HomeMy WebLinkAbout0107 SHELL LANE - Health F107 Shell Lane
Cotuit
A=019-099
TOWN OF BARNSTABLE
LOCATION Sti e/l L, SEWAGE It a 0(D
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. TC � j¢o
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) a-P05, cA4M.-r5 (size) /a 3xasx,
NO.OF BEDROOMS 3
OWNER o S
PERMIT DATE: 0-(1)COMPLIANCE DATE: )I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well 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-/ =30
a 3 „ c-3 = P' G
I3-3 a� ° :3a 4
010-7
a p
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in Co.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2ppricatiou for Bizpoal *pttem Cou5tructiou Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address orrL $G Lot No. /Q 9 .-// L er C Owner's Name,Address,and Tel.No.
Assessor's Map/a cel1 �p �'� • "•�. GCO/ ( W of
Insta is Name,A dress,and Tel.No. Designer's Name,Address and Tel.No.
_ $
Type of Building: O&jo?S"/-770'A
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other . Type of Building IIG No.of Persons Showers( ) Cafeteria( )
Other Fixtures 2
Design Flow(min.required) 330 gpd Design flow provided .J gpd
Plan Date Number of sheeis- Revision Date
Title 0.
Size of Septic Tank K OO 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 Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by th' B and o ealth.
Signed Date -`
Application Approved by 6 IL Date —f
Application Disapproved by: Date
for the following reasons
Permit No. y`a j® 317 Date Issued 7-
r"
4,
2 010`91 1
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TO.WW OF BARNSTABLE, MASSACHUSETTS Yes
0(ppCication for 33i5ponl *pgtem Congtruction Permit R.. -
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot.No. S ``F' L ce N of Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel� �" G Gel U/
! Instal,er's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No. of Bedrooms /t Lot Size sq. ft. Garbage Grinder ( )
1 Other Type of Building R< S• No.of Persons Showers( ) Cafeteria( )
Other Fixtures
i
Design Flow(min.required) 330 gpd Design flow provided 3 5 gpd
Mari Date Number of sheets Revision Date-,
Title
Size of Septic Tank 150,9 Type of S.A.S. a St9'C�
�t
Descriptionof Soil
Nate of Repairs or Alterations(Answer when applicable) yi
a
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 Code and not to place the system in operation until a Certificate of
Compliance has been issued by tK,, ci' alth.
Signed Date
Application Approved by _ IL Date _30 — ry
Application Disapproved by: Date
r
for the following reasons
q
Permit No. 2610
3 / Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
j BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( � '
Abandoned( )by ?1
at I6 7 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. p)b— °t� dated
Installer Designer
73#bedrooms �'7j Approved design flo gpd
i
i The issuance of this permit hall not be construed as a guarantee that the system w rYl f .Gtt n as des- Id.
Date h �0 Inspector- �!
3 No. joI(! '.
— �� .--- ---->— t---z�--,—. ----.— ..— Fee_,—,� €J . ----
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION.— BARNSTABLE, MASSACHUSETTS
ligpogal *pgtem Congtruction Vermit
i Permission is hereby granted to Cons ct ) R it ( ) oe ( ) Abandon ( )
System located at W
l
j and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this permit fj
7
2 J S
Date T'� 0^ (o Approved by �`!� F--
r
Town of Barnstable
°F1HE Tom, Regulatory Services
ti
Thomas F. Geiler, Director
BAMffr" ►
MASS. g Public Health Division
`b 039. .�
ArEON,o.�A Thomas McKean, Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: i/$=/d Sewage Permit# a 0/0 -3�q Assessor's Map/Parcel
Installer & Designer Certification Form
Designer: W_,`/r # Installer: TC A4 /6 6�1S1�
Address: 1°9, /30,( L/i7 Address: go, /3ox 3 3y
On 3 0-/O j"�. �R, ��o was issued a permit to install a
(date) - (installer)
septicsysteni:'at i YQ 7 5 // L h , `_ ,- + ;+ = bas'e`d on a`:design drawn by
(address)
dle dle dated -d yl.0,
(designer)
ZI certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the.
distribution box and/or septic tank. Stripout (if required) was inspected and the,soils
(' were found satisfactory.
