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HomeMy WebLinkAbout0620 SAMPSONS MILL ROAD - Health 620 SAMPSON9MILL RD. , COTTUIT I A = 040 134 " i i TOWN OF BARNSTABLE LOCATION �j ;� d�'lPS'o� 177iLl eQ SEWAGE # ` G¢ 7/ ate--VILLAGE ASSESSOR'S MAP &LOT 0�l®_ 1� INSTALLER'S NAME&PHONE NO.) 5. Z 77&/-7 7 SEPTIC TANK CAPACITY F e / ellLEACHING FACILITY: (type) J � �8/`�r'/ .(size) .�`d NO.OF BEDROOMS r BUILDER OR OWNER 1:4A1 �. PERMIT DATE: 2'!�' ` � 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 c rp; 1 e l�lg� Q -3 6" ----------------- '® F i :. `©No. Fee p�d 3 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLE., MASSACHUSETTS es 0[ppYication for Digpogar *pftem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.% o 0 A4 Owner's Name,Address and Tel.No. s p ll�Assessor' 3 ii/l VI�Li�I/ Installer's Name,Address,and T 1.No. ,^��r�C(` I e igner's Name,Address and Tel.No. yaj44((Z Typ of Building: Dwelling No.of Bedrooms Lot Size is sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures n Design Flow !l6��,���/ �i�otf f 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 S P67 t 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 Environmental Cod nd not to pla a system in operation until a Certifi- cate of Compliance has been issued b th' Board of Health. Signed w _. _ Date 4� ` Application Approved by Date Application Disapproved for follo ing reasons Permit No. T7^ -7 17 Date Issued TOWN OF BAMSTABLE i LOCATION Si7?PS'0/9 fir`/ e Q SEWAGE # VILLAGE C�a�U� _ASSESSOR'S MAP & LOT 77 INSTALLER'S NAME&PHONE NO. � 5. ��C� ��1�f a 7 76j�� SEPTIC TANK CAPACITY �SCid - r r LEACHING FACILITY: (type) Sr ��>� (size) NO.OF BEDROOMS ,_. - BUILDER OR OWNER PERMITDATE: �!7 � � 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 3CO feet of leaching facility) Feet Furnishfd by l k� SO No./ / — Fee x THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for �Digogar 6pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components s Location Address or Lot No. b]O 5��N A J Owner's Name,Address/and Tel.No. Assessor's Map/Parcel �/` Installer's Name,Address,and Tel.No. 1� 1� e gner's Name,,,,Address and Tel.No. Type of Building- Dwelling Dwelling ' No.of Bedrooms � Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures f } Design Flow «V l l om V gallons perday. Calculated`daily flow gallons. Plan Date Number of sheets Revision Date e i'r Title' Size of Septic Tank Type of S.A.S. Description of Soil i Moto Nature of Repairs or Alterations(Answer when applicable) f 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 Cod d not to placesthe system in operation until a Certify cate of Compliance has been issue bV oaz of Health. ✓ Signed �- "� Date Applicatl'on.Approved by 1� J � Date a— ( - Application Disapproved for t e follo ins reasons .a Permit No. ?' -7/ 7 Date Issued 4 _ ---------- THE COMMONWEALTH-OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compli4hre THIS IS TO CER h,t the O -ste-S�w ge ispo 1.Sy�Constructed( )Repaired( )Upgraded( ) Abandoned( )by X at has been constructed in accordance with the provisions of Title 5 an the for Disposaf System Construction Permit No. - dated Installer Designer The issua e f s tMa1 not be construed as.a guarantee that th s e -will function-is,des e O Date Inspector �Jl U f r� —————————————————————————————————————— No. Fee 0, t--)— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS 30igpo5af *p5tem Construction Permit Permission is hereby granted to Construct )Repair( ) pg , e( )Abandon( ) System located at d ✓ 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"be completed within three years of the date of this t. Date: / l �" Approved b vyt Towh olF.6ar-nShable ps `yv3 Department of Health,Safety,and Environmental Services Public Health Division Date /7 97 367 Main Strccr,Hyannis MA 02601 dARrier'ARUK 1MAt7& 4oraeal�� Date Scheduled i7 97 Time AIoo� - Fee Pd. - Soil Suitability Assess»zent, or Sewage Disposal Performed By:A P_m� oJC\S,„,_ a'w._ ~ _, IWitnessed By:_ J F_,-9--/- LOCATION & GENERA;.L- NFOR.MATION Location Address Owner's Name Address Assessor's Map/Parcel: s C l_ ( Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use �P��,��tm Q Slopes(9.0) Z 76 — Surface Stones ,r/oitJ Distances fmm: Open Water Body N N 1t Possible Wet Area �'W C-Q Drinking Water Well A)aN R Drainage WayA)O A,,""t ft Property Line 7_ft. Other g SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) � 7 2oG f Parent material(geologic) 94.1 t Depth to Bedrock Depth to Groundwater; Standing Water in Hole: /V0A-) ' Weeping from Pit Face NO N Estimated Seasonal High Groundwater NON DFTERMINATIHN FOR:SEASONAL HIGH WATER TABLE Method Used: !vim wAf4/L `� Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side ofobs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj,Groundwater Level PERCOLATION TESTlate: Tirtrc Observation � � &A, Hole# , .°�, Time at 9" / Depth of Pere y��w " ' Time at 6" I d'^fN Stall Prc-soak Time( Time(9"-6") End Pre-soak " Rat;Min./Inch Site Suitability Assessment: Site Passed x.-- Site Failed: Additional Testing Needed(YIN) Original; Public Health Division Observation Hots Mit i To Be Completed on Mack------� Copy' Applicant DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Tcxture Soil Color Soil Qthcr Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ' o 0 m 4 DEEP OBSERVATION HOLE LOG Hole Dcpth from Soil horizon Soil Texture Soil Color Soil " ' Other Surface(in.) (USDA) (Munsell) MdulioS (Structure,Stones,Soulderes. Consistency. v t DEEP. OBSERVATIfON HOLE LOG ; . Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°' gavel DEEP OBSERVATION HOLE LOG ,;Hole# Depth from Soil Horizon Soil Texture Soil Color `Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.rn to c X r% t \ - Flood In u . Above 500 year flood boundary No— Yes X Within 500 year boundary No_ Yes Within 100 year flood boundary No_ Yes t.•Yr fit' ;f?� Depth of Naturally Occurring pervious Material Does at least four feet of naturally occurring perviou tit terial iexist in al'I areas observed throughout the area proposed for the soil absorption system. ti If not,what is the depth of naturally occurring pervious material? � Certification / q I certify that on / (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-3196MR 15-017. x COTUIT PLAN REIN 537145, L C. 22824D SH.3 O w RES . ZONE "RF" FLOOD ZONE.- �O 4 CROUNDwATER PROTECTION OCUS 0 VERLA Y DISTRCT "AP" \ 101 "LE'ESIDE LANDING" '� ST � OPEN SPACE A30•,7cp 5 I /4 �p LOCUS MAP of 2 3 __PROP.=.. 00 s2 W _3B�-_o_ o ROOJlS `C.B. --_- ,-_ ==2�•0 OC I A.M. w 70� 40/7 coRrc. 