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HomeMy WebLinkAbout0091 FOREST HILLS ROAD - Health `91 Forest Hills Road Cotuit4 __ _ A _ '025 007010 OP 3/0110 4. 1A. ' TOWN OF`BARNSTABLE / LOCATION s Igrt'-�VW-AsV-%- b V t c SEWAGE # 2006- q Sip VILLAGE C� -� ASSESS �ASSESSOR'S MAP & LOTO01() ME INSTALLER'S NA &PHONE NO. f'Zahe Ctk-sO�-. SEPTIC TANK CAPACFTY ll VC)c-) �n LEACHING FACILITY: (typed 5wco C►ou (L" n (size) NO. OF BEDROOMS_._ BUILDER OR OWNER ✓J PERMTTDATE: 7-Z�Z lJ COMPLIANCE DATE: r/1 O 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 260 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Y ` pr r I 4d n No. �►i1' Lt�+ .T ti7 THE COMMONWEALTH OF MASSACHUS'ETTS FEEY �p BOARD OF HEALTH OF q APPLICATION FOR DISPOSAL SYSTEM AL Y TEM CONSTRUCTION PERMIT� Application fora Permit to Construct (,.14cpair ( ) Upgrtde ( ) Ahandon ( ) omplete System [-]Individual Components fq k 5 -S � LPCatio❑ Owners Name �p�y Map/parcel k Address 1=/C o ,^ in—, s2i aLs Telcph e Installer's Name Designer's Namc Address Telephone it Telephone# Type of Building: ^~ Lot Size f I q(a� Sq.feet Dwelling—No.of Bedrooms 3 Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow 3-3 Design flow providec��C-2 gpd Plan- Date Number of sheets I Revision Date Title dY TT {�� Descriptio of Soils)��°� 1 I �U -'�r�" nt a l U �.. (�"-1(/�VIA . S O Soil Evaluator Form No. Name of� S Evaluator � ShnM=d, ,;� Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The 9 undersigned agrees to install the above described Individual Sewa Disposal System in accordance with the provisions of 9 TITLE 5 and further a es not to place the system in operatio Certifi of Compliance has been issued by the Board of Health. Signed. Date I'Aspe@tWas F + FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 r` '=No H�JD�•+ 9 THE COMMONWEALTH OF MASSACHUSETT' S FEE 5� BOARD OF HEALTH A a` t 49AW OF lQ--_ �� c - 4 ' APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT ` U' ,, Application for it Permit to Construct (,/Rcpan. ( ) Uligra de ( ') Ahandon ( ) - 1-4/omplete System ❑Individual Components LocUion Owner's Name - 4 Map/llalcel It Address log �u r lelopn ,eu il 'A Inslallci's.Name - Designer's Name 1 Address qT `�ylJrs� / Tcicj'h'(*)ne It - Telephone It , d" Type of Building:' Lot Size Sq.fee Dwelling—. No;of Bedrooms 3 - Garbage Grinder ( ) ' Other—Type o ildin f Bug No.of persons : a!/ Showers (` ), Cafet rfit Other fixtures Design Flow(min.required)= gpd -` Calculated design flow _33ngpd Design flow providec��gpcl /Plan-:Date - �'dd Number of sheets Revision Date Title �(, AiYu,i cI -7II Description of Soil(s)-0" vCL, N-j C2, Soil Evaluator Form No. arrie of Soil Evaluator "'P., &nJLl Cj vL Date of Evaluation r- ' QU DESCRIPTION OF REPAIRS OR ALTERATIONS ' ' The underiigned agrees to install the above described Individual Sewo a Disposal System in accordance with the provisions of TITLES and further o�ar�es-not to place the`system in operatio tit a Certific to of Compliance Fi s been issued by the Board of,Health. 