HomeMy WebLinkAbout0023 EEL RIVER ROAD - Health 23 Eel River Road
Osterville
A = 116 107
i
I
I
�p
No. v FEE
COMMONWEA 14 Of MASSACHUSETTS fc.
Board of Health, 3! � 0.M @_ , MA.
APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) RepairX Upgrade( ) Abandon( ) -XComplete System ❑Individual Components
Location g` Owner's Name
Map/Parcel# ` ` o Address 2,3 ( O `
Lot# Telephone#
Installer's Name Designer's Name
Address -t- Address 1
Telephone# ,D� - \0 Telephone# 5 �l��(� 9 02 s J
Type of Building 2QF�i C`, Lot Size j% � sq.ft.
Dwelling-No.of Bedrooms V�U� �,4— Garbage grinder(4 f iq
Other-Type of Building No.of persons Showers (vf,Cafeteria (►�
Other Fixtures Laoa ,&
Design Flow (min.required) 4AIDJ , gpd Calculated design flow 44D 0 Design flow provided `ti gpd
Plan: Date ��� \o �L Number of sheets I Revision Date
,� r
Title �� r\mac otx� d r c W 'K--4 St NSAP-�
Description of Soil(s) �(1
Soil Evaluator Form No. `� 1 �� Name of Soil Evaluator Date of Evaluation d,
DESCRIPTION OF REPAIRS OR ALTERATIONS `�ZJ '171C'wCl .
DESIGNING ENGINEER MUST SUPERV7Sr-
1NSa%c �� ill IuE and`
The un rsigned agrees to ins the above described Individual Sewage Disposal System in acco�rdTALL C = gf'�1))�
Rj
further a e t o to ace e o on until a Certificatie+of Com 'ance has bee�'�: 1 �pt�1C,E TOar�N Iea .IN STRICT
SignedV Date 11 r 3 e
Qo�} — 11�'y o '
Inspections
I
��-'�+'i" ,,�^r�-I'` -.,.c"�,nr"a..^ �'r'�-+�'�n..^4,�,_�-01.� �_1z�d�^'ir�f�`��` 'M,..+T."�."'y�'^r"'1a'S*.j'�''�rr'rtt.f7��M�Y��'��+"Fj�.a•...n.J,. '(`�,y. +�y'r '✓"�'.r.
No. 0 .-4` j J .e a ,g FEE
/ Board of Health, t MA. '
Application for Permit to Construct( ) Repair Upgrade O Abandon O - Complete System ❑Individual Components - -
Location e` � Q t Owner's Name n((
.Map/Parcel# 'Addresstw
Lot# Telephone# t
Installer's Name �� �Q`v( Designer's Name
Address 1 � �� Address , � ,� G
�f
Telephone# Telephone# ®` .�d �" T J� CDC 5-Sk0
Type of Building Q1 Cl'�c'1�1,\ Lot Size `- sq.ft.
Dwelling-No.of Bedrooms Q�R� �� - f Garbage grinder (MA
Other-Type of Building t p (V�, (v)'
f - ` ��C"1�. `,,,_ No.of persons � Showers Cafeteria
Other Fixtures t r:\�iCl`�'CZ�1�. i` t p�
Design Flow (min.required) 2 Cam` 1 gpd Calculated design flow A4D U Design flow provided �'1i� ,44 gpd
Plan: Date ` �� \ �0 "�) Number of sheets i Revision Date
Title S(�Sl,,��
Description of Soils) � C- v
^� j
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation 1
DESCRIPTION OF REPAIRS OR ALTERATIONS -(:�X -moo `t:��GCI • '
The undersigned agrees to instajl the above described Individual Sewage Disposal System in accordance with the provisions of TITLQ dd
further a_ a to not to p ace Td/i'
sys�em in o Lion until a Certificateof Comp'ance has been issued by the Board of Health.
Signed �� Date i
..Inspections
No. an '{. s� FEE
COMM ONWFA..� 14 ®f �'ASS-AC14US ETIS � -
Board of Health;' U�/ / I I , MA.
