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HomeMy WebLinkAbout0088 EISENHOWER DRIVE - Health 88 Eisenhower Drive, Cotuit A= 039-102 Lotj33 TOWN OF BARNSTABLE LOCATION 4�IS,C N Yo u, 9.A- Q 2 SEWAGE# 2 3.s VII,LAGEC ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. R642>�-(Ll Nt P,12`3l�+!'AcrCyo��33 y-ba30 SEPTIC TANK CAPACITY S-®® d a L LEACHING FACILITY: (type) D(ZY tv (size) X ?3 v? e NO.OF BEDROOMS 3 BUILDER OR OWNER /'a c—99A S PERMIT DATE: 'a ' 9 COMPLIANCE DATE: �. Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility IVJA. Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) A.)-.10 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 fee f leaching facili /L /,0 Feet Furnished by o'1 .y 1- `v` ti THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH �PlVt 1 OF \ t� v v �p#Iiratinn for 3iiipn 1 19:ystrm Tomitrnrtiort Prrmit A plication is hereby made or a Permit to Installex or Repair/Replace ( ) an Individual Sewage Disposal System at: Luraliun-Address t or Lot No. Owner Address I�o le 617- 1,1 AK7 l,neeA(J -3/L `/ M Designer or Ins(aller Address Type of Building Size LoO ef), 06,0 Sq.feet Dwelling—No.of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No.of persons (/) Showers ( )—Cafeteria ( ) Other fixtures Design Flow S gallons per person per day.Calculated daily flow ?, (� gallons. Septic Tank—Liquid capacity LSO gallons Length`,; ' Width ��( " Diameter Depth ( " Disposal Trench—No. I Width '�(� ' Total Length-,-,) i Total leaching area { sq.ft. Seepage Pit No. Diameter Depth below inlet Total leaching area sq.ft. Other Distribution box ( Dosi?tg tank ( ) n Percolation Test Results Performed by Cn-A-e- �4, out ;,�A -Jr. Date X-61 Test Pit No. 1 Z minutes per inch Depth of Test Pit /?Z Depth to ground water Test Pit No.2 -i minutes per inch Depth of Test Pit It Ze'�> Depth to ground water. Description o Soil `'-Z`'--'C�if A.n-c L.,.�l"-1(.," �c y-tyl li ���r�c,.,5C1,,(_.0 v_ -(''�- mt_d C Nature of Repairs or Alterations—Answer when applicable Date Last Inspected Agreement:—The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by theJ4oard of Health. Signed ��� 1/7 Application Approved By le Application Disapproved for the following reasons: Date Permit No. Issued Date *3� /ADC• -- .i'1 1 , NO. THE COMMONWEALTH OF MASSACHUSETT.lS s. FEE (. BOARD OF. HEALTH) P. 0 F �haAA,64�, .Alipfiration for �i u tti item Cann trurtinn ermit A plication is hereby made o.r a Per it to Install �/) or Repair/Replace ( ) an Individual Sewage Disposal System at: Lucaliun-Address � �- or Lot No. Owner' Address !�o Irn T M A rL-T N e AU '3(1 3Q M ,r-,,r2.v /I. /av < r~!�_ r?, o t.