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0094 ELLSWORTH ROAD - Health
94 Ellsworth Road Hyannis 269 222002 rA TOWN OF BARNSTABLE j OQATION ©l y ���� � R® SEWAGE # VILLAGE 1 �� ASSESSOR'S & LOTo?49''o?AP r � INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /0670 LEACHING FACILITY: (type) Z/L," 9(size) ,Q NO.OF BEDROOMS i C13UILDER OR OWNER I�Ic,l t�,(� T'Ir n(l.(1 0y, PERMU DATE: 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 �`�' N t � �� G � � �� �� `� , s� �� t c� � a � �- --- � . . i. s � � P- LO CATION � SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME _ & ADDRESS t U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED rl N e � � '.� � � o� �� �' �' O y � A J 1:� _- _. _. __ J No. 64 Fee - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: h Yes r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS .01pplicatiou for �Digool *p5tem Con5tructton Permit Application for a Permit to Construct( )Repair`)Upgrade( )Abandon( ) O Complete System�dividual Components Location Address or Lot No. �j �Z J '� Owner's Name,Address and Tel.No. `� Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. el 1�iy Qre�t�'� 53C S Type of Building: Dwelling No.of Bedrooms _ 3 Lot Size �j��`� sq.ft. Garbage Grind r(� Other Type of Building O[ (c04No.of Persons /-3 Showers Cafeteria Other Fixtures ctp r\ Cv I r LA--.rtYqx_ Design Flow gallons per day. Calculated daily flow 3,2) i gallons. Plan Date l.� 1)!k Number of sheets t Revision Date Title ` ?t'a rn� �-54?- n. lP Size of Septic Tank I i b10 ,:X1 z. Type of S.A.S. _IS7-2d I+ro S Description of Soil .41 Nature of Repairs or Alterations(Answer when applicable) --kb P1�� 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 been iss y t t IE a - Signed Date Application Approved by Date e Application Disapproved for the following reasons Permit No. C)0 Date Issued o ` ——————————————————————————————————————— 1r` ,.:� ''"�^ ...- dr^r-�� F.r., "fir. 4.. ,.� ..� !'."`.r-; '«» �!z• .i .�r ! No t , Fee Ail THE COMMONWEALTH OF MASSACHUSETTS-' Entered in computer: ,,1*,. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS r A.- ppYication for ;0,igpoga1 *pgtem Congtruction 3permtt Application for a Permit to Construct( )Repair`)Upgrade( )Abandon( ) ❑Complete System :N ndividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel l ' Installer'sJ�ame,Address,and Tel.No. Designer's N Address and Tel.No. w;,4 c t-rA� oQIM�f�o1 5�lc s NIAeWACv1 , ,•�� ' Type of'Building: ' Dwelling No.of Bedrooms Lot Size {" C) � sq.ft. Garbage Grinder Other Type of Building 0..of Persons= Showers( �/) Cafeteria( P) Other Fixtures ' Gc.1Ca - C V-e_r�, !o L-oory_-�- Design Flow ?> gallons per day. Calculated daily flow gallons. Plan Date )_31 O Number of sheets Revision Date Title ?C b CxstXA U Size of Septic Tank 1 1)bU eYj�>4 1.r Type of S.A.S. S l Description of Soil ,plcr, "_ 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 n nmental od and not to lace the s stem in operation until a Certifi- P � P .Y P Cate of Compliance has been issi by this ' al ' Signed Date Application Approved by Date Application Disapproved for the following reasons + Permit No. —41 Date Issued M THE COMMONWEALTH OF MASSACHUSETTS BARNSTABL-E, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired(�)Upgraded( ) h Abandoned( )by � at i` U has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of thisOermitsshall not be construed as a guarantee that the systemll fW icLon as designed. Date ! G 1©� Inspector N — o. Fee� 7 / ------------ ---------..—,—. w� ' . . 'C THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lDigogal *pgtem Con!9truction Permit Permission is hereby granted to Cons ct( )Re r Upgrade )Abandon( ) System located at � S W � ±� 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 w Provided: Constrdction must be completed within three years of the dat of this pe :i r Date:_._ lX tf Approved by f TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAG ASSESSOR'S &LOT - 5° INSTALLER'S NAME&PHONE NO. '�'� SEPTIC TANK CAPACITY I LEACHING FACILITY: / size) S NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 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 anymetlands exist Feet within 300 feet of leaching facility) Furnished by -,- to rO 14�A ec i 1 � \ V � � � � �. i �� � � � � , '- � � � } . - .