CERTIFICATE OF COMP IANC�
Description of Work: ❑Individual Component(s) YComplete System
The u dersignee here �y certify,,that the Sewage Disposal System; Constructed ( ),Repaired ( Upgraded ( ),Abandoned ( )
at ZE�q, M Y2- V&jaf(w) I LA
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application No. �00.1-.S S`1, d ted_ if /"I b 3 . Approved Design Flow (gpd)
Installer cc�
Designer: Inspector: 4,AV) v, Date: /( 11,103
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No. a 0 3`GFS� FEE
Board of Health, &Jlmdabll , MA.
DISPOSAL SYSHM CONSTRUCRON PERMIT
Permission is hereby granted to; C truct , ) Re air(t Upgrade( )° Abandon( ) an individual sewage disposal system
at 7 3 �ej_ ur� gad , 05V r V) l 1 IL as described in the application for
Disposal System Construction Permit No. �?W 3 -SM, dated
.Provided: Construction shall be completed within three years of the date of ttthhi`s\permit. All to 1 conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date )/)/ Board of Health
l �
TOWN OF BARNSTABLE
LOCATIDi I SEWAGE
VILLAGE C157�/�c%1 ASSESSOR'S LOT o-
INSTALLEWS NAME&PHONE NO. ..
SEPTIC TANK CAPACITY
r
LEACHING FACILITY:.( ,. ®�'�� 1/�r l!-- (size)
NO. OF BEDROOMS
BUILDER OR OWNER -�v—
PERMITDATI:: ( 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
60
i I
i
h.
� f39
140 . ,
02/14/2014 20:08 FAX IA 001/001
CARMEN E. SiiA (508)-548-0796
NVIRONMENTAL SERVICES,lk.. P.O.Box 627,East Falmouth,MA 02536
November 18,2003
RE: . Certification of Title V Septic System Installation:
Residential Property 23 Eel River Road,Osterville,MA
Dear Sir or Madam:
On November 14,2003,Roger Roberts,Inc.was issued a permit to install a Title.V Septic System at 23
Eel River Road,Ostervilte,MA,based on a design drawn by Shay Environmental Services on November
13,2003.
t
I Certify That The Septic System Referenced Was Installed Substantially According to the Plan
I Certify•That the Referenced Above Septic System Was Installed With Changes but in
Accordknce With State and Local Regulations,Revisions or As-Built Plans/Sketch will Follow.
The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is
Required.
If you have any questions,please do not hesitate to call theundersigned at(508)-548-0796.
Sincerely,,
CAR M--NE,Sim
ENvIRONMENTAL SERVICES,INC.
Catrrien E.Shay,R.S. C. N ' s
President
NOV-19-2003 WED 07:53AM ID: PAGE:1
Sep - 20-01 13 : 62 BARNSTABLE HEALTH DEPT 5087906304
i
t�
S25r01
i
VOTICE: 'his Form Is To Be Used For the Repair Of Failed
Septic Systems Only. _
PEKCOL,-TION TEST AIND SOIL EVALUATION EXEMPTION
FORM
i
AQr� H W hereby certify that the engineered pian signed by me
u tec I 3 concerning the property located at
meets all of the
i�l:o��,ng .nteria: •
• This failed system is connected to a residential dwelling only. There sire no
:omrnttrzial or business uses associated with the dwelling,
T? e soil is cjass:fed as CLASS I and the percolation rate is less than or equa; to
ri:�ur;s net )inch. The applicant may use hismncal data to conclude !h!s f3c: Or may
:onduct ?re!�,r.r,ttar•;% tests at the site without a health agent present
o There :s n iincrease in flow and/or change in use proposed
• I here are ,to variances requested or needed.
The bottom of (he proposed leaching facility will not be located less than fourteen
l;) fee: aoolve!the maximum adjusted groundwater table elevation. ;Adjust the
-�undwater table using the Frimptor method when applicable)
I '
Piease complete the following:
�. To, •Di Ground Surface Elevation (using GIS information) _ lP • _�_
3; ��.W E;e vat:on —D_ + ad;uscmcnt for hi;h G.W. Ak-cl _ .._. 'An
FFERcN( FISETWEEN �� and B l '05
S G,E D _ D ATE: �1_ "
,NOTICE
33sec J-porn the -,ore ir.formsoon, a reoair permit wil! be issued for '-)edr^ems
z.�iMUT ` ad6uon2l bedrooms are authorizes to future without engineerec
is pt.c sy.te^n plans'.
