HomeMy WebLinkAbout0258 POPONESSETT ROAD - Health 258 Poponessett Road
Cotuit
- -- - - -- - - - - - A = 019-064
TOWN OF BARNSTABLE
LOCATION `ram �04�0��`�'��` G�� SEWAGE#
VILLAGE CC,%G rT ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO. /�! ���'oC;"'If- 77�o�c9
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size) 3 Ix
NO.OF BEDROOMS 3'1
OWNER
PERMIT DATE: —a-7 —o/9 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
A fGeo N j �a���! �o�.•�.orTier �,
.i
No. l I }: FEE G
C®MMONWEALT14 ®r'MAOCHUS ETTS
'- Board of Health, �� ��. MA.CC, I
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) - ❑Complete System ❑Individual Components
Location Z50 Q Owner's Name r�
Map/Parcel# Address ao Q5 + C3 f.f
Lot# Telephone#
Installer's Name Designer's A"BY ENGINEERING ASS4"IAM,M.
Address I��fT/� ��a ��/ Address 18OisY3ltRoad
Telephone# �� ��>/� Telephone# HYMPMv
MA 02367
Type of Building Lot Size ,,Y,/ sc-ft�
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures `� +
Design Flow (min.re uir d) �d gpd Calculated design flow [ o Design flow provided gpd I
Plan: Date ( Number of sheets Revision Date
Title
�t�o= s _
Description of Soil(s) P� "��A„
rG
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluati((_o
n s t. C. .
� VERACKA JR
DESCRIPTION OF REPAIRS OR ALTERATIONS 6Q7 V� CIVIL
The undersigne ees to install the above described Individual Sewage Disposal System in accordance withC�pvisions of TITLE 5 and
further a s to to ac s tem in operation until a Certificate of Compliance has been issued by the Board of Health.
Si Date
l/�alo9
Inspections
No. v`—� 1 t FEEfflMMONWfALJH / V
(�.� � •� ` +...i: .,,°mot;a.. ,
ASSACHUSITTS
Board of Health, 17�r1�Tt.��IC�, MA.(Lj U
APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT
e i e
Application for a Permit to G+nstruct( ), Repair( Upgrade AbandonO - ❑Complete System. ❑Individual Components
[Address
ation Zs�Q Owner's Name C rG
p/Parcel# Address
# / d t Telephone#
aller's Name O'// eCQ ,owe'/� Designer's'�,1 Y ENGINEERING ASSOCIATES,INC.
� I �7�¢��' /✓. � / Address 180 GoUnty Road
67
ephone# �j7,�i �y',7'��` Telephone# W m n+ MA a A
Type of Building `fit ue I'rW Lot Size 4P Y% Ac •.sq: r—
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building �,No.of persons Showers ( ),Cafeteria ( )
Other Fixtures / At
., Design Flow(min.r uir d) `7
C Vd gpd Calculated design flow l %o Design flow provided gpd
Plan: Date Z p Number of sheets Y Revision Date
Title
r _o"^ass_
.a
Description of Soil(s) Ott
G
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluatio o :. .l
DESCRIPTION OF REPAIRS OR ALTERATIONS ^3
The undersi a ees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
g" ln' g P Y
further a es t ' t to lace th s tem in operation until a Certificate of Compliance has been issued by the Board of Health.
Si p,e n' � Date ,/4," .✓`C''9
l Ap--40
Inspections
1 �
7R. 64
R� ,/� �
No.:- aC)C)q �/y COMMO�T��r�(ALTH OF m ( �T �( FEE �v
TS
Board of Health, Y1 s G��0 MA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) Cri omplete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded r Abandoned ( )
by:
at e.. efy P
has been installed in accordance with the pr visio s of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
applicatio--n7-No.Cgc� Iy , dated ��� C� Approved D ign Flow L)y U (gpd)
Installer 1 i�% )I— r r� /�
Designer: v Inspector: IL✓._ � • Date: ( D 1LI 0
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. t I FEE 5 c�
Board of Health,Q G r n S"l ue , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby to; Construct( ) Repair( ) Upgrade(V<Abandon( ) an individual sewage disposal system
at 5 5 �.ranted
M0 p 7c, 'r as described in the application for
Disposal System Construction Permit No.SCO d^6/y, dated
Provided: Construction shall be completed within three years of the d johr, �,4j l local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date C/ �G ` Board of Heat
Oct 14 08 02: 08p p. l
_ gown Of Barnstable
tioF "�rOKti Regulatory Services
P
'Thomas F.Geiler,Director
nn�rKAM iAFASLe, _ Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862A644 Fax: 508-790-6304
Installer &Designer Certification Form
Date: , luU
Designer: Installer:
�G.
