HomeMy WebLinkAbout0027 TRUDY LANE - Health 27 Trudy - L- - �-
�
Cotuit
- - A= 020 139
J
TOWN OF BARNSTABLE
LOCATI&N' ��' �� IN,. SEWAGE # ZOQ SU
VILLAGE,t ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. I tC��Iht. Coh •
SEPTIC TANK CAPACITY 40 I'S-GO -
I! LEACHING FACILITY: (type) (a� a 6� P r-S (size)'S60 qaJ
NO. OF BEDROOMS
BU1iDER OR OWNER �G
I
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 any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
o
f v
�o
I
; � n
CP11�5
Lv
N
N .
No. THE COMMONWEALTH OF MASSACHUSETTS 9 FEE
�����///�// BOARD OF HEALTH
APPLICATION FOR ISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct (1 ) Repair ( ) Upgrade ( ) Abandon ( ) - 4omplete System ❑Individual Components
2,1
cation. Owner's Name
`V1'Y �2 v &,,, 1?�Gl
n Map/Parcel# Address
(f� Lot# 14Telep e#
Installer's Name Designer's Name
Address Address
—1,-Lr�
Telephone# Telephone#
Type of Building: Lot Size 613 Sq.feet
Dwelling—No.of Bedrooms Garbage Grinder ( )
Other—Type of Building No.of persons LP Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.re fired) gpd Calculated design flow:_i5o gpd Design flow provide gpd
Planfi Date �U V Number of sheets �T Revision Date
Title `` 'cLaD am ff
Description of SOil(s)V�- b, Lea II- ° LO S -� 3 *% 12.0"
Soil Evaluator Form No. Name of Soil Eval ator 9 ,SGiM�-Glt.0 Date of Evaluation 1-3-67,
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the a ve described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and fu s n place th ystem in operation until a Certificate of Compliance has bee issued y the Board of Health.
Signed at �®
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
No. H'E'COMMONWEALTH OF MASSACHUSETTS Vf \ �O�
. - BOARD OF HEALTH '
y ~ APPLICATION`FOR ISPOSAL SYSTEM CONSTRUCTION PERMIT
i Application for a Permit to Construct ) Repair ( ) Upgrade ( ) Abandon ( ) - �omplete System ❑Individual Components
Z'1
4 wy n )1 �a��i{ocatio; � # �( � Owner's Name
.� f1 , Map/Parcel# \ t ( ' f Address
Lot# Telep tie#
Installer's Name Designer's Name
t
Address 1�- vr„ Address
Telephone# i Telephone#
c
Type of Building: ' z: '" Lot Size 1591.3 Sq.feet
Dwelling—No. Bedrooms I Garbage Grinder ( )
Other=Type of Building ..f J No.of persons LO Showers ( ), Cafeteria ( )
Other,,fixtures )
Design Flow(min.required) gpd Calculated design flow 3_5 gpd Design flow provided gpd
Plan: Date -2 _(jam. Number of sheets Revision Date
Title Ltn ,. j A 'SAD
Description of Soil(s) »-w 3c;�4.LD 3t "-� 1.2,0" -
{ I m
�' ,
Soil Evaluator Form No t.t `Name of So11.Eva1 ator .sAAh Gf=t,c.. Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS t
The undersigned agrees to install the a ove described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and fv gems reel ft place th system in operation until a Certificate of Compliance has bee issued y the Board of Health.
Signed n /{ at
` —ijspections �/ o
3
FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
r
NO.ZOn- -W3 THE COMMONWEALTH OF MASSACHUSETTS FEE 160
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( )
by, p / _ t�+
at Z �i tti lJi�r t�-� yfik+
has been installed in accordance with the provisions of 31(0 (ZMR 15.00 (Title 5) and the approved design plans/as-built
plans relating to application No.7-0 0 2-313 dated 9!r3 OZ Approved Design Flow (gpd)
Installer
Designer: Inspector Date 2/Z e 4,3
Th'e 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 t
No O ✓ /—rHE COMMONW ALTH OF MASSACHUSETTS FEE
PA V�,-TP,1`BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is her by : anted o C nstruc ( pai ) Upgrade ( A n ( ) an individual sewage
disposal system at s described
• in the application for Disposal System Consfruction Permit No. dated
Provided: Con it 4ion sh 1 be mpleted within three years of the date of this p r it. 11 Va7filltions10)
ust be met.
