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HomeMy WebLinkAbout0125 ICE VALLEY ROAD - Health Fr y,5 jCr. V l� Eta' ROAD Osterville . - -096 017 A, i S J �d I TOWN OF BARNSTABLE L0CATI0N Ito. a SEWAGE# /�CQ /�713 VILLAGE 0�k-e Ak& ASSESSOR'S MAPt&PARCEL ' INSTALLER'S NAME&PHONE NO. qQN,, S% SEPTIC TANK CAPACITY LEACHING FACILITY:(type)' g_k0. i f-4k Pr S``,, (size) -NO.OF BEDROOMS b OWNER PERMIT DATE: a COMPLIANCE DATE: l�' 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 Facili If any wetlands exist within 300 feet of leaching facility Feet FURNISHED BY G co eo 0 No. G l 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: toll PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21ppliLation for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( V/Abandon( ) &/Complete System ❑Individual Components Location Address or Lot No. 125 W va j, 4 'Owner's Name,Address,and Tel.No. �z �d�'�1� IYof Assessor's Map/Parcel 'f Installer's Name,Address,and Tel.No. Designer's Name, Address,and Tel,.No. tw Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 1D1o0 gpd Plan Date gd Number of sheets Revision Date Title Size of Septic Tank �f Type of S.A.S. �(- Description of Soil c� 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 dthnnvironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boarlth. Signed n Date C3 Application Approved by _ Date 3 —F yZ Application Disapproved by Date for the following reasons Permit No. �}©� V Date Issued t � `.� No. Fee ,, THE COMMONWEALTH � MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitatlon for bisposal 6pstem (Construction Permit Application for Permit to Construct( ) Repair(_ ) Upgraded(\/Abandon( ) I_J Complete System ❑Individual Components .s Location Address or Lot No. '�5 ACC'�/�( C(y� "Owne�':N�t e,Address,and Tel.No. Assessor's Map/Parcel 7 F f-��(.�t Installer's Name,Address,and Tel. o. Designer's Name,Address,and Tel,No. Type of Building: Dwelling No.of Bedrooms Lot Size -7 7i sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Q _ gpd Design flow provided �l� gpd Plan Date e��� 1:77 Number of sheets Revision Date Title Size of Septic Tank I?I() Type of S.A.S. Description of Soil ! , Nature of Repairs or Alterations(Answer when applicable) Date last inspected: 2 S_2 k is 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 Certificate of Compliance has been issued by this Board Signed ii Date G3177 Application Approved by i _ t Date �G Application Disapproved by Date for the following reasons , Permit No. �?0 V Date Issued ------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired,(i ) Upgraded( ) Abandoned( )by at 17� 7(� ��{ �,[,� p S�'frV lhas been con c in rled ce with the provisions of Title 5 and the four Disposal System Construction Permit N . O Installer rU f hW Fx(G y(a:h6 N Designer_b­q JA /'/&-e_ �►�i' ( r L #bedrooms Approved design-,ao v gpd f The issuance of this permit shall not ybe cons ed as a guarantee that the system will fffu"nction e5 dd) Date n /Gi Inspector ------------------------------- _ - - - - - - =---- No. r�0 6f3 Fee 's o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal &pStem Construction Permit Permission is hereby granted to Construct..( ) Repair(. ) U grad Aba on( ) System located at 12,5 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co m eted within three years of the date of this permit. / Zt�&IL5 Date �j �` '— ' Approved by f Town ®f Barnstable THE Regulatory Services Thomas F. Geiler,Director # 13"NSTABLF MAM Public Health Divisioh Thomas McKean,Director 200 Main Street,Hyannnais,1�u 02601 Office: 508-862-4644 Fax: 508-790-6304 l t Installer& Desigger Certification Form l I Date: 1 4 I Sewage]Permit# Assessor's MzP\Parcel �6 / II Designer: pU W� e- ALUM-1 V Installer: Address: Jt Address:. I On was issued a permit to install a (date) (installer)) septic system at �1-Ct Va G l/ based