POCCAMP
TOWN OF BARNSTABLE ,EL
LbCATIO� � - �V SEWAGE
VILLAGE 4St/►� ASSESSOR'S Ng, LOT o- D
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
(size
LEACHING FACILITY: (type
) ) �NO. OF BEDROOMS
^=BUILDER OR OWNER �4-
PERMITDATE: I COMPLIANCE DATE: 0JJJk3
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
i i rows
60 p
h
�} l0 3 9
�'
a �
LOCATION SEWAGE PERE31T 930•
-VILLAGE
107
INSTALLER'S NAME & ADDRESS
J'
6 U I L D E R OR OWN ER-
S,0 `c/-/A 6()U g�'2 A)
QA T E. PERMIT ISS.0 E D-
DAT E COMPLIAN-CE ISSUED
C
l�
' 3 7
. . 3�
jj
1
P
i
I; Permit Number: Dater
Completed by:
HIGH GROUND-WATER LEVEL COMPUTATION
,� ` �
Site Location: �L` i E'er ' Lot No.
Owner: L1t (1 2' r �t Address: �--
Contractor: j14ddress:(�C �n i R �1`f�CA,
Notes: C� �t �-� V
_T_
STEP 1 Measure depth to,water table
to nearest 1/10 ft' ........................ .Date A0 J
mon h/ ay/year
STEP 2 Using Water-Level Range Zone
and Index Well Map locate
site and determine:
OAppropriate index well.................................................... i
OWater level range zone ..................:..................................
STEP 3 Using monthly report "Current
Water Resources Conditions"
determine currentidepth to
water level for index well ........................... 0 f Ck
mon h/year
STEP 4 Using 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 2B)
determine water-level adjustment cQ
STEP 5 Estimate depth to(high water
by subtracting thewater•
level adjustment (STEP 4)
from measured depth to water
level at site (STEP"1) ...................................... . `
k
I
Figure 13.--Reproducible computation form.
i
15
i
O a
- � W u
DECK I TERRACE .l 9
�+ 9
• 15L1TdiENl
SITTING AREA -
1 ------ ----------------------; I
j ❑ � IB
SHED
o K
,
,
,
BUNK ROOM
I
DINING AREA I LIVING AREA Z
La
:�m .. PANTRY
w
SET A � CLOSE
B -
rL..I I
CLOSET .
----- -
D,
`f
ENTRY FOYER � � �\
w
.. FFORA!]M
o a
.. .. .. .. El
El
El
IN LU
POM�ER
:j :: El .
j , _ .. _ .. .. ❑ Y' MASTER BEDROOM y L�
UP
FOYER
lob
BEDROOM 3 w
om
-- J a
m a o! N o
m DRIVEWAY a
BATHROOM
'0 PROP05E D F I R5T FLOOR PLAN
HALL B ALE:VA'=1.1.
1a ON ❑
LINENS BEDROOM 4 O
GUEST BEDROOM
� O
O O �
e C O Z
LL U
LL A o
Lu
N
a
PROPOSED SECOND FLOOR PLAN Alol
SCALE.1/4••I'-0'
i
S CTION
10 min„ from NOTE: ALL PIPES ARE TO E 4 SCHEDULE P .' >--; E A - A
i
B S DULE 40 P.V.C. - au,outtEt r�pEs F7ta� trrE
Exist Foundation1ho.se septic tank
rtig , to � ,,.-, aisTRleuTroN Box SHALL BE
,.,; PROFILE VIEW OF LEACHING SYSTEM SET 12•
TOP OF' FOUNDATION 1=LEV. 30.60 Assumed`` spec tonk covers must be tee r•oR AT LEAST z rt. carcREtE cav1=R
Within 6 in, of.finished rode
e e over SAS - Not to `Scale ,�_-. .- 7RIIA11
Grode over To*-29.50 over Box- ELEV. 29.00 - ._ s. BA
Septic Grade. D- 29.25 •- 3 - 5'OUTLET s -,c.,,; �,It;$T.
