HomeMy WebLinkAbout0100 CLAMSHELL POINT LANE - Health uu C7amshell Yoint Lane, C otuit
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's Neck Rd. , -Got -•
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No. 4210 1/3
1palmd MODON
ESSELTE
10%
A
TOWN OF BARNSTABLE
Lb-CATION SEWAGE # Ie
�7'
VILLAGE ASSESSOR'S MAP &LOT _ (-o
INSTALLER'S NAME&PHONE NO. 4 ttA/
SEPTIC TANK CAPACITY
ACIiING FACILITY: (type)
IE
b �J (size)
r
NO'IQF BEDROOMS
R OWNER /�✓Pt� C i�.+
/7 —//1 PEIZIviTTDATE:
" � COMPLIANCE DATE: ZLrl0
�4 7
i Segation Distance Between the: !
IviWiiium Adjusted Groundwater Table and Bottom of Leaching Facility
Feet
pnvate Water Supply Well and Leaching Facility (If any wells exist Feet
:ot to or within 200 feet of leaching facility)
e:.of Wetland and Leaching Facility(If any wetlands existI'dg Feet
thin 300 feet of leaching facility)
Furl shed by
n� 4
0
a No. �� r: ? Fee /160
THE COMMONWEAL4DF MASSACHUSETTS Entered in computer:
f 8 17 Yes
�UBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
Application for Migpozat *pztem Con6tructton Verna
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. �-�j?1SHFL/ l�O/ T Owner's Name,Address and Tel.N
cV rug T- �- �. ���-�
Assessor's Ma > /") c
Map/Parcel
p .6 P,0, 60e cd/-I<P&�F loW� 0021)
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel No.
Type of Building:
Dwelling No.of Bedrooms ,� Lot Size, sq. ft. Garbage Grinder(Af
Other Type of Building ;?6�i 66"W'///1, No.of Persons R Showers( ) Cafeteria( )
Other Fixtures
Design Flow .3`a gallons per day. Calculated daily flow U gallons.
Plan Date Number of sheets Revision Date >/ .S 9 6
Title SkiF c3�Gc�A�E ESi3Plts/7•C (/�� '' ® f o'2.3C- 7
Size of Septic Tank 11aW —Ty pe of S.A.S._'3—,s-06 6?,WZaAJ
/'' t r /r 11, (%
Description of Soil 6 _ -,9 ,EJ96:r ILYV 5w)- /2, —.3e
lif A 010/1�1 5-A10 z`Z C,) '- 31
—7 6 -"/,off' �� � /U"" "'y
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore desc ibed on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code a to p e tem ' o er ion until a Certifi-
cate of Compliance has been issued b this Board of Health. /��� 7
Signed Date
Application Approved by Date — 7
Application Disapproved for We folio ing reasons
Permit No. Y 7 •- V Q_/ Date Issued
_ 7.
o �'�, Fee l/o
+ Y Entered in computer: .
THE COMMONWEALTH OF MASSACHUSETTS
fS77fj ` , , Yes
U / vPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS
4
. ricativri for Migpogar *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components
Location Address or Lot No. C-% SX Z O/k1 T1 Owner's Name,Address and Tel.N
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel No.
t
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(A9
Other Type of Building RES'/ No. of Persons $ Showers( ) Cafeteria( )
Other Fixtures 3
Design Flow gallons per day,. Calculated daily flow ;S�S/4 gallons.
Plan Date / 97 Number of sheets •/Revision Date >/ 9
Title F eW o O �2 3`F 57
Size of Septic Tank ���0 Type of S.A.S.3d f
Ile r
Description of Soil b ,eafw /, ,% —dad
Nature of Repairs or Alterations(Answer when applicable)
i
� I
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 a not t p� a em ' o er ' n until a Certi f y
cate of Compliance has been issued this Board of H th. � /
Signed Date �•� q
Application Approved by Date
Application Disapproved for Ye following reasons
Permit No. 7 7 Llr Q_ Date Issued
———————————————————————————————-———————
THE COMMONWEALTH OF MASSACHUSETTS '
BARNSTABLE, MASSACHUSETTS ,
Certificate of Compliance
THIS IS TO C - ,thaythe�0n-sit Sew _ I)isposal,Frystem Constructed(�jr)Repaired( )Upgraded( )
Abandoned( )by
at D C) has been constructed in accordance
with the �isi ns/�jf T'tle(5 and the ° Disposal System Construction Permit No. - d1. dated _
Installer�7C�u c!r/® �D tr / b A nsc; f S Designer`. �S�A f- cJ C<Cr 5 `
The issuance of this permit shall not be constr ed as a guarantee that the system wil .unction as designed.