I certify that the septic system referenced "above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or. any vertical relocation of any component
of the septic system) but in accordance with State & Loca Plan revision or
certified as-built by designer to follow. Stripout (if req � F ed and the soils
were found satisfactory. DA E cyGN
V YER. Cn
No.1140:
(Installer's Signature)
G/STE
IF, S4N}?AR\�N
esigner's Signature) (Affix Designer's Stamp Here)
PI EASE RETURN TO`BARNSTABLETUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
gAoffice fortes\designercertiflcation form.doc
1 U�1'l1 l►1 11►i11'lI5Z1�)Il. 1'f�f
Department of Health,Safety,and Environmental Services
Public Health Division Date '
367 Main Street,I lyannis MA 02601
HARMABM
f63q
°rEotrtK+� Date Scheduled �' 'Time„ _ Fee Pd.
' "bit -Assessment`or.Sewa' a Dis osal '.
Soil Suitabil y,., .f g. .. p _.
Performed By. �t/ W itncssed By:
LOCATION & GENERAL INFORMATION'.
Location Address Owner's Name
45 i?' :le G'•. mac
Address d/* /i�/>,,xP.-I ST
Assessor's Map/Parcel: ®j�--- O99 Engineer's Name 4.,),:GG�
NEW CONSTRUCTION REPAIR Telephone N
Land Use /�v�IG �S7�i � � Slopes(%) Surface Stones
Distances from: Open Water Body-4 " tt 'Possible Wet Area/-� ft Drinking Water Wel12PAC>ft
Drainage Way ��� R 'Property Line - *'ft Other ► ^-- ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
S E P 1 7A REC'D
By
_ '
zwlorl
vi
Parent material(geologic) >> Depth to Bedrock
Depth to Groundwater: Standing Water in.Hole: ti/ Weeping from Pit Face"' 'y
Estimated Seasonal High Groundwater
DEA4 Rif I ATION Fail SEASONAL HIGH'WATEII'tTABLE
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 ft.
Index Well#_ Reading Date:_ Index Well level• Adj..factor Adj..Groundwater Level_
PERCOLATIONTESTTune `
Observation '
Hole Time at 9„
Depth of Pere �. 36c _ .� ',. Time at 6',
-
Start Pre-soak Time Cu i! Time(9 6')
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed_� Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back=---�
Copy: Applicant -
DEEP OBSERVATION HOLE LOG Hole#�_
Depth from Soil Horizon Soil Texturc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
%
r
DEEP,OBSERVATION HOLE LOG Hole#:,:I;�
Depth from I Soil Horizon I Soil Texture Soil Color ,, Soil Other
Surface(in.) (USDA) (Nlurse!!) Mottling (Structure,Stones,Boulderes.
oGravel)
2 � -�
DEEP OBSERVATION HOLE LOG Hole# ''
Depth from Soil Ilorizon Soil Texture Soil Color Soil"" Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,oGravel)
41
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon , Soil Texture Soil Color Soil' Other
Surface(in.) (USDA):' (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,%Gravel)
41
32f z c -IS s
Flood Insurance Rate Ma.)7
Above 500 year flood boundary No_ Yes H
Within 500 year boundary No o/ 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? _
If not,.what.is ifie depth'of naturally,occurring pervious material?
Certification
I certify that on 1(0 9 (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 requir ining, xpertise and experience described in 310 CMR 15.017.
Signature ~ � ate �7 g
lv
Depsu-tment of Ilcallh,Safely,and L'Ilvir-On111ell(III Services
Public Health Division Hate
367 Main Street,I lynnnis MA 01601
� eAarmrAara g »
MARS039.
�-
9to Date Scheduled ' �J L 'Thne; Fee Pd.
-Soil Stuctabilcty Assess»zeld for Sewage_Dcsposal
Performed By \ 1����� V" I ice— Witnessed Dy.>� i` (v. ' lh
LOCATION & GENERAL INFORMATION
Location Address Owner's Name
O 7 ��c-oozy[-- c,��S S•
6W—LC Wr l Address
T' i9cE�y�vvrLl, !/�9 2 3i
Assessor's Map/Parcel: 9p, C> Engineer's Name
NEW CONSTRUCTION REPAIR Telephone 0 7 7•S cy 3-5-
Land Use layll c-S� Slopes(%) Surface Stones
Distances from: Open Water Hod 17 23 n Possible Wet Arca/5rU^ n Drinking Water Well 11R
Drainage Way ,1So tl Property Line ft Other n
L
SKETCH:(Strcc(name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
n - -
V Q r ^ r • ^
Y
Parent material(geologic) Depth to Bedrock
Depth to Groundwater: Standing Water in I tole: Weeping from Pal Face'
Estimated Seasonal High Groundwater �f.9
I)ETERMINATION FOR SEASONAL NIGH WATER TABLE
NIcthod Used:
Depth Observed standing in obs.hole: in.- Depth to soil mottles: in -
Depth to weeping from side of obs.hoic: in. Groundwater Adjustment It.
