HomeMy WebLinkAbout0102 WILD WAY - Health 102 Wild Way
Cotuit
A = 027 /38
I
TOWN OF BARNSTABLE-
LOCATION f SEWAGE #
VILLAGE I y�t SESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. fA
SEPTIC TANK CAPACITY
�p(
LEACHING FACILITY: (type) size)
NO.OF BEDROOMS
BUILDER OR OWNE
PERMITDATE: h 111H COMPL DATE::
Separation Distance B ween 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
u
No. N,a Z r • T Fee
ry THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALL H DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZIppYicatiou for 0i5po6al bpgtem Com6truction Permit
Application for a Permit to Construct( . )Repair Upgrade( )Abandon( ) O Complete System dividual Components
Location Address or Lot No. 10 a W i I CX W�k (2b T%31-- Owner's Name,Address and Tel.No.
K4?— ���co
Assessor's MapTarcel S8 GA M
Installer's Name,Address,and Tel.No. GL48—S31G Designer's Name,Address and Tel.No.
Robe�c-fS 57_P*,,C_ Secv,Ce- 5 NAy
S Tc�-_o*CA-, Sk.) Yc rrnoJk�),M A -P-10-' ox (o;k F r'lrtnovtv),P�fl
Type of Building:
Dwelling No.of Bedrooms 3 — Lot Size�sq.ft. Garbage Grinder 0/110
Other Type of Building's l-3e�np_ No. of Persons —3 Showers(✓) Cafeteria( ✓f
Other Fixtures L Av A-raQY k,iC -,gq. S1i-�k LAurj(>V '
Design Flow J?)U gallons per day. Calculated daily flows a gallons.
Plan Date IS I64 Number of sheets Revision Date
Title 6 ��� �h'�' �u S can V[PRO,c e
Size of Septic Tank £xLST• 1 .tY_n !p4a 1. Type of S.A.S. i( g 2a t 1e`Qr 1�- 1t���tyr00
Description of Soil �t2,2 'k� '3?\ny� ,
Nature of Repairs or Alterations(Answer when applicable) t�2 � At" nkcao.
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 Certifi-
cate of Compliance has bee d t ' o ealth.
igned Date 10 '0.
Application Approved Date (3
Application Disapproved for the following reasons
Permit No. ,�-- `-t. °'a Date Issued 1
No. - 60
Fee
THE COMMONWEALTH OF°MASSACHUSETTS
�+ Entered in computer:
PUBLIC HEALTH '�SION -TOWW, -BARNSTABLE., MASSACHUSETTS Yes
Zlpplicatio ss ,or Mi5possal *potem Con!6tructiou Permit
Application for a Permit to Construct( , )Repair(' )Upgrade( )Abandon( ) O Complete System \,29 individual Components
Location Address or Lot No. 10 a w i 1 C\ W tiCo T'UI t Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
t g I - o4e-o}9(,
Installer's Tame,Address,and Tel.No. ��'rJ 10 Desi ner's Name,Address and Tel.No.
RotertS sej>*�c szco"ce 5Nsa`l ��U�sor�c� n�0 SACS .
S `ce�,toc� S{•i �cct�o�Tbn�Mtq ��,"3oX (nab G`" Fa)m00110,Me
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 19 �`�'c1�"sq.ft. Garbage Grinder Q'i/I�
-' Other Type of Building NOt'>2 No. of Persons -3 Showers(V') Cafeteria( ✓�
Other Fixtures 1.gva Tc2n,a k�'Ec\yor� Slr�}( 1 LfluNoR,J
Design Flow 32)o gallons per day. Calculated daily flow 2531 9 gallons.
Plan Date (og 10 4- Number of sheets I Revision Date
Title O�COS@� J2p'fi G 5�,5-4�n, V Ixce
Size of Septic Tank Exys-r} -\~-iUC,O Ga i Type of S.A.S. ��c�6ro ,,
Descripticn of Soil
•
Nature of Repairs or Alterations(Answer when applicable) "1t \®(�•
i
I x
Date last inspected: 47
r
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 Certifi-
cate of Compliance has been-issuedb" thirBoard of ealth.
- �}-
� r
i n Date S g ed
Application Approved�'b'y Date
b
Application Disapproved for the following reasons
Permit No. � �-� Date Issued b II G LI
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance �
T-HIS IS TO CERTIFY, that-the On-site Sewage Dis osal System Constructed ( ) Repaired ( )Upgraded
Abandoned( )by , o ✓ C.
at \ �- W't "l� �C� V �~ has been constructed in accordance
with the nrovisionstof itle 5 and the for DisposalCSystem Construction Permit No. dated
Installer ,.�1 Designer
The issuanco tt�s pe s all not be construed as a guarantee that the stem it function as desi_ned.