�Py,y "•"" Designer or Inslaller Address Type of Building Size Lot. 6s ()<-30 Sq.feet Dwelling—No.of Bedrooms 3 Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No.of.persons (0 Showers ( )—Cafeteria ( ) Other fixtures -Design Flow 6 S gallons per person ver day.Calculated daily flow 3 s f°) gallons. Septic Tank-quid capacity gallons Length ' ' Width S' " Diameter Depth S �1 Disposal Trenc No. I Width 3� 2 Total Length a 51 Ibtal leaching area 1491sq.ft. Seepage Pit No. tDiameter Depth below inlet Total leaching area sq.ft. Other Distribution box (� Dosi g tank ( ) I Percolation Test Results Performed by Date (o P_ 96.19 Test Pit No. I Z minutes per inch depth of Test Pit Z " Depth to ground water Test Pit No.2 y minutes per inch Depth of Test Pit Zd" Depth to ground water Description of Soil 6"-2"^--'(5/ A.n4 C_ " jeaa�✓1 0"_- g' n alAtA4 alAtA4-S" "- L3 2"1 M40J 5a4a_ C. 6'1— " Q.Yti d"- �9 IO -"L 91 d 0,11- 12 O'I - CL - Nature of Repairs or Alterations-Answer when applicable f' Date Last Inspected Agreement:—The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued+theoar�df Health. Si nedgApplication Approved Byv a! D te.a. l Application Disapproved for the following reasons: Date Permit No. Issued `m Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � (�rrtifirtttr of(�nm,�tittnre -• �. THIS IS TO CERTIFY, That the-On-Site Sewage Disposal S stem'n'tall"ed or Repaired/Replaced g P �� ) . ( ) on by (,o/9I.rn.T M/� tiZi�+d�ig(I for at has been constructed in accordance with the provisions of T E 5 of The State Environmental Code as described in the application for Disposal System Construction Permit No. } �'"" 5, dated Use of this system is conditioned on compliance with the prj4dons set forth below: THE ISSUANCE OF-THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION AS DESIGNED. This Certificate expires on /{ Date DATE _ Inspector MT No.�� THE COMMONWEALTH OF MASSACHUSETTS FEE "at2fi&rBOARD OF HEALTH . +�il�,pn,s�i ��s#em.C�nn,�trnrtinn rrmit Permission is ereby granted to r- -y' )6A An-IA/'CAU m- $ s to ConstrV or Repair/Re lace ( an n-Site Sewage Disposals jsteploc d at j rcbt as described on the 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.. All construction must be completed within three years of the.date below. Board of Health / DATE - 7 FORM 1255 (REV.4/95) H&W HOBBS&WARREN TM PUBLISHERS - BOSTON 1 THIS FORM APPROVED BY THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION i SOIL EVALUATOR&PERCOLATION TEST FORMS �tM Page 1 of 4 Town of Barnstable 9B"NSTA Department of Health, Safety, and Environmental Services IAI Public Health Division ' ArEO MPS A 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 FAX: 508-775-3344 Soil Sultablllty Assessment for Sewage Dls,�osal yy. Date: ' P=� ' Performed By: f�I�'A hate: Witnessed By: - Location Address Owner's Name������� Lot# � Address,and Assessor's Map/Parcel: J 1 0 Z Telephone# NEW CONSTRUCTION REPAIR A Office Review Published Soil Survey Available: No Yes Year Published I q 4 3 Publication Scale t t 2r- ' Soil