Loading...
HomeMy WebLinkAbout0025 FLOWING POND CIRCLE - Health (2) 25 Flowing Pond BWd C rd _ Osterville r A= 311-064 0 t No.a-co3 _3?y THE COMMONWEALTH OF MASSACHUSETTS FEE PSZ, BOARD OF HEALTH -0"1/.j OF cf,+A Nl�4�C-� �OSTV""tt�� APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT ,r Application for a Permit to Construct ( ) Repai ( ) Upgrade (K) Abandon ( ) - ❑Complete System &Individual Components /9 cati n E� Owner's Name Map/Parcel# Address (0 �60 Lo Telephone# �►4%j �i l�11L, it/lY`1�s 4�►,u,�L Do err oN Inst I is Name Designer's Name Address Address 05-771—430 er g►1 r f)_, —19%'t Telephone# Telephone# Type of Building: ��G�JlA&7i1JTj,4 Lot Size ® , Sq.feet Dwelling—No.of Bedrooms ef-,-s Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 3) gpd Calculated design flow gpd Desi n flow provided 3 /, Sgpd Plan: Date ` 'l j Number of sheets f Revision Date Title C-e JLr�^' G e r o1,re JYJl-ep"^ Description of Soil(s) mew. -c+,vv Soil Evaluator Form No. Name of Soil Evaluator .J Off^'s c2' .j Date of Evaluation /o�3i�o� DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further s no ac the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date G Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 N =3 THE COMMONWEALTH OF MASSACHU_SETTS,1 . / t FEE SSJ F s BOAK'D OF HEALTH x: Zv-:? + of �i4�rrr c.F ®src : A`.PPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT fi,'"Applic14 ation fo'"a Permit to Construct ( R poi ( .) Upgrade:(� Abandon ( ') - ❑Complete System Individual Components' ; o$? icv�u_L jo EJray . " Ycati n Owner's Name 7 N W�p/ reel# Address Lo I Telephone# .,.•_' Ins[ ler's Name Designer's Name , 1 d tt'l/' �r�'SrY•. //IJ�JIS €�a`l 4iAu17" 1-ir B Address Address:^" Telephone# � ` Telephone# Type of Building: G2�j��CNTIR Lot Size D Sq.feet Dwelling—No.of Bedrooms 3 e*,J t'- Garbage Grinder. ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria Other fixtures Design Flow(min..required) 31 o gpd . Calculated design flow gpd Desi n flow provided 371,Sgpdr Plan: Date I'A Y37. Number of sheets r Revision Date o Title Description of Sdil(s) AAerv. x4Ae w Soil Evaluator Form No. Name of Soil Evaluator & JV#—*�s . Date of Evaluation. /o/3i oU- DESCRIPTION OF REPAIRS OR ALTERATIONS �Le4oz,oe a 4oyc.ow gin/ The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further rees no place the system in operation unhl;a Certificate of-Compliance has been i"ued by the-Board of-Health.- L'Signede Date 6 r e k r• Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 . No. 3 r- Ql THE COMMONWEALTH OF MASSACHUSETTS FEE S O ���� 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( b )r� Y at has been installed in accor nce with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans rating to application No.20031I-3?� dated 2-12—0 3 Approved Design Flow (gpd) Installer rl ' Designer: I' n Inspector ' 'The'issuance of this certi hate shall not be construed as a guarantee that the system will function as designed. FORM,3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 ,, No. 3� THE COMMONWEALTH OF MASSACHUSETTS FEE S lL� BOARD OF HEALTH i DISPOSAL SYSTEM CONSTRUCTION PERMIT r Permission is hereby,granted to Construct _) ep r Upgr e Ab don ( ) an individual sewage _tru . _ disposal system at / + as described ti in the-application for Disposal System Construction Permit No. P.c 3 L� dated �I I'd-IU Provided: Construction shall be completed,within three years of the date of is perm, 1 cal conditions`"must be met. I ,. Date ) Board of Health k FORM42 - DSCP DEP APPROVED FORM 5/96 -" i F6RM.