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HomeMy WebLinkAbout0589 SAMPSONS MILL ROAD - Health 589 SAMPSONS dYll�l. EZO -- - -- COTUIT ' A = 039 086 I I 1' . C . TOWN OF BARNSTABLE LOCATION VIRS SEWAGE # 101 -' VILLAGE I:OTU LT ASSESSOR'S MAP & LOTO INSTALLER'S NAME&PHONE NO. 'mill nn �JL4911-- ZO' 02-$r0 SEPTIC TANK CAPACITY - I S00 LEACHING FACILITY: (type) 5-00 50A Ch (size) `I" NO. OF BEDROOMS BUILDER R `D l C t WA P Im 5 PERMITDATE: ® COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If ahy wetlands exist within 300 feet of leaching facility) Feet Furnished by r Ai qo•$ $ A 3 (, bg• (o { No. QCR2 Fee IUD THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE} MASSACHUSETTS s 01pprtcattou for Digofsat *pgtetu Cowaructton Permit Application for a Permit to Construct(�4)Repair( )Upgrade( )Abandon( ) Complete System El Individual Components Location Address or Lot No. Q� ��r'l i � Owner's Name,Address and Tel.No. Assessor's Map/Parcel "AIN pa vim, 1� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. pa� Type of Building: Dwelling No.of Bedrooms Lot Size� D T3 Q k)sq. ft. Garbage Grinder( ) Other Type of Building N�j %!z,vZz No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Envir nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss d by this Board o"4�� Signed t�c.ciJDate Application Approved by _ Date Application Disapproved for the following reasons Permit NoROEDate Issued 317-0 ) b) n r t -f TOWN OF BARNSTABLE r LOCATION -:.: SS� SKMPSW IU. SEWAGE # VILLAGE (S-ru L? ASSESSOR'S MAP ,LOT D l.' INSTALLER'S NAME&PHONE NO. -1 t M Aouol2— SEPTIC TANK,CAPACITY I S'D.O LEACHING FACILITY: (type) 00 a CflPA41A (size) NO. OF BEDROOMS ,. I BUILDER no-D/5t Aq C tJ I AIM 5 PERMITDATE: 0 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 -- — -— - sj r 9-LF 9-LI ir. .,.„ .. 1 i e ``` h: ! j.. .. r .. iJ t .;,",t :1.#s c.:,.:y s .r ,3 `t•7i., ,.� ut^ — yt ' rw; - b d sill �* t #.;p `�•—•—� ' No. — _ v. ---Fee , Entered in computer: t { THE COMMONWEALTH O MASSACHUSETTS tYes P PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Z[pprication for Digaal *p5tem Con5truction J)ermit �r Application for a Permit to Construct( ().Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. SM 36 -VS(DNJ.S V-f�l Owner's Name,Address and Tel.No. 0 Assessor's Map/Parcel3 t/ ��y r Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �f t ' Type of Building: Dwelling No.of Bedrooms�,Z Lot Size _� l�0 0�Sq.ft. Garbage Grinder( ) Other, Type of Building „ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs of Alterations(Answer when applicable) 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 Envir nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu d by this Board of Signed ' Date Application Approved by to Date Application Disapproved for the following reasons l' Permit No. 300 I ILO Date Issued 3 70 ) D r THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Dispo al System Constructed(\/)Repaired ( )Upgraded( ) Abandoned( )b at S8 �►9 6Ak ED. CbR)rF has been constructed in accordance with the provisions of Title 5 and the for Disposal.System Construction Permit No. a 62-)j—11 A9 date )ZD J Q Installer Designer The issuance of this ermit h 1 of be c d as a uarantee that the s st 1' �ctt''. n as desi(nedV&` Date P g Inspector y /1/ 0 ——————————————————————————————————————— No. lJy )(.P Fee—/6b -.— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS k liopaar *p.5tem Construction 13ermit Permission is hereby grantedgstru t'( R pa Upgrade( )Abandon System located at /tt and as described in the above Application for Disposal System Con 1 struction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be co 10 mpeted 'thin t ee years-of fhe date of thi,�/per/mit. Date: �/ l l Approved b PP y w w 4 6 J ? ini Z-4 Nf1L� R.fb OATTir JaxV� 6IfA- {Z\/i61D NLUI �G M( o p VI . — Y y "V a Re rrb ZI 4ti�i 3*Yg^y bu,w 9 i r+su cc�wv TTd 4� ZYi )L 26 vRv4iAu- ��$ 71(?AC Al" SEC,TIONO 24fe z,a 244o . �I,NEL / L�MNfY L411E11 M1 MV.I lE� y� .� Bar U4EBEDPOO_/ 61.D4 LING ' D\DL.La•Q - iVr Ma2 yEEDPOO M'3 Q CMPET .+J CARPET :�J — c WA."O.a or 10 vv. _ - 4 41-7' IY2 2�1,1w31-IM.\ 1�� �Z!I� Yz� 41_22 •- R•i.e. �f �s gc o 4 �.lp e.e ofaa 12 a.. KH>A S5 -� 55 — __ r o 2fi25 _ J a cAaxw.war w.. ` .�„ tOT(+M4.►b; - a."... <xnw•4.w waoc mr R(T\ TO CAfreT K w cr 3 r. �� -o C U - � . W v 674TRY z.e 1'W�lt�1 L—PV4& -B:PoLEVEl_ s,.artro I '�a L��/E1� Ytna Lea 40514 ■`■ . 4 �41J ZI-4� 'SIC 51-0 21-4� 31-4 e dioli v 9MGs l r r �.e.ovmr e•9os�s -4t. .�� 'r Mumx'6.,4. — SECO JD LEVEL FLOOR PLAID -- ... .i\OINK•. ®® OR`MKL L•D O FLOOR lflEl ,wa�•ii 6YL1tT1 ♦!l bC11L� o mn b?af un R-6 SAT". �C11vC.,f1LGR M�(If CIL�1' <.F!'1 TFOY1C. ulu-11Ci6 3123 �rrccsc�w Lrvc- FkDO. f FOR VALK-W e�•e'.Jua's. i "ex-lW— •j ` .' ��TAf4� GT IOf�J© SFt�r�c K7ri Q5 `" C m - L l -� t - 4i 4 -jL.t-I 1 tt F��a 5 �1 �K ]tQ\toht.{{h� . _ '�ci ]pia N y, f{f+��• _n it MGT. fir. Rnt.-L11C I I J A�-- -? I 1 3 /L15 r1�2 `...'W` Ox, It 0 • y � �• S � �•� e(1� �I� �I!1��� Y Sao li�[1 aR.l S �� 0 LET Y r s I •G I OK OOO D"T IE PJt_11 I z(IH Q �'l^X.N^O�wjtvK I' flUAMV.V �(1 TWE tj r u vra. tr - - N� Wt(t2i y1"• aCa.�RAL�� wcacz LN�♦ow 40 Jk L.6 Lr1F7.4 ^ I :OF/aa�y� 4 I saw I I� a� I •\aO, R� / I �•.7'w.oar I �` � �Ino vai�mrr� �q LL9b6 tmoC � 3123 `.' I 1 Col I +sr.� rLDQr- Z-b IZi::; 7 I •i rw. '•O . To Barnstable wno Depar,lnrent;of Health,Safety, and Elavironmental Services Ili rth Public FIealtl� DiVI1 Date Sl01 D �C1 367 Main Street,Hyannfs.MA 02601. eArurarAurB rUs9 loco Tinie ©i"00 I,ce Pd _s6�p " . Date Scheduled �� �� ✓ s i � ' `oil Sccita� lity�lssessmerit fare Sewage Disposal 1 �►lw 1Ct Wltnesseday: Performed By, ah Je1 ON UNA. A� lCN 4� S�7C�gN rr Locntlori Address "'�C, SOTS f'L Owner's Narnc � �trs,,r a fY3i�t+t �0`J-Se r►+1° t Iti¢ IQ s19�e CcuJo. Address:" G I Y d G Assessor's Map/Parcel •Aw! 3�t t!. Engineer's No lie ikll�Gr y� A►lC�N15un.: Tole hone H d} NCW CONSTRUCTION > X' REPAIR P . S v� lj'D. Slopes.:(%j. _ Surfoce Stones Land Usc " y ' R Possible Wct Ar6a //� R Drhrking Water Well Distances from; Open Water[3o.d —�'F�—. . Drainage Wa N (l Property Llnc Sy: fl Other' g Y cY d n,erisions of lot;exact locations ottest holes&Pero lcs(s,focate wetlands in.proximity Wholes) . SKETCH, (Streel naive, i .. „ :.. . Z. /30 /ate 50 Z O Sd 1].Ei.od 3 ? .92� a Parent Imcr al{geologic) p peptn to Uadroek Depth to Groundwater SlandkgAvAtcr In Hole: Weeping from Pit Face A Cstlmated,S.ciuonat High Groundwater - T� N Method Used, in: Depth to soil mollies in. Depth Observed standing in ohs Dole in Oraui,dweter Adjustment (1 bepllh to weeping front slde.of obs hole, r Index 1Vell a .....:'Rnading Date: Index tiVcli.levcl Adj.factor Ad):Groundwater Level .........:.....::.r:.