17 ,,. Signed- -% l DateInspections .._ FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 -0 NO. f' �THE /COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF,-HEALTH , ' CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System r The undersigned'hereby certify-that the/Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: has been installed in accordance with the /r-ovisions o5310 CMR`15.00 (Title 5� and the approved design plans/asebuilt M plans relating to applicati;Nm ,i dated `` ' Aboroved Design Flow (gpd,Installer 1�`; � tr""�1'`,�� ',f ist � Ii / 703 Designer. yt Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF,,COMPLIANCE DEP APPROVED FORM 5/96 'ff NO• � q�r?TH COO]M�.MOWBOARD H OF MASSACHUSETTS FEE OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereb grante to Construct ( i�')f epair ( ) grade ) Abandon ( ) an individual sewage ( disposal system at _ as described in the application for Disposal System Construction-Per, it No. ;?4A1* dated Ar Provided: Construction elcomple ed within three years wall of the date of this p it. 14 'cal '°ditions b�met. � ! U Date �-�-/ � Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARREN rra PUBLISHERS - BOSTON� NIF z 2� TOWN OF BARNS TA B L E ` \; LO U.P. 0A cz_ i �- A PEA S UMMA P Y LOTS UPLAND; 257, 713 S. F. 6. 15 WETLAND; OAS. F. O--AC. TOTAL; 2571 713-*S. F. 6. 15-4AC. 28.8 % N_ POADS 116, 189 45. F. 2. 67�AC. 12.4% OPEN SPA CE i UPLAND; 514, 558�S. F. 11 . 81 SAC. WETLAND; 32, 116-S. F. 0. 74�AC. TOTAL; 546, 684-S. F. 12. 55�AC. 58.8% b, �r TOTAL 930., 586-5. F. 21 . 37-�AC. l00 % OPEN SPACE UPLAND=132. 818-S WETLAND=OAS. F. TOTAL=132. 818$S. 594.17 S36' 58' r,, N / F N/F RAYMOND R. 8 IRENE ANTONE RODGERS I SOUZA s l _ TOWN OF BARNSTABLE LOCATION �� d© SEWAGE # 2006 q 0 VILLAGE COLk: ASSESSOR'S MAP & LOT — ® 0 INSTALLER'S NAME&PHONE NO. '1�a�� SEPTIC TANK. CAPACITY :n LEACHING FACILITY: (typeh) �WCal a k-Uze (size) NO. OF BEDROOMS_ _ BUILDER OR OWNER PERMIT DATE: F)— COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Ah, 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 Aa,�y within 300 feet of leaching facility) �� //�_ Feet Furnished by A- i i i � II C., 42 = �i y 33 rri- `1z ` i a4_ .33 Town of ilarnstable PI/ `' v ✓ �— Department of Health,Safely,and Gnvironniental Services �IHE Public Health Division Date 2-.3-bo c( 367 Main Street,I lyannis MA 02601 t eAaNSTAarAMASI _ rf 19. Date Scheduled 2 Z 8 a d Time Fee Pd. . Soil Suitability Assessment for Sewage Disposal Performed By. �IA1 t .1 �V�-t l t� Witnessed By: I LOCATION & GENERAIL INFORMATION Location Address FdnejG,� `�' `_ Owner's Name /r `z�4� Address Assessor's Map/Parcel: ,{Y11� ZC� OCR 7—(7�0 Engineer's Name cafle Y�1pL"4.,5 . NEW CONSTRUCTION V REPAIR Telephone N Land Use Aloe d•sct L+* Slopes(%) Surface Stones Distances from: Open Water Body It Possible We(Area R Drinking Water Well n i Drainage Way Il Property Line R Other (t SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands In proximity to holes) t t41 ' -n GR Parent material(geologic) O u 76 ra4 3 Depth to Bedrock Depth to Groundwater: Standing Water in I lole: Weeping from Pit Face Estimated Seasonal High Groundwater . I)E`ERMINATION F+OAS EASONAL.IIlG-H� EIS"TABLE I Method Used. Depth Observed standing In obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.