-1255 (REV 5/96) H&W' Hoses&WARREN TM PUBLISHERS-- BOSTON 'ALL '+'�•� .r"�` .`� � __ ._..�..._...� _..__-- '-__- .'. ....- �,e __._ ..l.'_ ... ... »1. �._ : .� .- ... y TOWN OF.BARNSTABLE LOCATION Z� SEWAGE # S, I � VILLAGE 1 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ALLIQM •4I`,l�Z�� SEPTIC TANK CAPACITY 100b c. LEACHING FACILITY: (type) (size) Z. NO. OF BEDROOMS > 1 ` " BUILDER OR OWNER `0 AJ6Z-� PERMIT DATE: — COMPLIANCE DATE: v` 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 I within 300 feet of leaching facility) Feet Furnished by ij ( Y 1 T-b W 4 4 y � �• � - Fps�5 1 No.._._... .................._ .THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA TH V1 Appliration -fur 43iti uuttl Works Tuuitritrtion Vrrutft Application is hereby`made for a Permit to Construct or Repair ( } an Individual Sewage Disposal system t: ---- ------------- -- ---- ----- - ---- r�Locati 'ddwre�ss� or Lot Yo- -••-----•- .. W.- -----•----- -------------- --•-•-- ----- ---•--•----•----------••-- --••- -----.....---- �� C Owner Addre Inst er Address d Type of Building Size Lot._1'�,!�?,;LSq. feet U Dwelling—No. of Bedrooms._------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) Cafeteria ( ) dOther fixtures ....sue - C W Design Flow..........6 7......._...............gallons per pet-son per day. Total daily flow__.._..�_0_�____._______.__-__-___gallons. WSeptic Tank—Liquid capacity._ a ons Length---------------- Width------------.___ Diameter-----........... Depth___.________... x Disposal Trench—No. Widt ________________ Total n th___________________- Tot eacl area............._._-_-_sq. ft. Seepage Pit No._lDi ___ ______ g area _� ___sq. ft. Z Other Distribution box ( ) Dosing tank ( ) b _ /V ''Z`/` 7 I aPercolation Test Results Performed by-------------------------------------------------------------------------- Date-------------------------------------- ,� Test Pit No. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water_.__.-_________-___-- f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water----_----------------- ----------­--------------------- ------- - , -4.. .......................... ic DescriWion of Soil______________ �_ __.__... '" ---- x _..__..-a•-1�--._.. -- .: -sue w -------------- ---------------------------------------------------------------------------------------------------------- ------ UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --- --------------------- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code- The undersigned further agrees not to place the system in operation`until a Certificate of Compliance has been issued by the bgard of ealth. igne ------------ -----a Date Application Approved BY -`-- -- ---------- --• •---- ... ---_--- - --------------------- -- 7 7 Date Application Disapproved for the following reasons------------------------------------------------•_-----___-_---•-------------------------------_-----________-_-_ •--•--•----------------••-------••--•-•--•--•----------------••••-------------------•--------•-•-•-------I---- --- ---- - - - - ------------------ Date w Permit No............... Issued.......Ld--;- 7- - w �. . Date . No......_....... _. .... t Fps f 5.. ............... ! .THE COMMONWEALTH OF MASSACHUSETTS ,�,- BOARDSOF HEA TH ApplirFatiuu -fur ENripwuaf Workii Tlaustrurtivat Vantit Application is hereby'made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: Location' ddress / r Lot No'. Y ................... ._. ........_.......•...._...__._ s ..... � ...............e------_-_---------.__ �r •/f�(»e�/�........................................................ Owner �ddres5 ��I __ -------- p Installer �. Address Type of Building Size Lot..... - �1rSq. feet g— ,,,,�_______________________________-----Expansion Attic ( ) Garbage Grinder ( ) U Dwelling No. of Bedrooms___ Other—Type of Building ............................ No. of persons -- Showers — a YP g 1 •--- ( ) Cafeteria ( ) dOther fixtures --- - ------- --•------------•------------------------------------ ---- W Design Flow..........��.a-----------------------gallons per person per day. Total daily flow.....__.3_4..a----------------------gallons. 04 Septic Tc:nk—Liquid capacity/.f.�"?�a ons Length________________ Width__..___.-._.- Diameter__----.--__.-_ Depth_____-_-_.-._.. xDisposal Trench—No_ ____________________ %Vidt/hp• ---_.-___.-_-_-_ Total ngth__---.--.-._-___-.-. Total4each g area--------------.-----sq. ft. Seepage Pit No._l'_!�Dia�C�r-C /---�-•D.e �k )(,0<y 4�e�'--- Pot�i�� irea�---- sq. ft. l --- g t f 1 z Other Distribution box ( ) f. Dosing tank ( ) U�- �G 7 Percolation Test Results Performed by----_---------- ........................................................ Date-------------------------------------- Test Pit No. I................minutes per inch Depth of "Pest Pit...----------------- Depth to ground water...-_-_.____--......... w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__.-_-_-__.-_--_-__-... ------------------ -------- D Description of Soil----- (?' �_�.�._.. -- • - z / `Z u ------ a.-.� - ... - .- - u -� --------------------------------------------------------- W x ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ - -------------- U Nature of Repairs or Alterations—Answer when applicable-------------------------------------------.-------------------------------------.------------- ----------------------------------------------------- ------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. XDate f Application Approved B PP PP Y _.. --=--------------------- ... ....... Date Application Disapproved for the following reasons:---•-------•------•------•-------•--•---------•--.-_--••--------------•-•-----------•----------------.......... ...............•-------••---•---•••••-------••------.......---------•--•-----------•-•-.-••-•-----------•------.---------------------•--•------•---•-----------------------------.---------------------- Date PermitNo......................................................... Issued.-- .................................................a _ Date THE COMMONWEALTH OF MASSACHUSETTS � ... BOARD OF HEALTH Cs, -!f- - ......0F.40��� ..!...I ............4............................. fUlrrtif irate of Tuutph aure THIS IS TO CERTIFY, That they Individual Sewage Disposal System constructed or Repaired ( ) bY.............y 6`"'. -cal...------- .` � 2 ------------- ------- --------- Ins all, has been installed in accordance with,t, e provisions of 6ti�� e X of Tl e State Sanitary Co e as described in the 6­1application for Disposal Works Construction Permit N ._�:�__ — 7 - ------------- dated----- -- ---`'�---------------....------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........( --- -E --- ---------- -7 --•-------- Inspector........................t...... .....................-.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 , r •fiG'" �� -- — a ... ............:................OF... ... �� � .......... _............ - � No........`�S FEE..�.w'..--•-........ Iispu.ittiWork-o 101,1 onstrurtigaat Vrrmit Permission is hereby granted___.-___ 1_.- f?, ..