on a design drawn by (address) r � J• PE Pt s' dated ( signer) - v 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 t4,I Q 9C,) � OJALA (Installer's Signature) U CIVIL No.46502 S8/ONAL LNG S4 (Designer's Signature) (Affix-Designer's Stamp Here) PLEASE RETURN TO BARNSTAB LIE PUBLIC HEALTH DMSION. CERTIFICATE OF COMPLIANCE WILL, NOT BE ISSUED UNTIL BOTH THIS ]FONT AND AS-BUILT CARD ARE IECPMID BY THE BARNSTABL E PUJIBLIC HEALTH IDMSION. THANK YOU. I Q:Health/Septic/Designer Certification Form 3-26-04.doe s tK INVERT ELEVATIONS TANK IN 31.2 TANK OUT 30.95 CHAMBER IN 30.2 52.301 N r? - � o i p O O o ; EXISTING DWELLING �- EXISTING TOP OF FN D N GARAGE EL. 36.3 �- JOB #17-033A AS BUILT SEPTIC SYSTEM PLAN PREPARED FOR: LOCATION : 125 ICE VALLEY ROAD PLYMOUTH DEVELOPEMENT OSTERVILLE, MASS. PROPERTIES LLC .SCALE I = 20' DATE JUNE 22, 2017 REFERENCE: ASSESS. MAP 96 PARCEL 17 � y(ti OF lvMg ,I"OF 4fA g off. 508-362-4541 O� DANIEL y�N fox 508-362-9880 A. DANiELA. I o � o OJALA a ; down cape engineering, inc. OJALA " CIVIL C ' No.40960� No.46502 CIVIL ENGINEERS �Ess `'� po�lp ti LAND SURVEYORS sua\1 �ssio T S „ 939 main st. yarmouth, ma 02675 DATE DANIEL A. OJALA P.L.S., P.E. ffJJ1 �Cff 1 } 1- P4 IF I ,- COVERED ou PORChL -7 4-- J t 3 - - - - � _ _1 7 s J IF L COVERM PORCH pool ."I rc JIQ71 . U . r A Town of BAmstable_ P# ; Y � Department of F.egulatory Services Public Health Division Bate ♦s� 200 Main Street Hyannis MA 02601: ''rEo rMtii t Date Scheduled }6 i Ti JoA d'f Tree Pill Foil Suitability pAssessment,for Sewer e osa'�l } Pecfotmed By.� {LN M'GYGF Witnessed By: G 't W JT l�^TDn Y lL LOCATION&GtFNIFRkL IlNORMATION 4 Location Address .i2_5 f_ _ Vot tl kJ ; owner's Name }2 jY��/,(,���!p tL '` Address 11 DJ p!�-''� � - t75f tom. ( 05$ewVltr AM Assessor'sMap/Pateet: � IQ d 7./ ( Fingineer•sName MQ'Yv,1 gyyts NEWCONMRU ON REPAIR ^� E� Telephoned � T 33tf Land Use� �� �t� Slopes('.) 1 �D Sor€aeestoaes Distances from: ripen Watts Body > �o ft Possible Wsa'Atea >� A Drinking Water We0�ft 1 Drainage Way >/Ot, ft Pmpeq j4 `!/O ft Other ft SKETCH:v. t ii, \� I I ! i \ i \♦ ��`` ,ice - \ \ ♦ ��i \ BfNQtMAR1(CCtB$R \ ♦ eF ss..l.4AlE,PRKK WAIL ♦ ♦1 COVER PLAN7EnISLAND ; ! / 1,Cnt IXBYEtl'AY PAtCII' PAVED ! [�iEWAY �S Pan � JA Parent material(geologic)) A S1 I Depth to Bedrock t� Depth to GmundwaWr:Standing Water in Hole:' '� (!— Weeping fcam Pit Fay �+ Estimated Seasonal Ogb Groundwater Dt TION FOR SEASONAL HIGH WATER TALE Method Used: I In. Depth tltery standing in obs,hole: in. Depth to soli mottles Depth toiweeping from side of obs.hole: Ofouadwn[eY Ad}utlhifertt,_„�.�.�..,....IY. . Index Well tl Reading Dale: Index well Ievel AcU• 111el0r Adj.()rwadwatertevel w PERCOLATION TEST . Date_ Observation I' 1 Tune at 9" ' Hole# Depth aPerc 3�.53tt �.�S61t TmieatG" .. Start Pre-soak Time-0 '} r o End Pr"oak Z M Rate NFmAnch Site Suitability Ass0smeat Site Passed A Site Failed; Additional Testing Needed(YIN) original:.Public IleM Division Observation Hole Data To Be Completed on Back— i'' ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable C4#servation Division at least one(1)week prior to beginning. 171; *r DEEP OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in:) (USDA) (Ntunsell) Mottling (Structure,Stones,Boulders. onsistency%Graven 1�Ytw��1. Maya► G r>' Sly t'!� `ease favr�l� DEEP OBSERVATION HOLE LOG Hole# Depth from, Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling jStrvctur,Stones,Boulders. consistency, Gra el ...... ®"- 164 oa a o ti-411 N $ -3y�' � LoarK and 1 � gel MAss Ive t a - 34 12A' G ME S 2 5Y Loses cahu,la� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil.Color Soil Other Surface(in.) (USDA) (Muosell) Mottling (Structure,Stones,Boulders. Consistent Gravel o'I IoyR �� ►� �4 39 6a-ti 6� Massive 9 G Z.