Index Well H_ Reading Date:___ Index Well level Adj.factor Adj.Groundwater-Lev I_
PERCOLATION TEST. >dite Y-Ua Time
_ Observation
Time at 9" -
Depth of Perc �G -Sy y9 Time at 6"
„ J
Start Prc-soak Time(0u i/ .Time(9"-6")�
End Pre-soak
Rate Min./inch
-------------
Site Suitability Assessment: Site Passed I/ Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To He Completed on Back---
Copy: Applicant
DEEP OBSERVATION MOLE LOG Hole#J— s
Dcp1h from Soil I lorizon Soil Texlurc Soil Color Soil Other
Surfncc(in.) (USDA) (Munsell) Mottling (Structure,Stones,noulderes.
e
Z,S
DEEP OBSERVATION HOLE LOG Hole#—
Depth from Soil Ilorizon Soil Texture Soil Color Soil Other
Surface(in.) I (USDA) (NAunsell) Mcitling (Stnictcre,Sims,Doulderes.
e
� � y
/--V
o J
DEEP OBSERVATION HOLE LOG Hole# 3—
Depth from, Soil I lorizon Soil,rcxlurc Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
e
0-2
v
w ,
,1j Z v /-
L` ! .'s t
i
Its v
DEEP OBSERVATION HOLE LOG Hole#�_
Depth Bonn Soil Ilorizon Soil'l'cxture Soil Color Soil Other
Surfncc(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes.
e
o
3.7 $ 5 2 L
3Z`- Z6 c s s
Flood Insurance Rate Mane
Above 500 year flood boundary No__ Yes
Within 500 year boundary No `✓ Yes
Wi(hin 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?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on 1019 (date) I have passed the soil evaluator examination approved by the
Department of Envir6nmental Protection and that the above analysis was performed by me consistent with
the required- fining, xpertise and experience described in 310 CMR 15.017.
Sionahirp ► 1 �/ �/ C 'L " . �l/�/ ).l —
A ' INSTALL K15EK5 COVERS TO PIPES TO BE LAID LEVEL FOR DEEP OBSERVATION 110LE LOGS
I\ WITHIN G" OF FIN15H GRADE 2' OUT OF DISTRIBUTION BOX
(SEE PLAN VIEW FOR LOCATIONS)
2" LAYER OF 3/8" PEA5TONE DATE: 09-09-2010 P-13047
OVER 3/4" - I %2" DOUBLE WA5HED TEST BY: D. MEYER, RS CSE
j 5TONE ALL. AROUND WITNE55: D• 5TANTON, HEALTH AGENT
PERC RATE:. < 2 MIN./ INCH
U
EL. 26.5 DEEP OBSERVATION HOLE#I EL. 28.2
EL 28.0 EL. 27.7 DEPTH T.O.F. @ - SOIL 501L 501LCOLOR 501L
4"5CH FROM OTHER
EL. 28.5 4"SCH 40 PVC OP @ EL. 25.2 HORIZON TEXTURE (MUN5ELL) MOTTLING
_ 40 PVC
T .SURFACE
Ii.i� 1 p 4 5CH 0 PVC`., -
25.75 25.50 8 -32 B LOAMY SAND I OYR6/8
(2) 500 GAL PRECA5T DRYWELL5
Q �24.63 BOTTOM @ EL. 22.50
i>s INSTALL GA5 BAFFLE �24.80 32"- 144" C MEDIUM SAND 2.5Y7/4
IN OUTLET TEE 25.25 24.50
T) DB-5
Q INSTALL TANK*D-BOX G 3'
1500 GALLON PRECAST ON G" LAYER Of CRUSHED DEEP 005ERVATION HOLE#2 EL. 28.2
STONE
LOGU� w 5EPTIC TANK °EPT" solL solL solLcoLOR solL