Address: ,Address:
Qn vas issued a permit to install a
(date) (insttOP )
septic system at . � fop C, � C� ' based on a design drawn by
r��a-ess)
dated
t.u'�'8•11�'�
certify that the septic system referenced above was installed substantially according to
:the design, which may include minor approved changes such as lateral reloeatian of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes
— greater t]�= 10' lateral relocation of the SAS or any veatcal relocation of any componem
of the septic;qti qem)but in accordance with State&Local Regdlations. Plan revision or
certified as-Ull, by designer to follow.
(installer's Signature) S' CA
b1ASON
' No.1066 ti
�FQ/BTi
(I] • er s Signature) ^� ( x er's Stamp Here)
PLEASE RETURN TO RAR10TADL'E4UBL1C HEALTH DIVISION. C RTWICA.TE
OF COKPLIANCE WILL NUT BE SSUED UZM BOTDU-THIS TORM AND A -
RMT CARD ARE RECE WED U :."��,��RL�ISTAULE PURJAC ffl DIVISXON,
THANK YOU,
Q; HealtWeptie/17esigncr CcrtiFir.Oon Form
3CTown of Barnstable P#
Department of Regulatory Services
, NABS. Z. Public Health Division Date
�A 16J9. 200 Main Street,Hyannis MA 02601
rFD MKS �%� M- 1
Date Scheduled ?Time Fee Pd
r
s
Soil Suitability Assessment for Sewage i posal o
Performed By: Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address • ' Owner's Name l21 C Vic
n C
TC
Address /2 7 14V44
d Pr 14ACifQx 2Y
, 0 38
Assessor's Map/Parcel: 0(4/0(p Engineer's Name & c�I n ePN IV 15
NEWCONSTRUCnON REPAIR Telephone# `1
Land Use, hcXP��'I(A Slopes(4'0) Surface Stones
Distances from: Open Water Body O ft Possible Wet Area O ft Drinking Water Well ft
Drainage Way 0 ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
_."
..xet69wvas'0.1/ aMc�4:'Ptl i•.4Ttlfl R1w12�' /lll�
Parent material(geologic) $ Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:ate► IC/ a Weeping from Pit Fttee
Estimated Seasonal High Groundwater
DETERAHNA TION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles: _ in.
Depth to weeping from side of obs.hole: in, Groundwater Adjustment Vkbw, ft.
Index:Well# Reading Date: Index Well level „ ,Adj..factor Adj.droundwateral
PERCOLATION TEST Date Tlnte
Observation /
Hole#
Depth of Pero �L Time at 6"
v Start Pre-soak Time @ �U t /0 Ln� Time(9"•6")
End Pre-soak /o'
Rate MinJInch
Site Suitability Assessment: Site Passed ® Site Failed: Additional Testing Needed(YM)
Original: Public Health Division Observation Hole Data To Be Completed on Back*----------
{
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:\SEPTICVERCFORM.DOC R
I,
1
r
DEEP.OBSERVA'TION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil' Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.96ulders.-.-
iGravel)
�j S L
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
3L )&.,.a?/-?
iwse
7-71
DEEP OBSERVATION HOLE LOG Hole# 3
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
sistency.%Gravel)
Q 7 -7 tr a6
3 O ,.v SSE
2 2,N 1,40 to
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders.
0 L. p � 5
26 AIS b
2 �
Flood Insurance Rate Map:
=' =Above 300 year Hood boundary""No Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Depth of Naturally Occurriniz 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? J
If not,what is the depth of naturally occurring per' . us material?�. .
Certification
I certify that on AjLrd g/ (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 trainin expertise and experience described in 310 CUR 15.017.