—b` 1-��e, an u�a, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency- ra 1 Orr- 10" 40''- 34' 8 Ste► l ��� 3V- 132 MEO S 2. b ease U Flood Insurance Rate Map: - - - - - . Above 500 year flood boundary No_ - Yes Within 500 year boundary No�X Yes e_ Within100 year flood boundary No!� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pe s material exist.in all areas observed throughout the area proposed for the soil absorption system, If not,what is the depth of naturally occurring p ous material?. Certification I certify that on t (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the require&' iningg,expeertise and experience described in 310 CMR 15.017,.) Signature 1 �/v �- Date Q:1S EPf ICtPERCFORM.DOC Town of Barnstable P# Department of Health,Safety,and Environmental Services Public Health Division Date 367 Main Street,Hyannis MA 02601 S BAANBiAO[$ rtn � Date Scheduled Z Time b ITAA Fee Pd. �00 • �49 CD • V Soil Suitability Assessment for Sew e l Vosa Performed By: G`t��l° k?A, p r Witnessed By: � �• �► n;:::.; T ,ii::::: :' :h•: :. `:; is '• :. :......:..::..:::.::::::::.::. :.::..:::.,.::.::::::.:..............::..:::.::.•.(�x,.I".l+.X!1�.il�. YX.A�''�.Q.N.:. . .:.:::.:.. :::::::::::::.:.:: :::. Location Address`�Z5"-�e Va/!� Owner's Name irral�"0�. OJ'7`w✓t GL 2 Address 6 Assessor's Map/Parcel: 9I Engineer's Name W OW Ac y � NEW CONSTRUCTION REPAIR Telephone# S p& 36 a._ I r . a � Land Use lt, Slopes(%) _® Surface Stones Dislances from: Open Water Body_!2z(9— ft Possible Wet Area R Drinking Water Well G ft Drainage Way V(/ ft Property Line ft Other It SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) VG.y'�G - per, - 3�y: 17�• Parent material(geologic) �� ({l Depth to BedrockL;✓t,;I `t Depth to Groundwater: Standing Water In Hole: 1�[�t�/� Weeping from Pit Face Estimated Seasonal High Groundwater Method Used: ---�� UM Depth Observed standing in obs.hotel' " "" in."'Depiti to soifmotlles:' - in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft, Index Well#__ __ -Reading Date:_ Index Well level.-- A(l).factor Adj.Groundwater Level : rE R CI 1 . TU Observation �J Hole# y Time at 9" Depth of Perc Time at 6" Start Pre-soak Time© t�'C Time(9"-6") i End Pre-soak r Rate Min./inch / Site Suitability Assessment: Site Passed x Sitc Fniled: Additional Tesfing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant � ` ' _^ � � ` � � � � ` � ............ ........... ............ Depth from ��'iffiorizou, soil rexture S it Nlor Soil Other Surfaci (US )A) (Munsell) Mottling (Structure,Stones,Boulderes. sozo Depth from soil Horizon Soil Texture 8011 Color Soil Other 'Consistency.%Gravel) Dop(h from Soil iionzon Sell I'.r '....Soil Other Surface(in.) (USDA) (MI sell Mottling (Structure,Stones,Boulderes. Depth from Soil Horizon Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) Flood Insurance Rate Map: Above 0O year flood boundary- No_ Yes)(— Within 500 year boun my No X Ym___ � Within lon year flood boundary Nv.)(_ Yes____ Depth of Naturally Occurring Pervious Material � Does at least four feet of naturally occurring pom| et or' I iot{o all meuo oh000/e|'dhrnuohnutdhe area proposed for the nui|ahauryUun oyxtemY If not,what|m the depth of naturally occurring pervious mumxha|Y_________ Certirication I certify that on (date l have passed the soil evaluator examination approved by the Department ofBov|r6nmotlbl Protection and that the above analysis was performed bymo consistent with the required training,expedi d experienceduuurihodin3lOCMD 15.017. O|gnu10 DuU: ~~ � ' --_- _----___ -_— __--__-_ -LOCATION �. ^SEa'dAGE PERMIT NO. IDS .�cF 11ia-ll�tr VILLAGE I Ile" , 0 I N S T A LL R'S NAME i ADDRESS BUILDER OR OWNER �. ,ChAcl� R A I�beJ DA T E P ER III IT I S S U E D /3 - a DATE COMPLIANCE ISSUED r 0 roes ,t;;R No...82.`'.--`/13q - Fps. ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH T own Barn st able • ............ ...........................OF.........................................