BOTTOM TH @ FROM HORIZON TEXTURE (MUN5ELL) MOTTLING OTHER
00 EL. I G.2 50J I'F B E A LOAMY SAND I OYR4/I
2,5 8"-32" B LOAMY SAND I OYRG/8
Q 5EPTIC 5YS-i-EM PROFILE
32"- 144" C MEDIUM SAND 2.5Y7/4
2 G Sl
\30 24 / DEEP OBSERVATION HOLE#3 EL. 28.5
22 DLPIIi 501L 501L 501L COLOR SOIL
\ `r� S FROM
17 HORIZON TEXTURE (MUN5ELL) MOTTLING OTHER
I0"-7" A LOAMY SAND I OYR4/1
34 1 \ \ j /1 7"-32" B LOAMY SAND I OYKG/8
' \ i 20 32"- 1 2G" C MEDIUM SAND 2.5Y7/4
/1
I / 30 0 \ \ 18
DEEP OBSERVATION HOLE#4 EL. 28,5
��/ DEPTH SOIL 501L SOIL COLOR SOIL
\ I / FROM OTHER
i� HORIZON TEXTURE (MUN5ELL) MOTTLING
1�/ O"-7" A LOAMY SAND 1 oYR4/1
I / ZI / �,\ \ U / - �� \ 7"-32" B LOAMY SAND I OYRG/8
// `�\ \ /I ` \ j \�� �i 32"- 1 2G" c MEDIUM SAND 2.5Y7/4
L�l / NOTE: NO GROUNDWATER ENCOUNTERED IN ANY OBSERVATION HOLE
41
/-y�
I �� ` 6MTli #3 DESIGN DATA
/t`-,2o-C) P R�SFD �� \ \ �` DAILY FLOW: (3) BEDROOMS x 110 GPD = 550 GPD
h p/ \ SEPTIC TANK: 330 GPD x 200% = GGO GPD
U5E: 1 500 GAL. PRECAST SEPTIC TANK
/gyp / ` /f�TH #2 IST/NG / / DISTRIBUTION BOX: DB-5
�o)' JMTH #I r E�(/NG / ) / / 501L AB5ORPTION 5Y5TEM.
O F / _ _.. L'�-=E _', ' f:; GAI_. IORECIA5T DI Y WELL5 LINFID W/4'
OF DOUBLE WA5HED STONE
/ / 7b of eAlri � 5 , 28'S EXIST / CAPACITY:
s OOP SIDEWALL AREA: 76 x 2 x 0.74 = 112.5 GPD
G BOTTOM AREA: 13 x 25 x 0.74 = 240.5 GPD
TOTAL CAPACITY: 353.0 GPD
34
32 GENERAL NOTES
�
I . 5EPTIC SYSTEM 15 TO BE IN5TALLED IN ACCORDANCE
30 - �� WITH 3 10 CM R 15.00: TITLE V.
/ / / , / / / 2. TH15 SEPTIC 5Y5TEM 15 NOT DE51GNED FOR THE USE
OF A GARBAGE D15PO5AL.
3. TH15 PLAN 15 NOT TO BE USED FOR PROPERTY LINE
DETERMINATION.
5'2 4.,, CONTRACTOR TO PROVIDE 48 HOUR NOTICE TO
25 / '; I / / DE51GN ENGINEER FOR ANY REQUIRED IN5PECTION5.
° 5. CONTRACTOR TO BE RESPONSIBLE FOR LOCATION
OF ALL UTILITIES, ABOVE * UNDERGROUND, PRIOR TO
2G / ��� i / _ \ ANY EXCAVATION OR CONSTRUCTION.
24 -- - ', � �, SITE --- SEWAGE PLAN
22/ / / / _ / ��/ y \ 14 FOR
107 5HELL LANE COTUIT, MA
20/ / / / / / / / I \ PREPARED FOR
GEORGE E. R055 REVOCABLE TRUST 2007
i 18 / / / / / �� 12 �\ �o DA REN SCALE: DATE: DRAWN BY:
1 I. 20' 09- 1 5-201 0 TMW
G / / / / / \ MEYER !
/ '� I No. 1140 ' / JOB NUMBER: REVISION: SHEET NUMBER:
/ / / / / � I O �Fc/sTE � ,aF °N , 1 0-038 5P- !
14 / / / i S41VITARkP�, ��� � 1�� °, �� WELLER * A550CIATE5
12 1 G45 FALMOUTH RD., 5UITE 4C -� P.O. BOX 4 17 CENTERVILLE, MA 02G32
10/ EpGE 1•'�- �F-' 2 WINDY WAY, #232 NANTUCKET, MA 02554
�w��gNo TELEPHONE * FAX: (508) 775-0735
EMAIL: trl5Weller@comca5t.net
REGISTERED LAND 5URVEYOR5 ENVIROMENTAL CON5ULTANT5
Traverse PC