Signature Date d r�
{ QASBPTI0PERCP0RM.DOC
20"M.H. cover to finish grade note:
A-1801 HIP ZABEL FILTER 4" secured to prevent unauthorized access. magnetic tope shall be place above and along
3" 3" min. note: risers h covers shall be all components of leaching system not exposed
�A�,y �y watertight pat o in 0 er to locate them once buried.
r:L�J� �� t 6 a7
t "tight dr erpro f
(2) 20'M.H. covers within
} 12'-10"Wx2'Hx33'-6"L 5"of= 614 SF s-of ox
finish grade (5) outlet h�rade
.. finish gra
12" 41.50 4"cltARcaaL VENT
PaRiam DOUBLE -� F.G.=40.5f
Flow Line ALL STONE SHALL 3'1NASHED STONE39.8E MIN. FG=39.Ot
C,r 1 Q�I 5 I 13" MEET 310CUR 15.247 118'70 112" 4"did. pipe
Underground Septic Tanks & Pump Chambers 3"
2'MIN. LEVEL
4'dio. ACCESS RISER Top chamber-37.25
1.) Tanks shall be structure/ly sound and to withstand the 5= " 5-7"
GG�C Q O J780 A-1801 1#P ZWa fXW? 4"dio. within 6"finish
L J 24" 33" DOUBLE Sch. 40 P. gmde
g,f T " WASHED STONE Sch. 40 P.KC.
super imposed loads. 4 -0 KNOCKOUT 37.50 37.25 p
314710 1 112" 34.0 s-cmal�v
2.) Tanks shall be watertight. 14"
1500 Gal. 36.87 av
3.) Tanks shall be precast concrete. 4 10'-D"x 5'-2" 48" 1 " - 48 r• 36.70
knockout to be removed f0' mft Septic Tdnk 36. 34.5�
tanks shall implement a unlit when used as o center
4.) Manufacturers of septic to P quality a , . piece
control/quality assurance program in conformity with ^°�°Pf QED s °Y L°�1P`m 4' 25'-6" 4'
ASTM standard C-1227-93. Tanks shall be embossed 6" CRUSHED STONE ON COMPACTED BASE
with a sea/ stating that this ASTM standard has been
met. Tanks not embossed with a sea/ shall be rejected. 10'-6"x 5'-8"
�' �' �' 20' .flan. 33'-6"
5.) Tanks shall be accessible for inspection and mointen- Cff P. LZC,44 Cill1Y1 ffZ77 L
once. No structures sha!l be located directly upon, 16-OO Cal. ,�S''eclzon Thru ,S7�Sz`em
above, or near the tanks which may interfere with per- „ Leachznq Chamber Detail
formance, access, inspection, and pumping or repair. �r�r1P:1 =G�,9 .3 Precast 6,0nerete ,SF,VtZc Tank
NOT TO SCALE '
6.) Inlet and out/et tees shall be of cast iron, schedule 40
NOT TO SCALE
pvc, or approved equal Proposed Flow Line Grades As Built Grades
7.) Septic tanks shall be provided with at least three (3)
20" diameter manholes. Manholes shall be at the 37.80
/NV. AT FOUNDAT/ON
center and over each inlet and out/et tee. For comport-
/NV INTO SEPTIC TANK 37.50
ment tanks, the center manhole shall be the access to
the compartment connection. System designs in excess
of 1,000 GPD, al/ manholes shall be made accessible. /NV OUT OF SEPTIC TANK 37.25
1/2" HANDLE �-
For system designs of 1,000GPD or less at least one
manhole shall be made accessible. /f applicable provide - 36.87
watertight access port (risers),precast concrete or equiv-
alent, /NV INTO DISTRIBUTION BOX
with steps where appropriate. Manhole covers
4" SEWER PIPE /NV OUT OF DISTRIBUTION BOX 36.70
sha/l be removable, and of impermeable and durable 22"
material. Covers shall be within six inches of finished lNV INTO CHAMBER
grade and shall be secured to prevent unauthorized 1/16" FILTER SLOTS FROM TOP OF SEAL 36.50
TO BO OM OF UNIT 3450
BOTTO .
M OF CHAMBER I
access. FILTER GASKET '
8.) INSTALLATION. ,4O E WATER TABLE 27.6 r
A) Tanks sha/l be installed true to grade on a level stable °J� 6, 1% ;°s-" FILTRATION 800 G.P.D. NO WATER OR M017IES ENCOUNTERED
base that has been mechan/cd//y compacted, and on which
six inches of crushed stone has been placed to ensure � � A-1801 HIP )
stability and to prevent settling. A B E .m FILTER D ETA I L
Septic tank shall have a minimum of nine inches of cover.
