Loading...
HomeMy WebLinkAbout0045 HATHAWAY ROAD - Health 45 Hathawa Y` �o- � i A Osterville A -114 035 No. VIAE COMMONWEALTH OF MASSACHUSETTS! c FEE BOARD OF HEALTH OF Pr�> Lk' �d3iZ�vitc � APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade (�Q Abandon ( ) - X Complete System ❑Individual Components //,qLpcation Owner's Name / 3 S �7 6 '>^4 i^t S le ©S 7'Lr4-Vij1_tC Map/Parcel# Address Lot# Telephone# JaTFNIo..� Installer's Name Designer's Name Address Address (S-0 6 4�o - c 9,0,i Telephone# - Telephone# Type of Building: l df C-v-7/s¢l Lot Size Sq.feet Dwelling—No.of Bedrooms q Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 4® god Calculated design flow god Design flow provided 4 god ~ Plan: Date i!6�o l Number of sheets Revision Date Title S-SS✓AL r f-Lc. rn-, JYjrr— Description of Soil(s) /tC-41`.,&', Soil Evaluator Form No. Name of Soil Evaluator !a JP Date of Evaluation L%o- A DESCRIPTION OF REPAIRS OR ALTERATIONS /Le'P1,4 C_4"r 5 f'1 C-197✓ 4y-" CP-rt< 3 r —l- / `l rN IK V e2V &,wet.ems endersigned agrees II the abov described Individual Sewage Disposal System in accordance with the provisions of 5 and further agrees o pl ce ys n ngrgration until a Certificate of Compliance has been issued by 'he Board of Health. ip-ned Date 01 - 4j- 2 7 0 nspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 �� ,� f'-`'+-r��.. .....+H'.-=.',.+F- �,,,;'�'i 4 • 'TM43Kc�.++y!`ir '.,�`.r ry .{'YS ^«f"'i'�� ��mi..,,i�l� . ,..5t...s.l(. �i"�.'n-' NO: I)lI�- ikiE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH O F APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMITr Application for a Permit to Construct ( )-Repair ( ) Upgrade ( Abandon ( ) - K Complete System ❑Individual Components 9S" /f17Ns�N-+y . i�l cation —r 2.wner's Name //,q/3S »b t^� oS7�2vic�� Map/Parcel# r Address 9aa a Lot# Telephone# ,,}ott`/�faAl k- Installer's Name Designer's Name -3DY ST; S�tr(f B OSTCA_,/,ge- Addressr, Address Telephone# Telephone# Type of Building: K�l �� / Lot Size Sq.feet Dwelling—No.of Bedrooms PA_Q ro fC,9 // Garbage Grinder ( ) Other—Type pf�B�uil•ding " No.of person f� Showers ( ), Cafeteria ( ) Other fixtureA t 1 s` Design Flow min.re uired 4 o d Calculated design flow rt g ( q ) gpd g gpd spesign flow provided gpd Plan: Date /�!b/ 01 Number of sheets / Revision'Date Title ..S'6S� F,I CG �C vrk 7lJ�n tir JYJTi;'^" Description of Soil(s) [ 'm C4 r""`- lit^'o Soil Evaluator For W0. Name of Soil Evaluator 49• ,Ja107'"^' Date of Evaluation lletaa I : DESCRIPTION OF REPAIRS OR ALTERATIONS Re-cL,41-i l�rl L"' 5 -rt 1- -7*":*, -Y►"! .¢ (3-4't--, ! 4 C c4 tF�/AEG �.c y vrE1-L.S The under�grees tall the abov described Individual Sewage Disposal System in accordance,with the provisions of LE 5 and further agrees o place ys ae�a6on until a Certificate of Compliance has been issued-by/the Board of Health. i igned Date 4 os u - 2j. 2/7 v nspections f �a_>z•. ' `P FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 �4 [�h,C-.�_.c<o�'� .w t��t'a tr..sa.aw w+:w Sa.uo mv�i Cs mntie►.a[.re:-..cw...E�+rf+.ao F! r9 c.-c�[�P w M+r.+f+cr..s.� -(na.w.0 a0.'e+.W uu,+a-w[r [� —————--a-———cap——-- No. ,�00.)