106 �, 7� - 103 SITE & SEPTIC co vER N PLAN OF LAND LOCATED AT INE 5 3p ASSESSORS MAP 57 ALD - o . PARCEL 1 GER 0AD �. Ca. fo3 PARCEL "1 " s'�� 1 SAMPSONS MILL ROAD g' N A.M. 40/65 COM ,, MA. AREA= 88, 74 7 SF PREPARED MR- ros .B. EL=104 ` BRIAN BELLANI STK • C.B. YANKEE SURVEY CONSULTANTS A SHED S 3,��12 ��'� ` . P. 0. BOX 265 O UNIT 1, 40 INDUSTRY ROAD MARSTONS 'MILLS, MA. 02648 4120 �' �� ` PH. 508 428-0055 - FAX 508 420-5553 A.Af0 ( ) ti0 '° d PAUILI rn SCALE 1"40' 1 DATE.• 12117197 A.M. 40 64 +� REV 8/26/99 REV A.M. 40163 JOB NO. 51488A SHEET 1 OF 2 � 4 EL, __105.5' 7vp OF mTiRbATION I r 20' MIN. 10` MIN. CONCRETE COWJW 4" SCHEDULE 40 P.VC MIN.. PITCH 1/8 PER FT. YVP LOAD 2%4YER OF WASHED • + MAX . . .. . / / CONCRETE COVER EL=105.0 7EL=105-25 4" CAST IRON PIPE OR EIQU, j MINIMUM " ITCH 1/4 PER FT. CLEAN SAND lD D, FLOW LINE 5' INVERT 1.to 14. EL= 103.0_ MIN. EL=101.50 GA_vINVERT �6 , SULEVEL INVERT EL=102.5' INVERT _ INVERT °°O° °° °° = 102. 75' EL= 102__ EL=101.75' °°° ° �-:,o °0�°9 EL - =99.0 (m 9E PLACED ON M" BASE) DISTRIBUTION ° JAWHANICALLY COMPAMED OR B" OF S70NE BOX ---GALLONS EL=101_ SEPTIC . TANK �MORE W 4T R TESTED UTLET 7' x 40' TRENCBI FVRMATION PLACE ON 6 SMNE h _ PROFILE 0 F,: 3/4" � 1-1/2" SOIL .ABSORPTION SEWAGE DISPOSAL SYSTEM DOUBLE WASHED SMNE SYSTEM , (SAS) H-20 NOT TO SCALE BOTTOM OF TEST HOLE (9/17/97) ELEV.=_90.5= PERCOLATION RATE _�z_ MIN./IN. OBSERVATION HOLE 1 OBSERVATION HOLE 2. ELEV ELEV. 0" 102.5 0" 102 2" -T 102.3 2" 0 101.8 P,� 9013 p Zs " LS2. Y32 GENERAL NOTES' 3 I1o2.z 3 101.7 DATE OF SOIL TEST 9/17/97 " LS 7 5Y 513 ! " LS 7 5Y 5/3 JERKY DUNNING - BOH 6 I102 6 1OL5 WITNESSED BY: 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. M LS 75Y 2.513. ;. LS 7 5 Y 2.5/3 SOIL TEST DONE BY: ARNE OJALA, P.E. TITLE 5 AND THE 719WN OF __ BARNSTABLE__ RULES AND 9 101.8 9 101.3 DOWN CAPE ENGINEERING REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. LS 10Y 5/8 LS 10Y 5/8 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO 38" C 99.3 38" C 98.8 07THIN 6 OF FINISHED GRADE, OTHERS WITHIN 12 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF MEDIUM CLEAN MEDIUM CLEAN SAND WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN LS 2 5Y s14 Ls 2.5Y s/4 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE 138 No WATER 'f 91 138 NO WATER 90.5 DESIGN CALCULATIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. ENCOUNTERED ENCOUNTERED 4) ANY MASONARY UNITS USED TO BRINC COVERS TO GRADE SHALL NUMBER OF BEDROOMS . 3 BE MORTERED IN PLACE. � -5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH GARBAGE DISPOSAL NO TOTAL ESTIMATED FLOW DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT.IS TO INSTALL (5) MAXIMIZER INFILTRATORS "H-20" Il0 GAL/BR/DA Y x _ 3 _ BR) 330 GAL/DA Y OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. ( ----- 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VATION CONTRACTOR 2' DEPTH : SEPTIC TANK 1500 GAL IS TO CALL "DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS S719NE-ALL AROUND SOIL CLASSIFICATION . . . . . . . . 1 PRIOR TO COMMENCING WORK ON SITE. 40' X 7' DEsIGN PERCOLATION RATE . . . . < 2 MIN./IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS . / E. . INSTALL IN MEDIUM SAND EFFLUENT LOADING RATE . 74 GAL/DAY S F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE 8) PARCEL IS IN FLOOD ZONE___C . TOTAL LEACHING CAPACITY 346 GAL/DAY 9) LOT IS SHOWN G'f'h AS?ESSORS MAP _57_ AS PARCEL _ 1 ___. . 1DEN' t (40+40-f 7f 7)X(2)X( 74) BOTTOM 40 X 7 X . 74 ,Y _ _gmrlrT--9_n p 9 _Tn n NLIMRFR 51488A ___ _