Date �- �j 2/e Inspector
..... .:. mot..-...�T.ly-
--------------------------------------- ..
No. 7 ^ L i Fee O
r.".
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS
lwig;pogar *pgtem Congtruction Permit
Permission is hereby granted to Construct(x)Repair( )Upgrade( )Abandon( )
System located at 16
s
+ and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be14t;�4
ppllehin three years of the date of t ''s e
Date: -r Approved by -
TOWN OF BARNSTABLE (/
LOCATION C'IAMS'! // 41 SAAGE #
VILLAGE C ASSESSOfR'S MAP & LOT CC o 00
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO,OF BEDROOMS
6 _11ADER-OR OWNER As ?_( C'g�. :5 .�►-
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
r
1 i �,►��
t
Q
SOIL EVALUATOR&PERCOLATION TEST FORMS
Page 1 of 4
Town of Barnstable
■AMSTABM ' Department of Health,Safety, and Environmental Services
MAS&
.�� Public,Health Division
QED MA'I
367 Main Street,Hyannis MA 02601
Office: 508-790-6265
FAX: 508-775-3344
soil Sultablllty Assessment for Sewage Dlsposal
NO. Date:q- . (o
Performed By: Coc Q jam Date:
Witnessed By: 'CQ yjGc.nl rC-�
Location Address Owner's Name
00ClaW'Sk4II ?° DID
Lot#: Address,and
Assessor's Map/Parcel: �G' ( , Telephone#
NEW CONSTRUCTION ✓ REPAIR
Office Review
Published Soil Survey Available: No Yes Y �.� ��
Year Published 1113 Publication Scale /; 23-a °Soil map unit
Drainage Class Soil Limitations
Surficial Geological Report Available: No j.— Yes
Year Published Publication Scale
Geologic Material(Map Unit).
Landform 40 -P 14
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500'year boundary No Yes
Within 100 year flood boundary No Yes
Wetland Area:
National Wetland Inventory Map(map unit)
Wetlands Conservancy Program Map(map unit)
Current Water Resource Conditions(USGS): Month
Range: Above Normal Normal Below Normal
Other References Reviewed:
DEP APPROVED FORM-12/07/95
FORM 11 - SOIL E'VAIXATOR TORN,
Page 2 of 4
Location Address or Lot No. Its C ra4k,-[� �bvN �' La - .
On-site Review
Deep Hole Number Z Date: `�` 1 01- 9G Time: - / o S, Weather Su a k Z
Location (identify on. site plan) -.
Land Use Slope M Surface Stones
Vegetation: 4-
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet .Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOGO
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, %
Gravel)
p 3 q C. rS.y, c ) I
3.. /Z IVLe4 sN&r y_Ot
l t _ 3` C3 Loa..Y 4 s� Y
/1Co N✓'��Ow
3 off . /G'cr L'' C. s 41
73 j-1 s slG
OOV
d L,r .�, d ✓
Parent Material(geologic) W•s C4,V V e.01 DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: __...
Estimated Seasonal High Ground Water: -
DEP APPROVED FORM•12/07/9S
FORM 11 - Soil. (VALUATOR FORM
. J
Page 3 or 4
Location Address or Lot No.
Determination for Seasonal High Water Table
Method Used:
7 o p o ivC7, vp
❑ Depth observed standing in observation hole .. inches
❑ Depth weeping from side of observation hole .. inches
❑ Depth to soil mottles inches
❑ Ground water adjustment ... .... feet
Index Well Number .. Reading Date ......... _. Index well level
Adjustment factor Adjusted ground water level
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? -o
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on _7 tV � 1 G (date) I have passe the soil evaluator examination
approved by the i�eparianeni�f cr,v�i viirr u tal^r: ect►�� srid t".�.the abo•.n aria.,r:s
was performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017.
Signature � -*� ' Date ° F
DEP,APPROVED FORM- 12/07/95
FORM 12 -PERCOLATION TEST
Page 4 of 4
Location Address or Lot No.