B) The in/et and outlet tees shall be installed to the grades 'NOT TO SCALE)
. . 1""P. 4 7:P. 1 T.P. 2 T.P. 3
shown on the drawings. The tees shall extend a minimum a
six inches above the flow line of the septic tank and shall 38
be on the center line of the septic tank and located direct/
under the access manho/es.Cross-sectional f/ow baffles shall
393 390 3es E
not be used as substitutes for inlet or outlet tees. All P 19 SWDY SANDY S4�LE SUDY A
\ SANDY L SA,^/DY L SANDY LOA SANDY LOAM
C) FOR REPAIRS Contractor SHALL when connecting a new 38.2 A forR 3/3 3a.s A fcrR 3/3 3B.3 A fOrR 3/3 37.7 A fOYR 3/3
1O" 8' 8' fo'
FRABseptic tank to an existing sewer line. Verify sewer line is / l O 064
a4MY E Fr.AY S FWY$ aU ff E
Sch. 40 or C.I. in good condition or it shall be rep/aced. / L_ LLL9MY SAND LC MY S4ND LOAMY SAND LOAMY 8
Also that. al/ out flow pipes from building run thru / 3ss Bw foYR 5/e 37s Bw fo,;� 5/e 3s6 Bw forR 5/s 3s 1 Bw forR 5/e
l tic tank. 39 28' 18' 26' 30'
- - . 49 ACRES,
A/l work in conformance with Mass. State Plumbing Code. - - - - - - - - '
/ LOOSE LOOSE LOUSE LOOSE
A 40
DESIGN CRITERIA (
9. Unless otherwise noted (UON), the design of this system M-c SAND M-C SAND M-c SAND M-c Si/ '
conforms to the requirements of the o �-
Massachusetts Environmental Code T/t/e V", and the l 2.5Y 5/4 2.5Y 5/4 2.5Y 5/4 25Y 5/4
requirements of the local board of health. /
n of this system did not`allow for the use of l /
f0.) The design y
a garbage disposal.
28.5 C 1 28.3 C 1 28.5'- C 1 27.6 C 1 �
/ 126 132' 126' 132'
11.) The septic tank sha/l be inspected and cleaned annually. / / NO WATER OR MOTTLES ENCOUNTERED NO WATER OR MOTTLES ENCOUNTERED NO WATER OR MOIRES ENCOUNTERED NO WAMR OR MOTTLES ENCOUNTERED
12.) Grease trap, if applicable, shall be inspected every
month, and shall be cleaned every 3 months or when
38
the level of grease is 25Z of the effective depth of the /
trap. / Bench Mark
13.) The design of this system conforms with the following / ( 40
m � � / \ Percolation Rate Of <2 M%nUteS/lf7Ch RIM OF CATCH BASIN
minimum distances from the proposed sanitary system:
Present During Tests On 12111/ q
A.) Surface water supply g
or grave/ packed wells ft. / I
N Aen t: DONNA Z ,MIORANDI, RS
\B.) Tubular public wells.............................................250 ft. /
Soil EVCIUotor:• ✓OSEPH WEBBY SE2564 ELEV. = 36.66 j 00 00
• M.S.L.
G) Private potable wells...........................................100 ft. l O O
/ 1-4 O
D.) Other sanitary soil obsorbtion system.............. 10 ft. Z
/ \ / Design Calculations
E.) Wet/ands.............................................................. 100 ft. / nl GALLONS BEDROOM _
� NUMBER OF BEDROOMS = 4
/ N
14. No structures shall be located upon, above, or within l D ��d--GA L.
/ � REQUIRED GPO 440_ GAL.
20' of the leaching field area. The reserve area (1002 h�QU/RED LEACH/NG ARF4 = 440f.074 (0 2 min./'nch)= 595 s.f.
expansion) is considered to be the some as the leaching '
field area. // O O 24' 16.00� '00 � ' L:ACHING AREA PROVIDED = 614 s.f. > 595 s.f.