--............................................... t Appliratiou for Uhip sal Marks Tatutrurtiuu ramit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal \ System at: 125..1.Qe_yralley...&1....Qst.erst-ills-•-KA.....Q2 5.5... ....................•............................................................................. ' Location-Address or Lot No. UQ hand._T.__f,ra 1t,.an....................................................... 12.5-.I-ce•_V_a 11P_y--Rd_.....O texv--1l a, MA.-...02265j Owner Address a n •-; . ._$:_Ge aPQAl..SezY_-e.e----•-----•-----•----•-•----•--•-•----•-----. 128..Bisholas--�� ac�T--I13ran i�., ----a26-01...... Installer Address Type of Building Size Lot............................Sq. feet g— -______-Expansion Attic ( ) Garbage Grinder ( )Dwelling No. of Bedrooms.._._._..��___________________________ — PL4 Other—Type of Building ............................ No. of persons.......................... Showers ( ) Cafeteria ( ) Q' Other fixtures ---------------------------------------------•---• ---- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. t W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------_------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date-----------------....------------------" aTest Pit No. 1................minutes per inch. Depth of Test Pit.................... Depth to ground water........................ Gr, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------------•-••-----------------------------------------------------•-----------•-•-•----------------------- Description of Soil Sand...................... W =------ -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•-- UNature of Repairs or Alt rations—Answer when applicable........000 gallon, pre-cast,_..stone_.packed_..-_. -. -leach pit (overflow . - - ----------------------------------------------•-----------•------------------------------------------------------------------------------........._---•-- 'Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL1E 5 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 r Signed-- ........................I.•........ :... .................................. ------VD/..2..---.... �' Date Application Approved By--• �✓�'�-';l -- ------------------------------------- •----------8�1182 Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------•---- r. -----------------------------------------------------------------------------------------------------•------•-••---••-•-••-•-•••-----•-•-••••--••••-----•--------------...-----•----------••---........_ Date Permit No.........82- - Issued...........................8/13/82 - .................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 own Far:stable ...........................................OF.............. ........................................................................ Applir ation for Disposal Works Tonstrnrtion Vrrmit Application is hereby. made-for.a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at .-4,.-.. 2e',S .-. --------••--•-•-----------------------------------•-------..-----.----------------------..._-.---- Locahon:Address: or Lot No. ' 1?55--T I . 1a�c. ; "l.....�.............. ------------------•.............- owner, f.JK p Address /1 aA- ..F: O Ga., al CP ll f'O:. Installer a a Addre sPQ w Type of Building ; t Size Lot............................Sq. feet N U Dwelling—No. of Bedrooms:.....--5.................... .. .....Expansion Attic ( ) Garbage Grinder ( ) U —a Other—Type of Building :.....:..................... No. of persons..>�........................ Showers ( ) Cafeteria ( ) dOther fixtures'. ----------------------•--------------------- --....-----------------•---------------------......-----......---•---------•----.....::....._.. W Design Flow.................. gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity, ..