(role: In. Groundwater Adjustment It. Index Well N Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION.'I t >' � 9 59hBe . Tlitte it Observation Ilole N / Time at 9" 1 Depth of Perc Time at 6" Start Pre-soak Time® 5 Time(9"-6") End Pre-soak Rate Min./Inch 'e' Z- Site Suitability Assessment: Site Passed Site failed: Additional Testing Needed(Y/N) Original: Public Ilealth Division Observation Hole Data To Be Completed on Back—� Copy: Applicant DEEP OBSERVATION HOLE LOG hole# Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Molding (Structure,Stones,Boulderes. % 4 L-0 4 -4 b u yj2- c y =30 `e«..y 20 r>Ls7y 30`=izc7 zayIC 4/f- DEEP OBSERVATION HOLE LOG Bole # Z Depth from Soil Ilorizon soil'rexture Soil Color Soil Other i Surface(in.) (USDA) (Munsell) Mollling (Structure,Stones,Doulderes. 0 G — C /� w Lao w /C'mCW L/L L " G Jei 4(q C sp e-C/ Ga G1� DEEP OBSERVATION HOLE LOG '"' Ilole# Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Molding (Structure,Stones,Ilouldcres. % DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Ilorizon soil'rcxiurc Soil Color Soil i Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. e Mood Insurance Rate Man: above 500 your flood boundary No_ Ycs h Within 500 year boundary Nov 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? ir grJ If not, what is the depth of naturally occurring pervious material? Certification I certify that on Jr,/93 (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 will) (lie required training,expertise and experience described in 310 CMR 15.017. Signature Date 00 2X4 STUD WALL BASEMENTPJ R-13 INSULATION N - -+ 3 rig" CONCRETE • �Q�� !Ms'UL,¢TiD�/ SLAB ' 2 X 10 JOISTS a IG" D.C. l�ND Lv4TEx— U64ME I A U D P A!N7'z 7: lovR�Ex6D - •- ou? L45-rs %3-0 ,c 3G-o _ - g!-rota DooRs ' 4 - 2 IO bIRT - - - r r 4 - 2x GIRT, I I I 1 Ln 41 ; I - - -! Sro,et 4t Ale Lc� vbq /��ll4,ATGD I - •- - ly cr r— l A 9Sr tdlLL,S' ,Q040 AV -D rJTL9A T- 11 i a�u�2. K cTaI air- IRA T I I SYSTEM PROFILE NOT TO SCALE TOP FNDN. - FINISH GRADE OVER FINISH GRADE EL . FINISH GRADE 7 7. O FINISH GRADE OVER DIS T. BOX . G✓ OVER TRENCHES 7 4. 4 ;q'Pe,o SEPTIC TANK i •a.P� o i, 6 12 MAX. Qo:4'Q. �..•-a'�'n• .OQ..Ap'..D•?9'Q:;Q•e�DO.a;a.a�:�6�Qi�'.e•'. '� .A'b•tl... i0, -� /R1nx �rsw'e•r t.•j 0 •Q'a•D•.• a o, TOTAL LENGTH OF TRENCH 2 5' 3„ a OUTLET PIPE LEVEL FOR 2 FT. MIN. . O C� 56 O o "ro'P ;P1:0;.4 4e fie. r . �?• 72.63 •:b'::!:e.•: _ '9 •. .. . . .. , ° O O °da C. I. OR P VC TEES e 73.03 72. 6 r ` .Z O Q. :..a•'•n' p. Cam-� - ,L�/ 4 .o p �o. b• 0 1500 GA L L ON o DIS TRIBU TION BOX BSMT FL . INSTALL ON LEVEL BASE 500 GALLON DRMELLS EL . 70.E :,.o a PPECA S T CONCRETE b` ab H- /0 REINFORCED 0: O LO&DIw / :� OiO:o.27.d' '.0' •d: 'D:;p +vtp.e'[�•-"ppp:D'D. w.e•ro.C'7Q�' •s,eo.