COM
MONWEALTH OF MASSACHUSETTS
Massachusetts
Percolation Test*
g Time:,
Date: n G
Observation Hole Z
Depth of Perc G O
Start Pre-soak ! ; d l-------------------
End Pre-soak
Time at 12"
Time at 9"
-------------
Time at 6"
Time (9"-6")
Rate Min./Inch -
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
( ❑
Site Passed � Site Failed .............................._._......_......._
.........................................................................................
Performed By:
Witnessed By:
Comments: _. ... ....................._..._.................
..... ...... ................... ......... .... .
DEP APPROVED FORM-12107195 -
m 1 1
24.8 26.2 -
` 27.2
.oQ.3 boo'S I i ! S 69'44 '00"E
I i rye I bl % TOWN MAP 6 PARCEL 1
I - ' I I u /o ' �� LOT 12
HOUSE NO. 100 CL A MSHEL L POINT LANE
TOPOGRAPHY BASED ON NG VD
U
goo
N
b�
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i
J� All
2 4
goo
iti I yC
134.4
1 2t. J N 9B.t W
bob r" a N I `° a� u , m i •o z
dL_ i - 91.7 m
,v 10,
L a
°b i b
•YL V ��� �� '3 9
cb 39.7
IO
2.
Boa
voa I N v 36.5
1 313 vn �� ! kA
ll� � cl
dock
9 N40.5
C dock
roo°' � 314 m
f O 27.2
I t02.7
I_ _ r V) I 99.6
6.5 1 1 0
26 bob 1"9
Boa
,li ► ,� 36.3 r
00 W
6.7
bob I --
t9
SITE G SEWAGE DISPOSAL PLAN
L OCA TED IN
-_ BARNS TABLE - COTUI T - MASS.
►,r
PREPARED FOR
DAWF
x CHA EL IZABETH D ,
ANGEL O
.Y il(J11!,.1 iA
f` ►
N SCALE.' 1 "_ 20 F T. PLAN NO. 012397
DATE., JA N. 23, 1997 ( FILE NO. 1573A
DRA WN 3 Y.' DCS D-61 12C
20 1510 5 0 20 40 60
CAPE O ISLANDS ENGINEERING
SCALE IN FEET `� 4 133 FALMOUTH PD. SUITE 2E
MA SHPEE — MASS.
NOT TO ,SCALE
TOP FNDN. �, „ 7" FINISH GRADE OVER FINISH GRADE
FINISH GRADE A'- FINISH GRADE OVER DI S T. BOX o- �, OVER TRENCHES -3 �' • d
.;.o SEPTIC TANK �Q,o
o i•
o..o.p�
12" MAX. �R�tITTI,zRT'T9 '177Rgf�'
c . v: •
�•'•Q• �..••1e :'b•. .00•;G•••?1ti0.•::Q.e��•0.°'.v'•%AP.Io+bWp�•.'••. � .A'ti•O.•w�db
0. 46 TOTAL LENGTH OF TRENCH j %z
o.'o:P• 0 d OUTLET PIPE LEVEL
0,1 d a FOR 2 FT. MIN. -
0.000 - .p •Y � � a• .,•• A. .wp •: •' .D •o ';d• :6- a io b6r,°p�+•+
AD 6M 9r0
O
e �'0 Z'T O 0 11� 4': :n•:ora:. :b'....ey.: ag
C e
°db°•: C. I. OR PVC TEES :° z�•�6 � �7 ��_-o
,eobDo ; o
.pD.Ovp. �• r,e
.1500 GALLON D.I'S TR. ' T.l'O BOAC � �
BSMT FL .
EL . 3 o- �e' .° a 9' INSTALL ON LEVEL BASE
•`°•�� PRECAST CONCRETE ° 500 GALLON DR YIVE'L L S
b H-10 REINFORCED
t. )a'a is d,:do•.a p-d'•b'D::b.b.:tir,p•:o•Q Yp v�:v;a•p...."•'•e:o"X.i°.
•i . i..p,o •p. .pr° .V.•s:.w. .�• ,.LOb ';4•Y .P:
SEPTIC TANK TRENCH SEC TION
1 S oo INSTALL ON LEVEL BASE NOTE.' . EXCA VA TE TO ELEV. OR
LOWER TO REMOVE ALL IMPERVIOUS
MA TERIAL BENEA TH THE LEACHING AREA 4. DIAM. 12" MIN.