--.gallons Length---------------- Width---------------- Diameter................ Depth................ ; Disposal Trench—No. ......:........... Width.................... Total Length.................... Total leaching area....................sq. ft. ' Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ' ) Dosing tank ( ) Percolation Test Results_ Performed by........................................................... .............. Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ri Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground water---------............... - •-----------------------------------------------------------------------•--•••-•••-•-•---•-•......................................................... 0 Description of Soil.•------Sa ------••................••----..................•-•--•--------•--•...4.•-•--------•-•-------••----•--•----•••---...----•------••--••----------.----- x W ..........................................................I Nature of Re airs or Alt rations—Answer when applicable.__lz000- ep..11cn-t_.ire-cas+, s_toi:9._rq gked leach pit (poverfl ow). ---------------------••-------------•-•---------------••-=..--.........-•------------------•----•----------•-------•--•-------------------•--•---••-•-••--••...................... Agreement: The undersigned agrees to,-install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE - 5 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 1 e t � 0/13/82 Sagned --•-------- -----•--- ...................._.... , � P4,ty812 Application Approved BY......: ::; . �'r, ........ /-== Date Application Disapproved for the.following reasons:............................................................................................................... ,fs .. Date Permit No.-------- 2.......................................... Issued----------------------------................. 1 - ��13��2 Date THE COMMONWEALTH OF MASSACHUSETTS kr, BOARD OF HEALTH .1 own `7arnstable ..........................................O F....................::......................................................... ...... Trrtifiratr of TnmpfiFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by.....A..L.I.QQ.SS.T) ser�ria��,_:.12�:...Bi%boms..Te.?°+-n-P-6 ..kvaania,,..:M,A:4...02kf_l---------------------------------------- Installer at...25-- sQ_`lAlley--3ix,.. 0?6-55._-._R7charc3.`"-.--r?�1tD�3 has been installed in accordance with the provisions of TI 7 5 of The State Sanitary Code as.. r o in the 41 application for Disposal Works Construction Permit No_____.......____ ,3_ ................. dated............. . ................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BEONSTRII ® AS ' A NTEE THAT THE SYSTEM WILL FU CTI N -SATISFACTORY. � r` F3�13 82 f,. DATE..............•-..........--•--.................-....................--•-•---_.. Inspector.......... ••--. . ••-•--•. ....i. .............._i......._...... i J 'THE COMMONWEALTH OF MASSAC US TS i BOARD OF HEALTH £?2- T own.........OF s.table ............... ................................._...................._.... $ 5.00 No..........ZJ_'.. FEE........................ Disposal Works Tonstitution Vrrmit A & 34 Oesspool Service , Permission is hereby granted" ------------------------------------------------------------------------------------------------ 1, .N., to Constru ( ) or Repair ( an Individual Sewage Disposal System 1` 5 ce Valley d., Ustervi lle, MA 02655 - Ri_chard fit'. uralt on at No....--••••----• ......--•--••-•----•......................•-•---------••...........--.•••.•. ------•--•-•--------------•-------••---------•-••-------.............. Street as shown on the application for Disposal Works Construction Permit No... 2:-.......... te --------- ./_i� r...... �y 1 . .............. F'/i3/ z _ r of ealth DATE............................