•p.o;bp,ed p•o 'b::V. o .s. •�.�•Pre;Ob4'o ,,V•Y .,b.P: SEP TIC TANK TRENCH SEC TION INS TALL ON LEVEL BASE NOTE.' EXCA VATS TO EL EV V. k1�,4 Of �� LOWER TO REMOVE ALL IMPERVIOUS` 12 MIN. MATERIAL BENEATH THE LEACHING REA 4- DIAM. REPLACE EXCA VA TED MATERIAL WI 7 '/ o; �•.a , ..a.,. ..•..0 4:o o•p, b'•; ;o,: s;.° ,�°,gti 3„ OF 1/6"-1/2„ 0 m OF G. p�S l N ° A i° ° WASHED PEAS TONE CL EA N CL A Y FREE SAND 4 ° 04 EL. Cos. JO' • •�° 00 ~ 314" _ 1-1/2" WASHED a •: o N o �, ; S o n, �q- CRUSHED STONE • $ _ �,_z„ - 4,. _EL . 9_-z. 19 TRENCH WID TH �N 4 O7 z 8 C ti O GENERAL NO TES �. � 1. ALL EL EVA TIONS SHOWN ARE BASED ON BSC GROUP NUMBER OF TRENCHES 1 +1 ��\ \ v / 2. ALL PIPES IN THE SYSTEM MUST BE CAST IRON NUMBER OF ORYWELL S 2 h �. \ �--� ; OR SCHEDULE 40 PVC. ,R VA TION PIT 3. THE BOARD OF HEA L TH MUS T BE NO TIFIED O SE t9 \ �` c1 a} ---- WHEN CONSTRUCTION IS COMPLETE PRIOR P-9674 �\\ , . a N PERC01-A TION PA TE. Q ) TO BA CKFIL L NG <Jr `tJ�-T LA N D E L I / I MIN./IN. -- ------ -�``G1''" =y f j + 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED WITNESSED B Y.' �� � � � J B Y THE BOA OF HEAL TH A�'VD CAPE 6 ISL ANDS L- 07 � O SURVEYING CO. INC. DONNA MIORANDI ;, E 5. MA TERIAL S AND INSTAL LA TION SHAL L BE IN BARNS." BAD. OF HEAL TH DESIGN DA TA \ �' TA T SA TARP -- co ti \ ` / COMPLIANCE WI tH THE S E DATE. FEB. 2Q 2000 \ 2 ' /% I . CODE — TITLE V — AND LOCAL APPLICABLE *I -T # i o RULES AND REGULATIONS o O w NUMBER OF BEDROOMS 3 �9 � - N 6. NORTH ARROW IS FROM RECORD PLANS AND �•• w LOAM o� �„ Uo°M ioY�ZLz NO brz�Nt�,G e GARBAGE DISPOSAL IS NOT TO BE USED FOR SOLAR PURPOSES � 330 GAL . 7. •FL DOD HAZARD ZONE C (NON—HAZARD) �NDY �Y � \ » l 4 SISNDY LOOM DAILY FLOW , " \ 8. WATER SUPPLY ',D G +o Yrr s/4 SEPTIC TANK REO D. 1500 GAL . rl- SEPTIC TANK PROVIDED 1500 GAL O LEACHING PEOUIPED 330 GPD. MEDIUM ('1 olur1 f � � ' ' #2 SG�1.1 b S�t�O 10`(�. /G ►o`rtz �/6 SIDEWALL AREA = 152 S. F. 152 0. 74 _ 112 j S. F. X G/S. F. — GPO. C gyp,. �,, , BOTTOM AREA — 329 S. F. (0 / ` o /i i �2 329S. F. X 0. 01S. F. - GPO LEGEND243 LEACHING PROVIDED - _GPO 35 NO . I'LOUNDWd7E PROPOSED EL EVA TION `� 70 -- EXISTING CONTOUR . SINGLE FAMILY RESIDENCE C \, � OBSER VA TION PIT �--- o DISTRIBUTION aox o 8 PROPOSED SEW GE DI SPOSA L S YS TEM ----, TRENCH �. PREPARED FOR co Co / o o . SEPTIC TANK o z MC SHA NE CONSTRUCTION FOREST HILLS DPI VE RESERVE AREA LOT T 1 O BARNSTABLE-COTUI T-MASS. 7�-50 PIPE INVERT ELEVATION -0 i! DA TE.' JULY 5, 2OGo CAPE G ISLANDS ENGINEERING Pt O o PL AN i� ¢, ., � SCALE AS NOTED 800 FALMOUTH ROAD — SUIT_ E 301 SCALE.• 1 "= 20 25 007-i 10 MA SHPEE, MASS. 3�01 �h MAP SEC PCL LOT HSE ,» PLAN NO. �o 0500 S YS TEM PROFILE NOT TO SCALE TOP FNON. FINISH GRADE EL . 7 Pe x cD FINISH GRADE 'l -T O FINISH GRADE OVER FINISH GRADE OVER OVER TRENCHES 74. 4 DIST. BOX . 5 SEPTIC TANK 74 9 AM o�a'Dp 12" MAX. 6 .o •.o"b C o:4Q. d:.•-n`�'�': ;O�.:a�.��;Q'::Q.e�.D•O :a /-o4�6p�i'v-• ! •A'b•V•'.r 10 -� %+�/ r coVtr e.