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HomeMy WebLinkAbout0063 MILNE ROAD - Health 63 Milne Road Osterville A= 118-020 % 7 0 0 TO OF BARNSTABLE LOCATION 63 /i/t/F SEWAGE#a0//- Y63 . VILLAGE ASSESSOR'S MAP&PARCEL 118-Oo2O INSTALLER'S NAME&PHONE NO.�.t(nil,(;s icr— so8'Y�8�SS�Q SEPTIC TANK CAPACITY (SOO GlyL LEACHING FACILITY.(type) SC:OGA(. C"c(C-� (size) /o2.S")c 025 NO.OF BEDROOMS �3-t OWNER Y�e��� 1 �o r►'�r�s PERMIT DATE: I(-oZ$- (( 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 Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY n s \ 1 No. ow- i_j 3 Fee (JV THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION,_-TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplication for misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(V) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.(3 tA11k n1__ Owner's Name,Address,and Tel.No. 5►\c..la"Th,o MflS Assessor's Map/Parcel 8 pap h<<n�j�{ oT Installer's Name Address and Tel.�,o._ Designs"'s Name,Address,and Tel.No. UP '�ruCe �IC..00.�1•se<< 6-08-Yd8- I�C�er{Son5:3-nG -T)ArM,\.tlle. o79,;49 Type of Building: Dwelling No.of Bedrooms ,3 Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 334 gpd Design flow provided 3,Yd_4 6' gpd Plan Date Am"-a- „A0 Number of sheets C2. Revision Date Title Size of Septic Tank 1 1500 Gq, Type of S.A.S. 500 6 A t✓ Description of Soil lqs DU' f�/1 Nature of Rep irs or Alterations(Answer when applicable) vM Fi t°Y t S l i rt e5 0 S - ! 1160 sep`c�c�nn —1)LSI 3ok — a -Soo SAIAoA c-t+AVVk des— ytoi- iv STo,,le 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 Certificate of Compliance has been issued by this Board o Health. // //j Signed Date ✓1�Ov.41101 / Application Approved by Date Application Disapproved by Date for the following reasons Permit No. go q03 Date Issued ha 4 No. a6rl _ Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION,,T_OWN OF BARNSTABLE, MASSACHUSETTS Yes a!I 01pplicatlon for Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair V/5 Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or.Lot No. Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel't Installer's Name,Address and Tel.No. Designer's Name,Address,and Tel.No. �°- Ed.- 6—, C �c,cc"k ,7,-� ;Cad '/�' �fC-JCS• v.ti �, f. `:i��r c \l_,{r o!%0702 �° 1¢a �• - `'a J�S:?� 1Ji 1'.a c, Type of Building: i Dwelling No.of Bedrooms �j Lot Size sq.ft. Garbage Grinder V(p Other Type of Building No.of Persons Showers yp g ( Cafeteria( ) Other Fixtures Design Flow(min.required) 5 U gpd Design flow provided 3 qZ,2 5 gpd Plan Date p lk 1 Number.of sheets Revision Date a Title Size of Septic Tank SUf� G�� ;Type of S.A.S. ,,`j OCi Description of Soil f��Y r Nature of Repairs or Alterations(Answer when applicable) c�'a�f� — �� i Uy j T�t1�t�� CTft\Il 1�jc'?2 r �� 4 STc"Ir 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 Certificate of Compliance has been issued by this Board o Health. //V S� wed `' �� i Date /(/oy. ,�1�„,2n/j Application Approved by d Date 11`-lLtr^11 Application Disapproved by U Date for the following reasons Permit No. 0 Y03 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(r.