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - , d #'.Gown of Mmsta.ble. P � � �� Department of Regulatory Services :' _ • arR ' Public Health Division Date I ' 200 Main Street H dnnis MA 02601 J. Date Scheduled _ b 'Time o lA Fee Pd. U Soi[Sditability Assessmient,for Sews eD sposal M �` 4 Performed By:�hf�rv' "ta c- — ' Witnessed By: f^ / j LOCATION & GENERAL INFORMATION Location Address .`'Z5 ,�a�lQ Owners Name `j �(( `„„j ,b�����pp Address a. 65ty ll tc, Imo" Assessor's MaplP;ircel: Jp( � _ ;I Engineer's Name Me S'PT)S NEW CONSIRU�.EON REPAIR '�" 'Telephone* 33 Land Use � � n Slopes Surface Stones Distances from: Open Water Body�ft Possible Wet Area ft Drinking Water Well ft Drainage Way l Ob 'ft- Property Line /Na ft Other ft SKETCH.(. \ I . BENCHMARK CORNER OF SLATE/BRICK WALL \ \ ELEVs95.1' `SEPTIC COVER i i i a.EANW y. \ PLANTED • 1 ISLAND / a / �CTR DRIVEWAY PATCH PAVED - 1. DRIVEWAY I : POOL- \ w 4 / ock lA Parent material(geologic) S"1/�/ I Depthlt0 Bedr Depth to Groundwawr. Standing Water in,Hole I Weeping from Pit Face r` Estimated Seasonal high Groundwater i �/6 Dt TION FOR SEAS 0�AL HIGH WATE,R TABLE Method Used: 1 Depth Obsery standing in obs.hole: in. •Depth to sell mOttics; Depth toiweeping from side of obs.hole: I in, pmun6 atcr Adjustment ' _ A .factor..._ AdJr firaundwater].t vet.,,,e v Index Well# Reading Date Index Well level --- Date PERCOLATION TEST Observation + T'line at 9" .... Hole# q `1rl i► N �. 31 -!J �s�e Time at6" Depth of Perc - —^ 10 °6 1c, '9 - StartPre-soak Time.@ 1' " Time(9"-6') � End Pre-soak Rate MinAnch Site Suitability Assessment: Site Passed X 'Site Failed'. I Additional Testing Needed(YIN) Original:.Public Iie¢lth Division Observation Hole Data'To Be Completed on Back 1 f � � \J ***If percolajibn test is to be conducted within 100' of wetland,you must first notify the Barnstable C44servation Division at least one(1)wedk prior to beginning. • - rl DEEP OBSERVATION HOLE LOG Hole# I _ Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel Loa^y Spiv �ta t.1 G rt� Zs l�ljF �eaSe fasti�l4r DEEP OBSERVATION HOLE LOG Hole# Depth fromm Soil Horizon Sail Texture Soil Color Soil Other Surface (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gra el �It '" �tl 04 10 D 1"3!( ►�l � — 3�'' � Loam and 1 � �l N�ass►� � a `34' lZ.o' G ME S 2. 1:ooS� rar►utal DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel oar► do"- 39 `' B Loam µ„d Hayti 6 MASS1�l C Sit' IseG IMF Z. b` I.��e fan u Ca DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency. ra I IM 3 6 ^� t 10"- 3s' 8 �A-A l R alb massive. -J 35r;"- 132 MEN S 2. b l.aoSe Flood Insurance Rate Map: Above 500 year flood boundary No— Yes�/ Within 500 year boundary No /� Yes,,�. Within 100 year flood boundary No!� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pe v'o s material exist.in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring p rvious material! Certification ' 9 e% I certify that on l (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the requir iningl,Aexpe�rtise and experience described in 3.10 CN M 15.0017. Signature 1 C'�/ Date Q:ISEPTICIPERCFORM.DOC �EPA8/201EI/I'L(E 09:30 AMFAX Ra, P. 006 b The Commonwealth of Massachusetts rr' Department df Public Sgrety g }t 527 CUR 4,00 U�/d-,Vq VA 1 E FUrm l ' Apglieat{oa;for Fermit;spermif;;end Cer#ficate of Completion for the Inatallatiaxi or Alteration of Flddl 00>B _ mi6bt and the Sto, Q Puel Oil cent ervill` `il sterirille; tans N[ s' or Town) (Date) , Permit Ws; FD Elec. FDID #: Fee Paid: $ Owner/Occupant Name; Installation Address:F/ ;- L/ / Y / '` Serviced Floor or Unit #:- Q Heating Unit . ❑Domestic Water Neater over Vent :Q othez Burner: Q N.ew' Q Eidst p. g cation: Trade Name.. - Mfg: ,pe: _ Model# or Size: Nozzle Fuel Oil p Kerosene gW�ste .Oii Storage Tank: Q New . IXExdsttng- Location: ':+ !r-t,. Type.,-, 6iferL �1. 'T� Capacity: S-45.0, gallons No:-of Tanks; . Spe a).requirements(or ad Bono,safety devieesj:22Ak I3 OS ..Valve[3.011 Line Fxote' d ,..