___.. ........................................................i___________ to Constrt , ( or Repair ( man Individual Sewage D posAl Sys�tem� F- f at NO../ -. .. .._ /-' t_+! i•...../.!..% .r.ram/`'-.t'Y'", '' ' ''`fit ------------- r ' a ✓/ :Street �' 3 Q _ as shown on the application for Disposal 4Works Construction Pit N ____ ________ ______ Dated.-.___..__.._._ .-____ _----........ . � _ � DATE................................................................................ Board of Heal FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS y f x} t S- EXP, I G� /p°Q o FNWARMD BAxYE r� CEQTIF IEL7 P LbT Pt_.lS�..i Na 2 tiNaf r' a� f, LOCATlo1.1 DST �di e..l.- na u - c-AL !"=3 0 SAT 1= 60 �-;1 h-1 G6-QT1;= THAT T141= Pot1.U�DAT'1p�.1a 5t�ow�.l PL41.1 R�.i='c2�1JGE tti-1�Q E tsu COAAPL'YS WIT" YWE 51 VIS- WEE= �, A (fov ar S1402 C- A��a 5ET�3AC1G QC-gvtQEM�uTs �D,F Tf1'-1C 'ToiwLJ OP B4 2W5TAT, 4L © T�;2.1/lu.rs tG�4T"5 uYE luG- tZEGIS L W*o Sut:vayo v-S -' WS FLAW IS MOT BASE'S oN AN OSTE�Z.�/1L1.1= o ArKaSS� IWSPQ(1�t�lE�JT- S�Qut=.�( �Tt�� UF�S�S"S SNOWL':J *AP:PL1 GAti..,1T ` ' � r A Pr, 1,t!I V, P(- N OF sEr77C. sYSTErt b , . ! , + r S(_ALE . l = Ao TiBT PIT DATA DISTRIBUTION BOX H -20 Performed By: Daniel B. Johnson. , t REMOVABLE COVER � 4"SCH 40 OUTLET LATERALS DISTRIBUTION BOX TO MEET SHALL BE SET LEVEL FOR A f REQUIREMENTS OF 310 CMR MINIMUM OF THE FIRST TWO Date: October 31, 2002 15.232(WATERTIGHTNESS FEET AND CONNECTED TO CONSTRUCTION.ETC). _�z' EACH DISTRIBUTION LINE TP-1 (aL. 99.2) � -- WITH SOLID SCH 40 PVC PIPE 1 i I ! N0 OF OUTLETS 2 4"5CH 40 6' 0" - 14" A/Fill Loamy sand i EL =9519 EL .9502 o 0 - MECHANICALLY CRUSHED 0 0 6"(MIN) 0 0 o o C 19 -� Bw, 7 . 5YR5/8 Foamy sand STONE (<-3/4"DIA.) ( - 42" Cl, 2 . 5Y7/3 Medium sand �, $'Q1�3 STABLE LEVEL BASE No Observed ESHWT No Observed Groundwater __ - - --------- - -- Xq,UV I { LEACHING DRY WELLS 5W GALLONS \ PIRCOLATICM TEST DATA � � fND"r_ROSS SECTION Dare' October 31, 200 � j MODEL SHORFYPRECAST CONCRETE FINAI C,RADF to Fif ��TAHIII:'F[? So i 1 Class : (.; lass I (0 . 14 GISF) Fi. - 1000(AVGI FINISHED GRADE(SLOPE - (V) f 0� a� Per.- Rate : < 2 MPI (TP-1 ) I Fi_2 EL ■95,45 De 1th of Pftr 'Twsr " ItiFiE,AICOL I P 41" - '8[7 �o lOrw_ ... IT I IiIN(i Di41'WE I L r. ., 1/2 DOU6LE ' i SC>t>�TLi �' tLiVAT20NE 4• WAr>H F11A`';TONE OVIM 1.►JFA04Wj AA(A 04„ 1 1/i'UUUOLt Tt1v . Out f�'K1undat ton (existing) We { I, WASHEU STONE 1- r�s"' Inv . In S"p t i c: 'Tank (o x i 3 t i,n q) _. Inv. Out Septic. T:ink (exinting) ��. !� i FL •324+ LEi0.C►11NGDRY WELLS Inv- In Distribution Sox 95. 19 4 1()COMPl.YWI1HIHE ((v f ' Inv . Out'. (:?istrlbutlon Box 95. 02 ( -.IMB' REQUIREMENTS OF / 1 rI v . In D r-y We l 1 s 94 . 95 ______ ?10 CMR 15 252 PICK Hot t:()rn ()f r)ry Wells 9 . 95 No Obs. t;W/F3KWT (3H EiISriN/r NOJSE �• � fFE= roa-z= I b � 9 } z rJR 1 v.+E t.C.S E.x 1,s t i n y (,��"'1`11 ;k! t .,. .. ,.. t�R ,. ,. .. U1(M'E$ Proposed Cot'l.t,ous ry$ 1 . All construction methods shah conf = to the Title V ( 310 --MR 15) and the Barnstable Board cf Health Regulations . Er >Ti,vv ( ,4+� 98wi � 4xr>*iv �TrLrT/E.S DESK /rNE / � 'xJ Irao Sky v Test. Pit � � O��1`Il°3 / r Z . 'here are no known private or public wel-ls within --+�'6' f3 9g*, .00 - tot { f" shod floc): Elevation, FEE feet/400 feet, respectively, from the proposed leaching y++ ( area. There are no known wetlands within 100 fee-, of the proposed leaching area, nor is the oreoosed leaching area tad ( Sa9ement F1,_, r f.' c>v r: ore within 200 feet of a riverfront . li*o ft.' 184 L,Water 1,ne W I I' , .r ��a / ova` / { i . Existing SAS to be pumped and removed prior to 9b / instating the new leaching area. 9� / 9� �B>;4 / r o��►3 r,;3 9 ' / .