✓) Upgraded( ) Abandoned( )by ::�Fk�r rj,',j P C o,j� I4 at ! r� - r; P ry" � has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. j— dated 11-a �—t Installer;Ut C ��f'_S f` tl , `�1cr Designers,:1t'(Cu HC.11",� #bedrooms Approved design flow :,4Q _Z,7 gpd The issuance of this permit shall not a construed as a guarantee that the syst wiikf�xn on "designed. Date 1 �� Inspector-- ...►.._ - ._. - --------------- ------, --- No. o2611 — `/53 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction i9ermit Permission is hereby granted to Construct( ) Repair(k,'� Upgrade( ) Abandon( ) System located at (�?, j, i� c aj �e �in c 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 completed within three years of the date of this permit.� ��( �Date /J 8" Approved by . /2 S i Regulatory Senices Thomas F. Geller,Director - Public Health Division Thomas McKean,Director 206 Mdhfgireet,Hyannis,INIA 02601 i Office: 508-862-4644 Fax: 508-790-6304 f Installer& Designer Certification Form Date: J7i • 10 0<< Sewage Permit# OWL103Assessor's MapXParcel / 8 -- 0&0 Designer: 11 F�i`r E U �fe tf eP Installer: �_ wCt Address: Address: 8 �o nOl t On �2Uce //ACALLI.S iSle was issued a permit to install a (date) (installer) f septic system at 63 1]e IP01— OS crvr��/c based on a desi, an drawn by (address) TAfi-zg NI y Ei, dated (designer) XI 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 107 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. OF ygPIP. D Installer's Signature) No. 1140 w RfG/STER�� QNITWP� )/l (Designer's Signature) (_Affix Designers Stamp Here) PLEASE RETURN TO BARNST.- LE PUBLIC HEALTH DIVISION. CERTIFICATE OF COPYIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM A.ND AS-BUILT CARD ARE RECEIVED BY THE BARNSTaBLE PUBLIC HEALTH DIVISION. THA►`iK YOU. Q:Health/Septic/Designer Certification Form 3,4&04da j Town of Barnstable P#---� . Department of Regulatory Services • Public Health Division Hate 1 �11� 11� i1tee$ 200 Main Street,Hyannis MA 02601 3 F i y l o Fee Pd. Date Scheduled_�J� f,�` ! Time ; . >Soii �Sr itahility Assess-ment fo ►� a Disposal • ' Witnessed By: Performed By: �A/r, �� LOCATION & GENERAL INIEORM[ATION Location Address i Ownees Name` �3 � -b Address Assessor's MaptT4=1: © I Engineer's Name7a,.4 i Telephone# J�� — NEW CONSIR�U��[;ION REPAIR I Land Use �y�)11y �� Slopes(9'0) 6 ' surface Stones �"a-Z ,,(�q R Distances from:, Open Water Body >U ft Possible.Wec Areal ft Drinking Water Well I I La ft Other ft brainageWay ft Property ____—. L SKETCH:(Street name,dimensiods'of lot,exact locations of test holes&pert tests,locate wetlands in prox truty:.to holes) _ r~7 r I 6n5t.Cesspools 4 �- y (see note 1 p) LOT 2° F_- z. :J h'N .00. 50.30' 'O m_ S X 77 iz y-. PP10P. 15000 I jl SEPTIC TANK ' 1, F LOT E-7 Parent material(geologic) 1 ��.5 ) ' :'Depth to Bedrock I Weeping from Pit FAee ' Depth to Groundwandr. Standing Water in Hole:'-- &ILA 1 Estimated Seasonal ifligh Groundwater DtTERMINATION FOR SEASONAL HIGH vvAxER TAL Method Used: I I io. Depth to Boll mottles: In. . Depth Cpperved standing in obs.hole: i in. proundwhter Adjustment It Depth toiweeping from side of obs.hole: 1 A {actor. Adj.Oroundwater Lavel,,,,,e, - index Well# Reading Date: index Well levlil PERCOLATION TESL' . Date Observation Time at got -=--- Hole# _ Time of 6" .-•.