map unit 7-7 Drainage Class C, $ Soil Limitations Surficial Geological Report Available: No ✓ Yes Year Published Publication Scale Geologic Material(Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No X Yes Within 100 year flood boundary No X Yes Wetland Area: p�¢ National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month 4p" � Range: Above Normal b Z Normal Below Normal, Other References Reviewed: DEP APPROVED FORM-12/07/95 r" a FORM 11 - SOIL EVALUATOR FORM Page 2 of 4 (.,ovation Address or Lot No. L o'f 3,3 On-site Review Deep Hole Number Date: S'Z F- Time: Weather a Location (identify on site plan) Land Use /��s �f �: Slope (%) Surface Stones Vegetation 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 LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % p/ Gravel) Z " v o. 94..: 1 oYIt 7 7— - 14 4 04... y,2, 313 16 '1-Ti/�- a Lmy ryS*.el Tore -n ", , /32rr C .Ned. Sa.o( l� 72 .4 Z O _ Z '� 0 Ovfi4»i c 16YrZ V/ Lm4-«yS4w..a/ �vo C�v„ wtv MINIMUM OF 2 HOLES REQUIRED AT EVERY PKUFUb[:U VISPUbAl-AREA Parent Material(geologic) dv�wkf,( DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit face: Estimated Seasonal High Ground Water: Z ` r�7�, C7_ s DEP APPROVED FORI\1• 12/07/95 FORM I I - SOIL LVALUATOlt FORM Page 3 of 4 Location Address or Lot No. Lot- 33 Srn Aaw �nve. Determination for Seasonal High Water Table Method Used: ❑ 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? YQ s If not, what is the depth of naturally occurring pervious material? Certification I certify that on�j,�, / 9s. (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 2� Date s— z DEP APPROVED FORM-12/07/95 i FORM 12 - PERCOLATION TEST. - Page 4 of 4 Location Address or Lot No. 3 3 A5jse ow -r �h'N-1- COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test* Date: 6 Time:, Observation Hole # Depth of Perc Start Pre-soak o Z L End Pre-soak a 3 7 Time at 12" Time 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 Failed ❑ Site Passed ......................................................................................................................................_...._......-......._. Performed By: Witnessed By: 15e r r Comments: :.. ...........,::.. _�..:..,:..: DEP APPROVED FORM-12107/95 _ __ .»w.,�w�w,. .,._,.w.�.,,.x.:k..�.w�..._ __,xxw.,..,m,.,,rrwtir �.� �.,,...... �..w... ...._•..,� ..w... ... ��......, , ..�, .z .,.,, >.,..,,....�.....w.�..�..._. .,�.��_._rW ., ,�. .w- ,� ,... ,.�_,_x.,...,,...v.�u, .. ....... _b�.��...,.x,x.w..� .. . .a..,.�..,..�w.._......_�. ...«.,.�,.�.., .. �..�..'''���y TOP FAIr _ _ _ �°"J } vv"I a i�d� a.� OVER 0° FINISH:�.1�Je�'7H .�e�?.1 xd EL .__ .—.1rS J SPASE %'f F, <-' a•. Y'�C:,�t�' GR DLL' 0 VLei .A E 0 V TRENCHES E SEPTIC TANK D ,�T. �50 O •a;o 0 �`�G',yC t� �2,I r77tR���C'1 Y� 11CR'CTT71R't�TTni11'VTfT . '•:'�.'rt��' T` AAQ 1MAX. �''l .