Date �/ y Inspector
-- —L -- --------- ---------------------
"7
No. � Fee 50
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
1=ig;pogal *pgtem Construction Permit
Permission is hereby granted to Construct )Repair( ()�Upgrade( )Abandon( )
System located at
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: Construct' n ine it st be completed within three years,of the date of this p .
Date:_._ � D`t Approved by
j T VAN OF BARNSTABLE
LOCATION SEWAGE # �:
VILLAGE �'� SESSOR'S MAP & LOT :2 13 4
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK•CAPACITY
�.
LEACHING FACILITY: (type) LT✓� n< (size) /� k
NO.OF BEDROOMS
BUILDER OR OWNS
PERMIT DATE: COMPL DATE:
Separation Distance Beeen_th \
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
�- IJ
<<
GLTl1w
f 0464
4J ..� 7•�1�+ i s '
I
Sep - 20-01 13 :1162 BARNSTABLE HEALTH OEPT 50879063U4
i � 1
'f S2S�01
d
OTTC ; This Form Is To Be Used For tbe Repair Of Failed
i Septic Systems Only.
PE4tC0L-n TIO:N TEST AND SOIL EVALUATION EXEMPTION
FORM
hereby certify that the engineered plan signed by me
uz;ec C) _, concerning the property located at
�% ' •-•__ '+ �` �-CS i�i�' meets all of the
i,L'ow,hg ;:r,reria�
This failed system is connected to a residential dwelling only. There are no
:ornrnzr,;ia11 or business uses associated with the dwelling,
The'soil is ciasst,ied as.C'LA5S l and the perco)ation rase is less than or equal to
-ri.n1utes per inch. The applicant may use historical data to conclude this f3c; or may
:oncuct are!trrx,,a.ry tests at the site without a health agent present
• T here :s no increase to Flow and/or change, in use proposed
• Thel(e are no variances requested or needed.
• Thcjbottom of the proposed leaching facility will not be located less than Fourteen
:l,j Fee; aoove the maximum adjusted groundwater table elevation. f Adiust the
nt1,nGwatcr cable using the Fnmptor method when applicable)
i
Please complete the following:
Top -Di Ground SUrIace Elevation (using GIS information) _ -)
6; C.YY' Elcv3con 45_ ad;ustncn( for nigh O.W. = ,I C)
Fl EREt�t F.. BETWEEN \ and B a
S'(,YE D
3asec j{rr�R ire atove r.formaQon, a (coal( permit wil! be issued For ')edr^orns
Ta irr.sT `o ;cd u`:nal bedrooms ue authorized to the future without engtncerec
:epr S a(C n plans. o-
�c:un!ri0ci �c�ccam�
I
I
i
Permit Number: Date:
Completed by:
i
HIGH GROUND-WATER LEVEL COMPUTATION
Site Location: &0 C- _ ;9�t T Lot No, t'_
Owner: L<_e,\\Lk Kock ~ Address: c;i�,�ta
Contractor: !:' i;.
Address:_ c��c
i
Notes:
i
I
i
STEP 1 Measure depth to water table
tonearest 1/10 fit. ..............................................................:............... .Date
month day/ ear
STEP 2 Using Water-Level Range Zone
andklndex Well Map.locate
site land determine:
OAppropriate index well....................................................
OB Water-level range zone .....................................................
I
I
STEP 3 Using monthly report "Current
Water Resources Conditions
determine current depth to
water level for index well
imonth/year
STEP 4 Usin!g Table of Water level Adjustments
for index well (STEP 2A), current depth
to water level for index well (STEP 3),
and Water-level zone (STEP 28)
r-
determine water-level adjustment ,,,,,,,,,,,,,,,,,
................. .
STEP 5 Estimate depth to high water
by subtracting the water•
level adjustment (STEP 4)
from measured depth to.water
. 1
level,at site (STEP 1) ..................................................;. ......,....:.......................................... %
i
I
Figure 13.--Reproducible computation form,
. � 15
Town of Barnstable
OF1NE Regulatory Services
Thomas F. Geiler, Director
+ BARNSTABLE,
9�AMASS. ,�� Public Health Division
39. Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: f
o 4-
Designer: S�)pA evly k Vov-,mm\� Installer: c� C
Address: ���. �p��— Address:
On was issued a permit to install a
(date) (installer)
septic system at ('OO C\U iT based on a design drawn by
(address
dated
esigner)
>< I 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.
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 & Local Regulations. Plan revision or
certified as-built by designer to follow.
��A of A%.
nstaller's Signa ure) �� CARMEN
� E. a:
SHAY C
No. 1181
esigner's Sign re) (Affix ;` R p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION.
VIS ON. 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.