� Depth of Perc Time(9"-6") Start Pre-soak Time. End Pre-soak hate Min-finch " 4 Additional Testing Needed(Y/N) Site Suitability Assessment Site Passed-- Site Failed; Original:.Public 1_e'�lth Division Observatioti Hole Data To Be Completed on Back ***If percolafiion testis to be conducted within 100' of wetland,:you must first notify the ek prior to beginning. Barnstable Cdnservation Division at least one (1) we DEEP OBSERVATION HOLE LOG ' Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 33 DEEP OBSERVATION HOLE LOG Hole#_I- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) yet► t( i DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil ther Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Gravel) .t Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No x Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring p rviou material exist,in all areas observed throughout the area proposed for the soil absorption systemI If not,what is the depth of naturally occurring p rvious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environi hentalProtection and that the above analysis was performed by me consistent with the required rat , 'n ,,expertise and experience described in 310 CMR 15.017. Signature �! " Date Q:\.SEPTIC\PERCFORM.DOC LEGEND ' ' -9STERVILLE PROPOSED CONTOUR "r ® PROPOSED SPOT GRADE UMPg RI�R RD. EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE ' BENCH MARK W— EXISTING WATER SERVICE 34 32 30 a oC7 PAINT SPOT ON 36 1 I I Z LANDSCAPE TIE TEST PIT O 1 1 I I ,A s ELEVATION = 37.04 BARNSTABLE GIS DATUM 222.11 o LOCUS 38 Exist. o0 Cess 15 / f p LOT 2(5ee note 1 O) AREA = 10185 sf LOCUS MAP / ---------- / I 4 ' ' i LOCUS INFORMATION / I TITLE REF: LCP 16603 37�I TH-1 /� 20\ I I I I PARCEL ID: MAP 118 PAR. 020 t I I I ' 28 PROPERTY IS WITHIIN ZONE II TH-2 QQ ix I I -0 ,o o�� ° �' i �� T SEPTIC SYSTEM °z �Z z �'_' _ • _ .�_' I• _ ; ' REPAIR PLAN 1 150.30 00 W LOCATED AT: °oz AjE 0 63 MILNE ROAD —w_ OSTERVILLE, MA I II I\ I I L _1• _yy_•� � , � I I 1 t I I 1 I PREPARED FOR 1 SHEILA A. THOMAS _ I STONE I PAVED i DRIVEWAY i I NOVEMBER 27, 2011 DRIVEWAY I I 1 / EXTENSION I I 1 -37 PROP. I500G I p IDAR y I II I 0 SEPTIC TANK I I No. 114 y d 1 I SOT E - 7 II IciSTE ° l o f ---------------\\ I I I I II SANITAR\a� l Z71 o I� AREA = 22118 sf +-I- I \\ I I I I SHED, \ I 28 MEYER & SONS, INC. ±r, SHED \\ I I 32 30 \\ 34 P.O. BOX 981 \\38 36 s EAST SANDWICH, MA. 02537 220 76 ft (508)362-2922 SHEET 1 OF 2_.__ - J 1317 ELEV. TOP �- FOUNDATION NOTE: MAGNETIC TAPE TO BE. PLACED OVER ALL COVERS (Existing) FINISHED GRADE (36.0) 38.07 F.G.EL: 37.50 F.G.EL: 37.0 F.G. EL:.36.00 ' MAINTAIN 2% MIN SLOPE OVER LEACHING AREA Y 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" • STONE OR FILTER FABRIC DOUBLE WASHED STONE A 6 ~"' 4" SCH 40 PVC 10 I 6 MIN. mama p mama :. 14" ® S= 1 mammama0mau A' TEES ARE TO BE INV.33.98 ) maa®aaaaa®a :Y 4' SCH 40 PVC 2 OF. DEPTH aaa®aaaa®®a INV.34.25 INV.33.78 1 4' 2 X 8.5' 4' GAS PROPOSED DB-3 EXISTING OUTLET BAFFLE EFFECTIVE LENGTH = 25' INV. 35.07 H-:10 DISTRIBUTION BOX ' INV. ELEV.= 33.25 INV. 34.50 PROPOSED 1 ,500 GALLON SEPTIC TANK OF ,y GAS BAFFLE TO BE INSTALLED ON �� As�9�yG BREAKOUT OUTLET TEE AS MANUFACTURED BY I o D TOP CONC. ELEV.= 33.75 ELEV.= 33.75 i TUF-TITE, 'ZABEL, OR EQUAL No. 114 INV. ELEV.- 33.25 ®®� ®® NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING m a I PIPE INVERTS PRIOR TO CONSTRUCTION '�6�STE � amaaaaa 2) TANK AND D-BOX SHALL BE SET LEVEL AND TRUE_ QNITAR��� L BOTTOM EL.