-03-0 THE COMMONWEALTH OF MASSACHUSETTS FEE ou � BOARD OF HEALTH CERTIFICATE OF COMPLIANCE * _ Description of Work: ❑ Individual Component(s) omplete System 4- The undersigned hereby certify that the Sewage Disposal,System,;Constructed�4,Repaired( ),Upgraded( ),Abandoned( ) at L�j 174�w�� rd 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. .fid -0 dated D/-7/u Approved Design Flow (gpd) Installer Designer: Inspector _ Date Z Q The issuance of this certificate shall not be construed as a guarantee that the system will function as designd FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 W—---—T-awe----e-e-- —— ——— - -- ---------- e------ ----,—a-,---------w--rn[-. ry No. 6 THE COMMONWEA-LTH OFJMIASSACHUSETTS FEE J� r BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby grante, o Construct \ Repair ( ) Upgrade`( ) Abandon ( ) an individual sewage disposal system at 4-r de/M Ai..r o r ' as described in the application for Disposal System Construction Permit No. �?U..?-Qj-y dated 2/ J/G 2 Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date ���A Z Board of Health - ` t / FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON i n' j ,^/ IP'A, G !ter✓p�P VVP 11 f F �Lf OWN OF BARNSTABLE LOCATION 04l19CC� SEWAGE # 06a- © O VILLAGE ASSESSOR'S MAP& LOT ^0 5- INSTALLER'S NAME&PHONE NO. A c64-§�-r v a SEPTIC TANK CAPACITY /SO LEACHING FACILITY: (,type) A( o N t✓r iite. (size) , NO.OF BEDROOMS BUILDER OR 0 R h. e PERMITDATE: O Z- COMPLIANCE DATE: Z d� 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(Ifany wetlands exist within 300 feet of I ac ' g facility Feet Furnished by r c� pj5E� v Rr��R i i It Dc � i i. 6 Town of Barnstable Department of Health,Safety,and Environmental Services Public Health Division Date 0/ � •. 367,Main Street,t Iyannis MA 02601 earwirrA0L > •. /r . 1e . .� UU Time D;UU Fee Pd. V ; �fb " Date Scheduled C9 6? ..� ?- Soil Suitability Assessment for Sewage Disposal S 00 Witnessed By: Performed By: :.::::.::::<....::.:;:.:,,.::::;.:.;>;::.:::•::::,..:. :l �c �Ev�cv/MLy� ....:...,. ... ...;:;•:�f;:<;•>:» �r>:�>;«:>:<a:•;>::•;::::;;.;::::.,•::.s::;:.:::.:.::::::;;;:•:•>:;.: Owncr'sNome rj,�rcN Location Address [rs �f / Z I' `► Address 7710 �� SI OJ�nviLC� Assessor's Map/Parcel: 14 1 3'r Engineer's Name NEW CONSTRUCTION _ - REPAIR. /1 Telephone N ��� �(�0 Land Use /tS l0 C"i r-1-l Slopes(%) t64�,, Surface Stones � Distances from: Open Water Body ft Possible Wet Arco ft Drinking Water Well ft ft Property Line ft Other ft r Drainage Way P Y --- —> SKETCH:(Street name,dimensions of lot,exact locations of last holes&pare tests,locale wetlands in proximity to holes) > 40 I I . i - i ®✓i is�3lf Depth to Bedrock N o� 0 6S Parent material(geologic) _ AJ•� m f a�S Wee from Pit Face /s�+ o'�S Depth to Groundwater: Standing Walcr In Hole: Weeping Estimated Seasonal High Groundwater ... Method used: in. Depth to soil mottles: in. Depth Observed standing In.obs.hole: Groundwater Adjustment ft .Depth to weeping from side of obs.hole: j Arl.factor AdJ.Gro Index Well level._— Level_ .•index Well!/_ __._._ •Rnading Date:�._�_ •__ ................ .::Ai:i w:::::SJ:;•:Y.:6'+::rv.;;4•., ... :?i: :: :. ;{•.... ,: •':iF:•:•r ••ai:$`{:;:i?;:;y'`;?':.:?•; •t '.'fi'�.. ::.:::::r:.is i??•..:....: ..r::::x•:.Sv:::•::•.:..4$:•::::::•.::.....::.:::. ...,:::v:........ Observation Ya:�7 --I Time at 9" Hole N � (©" Time.