O O 1 16 39 LtACH/NG CAPACITY = 454 9Pd > 440 gpd
15.) The top of all system components, including the septic / DECK o
OUTS/ E 16' SW [(12.83 x 2)+( 33.5 x 2)J 2 = 185 SF
tank, distribution box or dosing chamber and soil /
li absorption system, shall be installed no more than 36" � o SHOW
440 x 2 = 660 GAL. Bot (12.83) x (33.5) = 429 SF
l 16,'-•-� USE 1500 GAL. .U/N. SEPTIC TANK tots/ = 614 SF
below finish grade. / 00 32• 1
Leach n-g Chambers Area
// o PROPOSED o �� Issue Date Description Drawn Design Check Eng
16.) Leaching chamber shall be ACME PRECAST HOUSE
1 12 16 08 UPGRADE OF SANITARY SYSTEM
chamber (H-10 Loading) or engineer approved equal.
' � rW
17.) All installations shall be true to line and grade. 258 \
4.00' \ 9 EXISTING
18.) A// piping sho// be PVC SCH. 40 HOUSE
r o
19.) Distribution pipes) shall have a minimum diameter of 4'
p0 10•00� 16'
and a minimum slope of 0.01. I /
1 24 �� PROP 1500 GALLON
20.) Al/ unsuitable materiol including top soil and sub soil
1 EXISTING
shall be removed as folloEXISTING 1-411 22, 1 O O 40 SEPTIC TANK
Remove soils to elevation and a distance of HOUSE -A
\
ft. in all directions of the designated leaching area. I , ` _ J "D"BOX \ 4" CHARCOAL VENT Bench Mark
39 - - RIM Of CATCH BASIN UPGRADE Of Sanitary System
21.) Removed soils shall be rep/aced with clean sand, - ; 7P#
meeting the requirements of 310 CUR 15.255(3). r O O 3 39 M.S.L. TOWN: BARNS TABLE, MASS. L 0 T NO.: 64 MAP 19
22.) Leaching chambers stone shall be clean free of fines
and shall be double washed to meet the requirement of
TO!QE WED EXISTING "
310 CUR 15.247(1). DRIVE 4 ACCESS RISER LOCATION: 258 POPONESSETT ROAD
Ins2ection Schedule 3 _ � ' 5, \ ��1 PESERVE-
1 40' /��J38 WITHIN 6 FINISH GRADE
23.) To obtain the board of health certification, confirmation PROPOSED WATER LINE ` - ` �- PREPARED FOR: MARK & DIANE BRADFORD
of the proper installation is required. ""� 55'11'
a. Excavation at unsuitable material NOTES.' EXISTING WATER LINE `60' SCALE: I" = .2 0' DATE: DECEMBER 16,2008
TO BE REMOVED I 11'
b.) Placement of the clean back fill 1•) LOT 064 DOES NOT LIE IN A ZONE,/ �� 88•DO '
a) Installation of the system with o// components ,r ' 28
° 0° w' WEBBY ENGINE"ERINC� ASSOdo TLS, I1VG.
exposed for inspection and preparation of WELL PROTECTION ZONE. r39 / S 8� 22 / 7
As Built. \ � ' / CATCH BASIN
d.) When existing ground elevations are changed o 2.) LOT 064 DOES NOT LIE IN A FLOOD HAZARD ZONE AS _ - - Civil Engineers & Land Surveyors
finished ground ell asbuit" shall be required J \ /DETERMINED BY THE FIRM MAP. l / p _
prior to certificate of comp/lance being issued. _ ROAD � U O County Road P l ymp t o n, MA.
3 THERE ARE NO WETLANDS WITHIN 100 FEET
(781 ) 585 4 1 164
Utility Notes OF THE LEACHING FACILITY. �3 ' T
24. The location of utilities is approximate Only. Dig-Safe Avk Of
S
and other appropriate authorities shall be notified to
4) THERE ARE NO KNOWN POTABLE WELLS WITHIN 200
OF THE LEACH/NG FAC/CITY. �2 JOHN C. �csm �0���'Fi M: f JOHN C, '''
verify actual locations.
c VERACKA J, N a c Vr�RACKA JR. N
5) THERE ARE NO KNOWN EASEMENTS !WHICH WEBBY
o 8 J R.
`' CIVIL 1do, 28T17 � � CIVIL
COULD IMPACT THE SYSTEM. -0 A No. 25237 ,p10 ��� " No, aaa37
37-37
0
I
LOA
o Land SProfyor Pro Eng2n
3
h W. 3538