©5 eet , k p Sprinkler Ah-t,E:.Q 3'ps Ca A `E>�'_q yes Q.r10 and*1*le3l '(water heater) Co. Name Tel Address: Completiari'DAte: .If_, Combustion Test; Grass Stae Net Stack T Opt ec Draft: -. Smoke: t?verfire Draft: I, the uuderslgned certify that the instafTatioa of fuel buxxzing etliupzaaerxt has been 3aade iii`aecordaice with M.G.L. C. 14-8 and 627 CMR 4:00 cuxm atly tip effect. Furthermore,this 1datW;ih6ti has beta-tested in acwkdaace with such requirements, )a mow io proper operating condition and cotgplete iustructions as to Its use an'0"oalatenance have been fumished to.the person.for whom the iastaUatlon(or altexatlon made: Installer: PrtntNci Cert of Comp,# Stnature � tamp) Address- City: Odlre algaed y hd fire de t, a PE "fax the' a and U4e of oobif houlpment. Approved by: Date: REFEii TQ 0HSQKU6 fJ FeVEFISE SIDE Form Distribution:White:F[e Dept(Application) Yellow:In allation(Permit.To Store) Pink:Installer(Permit To install) fhb faint 8,W*VW by the State Fire MashW and provided.Courtesy of the Mass.Oq Heat Coundl dorm de5ign In NCP1 by Cotust and COW,M Fire Depts, J*1,19W PERMIT EXPIRES 60 DAYS AFTER ISSUE DATE, SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE 'VOTES LEGEND S A�� MARKED WITH MAGNETIC TAPE OR �� volley 99 - EXISTING CONTOUR (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS NAW 88 �� 0Ke PROVIDE MIN. 20" DIAM. WATERTIGHT pa - Sol F X 99• EXIST. SPOT ELEV. ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 2. MUNICIPAL WATER IS EXISTING �a TOP FOUND. EL. sss FILTER FABRIC OVER STONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. v�° .�v�� i� Locu -[99]- PROPOSED CONTOUR e 35.2' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 36.0' _ 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS a voiie 198.41 PROPOSED SPOT EL. NOTE: 2" MIN. WALL BLOCKS OR Baxter e d TO BE AASHO H-ZQ \oc PRECAST H-20 THICKNESS REQUIRED TH1 RISERS (TYP.) PRECAST RISERS 5. PIPE JOINTS TO BE MADE WATERTIGHT. �� �� a• 2'0 4"0SCH:jO PVC MORTAR ALL H-20 TEST HOLE s" MIN. SUMP PIPES LEVEL 1ST 2' 4' COMPONENTS VALLE OAD c ENDS INV'S EL. 32.0 4'- 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH ,, 27 SLOPE OF GROUND '. 12" MIN. INT. DIM. SIDES 33.0' E 310 CMR 15.000 (TITLE(TYP. (TI 5.) *33.45 10" 14" 0000 o D°opoo�o< t TEE 1500 GAL H-20 TEE ®®®® ®®®� ®® ®p� -�®®O °o'o E�� 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO 0 0 0 0 ®�.®®�®�®®®® ®®�I ®® ®®® o 0 0 UTILITY POLE 33.23 SEPTIC TANK 32.98j-..O-- o0°°°°°° o000 ®®4' LIQ. LEVEL °0°0°0°0, WATERTGHT D'BOX o 3°o°0°000 ®��®� � � ®®®� ®� ®® ° 0� 0L�J6.09' BE USED FOR LOT LINE STAKING OR ANY OTHER GAS BAFFLE :: o; ° o o- FOR kEVELNESS N °000°°°o °o°o°-'.• R=S98.00 PURPOSE.FIRE HYDRANT ACME OR EQUAL100000000 ®�®®® ®�®®® ®®®�®®®� ®0 00000°'0 31.0,0 0 do 3 321` ° ° ° ° ° ° ° ° " North NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING •• .. -.;•` .../••. ��.,•,•••••• ••°„• „ ,• •••. .• ••.•••• • � rn BENCHMARK: 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. Bay LCEMENT BOUND lJ ooa000000000000000000000000000000000000000000 a48.3' NAVD8B 0 0 0 ° ° o ° ° o -0-0-0-0, ° ° , o o ° ° ,• " H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OF EQUAL. O 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED 0,,0 0_^.0-0-0.� 0 0.^-^-^_n-o.o 0 3/A -1-1�2" DOUBLE WASHED STONE 4' MIN. 3 a (5) UNITS REQUIRED r., WITHOUT INSPECTION' BY BOARD OF HEALTH AND �- AL.L AROUND PRECAST STRUCTURES �' PERMISSION OBTAINED FROM BOARD OF HEALTH. 6" CRUSHED STONE OR MECHANICAL OVRgLL DIMENSIONS TO OUTSIDE OF STONE: 50.50' X 12.83' u 44 COMPACTION. (15.221 [2]) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING *THE INSTALLER SHALL VERIFY THE Li DIGSAFE (1-888-344-7233) AND VERIFYING THE of �, LOCATIONS OF ALL UTILITIES AND ALL c $ 3 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR_ TO INSTALLING ANY ,.