Date Board of Health
FORM 2 - DSC DEP APPROVED FORM 5/96
FORM 1255 (REV 5/96) H&W HOBBS&WARREN'TM PUBLISHERS- BOSTON
> i
TOWN OF BA.RNSTABLE
LOCATION Z� �� SEWAGE # Lml-su
VILLAGE co ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONErr NO. %C.S6 Cno
SEPTIC TALK CAPACITY t1�t� I�GO
LEACHING FACILITY: (type) ?a CA"ta rS (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMIT DATE: COMPLIANCE .DATE: 7-
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 Feet
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by
LT -i ZZ
1 �
i � - 3
N Vo
Cy
i
i
�. V■in s.si... ww.onm.
.asl mosses
a wool/O..M.`.�•.'/•/
jana
• flit+�...s-louse.iliIiss
F;'--i tki,I'm
irk Am.
U � �Ii1;�1111111 I.
o _
II Y,-'
11 ice';
Illegal
r .
08/30/2002 11:01 5082402396 S C HAYES ARCH PAGE 02
S ~
� II O II
II
OD
Q II
M 11
N II
O II
II �
II
II
II
I1
11 ,
II
Q ni
II
it
11 �
� II
II
,
11
m „
r II
m
< 1I;
D II
ii
—4 I I
Z I I• �0�
II '
II
ii
li
I1 '
II �_
1I
II
I1
I I�
II '
I ,
II
IIJr_
I I�
=Elt
Qt NCB
8/30/02ow. .u.wea na1 w-N1i owrui�ie.s0ief . 'i.r�.~.iiisw� r�br�i�Miu�s�u r .14s ia.w Meow
3 Torn of n1li nst9ible I'll l� a
Department of I lealth,Safety, and 1'snvironmental Services
AIM Public Health Division Date (o -C1(P-ca--
�y�� 367 Main Strcel,I lyannis MA 02601
• BA RNBTABIE,
039 � ,00 Fee Pd. 100, 6 D
'OrEu►Ao�" Date Scheduled Time
Soil Suitability Assessment for Sewage Disposal
Performed By:bA i1I� ���� Witnessed By: 4✓
LOCATION & GENERAL INFORMATION
Location Address Z1 �(U� A - u Owner's Name �\� �J�k�l
� Address
Assessor's Map/Parcel: (haP zoPa«<{ , 1 Engineer's Namc(�(19 4 14 ^
NEW CONS"fRUCTION V REPAIR Telephone H Cjpg. - ')2?-L- u
Land Use Loel.@nr� Slopes(%) 7d Surface Stones
Distances from: Open Water Body R Possible Wet Area It Drinking Water Well Il
Drainage Way R Property Line 0 Other n
SKETCH: (Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes)
EMIVE® +.
- 1
JUN 2 7 200?
Li vvvt�OF BARNSTAB�E
HEALTHOEPT.
---I —........--..............__...
cb\J
. \ t
Parent material(geologic) "47w a, S h Depth to Bedrock
Depth to Groundwalec Standing Water in I lole: Weeping from Pit Face
Estimated Seasonal Iligh Groundwater
IIETIERMINATION FOR SEASONAL HIGH WATER TABLE
Melhod I)sell:
r T Depth Observed standing in obs.hole: in. Depth to soil monies:
Depth to weeping from side of ohs.hole: in. Groundwater Adjustment fl.
Index Well H Reading Dale: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION TEST Date Time
Observation
ti
I tole N me at 9"
Depth of Percy •• Time at 6"
Start Pie-soak Time a /Z Time(9"-V)
End Pre-soak �� 7
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public health Division Observation hole Data To 13e Completed on 13acit j
Copy: Applicant
DEEP OBSERVATION MOLE LOG Hole# /
Depth from Soil I lorizon Soil Texture Soil Color Soil 01her
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Lloulderes.
n . o
Lm q ft
As� .
30 -Mo C- s
�o f�
DEEP OBSERVATION HOLE LOG Hole # 2-
Depth from Soil Ilorizon I Soil Texture Soil Color Soil Other
Surface(in.) (USDA) I (Munsell) Mottling (Structure,Stones,Lloulderes.
oina Pi
/ Zl
D
G —j 0 8 L. Y 2 S-X
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil I lorizon Soil"texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Lloulderes,
Consistency,° Grovel)
HOLE� � Bole #
I)EI;P OBSERVATION IIOI,1; LOG
Depth from Soil I lorizon Soil"texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
Consistency,%Gravel)
I
I
Flood Insurance Rate Mans /
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Depth of Naturallyoccurring 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? y.e f
If not, what is the depth of naturally occurring pervious material?