®6>� Depth of Perc Start Pre-soak Time® D / Time(9"-6") 30S�L End Pre-soak .Rate Min./Inch Site Failed: Additional Testing Needed(YIN) _ Site Suitability Assessment: Site Passed _ ..b1 �t ■yam, �Wy���.: �• .:'r, �•:f• .Y. .:t.4 ..:. ` Other� •� .. `S ••• r •�oll C Depth from: rSoil horizon So ll Taxlure . (USDA) (Mansell) Motllhng (Structure,Stones,Bouldcres. Surface(in.) ° L toA—r spa �a yA- �lz a8j .1AIL4 avj CJA",y tilr'o s-A- Sly L Cy. CagALC ------------- :..,..:....... other....,:....:..::..::...:..:.:.... . soli , ' Depth from Sof)Horizon Soil Texture Soil Color ruc Mottling (Structure,Stones,Bouldcres. Surface(in.) (USDA)- (Munsell) e f I 1 I ...:.....: •-Wit::•::-:�.:•:�....::..:..:.:::�":>:a;i:<r.';;�i:•:::.>i::t:.;:•::a:;:i55:Y:i :k: ::;:•`.:::: Dla ... .Q.... : ::..:.:.... 1 ... . .. .....,•:::. .. r:::..::::.:. Other ..:.......... Soil Depth from Soil Horizon Soil Texture Soil Cola) Moulin Structure,Stones,Boulderes.. Surface(in.) (USDA) (Munsell) g i Coneadenrm • t. i•:>;::::<•:;: ;:::•,:>:<::::•.,,;•.,•:.::<.:,, 5oi1` Other Depth from Soil Horizon $oil Texlure Soil Color Mollling (S4ucture,Stones,Bouldcres. Surface(in.) (USDA) (Munsell) Flood fnsurmiuJUILMAK Above Soo year flood boundary No Yes f 1 {:a a OWN OF BARNSTABLE 1� LOCATION / U l/l fl a) • SEWAGE # 2,00a O VILLAGE 0—,Ae--1ri1i ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) tJ C r&te. (size) 0 NO. OF BEDROOMS BUILDEROROWNER , DUMLA efU , r1p, . PERMITDATE: 2 7� COMPLIANCE DATE: ? �-3 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 1 achi g facility) Feet r Furnished by t r' �. ,/ ff , Y � �.�r`C S�c�.Er�� ?500;iALLON SEPTIC TANK l MODEL TK 1500(SHEA CONCRETE; (OR EQUNAALENT) SCALE, : J �o` TEST PIT DATA FINISHED GRADE Performed By: Daniel B. Johnson ( — 24"DIA �— " 24"DIA �9'JMIN1 24"DIA Witnessed BY: David Stanton 3" 3" t H 10 i Date : January 3, 2002 f 6 4"SCH 40 1 4''SCH 40 10' i FLOW LINE 14"� ZABEL FILTER A- 100 TP-1 (EL. = 98 .5) SEPTIC TANK TO MEET - 4"SCH 40 TEE 4•LIQUID LEVEL REQUIREMENTS OF 0" 8" Fill GAS BAFFLE 310 CMR 15 226 FOR �� 4"SCH 40 WATER TIGHTNESS, 8 - 16 0,A, 10YR3/2 Loamy sand TEE ETC ` 16" - 38" Bw, 5R5/8 Loamy sand 38" -126" Cl, 2 . 5Y8/3 Medium sand ALL WALL S LE EVE S/GAS K E T S No Observed ESHWT SHALL BE CAST IN PLACE OR 6" (MIN ) `_ a - MECHANICALLY *, zEarS �' INSERTED AT FACTORY. `_' o o COMPACTED No Observed Groundwater CRUSHED TONE --------- STABLE LEVEL BASE_ _ <®3l4"GIA PERCOLATION TEST DATA SEPTIC TANK,DIMENSIONS 10' 6"L X 5' 8"W X 5'8"H { Date : January 3, 2002 DISTRIBUTION BOX Soil Class : Class I ( 0 . 74 G/SF) i / H 10 �x�1riNls REMOVABLE COVER f/c�JE \oo i Perc Rate: < 2 MPI (TP-1) 4"SCH 4 SET LET LATEREVEL FOP AS L� 6C bEncIL.1SH8l1 I D15TRIBL TION PDX,TO MEE T MINIMUM OF THE FIRST TWO REQUIREMENTS OF 310CMR Depth of Perc Test: 42" - 60" 15.232(WATERTIGHTNESS ---- - FEET AND CONNECTED TO _ _ CONSTRUCTION,ETC) - -- 2 _ EACH DISTRIBUTION LINE 6'' BCLo�•►�s ) I SCHEDULE OF ELEVATIONS I �/ I WITH SOLID SCH 40 F'vC PIKE 1 4"SCH 40' 6" I 1 NO OF OUTLETS 3 _ _._� �i Inv. Out Foundation 97 . 20 6"(MINI ------ MECHANICALLY CRUSHED Inv. In Septic Tank 97 , 00 0 0 0 STONE (<e314"DIA.) n iosfs ,, ry � Inv. Out Septic Tank 96 . 75 STABLE LEVEL BASE 45 Inv. In Distribution Box 96. 55 (_ — ,00f,, Inv. Out Distribution Box 96. 38 j� - i Inv. In Leaching Dry Wells 96. 25 l..E:;CHING DRY WELLS 500 GALLONS p�poseo ! Bottom of Leaching Dry Wells 94 .25 3(1 m Bottom TP-1 (No Obs . GW/ESHWT) 88 . 