- c o,o:• Q °. .1. .o•.., • 1 .'.• ; .® •c••.•cT. ;v. .,,Qw .Y,...c'?'q•- .q.p •e. ♦•v .+'�•. '•L'1.•m .ip� `� OUTLET LEVEL i TOTAL LENS�{ OF Ore'TL E. s II T. MIN. p•C:O.e r cl 0 G' l P • f e , :oo�o ,� ✓. y. OP PVC TEES - Q t r�..� 4 •ro _,(y Sri BSMT FL . a°:o'o 500 i_ :.'lf o w..�". :o�-A �' � O EL W 9d .I NS TALL N L �"VEL BASE > :: . �/ � � ��s,/ ✓ � � �' a ' °'ob:o�4 'v•o:e? ► / ; r xi L' �s+'���t��,a J; •Q.v Q,p.C v ;;Q.„�. .y ,mil /` �*''� j� f� •eo:o.o.v,:bo•.b'd•CI'•+� 'G':ea :'a•e':n':q"s' •4,. v;o. e;�s..o.v . .p'o - .�,9 b.',D.•a.:e. �:o TIC TA AIK -c ON INS�TA L L ON L EVEL BA SE NOTE'�";;�-:' � �:CA VA ar'�a fk::s' ELEV. 1',14 OP RI- /ire J��..L .d MPO: ✓.4 iJ d..�.`.s� /Zi ` �\# f,�f K �` �%S�SC��7 7`MA ,r 'Bw'..�,a H T,, IE LEA�"%`.tr1Rd"�,.�' : 'a�f-A ef" Any 12" M_tN. R . -' .A w�... r R TERIAL )I f Tda uI -� t CLa:Ai' a,„,.�_,. ,.i .-V..., ',,: tn-; o°�i. ',v ,.ti? -,�a<;, ?. g� •G�6� �.*�1s .. ,, 1_ rOF 1e�3 YI_jay�' - i ,d a. . z tide° lf1"ti J!`,�t;Ll ,r�'�L.A:3 TONE �y /, �er. � -- J +�,✓� YY .��....�.�iG, e� ��A wi"J�y L a,.# :;, �4 ..� "'� { i,:�p, LI�"'IfiJ�'d'�'s°L tJf Td✓i 4"-« .�.�•''0 , \ 4� '� ., 1 -- '25.00 _ Y .,. 1. A '` L EL .-VA T.�'`ON '`�,f-5 N ,��._ ''�j py :VlJr`YFa�r. t'J," a .� , `.Y'. d. x3'$'a�7 d+ �L�e / J V�JELJ � l J- +r�r #_ .+°,.�/a..8� Y�'�t1�:Y T t�� LAST .1°'R©l'Y ilk �� � ..__....__,__ � �. �L L ,�.�'PIPES �6 N / NUNf.O��� O� �,a Y;�'L�. .�`. J:�F.� �BO�COL ��rt�. J h i s�.�,E)V CONS TI��.I'C ?. �t`J I CJ O IPL TL PRIORP—j x�d 70 ' i r LIN. 1c:IE "�Gi OL .I: * ON r�'A TES # �• moo. ti 3 '`' ANY �'hi4N+iE. .�14 THIS PLAN MiN l,/'T LSE APB='� Ob/E£� <2 M'N. /TN. �. 3Y THE BOAR-9 t7�" H.AL TH 4j'V� CAPE L% ISLANDS dOL"TN,�..��S D :BY.' `t- --� SUP, Vs�;'�«t N L19. 1 'o�a�, a art 0 4 L, AYAi I' L' T '+ Yr SHALL ea,A r i_J*. '!' � ��a�. .w N t ry �. .. x„.., _ — ply 3 f-1 s c� „ � N C.+for°� ~l..1 I"6 NCJ��. •�',d ,Y's THE I�� �s�"4 /�4 i �J:� HEAL 8�J � t� r'P d ti � L�.w/ .i�,�.. �� y �Ov 3 � _O `�` '� in t`Jq •y �,.ua aw.. .t TL rat �.�' a.�w/,JA t �i PPL.lam" / I�3L i y� r�J= N RULLY43 A4J YiJ r .r a a` N... - - t✓'✓ -- t� 16. Y2. O O ... 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"� 112 L^71R�L7. �y 0. , ' tiA -,. ,,•.f BOTTOM Y�l;'=x'EA .��'� S.F. 125.00 ' (�J7 w 1 g'47'35" __..,_.,_.,—_____..._ rva, c>..., ,•' $=- S. F. h O,/;`�•. F. �' �•f�9S S g-y /3 2" Gas! L EA CH.ihd'E�+ PRO V1,,0ED a PPPC PL" L� a L«.. the '.%.ON OB;<L P VA T.1�':N PIT C9 D [ -T&UTION BOX � 7eA-1 d �' r� r "': n ° �w° :. a' _. x.w ...e'. . L. a w. d ✓ L..Y d m.r " h RED FOi:? TANK ���.�� D'"YL w.�'�`r°:P�VL /i{e�'"i a..� i ,. •• �J � ,.,,. ,.... ..•. .. ....��'��. ... A' ,. V a�..� '�.¢_ ��.y,IA ^ro w PIPZ �f'9YT a..LLI/iT1®N g� ,y;• '• PL .JT P�fAl �+ i flti'�\+' d ''✓ _� �..�. CA E icy .,s7�3+.,•-^,AIoJs� d� e ►.!VALE. .� �-- U _ [ .-J ' A �' `.l .+. ,..