Certification /
1 certify that on yl 97 f (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 experie ce described in 310 CMR 15.017.
Signature— DateZ—
-
SYSTEM PROFILE
TOP OF NOT TO SCALE y
FOUNDATION EL. 77.5 FINISH GRADE OVER FI'41SH GRADE OVER
SEPTIC TANK 74.5 DI 3TRIBUTION BOX 75.0 FINISH GRADE
- . OVER TRENCHES 76.0
RISERS TO 6" �/ A
OF FINISH GRADE Y r
_ PRECAST CONCRETE
�. .. o' 500 GALLON DRYWELLS
3 MIN. - RISERS TO 6 .—.. b'
MIN.SLOPE 1% OF FINISH GRADE , OUTLET PIPE(S) LEVEL H-10 REINFORCED LOADING
13" FOR 2'( MIN.1% SLOPE TRENCH LENGTH = 25'-011
6" .-' MIN.SLOPE 1% ° 9 BEYOND
MIN. 0 DRYWELL LENGTH = 8'-6"
J- 73.05 72.85 �' 13"MIN. 14"
, a
16-SUMP r� ° °
MIN. F0
:< PVC OR CAST IRON TEES .<' t O,O:r 72.13 h�� `mod/" .,op;r •;, ,.a :r_ - `/ .,1 0,
- GAS BAFFLE � ,. ,: 4t.�•,' '`��° ,r: ,; .' ��,��,,.�,
-b bi0, ,,®, rp ;'r ,O ,e ,.P��-'O•e° r r ;•
DISTRIBUTION BOX 72.00 nor `� :: ►:; ; , - :,
I rr 3/4"- 1-1/2" DOUBLE EL.70.0 -
_ 1500 GALLON M NIMUM INSIDE DIMENSION 12
p w :� OUTLET3/4"- 1-1/2" DOUBLE ,
\ Ao �� PRECAST CONCRETE -0. M JIMl1M COENCRET EWAOLLVTH CKNESS 2T STONE D CRUSHED 26' WASHED CRUSHED 4
,< ._ -�• _
INSTALL ON COMPACTED LEVEL BASE STONE
BSMT.FLR. H-10 REINFORCED
ELEV. 70.0 - _ �6 0
�
or
�.:r r• :, OjO :'0 '1 'o'r r,f 'r � •'•r. •'''�r;...•.r , - rr , Ir ,, c , r
TRENCH SECTION
r `u'' '1 c'� °' r.` O r. � �...r'r o �®' ° • ,'0 ' 'r°� '0;'°, r.p'i0r0,"i ''''.rl
NOTE: EXCAVATE TO=C= STRATUM Ifni ORDER TO
SEPTIC TANK REMOVE ALL =A= & =6= IMPERVIOUS MATERIAL
INSTALL ON COMPACTED LEVEL BASE . WITHIN 5'OF THE SAS. REPLACE WITH CLEAN, 9" MIN. ' 3" OF 1/8" 1/2"
CLAY-FREE SAND 4" DIAM. 36" MAX:.,', DOUBLE WASHED
a, c -�'', .• • . . PEASTONE
~�^. _
N11 .