- -� � � . .. ` y ., f .. � � ' ' _ i . . .. � _.._.._. _ y, , - �, � � � � . _ ----� �- - �� �, . -. _._ _ - - _ _:_ „. �,. �. � . ,. :" ..I , . �,... � ^ , -- � .. � _ � '� -- ' _ , � 1 I I •I � � k '.� � � ' , � I I i ! ► t + + + _ ; 1 i f Town of Barnstable �1HErO�,Qn Regulatory Services Thomas F. Geiler, Director • snxxsenaM » 9� , `0� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form � P Date: �L� Designer: Shay Enviro-nmental Services Installer: Rodney Fisher Address: 34 Thatchers Lane Address: 476 Main Street East Falmouth, MA 02536 Harwich,MA 02645 On 8/23/04 Rodney Fisher was issued a permit to install a (date) (installer) septic system at 94 Ellsworth Road, Hyannis based on a design drawn by (address) Shay Environmental Services dated 8/17/04 (designer) XX 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. I4 ; 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. CARMEN c� nstalle 's ignature oa° E. SHAY No. 1181 (Designer's Signature) (Affix . Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- i BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form ,._ r t t brEUTI UN A -A relax S , + D 40 P-V.C. OUTLET FROM �1 NOTE. ALL PIPES ARE TO BE 4 SCHEDULE VENT PEE (O Least 34 inches toll) : ALL tl.Ef PPES THE 10 min. from P arcool Odor Filter PROFILE VIEW OF ADDITION :TO LEACHING SYSTEM 01S1RIBUTION BOX SHALL 6E l septic tank Schedu a 40 VC w/Ch AT fY ' E,dstkq Faarclatlon [house to $ep C 4 J Septic tank savers must be SET LEVEL FOR LEAST 2 FT. CONCRETE COVER pyM Y .. �� � TOP OF FOLMATIOl = ELEV. I09.09 (Assumed) e °a eAthln 6 in. of fkllstwd gad OO over SAS- 9&00 3- 6'OUTLET sr /� N Grade over Septic Tank 9650 Grads war D Box 96 • 3" of 1 8' - 3• Washed Peaston / KNOCKOUTS 4y 3/4' to 1 1/2 Washed Crushed Stone 3s' , PILET 5ahaa ! + 1 I r OUTLE7 t 12 t 9 � S 0.02 3 HOLE H-10 T -Elev. -95.25 DIST. BOX 3' Maximum Cove, op load Ale, vdatrttStAhte 1.-: - 10• EXIST. 5=0.01 or Greater Top of SAS Elev. -94,75 EXIST. PIPE ,"- v1 ~ 1,0 GAL - S- 0.01' per foot or greateir . `15.5 4" - SCHC 00 40 T JC to at - 0'•Effective Depth - - FROM EXIST. FOLOMATI N X SEPTIC TANK • N 50 /1 WLn PLAN SECTION CROSS-SECTION CONCRETE FULLFouNDAT1oN-� N M H-10 Ui O ��3 > U) ¢ 0.83. (10 inches) 5 Untts 2 6.25' 30' t� � `�•��.,,r yin s: SYSTEM PROFILE 31 a in.of 3/r-1 1/2• V I 31.25' 3 3 HOLE H-10 DISTRIBUTION BOX jro� '$.4^ I = -•..... yp„��P7 compacted stone c o u o rn NOT TO SCALE ,pp s "Aa ---�--• Not to scale > 0 9 37.25'- e2N4tLs�dhktmirtC�s +y� NAVfEO I r 4, 1�2.5 4' > Effective Length 6 kt.of 3/4'-1 1/2' ) 10' e`ai SOIL ABSORPTION SYSTEM (SAS) GENERAL. NOTES compacted stone Effective Vldth NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE m INFILTATR❑R HIGH CAPACITY (H-20 LOADING)/ GE❑RGE ❑'BRIEN 1. Contractor is responsible for Digsafe notification _Bottorff, of Test Hale I Bev.-87.00_ (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes. Obs. Groundwater Test Hole 1 Elev.= NONE OBSERVED 2. .The septic"tank onq,� distribution box shall be set NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10" level on 6 of 3/4'-1 1/2 stone. 3. Backfill should be clean sand or gravel with no stones over 3' in size. 4. This system is subject to inspection during installation T by Carmen E. Shay - Environmental Services, Inc. PERCOLATION T E C I 5. The contractor shall install this system in accordance J with Title V of the Massachusetts state code, the approved plan and Local Regulations. Date of Percolation Test: JULY 23, 2004 6. If, during installation the contractor encounters any Test Performed By. CARMEN E. SHAY, R.S., C.S.E. soil conditions or site conditions that are different Results Witnessed By. WAIVER (per BARNSTABLE B.O.H.) Excavated By. SHAY ENVIRONMENTAL SERVICES, INC. from those shown on the soil log or in our design Percolation Rate: Less Than .