KN(XXOUTS -
f0':f f,/k ' #seihed Critellyd-81onr' •` �..._ : 1 12' IIA.ET 5.5'0.02 3 HOLE H-10flIST. i30xOITLET
To Load - Elev. _ 27.00
3 Maximum Cover p: NEW S=D.01 or Greater .. -2EXIST. PIPE O r - 1,500 GAL S- 0.01• T Cd f` C7 t5 per foot agreater -^ 15 5 S I T4 - SCH. 40 TeFRON FOUNDaT1DN cv t` 5EpTiC TANK m 1.7s•H-1O r ao )K
PLAN, SECTIONCROSS-S CTION
a.n. Effective Depth o ECONCRETE FULL FOUNCa r` o 24• E eeI
6 in of 3/4-i 1/2 d > ._ , , a 5,Units e 7 _ 35 3.SYSTEM PROFILE II 4 4 o HOLE H-10 DISTRIBUTION` BOX'
e compacted stone 0 4 35
Not to Scale - c o a in t5' rj' NOT TO SCALE
> e, 12
LQCUS MAP
:. .; c - Z Effective Vidtfi > ' 38'
6 In.of 3/4•--1 1/2* Effective Length
GENERAL NOTES
. .; compacted stage " SOIL AB ❑RPTIBN
NOTE ALL:COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE _ $ SYSTEM (SAS)
w o I. Contractor is responsible for ,Digsafe notification
m INFILTRATOR MODEL 3050 (H-10-LOADING)/ SIiMNER & DUNBAR and protection -of all underground utilities `
' P g and pipes.
Bottom of Test Hole i Elev.- 18.25 (OR EQUIVALENT) 2. The septic tank and distribution box shall be set
level on 6- of 3/4 -1 1/2 stone.
NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30" /EFFECTIVE HEIGHT IS 24' 3. Backfill should be clean sand or gravel with no
stones over 3" in size.
4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
PERCOLATION , T� � with Title V of the Massachusetts state Cade, the approved plan
and Local Regulations.
Date of Percolation Test: JULY 2, 2002 c9�\ 6. If, during installation the contractor encounters any
Test Performed By. DAVID B. MASON, R.S., C.S.E. soil conditions or site conditions that are different
Results Witnessed By: WAIVER ( per Barnstable B.O.H.) ��\ from those shown on the soil log or in our design
EXCAVATOR: "UNKNOWN �\. installation must halt & immediate notification be
Percolation Rate. Less Than 2 MPi ® 38" made to Carmen E. Shay - Environmental Services, Inc.
$3.62' 7. No vehicle or heavy' machinery shall drive over the
septic ;system unless noted as H-20 septic components.
j_ Test Hole LOT #4 � 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
NO. 1 9. All Distribution Lines shall be 4 diameter Schedule 40 NSF PVC pipes.
DEPTH SOILS ELEV. 15.9f5 Square Feet +f- ��\ 10. All solid piping, tees & fittings shall be 4" diameter
0 29.25 �� Schedule 40 NSF PVC pipes with water tight joints.
L�aY 1 1• Municipal Water is Connected to ALL OF The Residence and Abutting
Properties Within 150 Feet.
10 YR 3/4 \
A, 28:50 THE PROPERTY LINES ARE APPROXIMATE AND
Sandy COMPILED FROM THE SURVEY PLAN GENERATED BY
Loam `.� ' DAVID B. MASON, R.S.. OF SANDWICH, MA
10 YR 5/6 `� ENTITLED " SITE &'SEWAGE PLAN OF #23 EEL RIVER ROAD,
PROJECT BENCH MARK OSTERVILLE, MA.", DATED JULY 20, 2002,
s•_ 39` B, 26,os ,�` AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
Medium TOP OF FOUNDATION _ � :.
Sand ELEV. = 30.00 (Assumed) �\ iT SHOULD BE USED FOR NO PURPOSE OTHER THAN
2S r 7/3 THE>SEPTIC SYSTEM INSTALLATION.
s8`- 144 1s.25 DECK \\
\ O EXISTING CESSPOOL TO :BE PUMOED OUT AND
\� p FILLED IN PLACE, AND OR REMOVED.,
:\
\ NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
p FROM H
RO THE EXISTING CESSPOOL TO BE :DISPOSED
� p F 0 AS PER BOARD'OF HEALTH,SPECIFICATIONS.