Q:Health/Septic/Designer Certification Form
SECTION A A �►Tttvaz��tt+ttLiY r /. f 1 w,
10' min. from NOTE: ALL PIPES ARE TO $E 4" SCHEDULE 40 P.V.C. ( ALL OUTLET PIPES FROM THE y
[h,,se VENT PIPE ®Least 24 inches tau) PROFILE VIEW OF ADDITION'-TO LEACHING SYSTEM DISTRIBt11,ON Box SHALL eEi2Existing Foundation to septic tank Schedule 40 PVC w/Chorcool Odor Filter SET LEA foR Ar LEAST 2 Ft CONCRETE COVER
TOP OF FOUNDATION = ELEV. 100.00 (Assumed) Septic took coves must be <` 3' of 1/8" - 1/'2" Washed P®astane
within 6 in. of finished grade
3/4' to 1 1/2 " Woahetl Crushed Stone '`-
f;rade over Septic Tank - 99.00 Grade over D-Box- 99.00 de over SAS - 99.00 KNOCKOUTS �` f
3 - 5'OUTLET .r•a"',, •:,c-s- 2 v' ,t�'/ ' �sI#StE.ts4fkle c
//N
S ' 0.02 3 HOLE H-10 top Loud -17aw. =98.25 { OUTLET 1Z' IwET L -
8" ¢'i,e
14' EXIST. S=0.01 or Greater DtST. BOX S Maximum Cover +F 2 �{ w*- VO sA L s
' t
NEW PIPE T 1,000 GAL. S- 0.01" per foot •
ME '6.5 s,, ��
FROM EXIST. F1AINDAT2[N UJ " SEPTIC TANK o 4" - SCH. 40 T ,.75' ?oR+'11 x 2V 0"EHectWe Depth
,�� /1 a W H-1() am. ,� , ° s units @ 6.c'S' = 30' PLAN SECTION CROSS-SECTION i�yhp `d` • -
TR A-
CONCRETE FULL FWNDA �, +> _ _ q rn ui 0.83' (10 inches) 3 , >~r�'°'�� P� 4,,�
m a > oa rn 31,25 .-^` ay �,. rf. Z i
TO SYSTEM PROFILE 6 in.of 3/4•-1 1 ° 7 3 HOLE H-10 DISTRIBUTION BOX " , �7 ``.
/2" o p 37,25 /
compacted stone u o rn Effective Length NOT TO SCALEE�+- R j
Not to Scale - o
m II �s7M4RxafM &Fam4wvB reedo�es
_ 4' � 4' SOIL ABSORPTION SYSTEM (SAS)
6 in.of 3/4'-1 t/2'C 05. 0 INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN GENERAL NOTES
compacted stone Effective Wkfth OR EQUIVALEN Not to Scale
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE ] w o ( 1. Contractor is responsible for Digsafe notification
o Bottom of atet Ode 1 d 0 132" m NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" FFECTIVE HEIGHT IS 10" and protection of all underground utilities and pipes.
Na Groundwater Observes o 132• JE P 9 P P
"- --�--'----- 2. The septic tank and distribution box shall be set
level on 6" of 3/4"-1 1/2" stone.
3. Backfili should be clean sand or gravel with no
stones over 3" in size.
OPEN SPACE 9a 4. This system is subject to inspection during installation
PL by Cormen E. Shay - Environmental Services, Inc.
105.00' ' 5. The contractor shall install this system in accordance
PERCOLATION
E p C O l n Tl O n i TEST
��` with Title V of the Massachusetts state code„ the approved plan
f IZ L/1 i V I L J and Local Regulations.
6. if, during installation the contractor encounters any
Date of Percolation Test: JUNE8, 2004 �/ soil conditions or site conditions that are different
Test Performed By. CARMEN E. SHAY, R.S., C.S.E. from those shown on the sail log or in our design
Results Witnessed By. WAIVER ( per Barnstable B.O.H.) �.' installation must halt & Immediate notification be
SHAY ENVIRONMENTAL SERVICES, INC. �,' made to Carmen E. Shay Environmental Services, Inc.
Percolation Rate: Less Than 2 MPI ® 36" 49 2'
7. No vehicle or heavy machinery shall drive over the
septic system unless noted as H-20 septic components.
8. Install Tuf-rite gas baffles or equals on all cutlet tee ends.
Failed Shoe d ,9$ 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
Failed Shed ,Test Hole Leact( pit 10. All solid piping, tees & fittings shall be 4„ diameter
No. 1 f / Schedule 40 NSF PVC pipes with water tight joints.
DEPTH SOILS ELEV. 98_ �' 7.25' 0.4', i- 11. Municipal Water is Connected to ALL OF The Residence and Abutting
0 99.00 f Properties Within 150 Feet.