+r_:# , .F.,.._tf :a../ / i' a . �'��� y } A.. �.... r �'�" �1'./Y^i� r`7yv�.d ! E 2E it/ - ' :a I'"° .....+.I.t 1•;� ard"q,,,gn,�s - yr d J...Y I.. 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OR P✓C TEES n. v 41500 L s.�!V BSM T FL . o o ;. ^� EL . 7 - 7 :!o Q.°' p4 s r'Ti+%.:._ __ .•r _ 50 0 GA L L ON V Qb f Al 0 CZ D �: bQ D• ��•4v:aa�.d•�:,`�'.ap'ia:�•'b':o-,i.-•�'�'B':a':ROr'��'••Q` •o.'�'�:�"O ��°.4'X�': ••v:r:4••o.v . .o•o•. •v,o• °.•n::a. D•�rr,oL1. .'.4.2' .,p�.0. , EP T C TANK INSTALL ON LEVEL BASE" . .)'CA VA TE TO EL E"V. '`' OR ":� REi�9OVE ALL ird r�' r v'?OUS BENEA TH THE -Esc CHIN&•" AREA { 12" MIN. 'CA YA TEL RA TER AL WT TH OF l/B"—1/2,. Lo l-f o-- is L A Y F�`•)EE SAND MASHED PEA STONE 9 314" — .4--.112," MA SHED y,. '7 CRUSHED STONE EIS ENHOWER ORI V E '� ----- �''.,��—__ 47'3 5"5 TRENCH Y10 TH 10,5.00 2. ALL E'.tL�''VAT�N 7' I�HO�/"� � � L D C.. ASSUMED NUAISER OF TRENCHES __- - . ,�� BE . AST IRON N OF r,'ELLS 2 MB N b!� OR S,CHED44=" 40 C" ^- -. THE BOA� � :AL T s fi _ _ D S -,3Su hX,HEN "`oMpL E T Ir "n 1COL A T.ION :RA TE. <' /.N. 4. ANY E`. IN II-�'.i"+ IJ.r� � �' <a` . ,. '. , ,0 �' MIN. ,t 3 — Ti-,, IaW 3 � Y."TNESSL:D B`Y �1 ,l T . .inn: �i" �AL P'"� ..'�1�1s.rp �i�,^�Lw+ rA.a.:.s4&.��i�:� k 3 5 P o c ..J U :Of c r " ',,-S AND "NS"IA L LA TION BHA L L IN R O ,�F TH ,' Z1'-� G°,., ,:"E !a T'`/ THE STATE SAd41TARy a .'TL E� V -- D ,� r r �" iJA T.7 - - � `•' ,,., �.� , � '" ' AND �0�.,,�.� APf='L IC�sB`:., I-- �-- 1 �, -_ r AND s�d '`:•.'"e .�., �s��'�. ''•'�.,, .�� � ./ '''I _ ____. ___ M L7. N R IraN fc,d"a ,i. ryPL A 1�S Ni \L�'�" r v r Q c 1 Y`.'. t l.;`s 1.}V, 't! _ N a..7 r T •T�Y r y...: ^.,.,.r:;, L r.l k,.�&., e^7 r PURPOSES e.? G C rti, i O F ti w !` 4. ----i� �.d�2 O M J IS �i d t t ' t>YR ��-- �'�' llA/ /7L r _ .,.�i ��v.7P� P5L /YL1 / . a�"s..,DO / t�"e U'.«_ �; : n_. l R� ..f _° �- A"ci-�---—- /G O A ww i v" M DA.1.L I FL Lo �.J� G/`i L . I I.G°A YT. _ L \\� B. 3wA d��- SL�PPL '.�' _._ Tyr .��N,-1 I"' � ��G J N � SEP T.� u �'B�,NK r��_-G '.D w G�4 L . � S P T."A' TANK P,RO 1 ID,LQ 1 50 2 GAL . /a y 1 L t=A CHINK f'aE O€./II'fa...0 __-1, 0 GPD. 1 � oT 2 3 o SIDEMALL kq A .Lf- a. F. S. --2-24 wg/2a. F. P GPD. +n. >. BOTTOM. At.+C "s =} r'—?.F. ++�� Q_i, . � � � A - /' —� •-- % wJG.� S. F. /4,._..... ��' P.,�.F• .� C�� L7t�D sEAC .c Nv t� , GPD PRt:*3GS4,7D r :V T /O .� i7c: �' S:X r:J TNL7° uYL,✓d'�` r 's .`^s/f�r .1. /"a 9 .w`. ...». -..� / .. ' ! q * I.X d� +k.. >` z "° TR,IBU:r. ON BOX .� ,.,..,,_ .�. �.�•. SEPTIC TANK �'�= � .e, e ,., , . r u ,d.� _ _ L T ...��o° . B/E-�? ► PI VE LEA r� PIPZ .LNVLRT ELEVATION �r,• .°. �.� .- �. . PLOT PLAN CAP 5LAND,5 ,�1V .WEEPING a--- ``' s},�frrsrF��� .SCALE AS NOTED �',��' F'�L,+�Ua,+';�'� ROAD — .�U.1"T� 2E SCALE.• 1 A- .� o 1 y i <_ G_: , , — —.,,� _, € -�� �� _ � r PLAN NO._7oz,-4- �°, 14�, ,.,, . _ .__ , ,.�_ �.. _� r