� 4
r
EXISTING NO WETLANDS ARE :PRESENT ,WITHIN 200 OF THE P
r- \ ROPERTY
Perc #1 I \
4 BEDROOM
Depth to Perc: to 58" t ASSESSORS 'MAP 116, PARCEL 107
Perc Rate= Less Than 2 MPI I HOUSE \ LEGEND
No Observed ESHWT \
No Groundwater Observed 0132" I #23
i I \\
\t DENOTES PROPOSED
O 11 104X1 SPOT GRADE
Porch I
DENOTES EXISTING
I l x 104.46 SPOT GRADE
1
g PROPERTY LINE
1 Septic'Talnkl � � � �' PL
1 I 00
AF 6P PROPOSED CONTOUR
_ ar »r
I Q I ,•: r m \
a I� \\ - - - - - -97 EXISTING 'CONTOUR
CL
vV) • :: TE T HOLE (#1 I
E 29.25
DEEP TEST HOLE &
D-Box PERCOLATION TEST LOCATION
3-24•DIAM. ACCESS MANHOLES i I :. -
_ 1 I �
I I • 3e'
_-�•_
� { 6 f00T STOCKADE FENCE
1 Failed 1 1
Cesspool
u ,
INLET ``-✓ -`/ ) OU 1 I • `
P LOT P LAN
r` THE ACCESS COVERS FOR THE SEPTIC TANK,
-Z DISTRIBUTION BOX AND LEACHING COMPONENT i ( 515,,
SHALL BE RAISED TO W1 6" I
�•Y,,r*.-,�...��.. �--e�--4•„-.�.;'�+:`,�.. R THtN OF I
FINISHED GRADE.. I 1 1 1
OF PROPOSED SEPTIC SYSTEM UPCRADI
STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITS GAS BAFFLES OR EQUALS I I g`.�.sz� PREPARED FOR
PLAN V1EW ON ALL OUTLET TEE ENDS /
3-24'REMOVABLE fOVER3
--- �_---_ ANN �c ROBERT CLEARY
.-. ' �' r o� r #23 EEL RfVER ROB
�-bT'•min..oleorana - .
INLET _ ^d^,I 2'�entn. inlet to twost !'min. 11.r Ra,ETouTLET (40 FOOT RIGHTOF.WAY)iNi.E - O.STE.R V I L L E M A
1a-min. Lam+ ,,. �` -, .-
e 4�-b- min. Design alculatlons �-
:, depth :;l„1 "
Number of Bedrooms. 4 Existing, Equivalent to 440 Gal./Day IN. � ss� . PREPARED BY:
Garbage Grinder: No
Leaching Capacity Proposed. 440 Gal./Day Minimum (Min: Per Title V) n� E. �` �{
Septic Tank - 2 x 440 Gal./Day = 880 USE NEW 1,500 GAL. Septic ra;1k.' �,
SOIL ABSORPTION AREA: Using ercolation'rate,of min <' "�
f�Q � - TI N E D SECTION g P <2 min./inch fl 20 40 5C� ENVIRONMENTAL SERVICES, INC.
N Bottom Area: 0.74 gal/sq. ft. .,x 456s`, ft, 337.44 gallons S1
q
Sidewall Area: 0.74 gal./sq. ft. x 200 sq. ft. = 148.00"gallons i'F a P.O. BOX 627
N SEPTIC 'Providing: s 485.44 gallons EAST FALMOUTH MA 0253fi
n _' c yam,.... ,,"r.,"�.,,+ ,.' TEL: FAX ."' 0 8:.... ,,,,-
21
NOT TO SCALI SCALE. 1 =20 �{ / 5 8 548 0796
Use: (5) HIGH CAPACITY INFILTRATOR CHAMBERS,' HAVING A 2' EFFECTIVE'DEPTH,
,
... 1 (.: i\C �NC9 (4 W x 7 L) TO'13E USED WITH 4 OF WASHED STONE ON THE SIDES AND SCALE, 1 20 DRAWN BY, CES DATE. NOV. 13, 2003
-1.5' OF WASHED STONE ON THE ENDS.
PROJECT SD 492 FILENAME. SD492PP.uWG SHEET 1 '(?F 1