0 'END"CROSS SECTION MODEL SHORE'r PRECAST CONCRETE LEGEND FINAL GRADE TO BE STABILIZED \ FINISHED GRADE(SLOPE = 02 _ _ f ) de 1 --- r- Existing Contour - - - 9$ _ 12 _ (MIN) I) ( 7 _ Proposed Contour 98 H •10 q,�SC / ��Y LEACHING DRYWELLS :3 - o -� 0o bRCLoN i LE sh► s ! 86"LX4'10"WX2'1"H c� �-� r.:- 5 i WASH 1 D01�8 � � Test Pit /S TANK 2.1. OVERALL LEACHING AREA 2 �_ j/4"- 1 1/2"DOUBLE 301X14WX2'H _ q — _ Finished Floor Elevation FFE WASHED STONE , � C_`_, Basement Floor Elevation BFE 1 Water Line W --- LEACHING r_HAM9fRS ,10t !1 / W Pl�oPaSED� TO MEET THE to0,4 4 tP-1 ` _ 6 ( "F� _�___.._ _..--__._ __� REOUIREMTNFTSOF "P t,A ci Ec=9d,5 9t% 97"4 9 ; 310 CMR 15 252 SE6 At 30 `Zfar 1 S � v y wELLs / o ,BAY Ast d w 3Ej'C 7L J4w /� / r9, / / � 0 5ccoAV c 9710 I THIRD oof ' 96rS 3 J'�y, 14 W Etrlrrnlr / / I AY �q {51 NOTES PARKER LA �No cR a't p� d 1 . All construction methods shall conform to the Title V ! ?"' -- ECK ----__,_. y'. POND N POND �ARNAR� Q CMR 15) and the Barnstable Board of Health Regula"for 3 a bll 3 EAvE ur' PA.I��ENT — C , ,. cRe aD of PRrvArE GOLF I �QQ 2 ENLNvt42K � ., ,8 HOLES "8 S'-"AV ` { 2 . There are no known private or public wells within 11 - s — p c , 1A feet/400 feet, respectively, from the p . R51 �Ec. =ivo,00 N� Tff� YV la� �: OAI� PAR ?o ti � � w� r op rti� °f Ro "� 4v �. .RA p Y, proposed le 0 7% HA7HAVAY ? �PKEarea. lA/� yQ ^, � e ✓ t2 4-N T • a A 1 � ECNARD RDVIANNO 7* v hL `� U z^'o AV 4 � V 3 . Existing SAS to be pumped and removed prior to installing the new s eot 'is tank. �a z yASN'Y67CN o 5£AW£W "L J,o I r 4 . No changes are to be made in the field without the approval { of the Board of Health and the design engineer. loz I 5 . Proposed leaching area is not designed for use with I garbage disposal . 6. Contractor to notify Dig Safe 72 hours prior to ,ov E�)sr/Nfr Cr construction . (800) 344-7233 . 7 . Property line information taken from Certified Plat Plan in \ Prepared oy BSC Group, Dated November 29, 2001,Craig tField, PLS. Septic Plan not to be used as a property line survey. --- 98x • 8 . Remove 5 feet horizontally around the proposed leaching area and vertically, approximately 3 feet (topsail, subsoil, fill) and replace with Title v fill (Reference 310 CMR ° ""go — to+t 15 . 255 for specifications of fill (sand) ) . The total amount — A'kN4o s J Mw � ( I of fill required is approximately 50 cubic yards . 0 I 96.75 CALCULATIONS _— 4 Bedrooms i Pi uposed) s`0f { 110 GPD/Bedroom X 4 Bedrooms - 440 GPD 94-Aj � ' Percolation Rate - < 2 MPT (TP-I ) ©19-710B0�lorJ 4 - box � �� Soil Class : Class I (0 . 74 G/SF) i I �E�crtinl6- I PROPOSED LEACHING AREA: 1 i 1500 GALA-0/4 3U'i. X SEPTrL rAHK i Leaching Dry Wells : 2 at 30' L X 14' W X 2' H ! i Side Area: 176 Sri' X 0. 74 /SF - 130.2 GPD Bottom Are<x : 420 SF X 0 . 74 G/SE' Total Leaching Capacity: 442 . 0 GPD i a n u go z t 9` o I - 3�.o � SUBSURFACE SEWAGE DISPOSAL SYSTEM 140 go 6G / 45 Hathaway Road, Osterville ESHwT ,{. . e As Shorn DRAWN BY SCALE: APPROVED BY cc O DATE: 1/16/02 Daniel B Johnson D.B. Johnson ) �'3i ( Prepared Dunhill Develapment LTD (508) 420-9222 3 Q W lore 716 Main Street, Osterville, 1!A 02655 cc repay SEPTIC DESIGN, INC (508) 420-1904 DRAWING NUMBER p+oC) 0+40 0*20 tfjt?O pi40 C�� O*ba 4 y Hair,. Street, Suite R, Osteriille !SA 0265 ;. ,d,, i