� MPI installation must halt & immediate notification be made to Carmen E. Shay - Environmental Services, Inc. 7. No vehicle or heavy machinery shall drive over the septic system unless noted .as H-20 septic components. Test Hole 8. install Tuf-Tite gas baffles or equals on all outlet tee ends. No. 1 �9$ 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. DEPTH says- ELEV. � 10. All solid piping, tees & fittings shall be 4" diameter o 98.00 ao Schedule 40 NSF PVC pipes with water tight joints. Sand Gj 11. Municipal Water is Connected to ALL OF The Residence and Abutting Lowry / Properties Within 150 Feet. 10 YR 3/2 / 0'-8' A. 97.25 THE PROPERTY LINES ARE APPROXIMATE AND Loamy / ,�' COMPILED FROM THE SURVEY PLAN BY JOHN DOYLE, RLS. Sand I ,� ENTITLED - "CERTIFIED PLOT PLAN OF LOT #2 ELLSWORTH ROAD, 10 YR 5/6 16'- ao' Be s5.75 / � HYANNIS, MA DATED OCTOBER 5, 1983, / I AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN I Med. / IT SHOULD BE USED FOR NO PURPOSE OTHER THAN 2.5 YN/4 / I THE SEPTIC SYSTEM INSTALLATION. 7.00 / I 132 C / I EXISTING LEACH PIT/CESSPOOLS TO BE PUMPED OUT AND I I LOT #2 FILLED IN PLACE OR REMOVED TO FACILITATE INSTALLATION OF NEW SAS. r 1 / 36,039 Square Feet +/ NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE FROM THE EXISTING LEACHPIT/ CESSPOOLS TO BE DISPOSED OF AS PER BOARD OF HEALTH SPECIFICATIONS. NO WETLANDS ARE_PRESENT WITHIN 200' OF THE PROPERTY _ _ ASSESSORS MAP 269, PARCEL 222/002 Perc #1EG " ri �Y�// I Depth to Perc: 40" to"58 i ' L_ I L- E N D Perc Rate= Less Than 2 MPI / O r/ ,� ) `-_7 �\ Observed ESHWTO - NONE OBS.- 132" Assumed rr rr �� r ASPHALT 111 104X 1 DENOTES PROPOSED ADJUSTED H2O Elev. = NONE OBS. - 132" Assumed rr ,�, - DRIVEWAY EXISTING \ SPOT GRADE r r� ,GARAGE DENOTES EXISTING - - r �\ SPOT GRADE r - 4" PVC ,,9a PL PROPERTY LINE VENT 9 _ PROPOSED CONTOUR o� .. ' ��''OiPe� - -97 EXISTING CONTOUR / �r Water der 14peEXISTING DEEP TEST HOLE &O/ 3 BEDROOM 36.5' 2-19• aAM. AccEss MANHOLES / 1 I HOUSE 0, PERCOLATION TEST LOCATION a' i I DECK c:,:. - 9�---_ 6 FOOT STOCKADE FENCE #94 D-Box • 'y� ,y INLET / PLOT PLAN \ ou / L v `` i, EXIST. 1000 al. 97 25' DISTRIBUTION ACCESS COVERS FOR THE SEPTIC TANK. � �, Septic Tank 9 ��- 0 F� PROPOSED SEPTIC SYSTEM UPGRADE 1,�, �. DtSTRI8UT10N BOX AND LEACHING COMPONENT �: SET DEEPER THAN 6 INCHES BELOW FINSHED x- GRADE SHALL BE RAISED TO MITHNN 6' of PREPARED FOR STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. r� r a'a r-LAN VIEW INSTALL TUF-TITE GAS BAFFLES DR-EOUALS 144 9 , Le4CFd1 Pit �� M S . P A U LA H 0 U G H T 0.N - 3-24• REMOVABLE COVERS `? TEST HOLE 1 AT PROJECT BENCH MARK # ELEV.= 98.00 .-•: 4• E0� OF 1000OTl�ssumed #94 ELLSWORTH ROAD _ 3 min. clearance _• INLET 6•minT Y mb. Inlet to outlet 6'mb tY srLeT HYAN N I S, MA ta• mh. �4x+id Ieva��- OUTLET °t4'"� Design Calculations }� 'S. _,. of M� PREPARED BY: 4'-D• min. Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Got./Day Min. per Title V) y►� c oe „ ca er., :• Liquid depth Garbage Grinder.,No o`` N 75*1Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) CA�1it L 1 ► E. �llu� l Y Septic Tank - 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL. Septic Tank. c� U' SERVICES, I:. r ,... S A ENVIRONMENTAL SE VI NC. "" -r t SOIL ABSORPTION AREA: Using percolation rate of Q min./inch 0 20 40 5 _ Bottom Area: 0.74 al s ft. x 370 s ft. - 273.8 gallons `� o P.O. BOX 627 CROSS SECTION END-SECTION g / q• q Sidewall Area: - 0.74 gal./sq. ft. x 78 sq. ft. sa gallons EAST FALMOUTH MA 02536 Providing: 331.80 gallons S NITAR�P� ' TYPICAL 1000 GALLON SEPTIC TANK Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, SCALE: 1 "=20' A TEL/FAX : 508-539-7966 NOT TO SCALE TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND, 3.5 OF WASHED STONE SCALE: 1 "=20' DRAWN BY: CES DATE: AUGUST 13, 2004 ON THE ENDS. NO STONE UNDER. , PROJECT#SD613 FILENAME: SD613PP.DWG SHEET 1 OF 1