= 31 .25 aaaaaaa TO GRADE ON A MECHANICALLY COMPACTED SIX � t �) 3.75' 5 FT. 3.75" INCH CRUSHED STONE BASE, AS SPECIFIED IN 1 Z 310 CMR 15.221(2) SEPARATION 5.45 FT. EFFECTIVE WIDTH = 12.5' 3) INSTALL INLET & OUTLET TEES AS REQUIRED SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: 25.8 - SOIL ABSORPTION SYSTEM (SECTION (500 GALLON LEACH CHAMBER (H-10) LOADING) DESIGN CRITERIA - GENERAL NOTES: SOIL LOGS P#:13480 NUMBER OF BEDROOMS: 3 BEDROOOM 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL TEXTURAL CLASS: _ CLASS 1 (0.74 GPD/SF) BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: NOVEMBER 23, 2O1 1 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DESIGN PERCOLATION RATE: <2 MIN/IN OF THE STATE ENVIRONMENTAL CODE. TITLE V, AND ANY APPLICABLE SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 . LOCAL RULES AND REGULATIONS. WITNESS: DONALD DESMARAIS, B.O.H. DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR GARBAGE GRINDER: NO (not designed for garbage grinder) ESIGNPENGINEER D APPROVAL BY THE BOARD OF HEALTH AND THE SEPTIC TANK: 330 gpd x 200% = 660 gpd USE PROP. 1,500 GALLON SEPTIC TANK 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING Elev. TIP-1 Depth Elev. TP-2 Depth FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN = ENGINEER BEFORE CONSTRUCTION CONTINUES. 36.50 A 0" 36.30 0" LEACHING AREA REQUIRED: (330) 445.94 S.F. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. LOAMY SAND A LOAMY SAND .74 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 35.83 10YR 3/1 8" 35.71 1OYR 3/1 7" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF B B USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4 STONE HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. ON SIDES & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D LOAMY SAND LOAMY SAND 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 10YR 4/6 10YR 4/6 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED BOTTOM AREA: 25 x 12.5= 312.5 SF TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 33.75 33" 33.63 32" THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING C C TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D CONSTRUCTION. DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd 10. EXISTING CESSPOOLS TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. � PERC O EL. 32.00 MEDIUM SAND MEDIUM SAND 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WTTHIN 150' OF PROPOSED LEACHING. 26.00 126" 25.80 126" 63 MILNE. ROAD, OSTERVILLE, MA 14. NO WETLANDS WITHIN 150' OF PROPOSED LEACHING. PERC RATE <2 MIN/IN. ("Cl' HORIZON) Prepared for: Sheila A. Thomas 15. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPECIFIED) NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN I • I, Darren M. Meyer, R.S., CSE, hereby certify that 4 am currently &SONS,INC. BcoTech IT'nr. Survey approved by MADEP pursuant to 310 CMR 15.017 .y N.T.S. DMM to conduct soil evaluations and that the above analysis has been performed by me consistent with the PO BOX981 508 367-8097 r requirements of 310 CMR 15.017. I further certify that�I have passed the Soil Eval. Exam in October, 1999. E4STSANDW/CH,MA02537 ( DATE CHECKED SHEET NO. ! 508-362-2922 1 1/27/1 1 DMM 2 of 2