REPLACE EXCA VA TED MA TERIAL Yl TH 3" OF 1/8"-1/2"
CLEAN, CLAY FREE SAND o'� �: . o°o' e'c;o,':o;A �-}?
E
eq , q• •o HASHED PEA STON
3140 _ 1_112" WASHED �, � �� �.•
CRUSHED STONE =�$
y• �_, Z ., is „
,2 , z „
GENERA A L NO TES TRENCH WIDTH
1. ALL EL EVA TIONS SHOWN ARE BASED ON NG VD
2. ALL PIPES IN THE SYSTEM MUST BE CAST IRON NUM_BEF7 9_EZEZENCH_ES_.-1—----
OF DR L S 3
OR SCHEDULE 40 PVC. OBSER VA TION PIT NUMBER .
3. THE BOARD OF HEAL TH MUST BE NOTIFIED
WHEN CONSTRUCTION IS COMPLETE PRIOR P-8770
TO BA CKFIL L ING PERCOLATION RA TE.'
4. ANY CHANGE:' IN THISPLAN MUST BE APPROVED <2 MIN./IN.
BY THE BOARD 07 HEALTH AND CAPE 6 ISLANDS WITNESSED BY.'
SURVEYING CO., INC. EDWARD BARPY
S. MA TERIAL S AND INS TA LEA TION SHALL B�' IN BARNS. BRD. OF HEALTH DESIGN DA TA
SITE G SEWAGE DISPOSAL PLAN COMPLIANCE WI TH THE S TA TE SANITARY
CODE - TITLE V .- AND LOCAL APPLICABLE DATE: SEPT.. 10 1996
L OCA TED IN RULES AND REGULATIONS
z Q o 4
NUMBER OF BEDROOMS
6. NORTH ARROk' IS FRO, RECORD PLANS AND ;, t Lam. y , �,, ,uyQ. 3/, 3" C L pg y J4„C+ GARBAGE DISPOSAL NO
BA RNS TA BL E — CO TU.I T — l�IA SS. IS NOT TO BE U.�ED FOR SOLAR PURPOSES
PREPARED FOR 7. FLOOD HAZARD ZONE C (NOIV—HAZARD) �o��y s���+ ,° ,2 5�� � �°° �,� �a„,, ,DAILY FL Oh/ 440 GAL .
8. WA TER SUPPL Y TO6IN YA TER , �L•• ; ,SEPTIC TANK RED 'D. 1500 GAL .
EL TZABETH DA NGEL O c SEPTIC TANK PROVIDED 1500 GAL .
SCALE: 1 "= 20 FT. PLAN NO. 012397 N1«+, h ,,�
LEA CHING REGUIRED 440 GPD.
DA TE.' JAN. 23, 1997 —FILE NO. 1573A
DRA WN BY* DCS D-51 12C
SIDENALL AREA 186 S.F.
CAPE 6 ISL A NOS ENGINEERING
186 S.F.X 0. 74 ,C;/S.F. — 137 GPD.
133 FA L MOU TH RD. SUITE 2E ;, „ „° N r .4411
BOTTOM AREA 7 S.F.
326
LEGEND / ` e,3 LEACHING PROV G/S.F. — 32 GPD
MA SHPEE MASS. z '"° �''~�'w'`� IDED GPD
b
--�- PROPOSED EL EVA TION
—— —— EXIS TING CONTOUR SINGLE FA MI L Y RESIDENCE �i
OBSER VA TION PI T
® DISTRIBUTION BOX
r ; PROPOSED SEXA GE DISPOSAL SYSTEM
i PREPARED FOR
0-0-1 SEPTIC TANK DICK BA IRD
HSE. 100 (LOT 12) CL A MSHEL L POINT LANE
RESERVE AREA
,r BA RNS TA BL E — CO TUI T — MASS.
w •
PIPE INVERT EL EVA TION
DA TE: ;
CAPE 6 ISLANDS ENGINEERING �g 8
PLOT PLAN ��� �� r �,. r � : ,
£{ r,s SCALE AS NO 133 FALMOUTH ROAD — SUITE 2E
SCALE.• 1
MAP SEC PCL LOT H5'E' f~�-°°w° ° ' PLAN NO. <s//0 5'r� E.
MASS MASHPE