Y l ll •Imv-r. 3/4"- 1-1/2" DOUBLE
.:, � J •, o .r .r o o
cBAs ��� • • r l P 48" 5'-2" Ar STONE WASHED CRUSHED
J
TRENCH WIDTH
131-211
GENERAL NOTES: NUMBER OF TRENCHES 1
NUMBER OF DRYWELLS 2
o ' 1. ELEVATIONS SHOWN ARE BASED ON ASSUMED
i I I 1 (� _ /�7 •'f o' 2. ALL PIPES IN THE SYSTEM MUST BE CAST IRON OBSERVATION PIT
I ?' �/ III I ` U w ' • . OR SCHEDULE 40 PVC:
3.HEALTH AGENT/CAPE & ISLANDS ENGINEERING P-10277
-
�n..ur<.ri. ..�.,Y"v.`.a...v.,....m.-r-.yne.�.��..•,o-r u.u...wca /'� TA ^.1_�. I A ni
�533 e ��1N� �� /� ,� , II N I i MUST BE NOTIFIED WHEN CONSTRUCTION IS FERCvLAE i0i�l �'wr . �'2 {`�Alr. lN
5 �� s I j of I I COMPLETE PRIOR TO BACKFILLING. WITNESSED BY: G.STANTON
"�
11�Op� L.76,3/ L /� I i I I I 4.ANY CHANGES IN THIS PLAN MUST BE APPROVED BARNSTABLE BOARD OF HEALTH
BY CAPE & ISLANDS ENGINEERING AND THE BOARD
of HEALTH. „ THD#14&2 SAME
3,2002 DESIGN DATA
k\ RFsERV� ��N i� 4=43039'14" R=52' i� �� I I i , 5. MATERIALS AND INSTALLATION SHALL BE IN 0
= COMPLIANCE WITH THE STATE SANITARY CODE =A= LOAM
I� N` �I , �� /� �� [TITLE V]AND LOCAL APPLICABLE RULES AND 10 YR 2/2 NUMBER OF BEDROOMS 3
If I i i i o REGULATIONS. 6" —
6. NORTH ARROW IS FROM RECORD PLANS AND IS GARBAGE DISPOSAL NO
z4 o / j e i� i� i� i� h ,' �� NOT INTENDED FOR SOLAR ENERGY PURPOSES. =B= LOAMY SAND DAILY FLOW 330 GPD.
FWgY o °0' o o / ' �'' '� ie I / 6 / / �� 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. 10YR 5/6
o i0 V< i i �, , SEPTIC TANK REQUIRED 1500 GAL.
Gq�GF�s o / jm j /J s) �9,>>�� �`��' �� / 8. FLOOD ZONE C [NON-HAZARD] 30" SEPTIC TANK PROVIDED 1500 GAL.
c-na ,5�^ i i ( og� n h� �� 9. THIS PROJECT DOES NOT INVOLVE ANY PHYSICAL LEACHING REQUIRED 330 GPD.
m °p �i �,; -I-- o I -00, / I i F �f J'ao.00' GROUND DISTURBANCE OR VEGETATION REMOVAL
WITHIN 1 00'OF WETLANDS,INLAND OR COASTAL SOIL ABSORPTION SYSTEM CALCULATIONS:
BANKS OR FLOOD HAZARD ZONES.
cq Rpp / I '► I =c= MEDIUM SAND SIDEWALL AREA - 15Z SF.
3 e�RM y� a, l // I o ,o`O 10YR 7/4
F
.00 '� l _ 152 SF. X .74 G/SF. = 112 GPD.
BOTTOM AREA= 329 SF.
29' I � =, I 329 SF. X 0.74 G/SF. = 243 GPD. .
LEGEND 12o NO GROUNDWATER LEACHING PROVIDED = 355 GPD.
i 2400 � I / I I I i 5i'i.' I I
52 PROPOSED CONTOUR
SINGLE FAMILY RESIDENCE
a ,' I i i'° I I I i ► -—-52=—- XISTING CONTOUR
PROPOSED SEWAGE DISPOSAL SYSTEM
d
OT 9 I i I OBSERVATION PIT �r�
,, 43 S43 (1 I I ► �( ,� �l��� PREPARED FOR
❑ DISTRIBUTION BOX
McSHANE CONSTRUCTION
0 0 o SEPTIC TANK r\\ i
HSE.NO. 27 (LOT 9) TRUDY LANE
_ ww✓ti=- 1 ° - COTUIT,MASS.
?S5 SOILABSORPTION SYSTEM
9s PLAN NO. 082102 SCALE: AS NOTED
N83o46os"w RESERVE c.. V � N or FILE NO. 337BA DATE: AUG.21,2002
RESERVE AREA �r ,<<�
r�avio ; SEPTIC FILE NO. 71 PCS FILE: TRUDY LN .
22.26 PIPE INVERT ELEVATION
St1 0-Ki t: k
28085 CAPE & ISLANDS ENGINEERING
PLOT PLAN
20 139 9 27 0 0 `�,`"��,i�— � 800 FALMOUTH ROAD, SUITE 301C
SCALE: 1"= 30' MAP SEC PCL LOT HSE w w � '' MASHPEE,MA 02649 (508) 477-7272