� �).00' ► i 4 . No changes are to be made in the field without the approval 9 Ioa v k�oryu Ov'e r Head Wire ORW �'S�kgo of the Board of Health and the design engineer . YENS fj4I r/Kb i000 6-.AUoN 5 . Proposed leaching area is not designed for use with M,,rt(- rAWK BeNcMFt•�rtvC -------- - - -- -- --- --.__... - - ' garbage disposal . C,►rfAOIL ENS ,�� EBE/NEZX-4 R-�,4D 01A 1 6. Contractor to notify Dig Safe '72 hours prior to LE.KN�• 7"bP of (•rtR.gTa �4CAC construction. (800) 344-723.3 . s W i CA2AAt13 f ? 2 ,.�� , _ Property bins informatib� taken from Subdivision Pl of ° `d R : cevr-,L it cf Y 7 J11.110 � Ra ' j �'?a AS band i,n Barn Barnstable, r'r�3p ) e,.j oy baxXLor' h Nye, `.'`urve e,r5t A + ° �L�� .,T 1, 1 �76. Septic FL�In not t a b�. us!►d ale a l July y S t t- r + �ECe� `°A vt`r_GQf+ - r Cwr� N aSJN " I- - 41 0 - rr property T1A! I){UrYt . t .� 'F ..�_�. •- ! ff�y+ O ACA Y u ' AFs� /V �000Y Af I �� *°,•�;� '' `< ^,tnfA "„` i A 0 . Contractor Shull verify all. plumbing from oxisting Structure r < t ^ ► a cAo asr o� o o VA Ra ', �� hour, will be connected to the new septic system prior. to t� �f /LE DF 5�?TlL SYSTEM # LOGS �� �,w 7^� `s t °� ;l,. ;rt s+''�'h ,,�' �° construction. It any existing plumbing exiting the I IO '6,. A ��, structure Is found to be different t,h* that shown on the I «`�" s approved r�aptiw system plan, the contractor shall notify the 0 e • � '�• �' ° � q All internal plumbing shtwll b4 connected to new q�$(,fi� � 1� v ,c..wrr ,.► / {.�esi nee . ,tENr 1k, •�,r,,r 4 M 0% .I2s* • +h �' ' Jtit` 'N,, p ati.� ,ietpt i ,- system, tin I#iss Otherwise spec. i f . od. f yM �► A.,oar r� uz - I : a `►o,` ,o" *�'- i .,: f '� ~, « " 010 VARIANCE. : VIA LOCAL UPGRADZ APPROVAL 3�'" Nl i ►4 4, °� Yy f •o �' °< . . Q Vdrldtl�E! LO reduce L h f1E° Proposed rw„ • w.+. f!" 4 r .AMA t C LATER• ,.011 i�w'ai. •1 A`''� j Request Bl":�U- ..h depth G�f t 'O{70''P.d I m .,. �` wf • + tA�aN leaciiin area ro existing grade from 3 feel: to 5 . 5 feet �o�,zw .o r VILE. E *, . • I 'max 310 .tea 15.Zz1 ( , 1 . fFB 9 9 E�lirINEf &A.A�� f 4VA N K 9 ` t..r i Do --'-i- ( .A �r, ^ r,MtIV ` lot, �'r ,r`, It 41 sit ��� • i Y •ALA"41 i ♦ j 1140 100 004 q < , „ ,- nr. tl'* �, C:ALCULATI02'I3 t3 � • �t `" � N � �` Co�E1. 7� *t ,vr. l� ; A MA 3 Bedrooms (Exist ing �ruN AG n 4 Mesa 1 1"s o' 110 GPD/Bedroom X 3 Bedrooms 330 GPD R` A si.0 iAv 1 r r KAf�tN' r a' +.. .,A Percolation Rate < 2 MPI (TP-1 ) t ° OlrAAw.aaC � J♦ � IA r c Ae C►AA► SC ° * , s" Soil Class : Class 1 (0 . 74 G/SF) AO 40 s , PROPOSED LEACHING AREA: Dry Wells : 2 at 25' L x 12' W x 2' H I SSiL I ! Side Area : 148 SF X 0 . 74 r/Sc - 109. 5 GPD ��srwb E><rss�Kb S� S,o� 4.lS I 1 BOtt,)iT� Area . 300 SF X 0 . 74 �/SF 222. 0 GLAD { Total .' eacriing 'APT; t f w I 9�..rr I D1ST�lB�Tionl 80� �l DILY wEL�S f �$L't /.L w AAN f Erirj�iv� ,,t!1 J. ng � SEpr( ri1/' X J ulel03 9° i Egg ow /n< O.JrLfr of T.tNK 9% It(. Irt. Ala 063 6_04 � ellPirAI-111 hoA/rZ41`/ U.L ,1-n7 7 t,)-r; G_,oL 44r1 /Levu ra ,v c rr Z V1/.sz r=7 oFF>e SUBSURFACE SEWAGE DISPOSAL SYSTEM 25 Flowing Pond Circle, Osterville Bb _ T-.._-_--___ .. ._.__�---.___.___._---T-.__�� _-_1_____.._--.-.. __r____._-,--,---.__r..____.r .____ r___- I SCALE: APPROVED BY By As sham !to;� 0r10 Onto OtJD 0f40 O+Sn 0460 p�)O a,`� p♦tea trot i ;1 N0. TQn DATE: 11/21/0 Denial D Johnson Joltusn TAaers wary (509) 420 - 0040 fl0t� C /O ( ,�Y, 9�/, c-� {" >11►s, 11., NA 01655 red SlIC S><?TIC DtSI41, I11C (BOt) i20-1>tOi DRAWINQ Nl)N1BER 004 Main stssat, Suit* 9. oetrtville, 1k 02053 4EQ