•r. .'a _. _ • , o TOTAL LENGTH OF TRENCH - 2 5 o.'o•Ps d 3„ OUTLET PIPE LEVEL w T MI 8' _ v L:o.p FOR 2 F N. o 0� 4�'•OpQ 00 0�" • ' . o. .o;• .p.. o od. ;b p b6' 0 6a 72✓.50 ao po' �� vo qP S! Qd'Q_n EKZ 1`•:n;'e•'e:. :b:•:!:a.•: 0 .. •`' "�d�'0 72. 85 'o C. I. OR PVC TEES sP 7z_ `l 7 I ,20 po6p �. c� 4 a:; 1500 GALLON DISTRIBUTION BOX BSMT FL . IQ o :s pc .INSTALL ON LEVEL BASE "500 GALLON DRYWELLS EL . 70.5 PRECA S T CONCRE TE A.ocoa e °op H-= 10_ .REINFORCED o .o. o: - " bo 1,•01p:orb.d,:O•.Cpe'�?oD.:C-b.:eorp:o'Q�.fl•.p :D;p'�'o'P'��.b'A': U 20 O nING SEP TIC TA NK TRENCH SECTION INSTALL ON LEVEL BASE NOTE.' EXCA VA TE TO EL EV--N/& - OR (per L OWER TO REMO VE A L L IMPER VIOUS 12 MIN. (9 1 MATERIAL BENEATH THE LEACHING AREA a• oraM. 0NGL1 C' IC 3" OF ?/B"-?/2" n, REPLACE EXCA VA TED MATERIAL WITH o; a,5':a . a.:;�., .vo•p q'•i ,b.: 121 m or- G. e&sl N • A ' r �' WASHED PEA STONE CLEAN, CLA Y FREE SAND o4 n. : •g`° �L.. .Co5. 90 3,!4" - ?-?/2" WASHED ti, `N • CRUSHED STONE :�$ -_---EL 5 n S,_2.� •� NERA L NOTES TRENCH WIDTH 07, 8 ti GE 8'e° BSC GROUP ?. ALL ELEVA TIDl1hS SHOWN ARE BASED ON NUMBER OF TRENCHES ? +I t 2. ALL PIPES IN THE SYSTEM MUST BE CAST IRGN NUMBER .OF DRYWEL L S 2 100 OR SCHEDULE 40 PVC. 'ER VA =T`ION...... .P. `T _ : �r BOARD ..._ ..a-.. F MUST, tom.... 7 / T I-p'-s L�� _ .... .., 3. THE �JOARD O Hi A`L Ti/ MUSS I arc � O �r / ;!�� O V{ ` WHEN CONSTRUCTION IS COMPLETE PRIOR P-9674 TO BA CKFIL L ING PERCOL A TION. RA TE: d _ <5 �T LAN D E • G �p �' �' ESE �� 4. ANY CHANGES IN THIS 'PLAN MUST BE APPROVED MIN./IN. •.r 0 II L..1 BY THE BOARD Ot' HEALTH AND CAPE 6 ISLANDS WITNESSED BY.• �,� L O I LJ SURVEYING CO.. �NC. DONNA MIORANOI 1 &, 4'G a - � - — 5. MATERIALS AND YNSTALLA TION SHALL BE IN �� Ip 8 m1GJ '� -- I COMPLIANCE WITH THE STATE SANITARY BARNS. BRO. OF HEAL TH DESIGN DA TA S DA TE.• FEB. 2B, 2000 CODE - TITLE V AND LOCAL APPL ICABL E - - - - - RULES AND REGUL.A TIONS 41 3 _° w l�O&M "' �oot�l 2 NUMBER OF BEDROOMS 6. NORTH ARROW IS FROM RECORD PLANS AND �•• 2 6„ o Z NO S , ( eel Ndq GARBAGE DISPOSA L IS NO T TO BE U.AED FOR SOLAR PURPOSES 5DN DY _ ®o► �— GAL . 7. -FLOOD HAZARD ZONE C (NON-HAZARD) 30 oYr�z;q-. sar�lN watt DAILY FL ON (�. \ B. WA TER SUPPL Y" �, - ►o Yiz /4 SEPTIC TANK REO. 'D. 1500 GAL . a Ni �O. � G SEPTIC TANK PROVIDED 1500 GAL . zz' �� �' \ •, LEACHING REGUIRED 330 GPD. MEDIUM C'1 oIL) "1 Z ' ®#2 SAN b ZErN D 10 YIZ �/� ►0YV_ r4/� SIDEEWALL AREA = 152 S.F. k yf Q� ?52S. F.X ?2 GPO. � i�DUNDWn?Eiz B329 M AREA 9 S.F. 243 i LEGEND 120" s. F. x GIs. F. = GPD L EA CHING PRO VIOED = 55 6PO PROPOSED ELEVA TION �,q,�" No {20UN0Wd E 14 Ex�i sTINc CON TOUR SINGLE FAMILY RESIDENCE & ® OBERVA TION PIT ❑ Dl. TRIeuTloN aox PROPOSED SERA GE DISPOSAL SYSTEM �0 7REt9CH PREPARED FOR 0� / o o SEPTIC TANK z �,A� . � � MC SHA NE CONSTRUCTION LOT 10 FORES T HIL L S DPI VE • i— —i RE. ERVE AREA �� BA RNS TA BL E--CO TUI T-MASS. EE Pll'E. INVERT EL EVA TIONDA TE.' DULY 5,2ocx� 6 SLANOS ENGINEERING x (;Fi:;r ti t CAPE I PLOT PLAN SCALE AS NOTED 800 FALMOUTH ROAD - SUITE 301 SCAL E• ? " 20 - --- 2 s� Oo7-i ICE- :r,� ca� MASHPEE, MASS. PLAN NO. S070s