Sandy
LOOM
,o r 3/2 1 ` : .• ' t_ ' ::•a, + THE PROPERTY LINES ARE APPROXIMATE AND
,t COMPILED FROM THE SURVEY PLAN GENERATED BY
A 98.00 �< r 4" PVC LOWE & WELLER OF YARMOUTH, MA
VEt'T �� ENTITLED CERTIFIED PLOT PLAN OF LOT #2 WILD WAY, COTUIT, MA,
Sandy G-Box DATED JUNE 21 1989 & PLAN BOOK 433, PAGE 3
10LYR/6 TEST HOLE #1 �� AND iS NOT INTENDED TO BE A SURVEY PLOT PLAN
12'- 36"1 Be 96_001
ELEV.= 99.00 2 8'
�\ IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
Mad. THE SEPTIC SYSTEM INSTALLATION.
Sand EXIST. 1000 gal.
as Y 7/4 co O Septic Tank EXISTING LEACH PIT TO BE PUMPED OUT AND
3s"-t32` C, 88.00 LOT #3 ��\ LOT #1 REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
t NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
DECK tt FROM THE EXISTING LEACH PIT TO BE DISPOSED
Co� i OF AS PER BOARD OF HEALTH SPECIFICATIONS.
____ _N-0 WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
EXISTING 1 ASSESSORS MAP 27, PARCEL 138
3 BEDROOM i LEGEND
Perc #1
HOUSE /
PROJECT BENCH MARK #102
TOP OF FOUNDATION r- "1tt //
+ /
Depth to Perc: 38" to 56" ► � � �04X1 DENOTES PROPOSED
Perc Rate= Less Tho 2 MPI ELEV. = 100.00 (Assumed) SPOT GRADE
Groundwater Not Observed
No Observed ESHWT I i DENOTES EXISTING
ADJUSTED H2O Elev. = None
t X 104.46 SPOT GRADE
I
ASPHALT i t
DRIVEWAY i �, PL PROPERTY LINE
I I PROPOSED CONi"OUR
i
- - - - - -97 EXISTING CONTOUR
i , f
� �/ �
TYPICAL 1000 GALLON SEPTIC TANK LOT #2 , / J DEEP TEST HOLE &
NOT TO SCALE 19,597 Square Feet +/- ( ; PERCOLATION TEST LOCATION
2-16' EXAM. ACCESS MANHOLES i
r � •-----• 6 FOOT STOCKADE FENCE
�• ,:,_ •�, � i it
O
MET - I I P LOT P LAN
ou-n ET
y. __ ,
70-00 OF PROPOSED SEPTIC SYSTEM UPGRADE
J THE ACCESS COVERS FOR THE SEPTIC TANK.
DISTRIBUTION BOX AND LEACHING COMPONENT
SET DEEPER THAN 6 INCHES BELOW FINISHED PREPARED FOR
GRADE SHALL BE RAISED TO NITHIN 6' OF
FINISHED GRADE 9p
STEELf REINFORCED PRECAST CONCRETE �'
PLAN VIEW INSTALL TUF-TiTE GAS BAFFLES OR EOUALS - M S . K E L LY KING
WIL I� T �i Y AT
�-3--24" REMOVABLE COVERS-� - # 10 2 WILD WAY
4, ,.; (40 FOOT RIGHT OF WAY) \
min. clearance ,r _ t , C O T U I T, M A
INLET B"mh.r 2' min. inlet to outlet 8.m -
L,�a;� Iovel - «I Design Calculations
to'mtn. s-
.� OFti PREPARED BY:
Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) s9�y / HEY
�j
e� Liquid mui't Garbage Grinder. No N �l fr1�l �1 1 E. AS �A Y
o$ q" d4 Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) •
- a Septic Tank : - 2 x 330 Gai./Doy = 660 USE EXIST. 1,000;GAL. Septic Tank. 0 20 40 50 " NVIRONMENTAL SERVICES, INC.
.:�_:r'� S Using at min./inch
OIL ABSORPTION AREA: Us percolation rate of <2
�_O• 4 -ID. Bottom Area: 0.74 got/sq. . x 370 sq. ft. _ 273. gallons O
O P.O. 80X 627
Sidewail Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons 'P ISTER�
CROSS SECTION END-SECTION Providing: = 331.80 gallons sgNITARtA� EAST FALMOUTH, MA 02536
SCALE: 1 "=20' TEL/FAX : 508-548-0796
Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES)'EFFECTIVE DEPTH, SCALE: 1 "=20' DRAWN BY: CES DATE: JUNE 9, 2004
TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE
ON THE ENDS. NO STONE UNDER. PROJECT#SD583 FILENAME: SD583PP.DWG SHEET 1 OF 1