` Flood Insurance Rate Man: hw e •00 year flood bcund;ry I it 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? Ye-S If not, What is the depth of naturally occurring pervious material? Certification I certify that on 'y gt— (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent With the required training, expertise and experience described in 310 CMR 15.017. Signature .� . Date ����710 ]641rz• r. A, DDT 26-51rz• 3'61rz' 7.812' �. 7/ C-0 V6 cc `7 m x (n 5Q- qq q Y b T � m 4 4 � = 1 a O �w 4 � r-A1 1rr y 4 :w a �za 2'o ` b U A ]6d In'— N N O O D D Project: Lagadinos Building and Design Inc. Z m Jevdet Addition Custom Homes,Additions, Remodeling 0 13 Thankful Lane Cotuit,MA 02635 508-428-4097 Fax 508428-7709 i M m _X (� C� o III ! '� �CD J 1 O O O N m o 0 D Q Project: Lagadinos Building and Design Inc. Jevdet Addition Custom Homes,Additions, Remodeling 0 13 Thankful Lane Cotuit,MA 02635 508-428-4097 Fax 508-428-7709 I MIN. II � tV q �5gps J�N 0 L p�71, T d I 144 o0 --- - U I I b i 0 - �� ' , 8 '0,- tc m - _ I I — jj �1'S 0 fp Q .�S R� V� (LL Z saal-I � ml-lol r AF P ;, l T -r _� cN $. i .Z n rn -- ------- — - C ! ...._..._ O Z. I? ,1.6. p Z n S VN- .. N I r _ - N n 7' _ o I 3I,J '-e SI-91 Z�d ZLO, I I I zl I I pZIE z� o O > I /` ! n,4 �)Zq P 1 dF A.21 V` m �$ O J vn� Ip� -a _ 8 D _ Ginj(It. QYOI ♦ry G19 ) p Zi 48x�.1t of T� l// 1 c = IIr'oA -IZ oil U 0 _ D N I I - I� 'v I S i � IQ F F T-o1 7I-o' l Eo. em, h s� c3 ' ".^''°°hA—d�he P,f�CH I—TECH A550CIPATE5 g additions and alterations to the np e.ey roeervee the ee yq M .. ^f these AraMrye eteeMlna to D JEVDET RESIDENCE the Athowtl. Wpb Copy.gIn Yrotect'on Act" of a r c h i t e c t u r a l design i n c. 71 CIAMSHEII COVE ROAD, COTUIT,', MA isso. Any �op�, elr�,.yo,�, e rop,aAucnen e,A.WG .V. of these plane Mthee6 the op e" .�.� mate" unemt of Amhl.rech 6 school street tel: 508.420.5335 v PLANS/SECTIONS m a Klm '°a^'^"'^p. cotult, ma 02635 fax: 508.420.5304 i oc66 GI�6• �Zr1 I I j cn A p I i Ii 0 II O I I -- -n j I om o_ m j1 —Di ---------- z i 1 O O I Z Z - n� I I z _ r L I _. r® . r- I I— � L Z+aSsC Iu1QG.