� PRIOR TO COMMENCEMENT OF WORK. 25.5' BOTTOM TH-1 z �B m 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE SCALE 1"=2000't PORTION OF SEPTIC SYSTEM. INTERIOR 2 1 ( 1 % SLOPE) NO GROUNDWATER FDUND PLUMBING TO BE RAISED TO ( SLOPE) ( SLOPE) REMOVED 5' BENEATH AND AROUND THE PROPOSED ELEVATION SHOWN IF NECESSARY. MIN. 60' H-20D' BOX 21' �' N LEACHING FACILITY, ASSESSORS MAP 96 PARCEL 17 11 SEPTIC TANK LEACHING FOUNDATION- FACILITY 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND LOCUS IS WITHIN FEMA FLOOD ZONE X REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. (AREA OF MINIMAL FLOOD HAZARD) AS SHOWN ON COMMUNITY PANEL #25001 CO544J DATED 7/16/2014 SYSTEM DESIGN: ZONING SUMMARY - 2 3 OWNER OF RECORD GARBAGE DISPOSER IS NOT ALLOWED ZONING DISTRICT: RF-1 DISTRICT 3 #125 ICE VALLEY ROAD REALTY TRUST PROPOSED 6 BEDROOM DWELLING MIN. LOT SIZE 87,120 S.F. �, 70 BRADFORD ROAD DESIGN FLOW: 6 BEDROOMS © 110 GPD = 660 GPD MIN. LOT FRONTAGE 20' 1 �' MIN. LOT WIDTH 125' °� �O WESTON, MA 02493 USE A 660 GPD DESIGN FLOW \ PAVED ' M sa DR PROPOSED ON MIN. FRONT SETBACK 30 3 MIN. SIDE SETBACK 15� REFERENCES SEPTIC TANK: 660 GPD (2) = 1320 MIN. REAR SETBACK 15 MAX. BUILDING HEIGHT 30' N USE A 1500 GAL. SEPTIC TANK � ` 3 C N CERT 212144 Semis �' [38] LCP 5725-66 LEACHING: SITE IS LOCATED WITHIN THE RESOURCE RMo Nc Ri e" E [36] TH2 1A TH3A PROTECTION OVERLAY DISTRICT o eFKgy �420 0 rn SIDES: 2(50.5 + 12.83) 2 (.74) = 187 GPD �- ' SITE IS LOCATED WITHIN THE WELLHEAD $ 0 1 3 c, T�i� TR4_-_-_-� BOTTOM 50.5 x 12.83 (.74) = 479 GPD PROTECTION OVERLAY DISTRICT �� ` X RESERVE AR TOTAL: 901 S.F. 666 GPD _AN 3 SITE IS LOCATED WITHIN ESTUARINE USE (5) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) WATERSHEDS FOR POPPONESSET BAY, WITH 4' STONE ALL AROUND THREE BAYS, RUSHY MARSH, AND CENTERVILLE RIVER '• .o s Gs/`o•G� EXISP AVED 9°0�°'° A I R REMNN ON ro 1 ELEV. 2 ELEV. ° �otic� .. 35:5' 36.5' n i, TES T' MOB � o 0 EXISTING DWELLINC3 i MA TOP OF FNDN a, EXiSliNy APPROVED DATE BOARD OF HEALTH €L. 3s.3 `. raRAG� LS LS '- `�-�" ENGINEER: CRALC J. FERRARI, SE #13871 10YR 3/4 '10YR 3/4 ppOl 4 WITNESS: DAVID W.' STANTON RS 9" 10" DATE: 2/23'/2017 B g �. NOTE: EXISTING ' PERC. RATE _ < 2 MIN/INCH LS LS �••. IMORK LI POOL FENCE NOT 1 OYR 5/6 1 OYR 5/6 ` •�.., LINE � INDICATED „ , ••� & + (TO REMAIN) 3a CLASS 1 SOILS P# 15275 36" 32.5 34 32.7 51 ° ;•• LOT c c '`.. PERC 118,068t S Ft TOTAL Sq Ft UP MS MS 2.49f Ac. 1OYR 7/4 10YR 7/4 �9rF � ?o �s / • .Bqy ,p+ . O W sss�4 . 120" 25.5' 120" 26.5' 160'.Z S 6a�Z NO GROUNDWATER ENCOUNTERED 0 SITE PLAN �a I / 1 �\ �• OF ti \ 9 #125 ICE VALLEY ROAD \ +� ELEV. ELEV. ELEV. ELEV. lA 3A OSTERVILLE, MA 0" 36' 0" 35' 0"' 36' p" 34' ��C 20 A A A A I I LS LS LS LS PREPARED FOR Oy I �� 1OYR 3/1 1OYR 3/1 10YR 3/1 1OYR 3/1 i $" 10 10" PLYMOUTH DEVELOPM ENT PROPERTIES LLU • I B B B B I ( LS LS LS LS I „ 1 OYR 6/6 33 2, „ 1 OYR 6/6 „' 1 OYR 6/6 32 7, " 1 OYR 6/6 DATE: MARCH 8, 2017 zl ) 33 34 32.2 39 38 30.8 oIM l_ ` to Scale:1"= 30' fl C C C C k � 0 15 30 45 60 75 FEET I PERC PERC _�""1 ' z T ST HOLE LOGS jHOFM �8ok a' W MS MS MS MS �NOF y �4jNOFMASS ��� ASS9C ��ZNOFM sq I 6g ��� qss �� q � y � as c off 508-362-4541 cy o DANIF_L �s o`' DANIEL fax 508-362-9880 s DARREN METER z qo o DANIELA. m downco e com i ENGINEER: o DANIELA OJALA OJA�LA o A. �; ? 0 I DAVID W. STANTON IRS 2.5Y 6/4 2.5Y 6/4 2.5Y 6/4 2.5Y 6/4 o OJALA CIVIL WITNESS: I Civil, No.409t3o o 4098 .46502 �, ND.4o�ao �ALA `� I! cope !'o8'//leer/a8, //!C. II / DATE: 8/26/2015 .,No. 5020 � FG� R t of ss�o� �n o �� C%vl7 en sneers PERC. RATE _ < 2 MIN/INCH 51 �� F� nL N � Fss�O AL EN�'\� "0 R� t �0,0 land Surveyors I 14794 120" 26' 120" 25' 132" 25' 132" 23' DA DANIEL A. OJALA, P.E., P.L.S. � 939 Main Street ( Rte 6A) CLASS SOILS P# _ YARMOUTHPORT MA 02575 DCE # 1 7-O33A NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED 17-033