�'.'.' ,:<.:�::<,�R�,;f:2^»?:as:`>,*'<::;;4i.+,:•`.;:;t,^:'r:i�r:.`'S:!i5> sr'i?%�i 'E;fy.. Observation. Time at 91' Hole a , Z. Cn� a i1'ICcrw-�a i N:. Time at 6 Depth of Pero QQ Start Prc•sonk Tlmc Time End Pro soak. Rate Mirti,/Inch Silo Sultalihity Assessment, Site Passed (/ Site Failed:_ Addilionel'Pcsling Needed(YIN) Otlginal.,1 ubllc Hoallh Div Islon `. .`. Obs.cevntlon:hlole,Dsitn To.De Co nipIcted on I3ack j \A .. . I Depth from 5011 Horizon So if Texture .Sol[Col.or Soil. Other Sur face;(In.) (USDA) (Munsell) M0111Ing (Stnicture,Slohcs,Boulderes, e 2 Nu/l YR S G c4✓�- Z �� L W►�drH; 2:S.y7 3 �e� give p. . . ..... ...........:...:••..,..:,.. I'..•0 .:�I(7.L�.: ..:..:::.....:..:::....•......,...:..:::::::::.:::�:. .;:•:::::.::.; :;<<.>;. ::>:;:.>.>;>,:: _ ; Dcpth from Soil Horizon., SoII:Texturo 5011 Color . Soil Other . Surface(in,) (USDA) (Munscll) Willing (Stru'c!ure,Stones,Doulderes; . Con.sistencieOrayell 2 - Zr v a 2 7I ►yv'� r 41 Depth from SoilFiorizon Soil Texiuro Sol l Color Soll Other Surface(In.). (USDA).. . (Munsell) Mottling (Structure,Stones,Doulderes, . Cnmistency.aGrayell DEEP ODSERV�TZONTgL L, )G Hti1a# Depth from Soll Horizon SoII Texture Sol)Color Soil Other Surface(In.) (USDA) (Munsell) Mottling .(Structure,Stones,Doulderes. Flood 11 Fame me ^rtaaj Atiovc S.00,.year flood.boundary No Yes • Wllhin 560 year.boundary No '. .Yes Within 100 year flood boundary No Yes Dgr�ll9f Naturally Occurring TmloO Materfal Does at least,four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption`system? _ If not, what is the depth of naturally occurring pervious.material?. !ertlIII cation i I certify that onS (date) 1 nave passed the soil evaluator examination approved by the Department of Environmental Protection that the.above analysis was performed by me consistent with the required trai , e ertise and a eHe ce described in 310.CMIt 1.51017. Signature Date �� . ' { LEGEND 9 uirements PROPOSED Design Schedule ELEVATION Leaching Area Re •' ExlsriNc q -- Edge of Pavement - tia y TOP OF FOUNDATION 58.5 -- -- - - Sewer Pipe s Rp��� 00 FINISHED BASEMENT FLOOR 58.0 4 BEDROOMS AT 110 GPD/BEDROOM 440 GPD W Water Pipe w -- �pP� �N FINISHED GARAGE FLOOR 51.0 ADDITIONAL 507. FOR GARBAGE DISPOSAL -NA--GPD - = - Drain Pipe ��� ��,�� < �O LOCUS SEWER INVERT AT FOUNDATION 56.0 r; Gas Pie -------------G Pi pe Manhole Cover F P� P �� SEWER INVERT INTO SEPTIC TANK 55.75 PERC RATE _ <2 MIN. / INCH (CLASS 1 ) l: � Catch Basin "' O�' SEWER INVERT OUT OF SEPTIC TANK 55.50 Water Gate F 74 GPD/S. . N y Q = y � a; SEWER INVERT INTO DISTRIBUTION BOX 55.42 LIAR 0. 6 Light Pole 2 P o g �� SEWER INVERT OUT OF DISTRIBUTION BOX 55.25 F1'-� G �, MIN. LEACHING AREA OF S.A.S. Utility Pole �- t...L� < SEWER INVERT INTO LEACHING SYSTEM 55.0 25 _ _.-- Contours errs^'" - o Spot Grade lU I O I <� �? BOTTOM OF LEACHING TRENCH 53.0 440 GPD/ 0.74 GPD/S.F.= 595 S.F. MIN. V Test Pit I I. ' `'' WATER TABLE < 45.2 PROPOSED SYSTEM I 532 GPD W/LEACHING AREA OF 719 SF ` LOCUS MAP GENERAL NOTES : ` NTS / ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH _ TITLE V OF THE STATE SANITARY CODE DATED -f ---- ------ ----- _-- MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE. IF ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING ------ BY JOHN K. HOLMGREN P.E. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, • • _ rT-- ----___ °NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT AM-PS-ONa MILL RO A;_- �� FOR INSPECTION. FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN l APPROVAL BY JOHN K. HOLMGREN P.E. 57 N 42'13'20" E 884.14' N 42*13'20" E ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC, SCH. 40. I 125.00' �, J 250.00' j 55 _....__...-. [-}2.0-- 24.0' -� 12.0'. o EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING o TP 2 SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER 0 0 56s m 310 CMR 15.255. •'l` ` I CB/DH FND o „•. Z o 54 ........ EL .^ 58.13' 1. TOP OF C B EL=58 13 ASSUMED ASSUMED -- -- ^, -- N -- -- r -- - - - -- -- - - -- . -- -- -- -- I. -- 12' � PRIMARY BENCHMARK PROJECT BENCHMARK . - " FINISHED GRADE I -fir-- - _ \\/\\/\\/\\j\\j\\j\\j\\j\\j\\j\\j\\j\\j\\j` COMPACTED FILL LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND 36"MAX.- 9"MIN. //\\//\\//\\//\\//\\//\\//\\//\\//\\//\\// // // // /• -- D \\\\ \\ \\� SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE 1 2 ...::............-:::::-.::::.-:::. ,.:....::::::::::..:.-: m - I UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. 21.7' PEASTONE 5 .9 > , a a 3/4" TO 1 112 " DOUBLE _ zi. 2 .o' --I a a° WASHED STONE I O• ;:' PROPOSED %� w •""� AM 39 PCL 84 TO "` SECTION v6. ' SINGLE FAMILY' , " O ?t• r ; F` DWELLING 1�.0 { TOF = 58.5; p � � NO SCALE „ E i AM 39 PCL 87 o41 a O , C 0 lr w 25.3' I m CUL'TEC RECHARGER 331) 10.a'R f p, AM 39 PCL 86 50,000+/- SQ. FT. , ALL PIPES TO BE SCHEDULE 40 PVC 1.15+/- ACRES 57 .O. - Iv 56 55 I �y .. �" I.. 02 ► �� F Septk Design son a �- " o Cotuit, Massachusetts 375.00' w. 94 S 42'13'20" W PREPARED FOR AM 39 PCL AM 39 PCL 95 AM 39 PCL 96 Chris Kosaba TITLE Sanitary Disposal System BAXTER, NYE & HOLMGREN, INC. P #9870 FINISHED GRADE 58t TYPICAL SYSTEM PROFILE SOIL LOGS DATE : 10/19/2coo ENGINEER BOARD OF HEALi-H AGENT • NOT To SCALE JOHN D. KUCHINSKI DONNA Z. MIORA.01, RS BAXTER, NYE & HOLMGREN, INC. t TOP DATION TEST PIT 1 TEST PIT 2 Registered Professional V. FINISHED GRADE OVER TANK 57 G.S.E. = 55.9 G.S.E. 56.6 Engineers and Land Surveyors FINISHED GRADE OVER D. BOX = 57 FINISHED GRADE OVER LEACHING SYSTHEM = 57 0 0 A 812 Main Street, Osterville,MA 02655 87MIN. 3" (mi . A LOAMY SAND L,DAMY SAND Phone - (508)428-9131 Fax - (508)428-3750 4" SCED. 40 PVC : ... 2„ 10 YR 412 2" 10 YR 4 2 FIRST 2 (TO BE LEVEL) € (TYPICAL) 4' SCED. 40 PVC 9' (min) Cover s•t .� B B PVC or OL2 min 36" (max) Cover LOAMY SAND LOAMY SAND k GAS'BAFFLE 6" SUMP 4" SC „ :. . . FINISHED CONSTRUCT ACCESS 10" CI TEES ED. 40 PVC 2"Layer 1/8 to1/2" 27" 10 YR 5 6 24 10 YR 5 6 Q' 20' 40' BASEMENT - MANHOLE OVER INLET : FLOOR TO TANK TO AT LEAST :- . ,, • -•s •. .:. C C Peastone LEACHING CHAMBERS ,. :., :. - WITHIN 6" FINISH G 6" CRUSHED - Slope 0.005 min ;.: ¢ REINFORCED coNCRET STONE MEDIUM SAND MEDIUM SAND FOOTING 4" PVC O O O O • O O O O O O 128" 2.5 YR 7/4 117" 2.5 YR 7/4 SCALE:1"=20' DATE: 2/28/2001 •Y SOD O O O O O O O10, O O REV. DATE: REMARKS A 3 19 2001 REVISE WATER SERVICE 1500 GALLON SEPTIC TANK DISTRIBUTION BOX 5' MIN TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE DRAWING NUMBER �- SEPTIC TANK TO BE INSPECTED & CLEANED ANNUALLY 7 OUTLETS REQUIRED No Groundwater Observed NO WATER ENCOUNTERED I CULTEC& RECHARGER 330 PERC ® 37" H:\2000\2000-94\civil\base\200094sp.dwg RATE= <2 MIN/IN 2000-94 4 I i s