- a r� ��-- n I II (2�ItJ4 r9 —HCK. (CGr1 C6Lo1-1) I 1 I I MIN. I I -- 1 r $ 4 lIt '5 'i 77 m u y 1 m 1 0 m O ------- J J -� — r � F p � � j qq S x II n z •;� a a i I elI_j .. I II II n m q < �--- I I I A 11 iI p II II ZIt- I I I I rr I I tl-off tI v\ I I I I 2 m Arp utjhAa.adawa.lna horobtf A 1�C H I-TECH A5 50C I ATE 5 additions and alterations to the °°p'°°'" °°°"°°`"°wpp ghc a1 chaaa drawinga acwrdhy w JEVDET RESIDENCE •'" "'w`w'°' Capyrlghc Pwwogon �v of architectural design, Inc. D 71 CLAMSHELL COVE ROAD, COTUIT, MA 1990. My wpy. alwra lm rap"w'von or dlatrl6urron of °"°°°a•^•"'"°°°µ°�'°°• 6 school street tel: 508.420.5335 o thou wnaws of A c frdf h n ELEVATIONS/FRAMING PLAN A.—I s :°k�.'°'^'"`"� cotult, ma 02635 fax: 508.420.5304 SYSTEM PROFILE TOP OF NOT TO SCALE FOUNDATION FINISH GRADE t EL. 74.0 EL. 73.7 FINISH GRADE OVER iFINISH GRADE OVER SEPTIC TANK 73.3 DISTRIBUTION BOX 72.9 FINISH GDE OVER TRENCHES 72.5 !_�=b :,_ :,A RISERS TO 6" _�/ •,_�, :,Q a OFFINI HGAADE , r PRECAST CONCRETE 500 GALLON DRYWELLS 3„MIN. RISERS TO 6" MIN SLOPE I% OF FINISH GRADE - OUTLET PIPE(S) LEVEL H-10 REINFORCED LOADING w 13' o FOR 21( MIN. SLOPE TRENCH LENGTH = 25'-0"6 MIN.SLOPE 1/o ° BEYOND (� DRYWELL LENGTH = 8-6 _ o o' Z. HOUSE MIN. . r n •,��. 13 MIN. f7 r O:r q o v �\ 69.75 0• MIN. r 6"SUMP �,-' � p °� PVC OR CASTIItONTEES :<y 69.50 =69. -z: ., 0,o:r 69.23 �a� .'.° +• �. .r ,o r y :,_ ., o' • 70.27 / r `, r - r OT..�p• n ---�/ � __ t 'r p: O A � '�b0 ADDITION �_ GAS BAFFLE ,�; � �; ,fib�-�'"_ �b°,.'�'•,`v ro ',;, � b �a r �t` ° � . ;2 DISTRIBUTION BOX168.931 ; � 'o' : .::. a 1500 GALLON W '' " 3/4"- 1-1/2" DOUBLE MINIMUM INSIDE DIMENSION 12 ` `A OUTI _T INVERTS 2" BELOW INLET INVERT WASHED CRUSHED 3/4"- 1-1/2"DOUBLE 4 In PRECAST CONCRETE '4 MINIL�UM CONCRETE WALL THICKNESS 2" WASHED CRUSHED ` i, IN; CALL ON COMPACTED LEVEL BASE STONE STONE H-10 REINFORCED ECD _ TRENCH SECTION w,.r �,r. :r O a r`r.•—'ro,. � �' +'^or �0' °'' r'� r 0011 '•i -,0 r r°�.P,:i SEPTIC TANK NOTE: EXCAVATE TO =C= STRATUM IN ORDER TO INSTALL ON COMPACTED LEVEL BASE r �` .' " �o REMOVE ALL =A= & =B= IMPERVIOUS MATERIAL . e" WITHIN 5' OF THE SAS. REPLACE WITH CLEAN, 9" MIN. 3"OF 1/8"- 1/2" 1 _ CLAY-FREE SAND 4" DIAM. 36" MAX. DOUBLE WASHED PEASTONE ublk r r y 1 r � UMin{ ,!Cotait ° 1 '°'':'4 DOUBLE WA ;:.Ike ° °" � • `•'a� 48" 5'-2" ., STONED CRUSHED r K: e aTRENCH WIDTH v Y, r NUMBER OF TRENCHES 1 /. NUMBER OF DRYWELLS 2 / GENERAL NOTES: OBSERVATION PIT 1 E-LEVATIONS SHOWN ARE BASED 014-ASSUkAEG —- Z1`ALL PIPES IN THE SYSTEM MUST BE CAST IRON iOR SCHEDULE 40 PVC. PERCOLATION RATE: < 2 MINJIN 3 HEALTH AGENT/CAPE & ISLANDS ENGINEERING WITNESSED BY: SAM WHITE MUST BE NOTIFIED WHEN CONSTRUCTION IS BARNSTABLE BOARD OF HEALTH do �,.d,,,,,.�w„ 1,.� �eQ r.�/ z %8 COMPLETE PRIOR TO BACKFILLING. #1 #2 DATE' NOV.17,2003 •-------_______..___ w__________ 4 ANY CHANGES IN THIS PLAN MUST BE APPROVED DESIGN DATA CLAMSHELL COVE ROAD , � � co \ $Y CAPE & ISLANDS ENGINEERING AND THE BOARD o C��.8) IOF HEALTH. =A= LOAM 5;MATERIALS AND INSTALLATION SHALL BE IN 10 YR 2/2 1 � !COMPLIANCE WITH THE STATE SANITARY CODE s" 6" NUMBER OF BEDROOMS 3 j� NOTE: THERE ARE NO POTABLE `[TITLE V]AND LOCAL APPLICABLE RULES AND GARBAGE DISPOSAL NO WELLS WITHIN 200'OF THE REGULATIONS. =B= LOAMY SAND DAILY FLOW 330 GPD. PROPOSED SAS 6, NORTH ARROW IS FROM RECORD PLANS AND IS 10YR 5/6 SEPTIC TANK REQUIRED 1500 GAL. \ NOT INTENDEDFOR SOLAR ENERGY PURPOSES. 36" 36" SEPTIC TANK PROVIDED 1500 GAL. 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. LEACHING REQUIRED 330 GPD. / 8. FLOOD ZONE C [NON-HAZARD] C1_ MEDIUM SAND 10YR 7/4 SOIL ABSORPTION SYSTEM CALCULATIONS: \ 54' =C2= FINE SAND — — — / 22.30' ? �z" SIDEWALL AREA = 152 SF. / � ' 1OYR 7/4 152 SF. X .74 G/SF. = 112 GPD. 22.72 15.30' EXISTING DWELLING 1 s.70 ., ; ti 1stFLR.EL.75.0 o o� BOTTOM AREA= 329 SF. 11.10 "' NO GROUNDWATER 329 SF. X 0.74 G/SF. = 243 GPD. o 22.s4' 13.30' w 1s.90 � .GEND 120" 120" LEACHING PROVIDED = 355 GPD. ti _ 52 PROPOSED CONTOUR \\'' GAS— —GAS (_V J° °�� 20' SEPTIC UPGRADE & ADDITION \ J PROPOSED ---•52---• EXISTING CONTOUR \ o� ADDITION 26 ,� - PROPOSED SEWAGE DISPOSAL SYSTEM OBSERVATION PIT , PREPARED FOR / REMOVE ❑ DISTRIBUTION BOX ' i ri �i ;Q ►�; > / 20' s' cEssPooL � \ 2y,. MARY JEVDET -----� --- o o `:�z ;:::Jst+`� -� � HSE.NO. 71 CLAMSHELL COVE ROAD HSE,NO, � SEPTIC TANK LOT 2� --- -----, , ,t .� COTUIT,MASS. 21 48�'SF. RESER ' � SOIL ABSORPTION SYSTEM 8 !--# -------- PLAN NO. 111803 SCALE: AS NOTED ----- I #Z-_--- RESERVE RESERVE AREA a ��tH �F tirlssq� FILE N0. 162BA - DATE: NOV.18,2003 DAVIn SEPTIC FILE NO. 73 PCS FILE: damshe1171 / 15' 22.26 PIPE INVERT ELEVATION N s ARLEi 197.00' 28085 CAPE & ISLANDS ENGINEERING PLOT PLAN N74 5230E 6 CISTER ��/ 800 FALMOUTH ROAD, SUITE 301C SCALE: 1" = 30' MAP SEC PCL LOT HSE S AL LANQ`'� MASHPEE,MA 02649 (508)477-7272 ..