HomeMy WebLinkAbout0012 POPLAR DRIVE - Health ]_2 Poplar Drive
osterville e
A= 120—074
0 - _3 D�
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2porication for Migpozaf *p.5tem Construction Permit
Application for a Permit to Construct( . )Repair(✓)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. , gl
O O ner's Name,Address an Tel.No.
Assessor'sMap/Parcel 1 POPLIFlL �21V/
/K I �A� Z.® Pn, u�
Installer's N!Te,Address,andTel.No. Designer's Name,Address and Tel.No.
(
��✓v1E�a `" Dt� 'r
FD° AnL 70z MAR -mg� m I a& IKA- �0° 9 9 bui t C&I S'o r,ark Z
Type of Building:
Dwelling No.of Bedrooms 13 Lot Size 1E147sq.ft. Garbage Grinder( )
Other Type of Building jZES(_b!54rjAL.No.of Persons 1 Showers( ) Cafeteria( )
Other Fixtures
Design Flow .330 gallons per day. Calculated daily flow Its&3 41 gallons.
Plan Date 10 0<T B 9- Number of sheets Revision Date OA
Title E t6� T
Size of Septic Tank N1✓J Type of S.A.S. d.C—SOD
Description of Soil SoU, L 6 NJ PI-A+J
Nature of Repairs or Alterations(Answer when applicable) IJ 5 u S'C_N4 (dymft !
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 Envi fonmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issdhd by this Board of ealth.
Signed Date
Application Approved byrlog
Date
Application Disapproved f e fowin reas llog s
Permit No. "" Date Issued
———————— ———————
�a No. V'O "<, ' =. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
2pprication for Migoaf *pgtem Con.5truction Permit
Application for a Permit to Construct( . )Repair(✓)Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. 2. �- // O is Name,Address.and Tel.No.
v uL. Ocanik)OLt.
Assessor'sMap/Parcel 1 POPI-*/L p21Ve
MAf (ZO Pu- )STrW/uZ'. P4 A
Installer's Nam Address,anEt tTel�o� Designer's Name,Address and Tel.No.
J n0 oZ.4,�8 oX 9'9
o, 8m 7oz / AzTbtu m 11-" M>q- ! c14 sod'.ro" �Dz�
Type of Building: �
Dwelling No.of Bedrooms 3 Lot Size ��''�7a sq.ft. Garbage Grinder( )
Other Type of Building 1FSt_bFA7_JPd-No.of Persons I Showers( ) Cafeteria( )
Other Fixtures
Design Flow `330 gallons per day. Calculated daily flow 3` t gallons.
Plan Date 10 OCT 0 Number of shegts Revision Date N A
' Title LU (,e S�$�Ep'�'l l 6
5 Size of Septic Tank �S NFt'`� p Type of S.A.S. �' SAD
x . ' Description of Soil 6E got 1, L o6 OAI PL'A J
Nature of Repairs or Alterations(Answer when applicable)
t
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 Env'ronmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss ed by this Board ealt r
Signed _ ''t `° e' 75 1 Date /V- fib' /
Application Approved by �/f �l �l l!�- ! Date
Application Disapproved for the following reas ns o V r
�-
Permit No. "`" f2 Date Issued 10 a dLI!
THE COMMONWEALTH OF MASSACHUSETTS
(� BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CER,1IFY, that th n-site Sewage Disposal System Constructed( )Repaired (✓)Upgraded-( )
P Y P
Abandoned )by tm L-Lelz_
at (Z ( DPAR• 'D21 Vl; C)s-rM✓1"'o has been constructed in gpcordance
with the pro ons of.Title 5,�n d the for Disposal System Construction Permit No.;o�S' S.l� dated/a/
Installer �J M4:`6 F*OLLM Designer 4'A-at- LATM--
The issuance of this peymit�s all 13ot be construe �
d as a guarantee that the s stem i fun�tio�as d signed.
Date Inspector � •..�.�- -_..�-�
= — ----=-----------------------
No �/ � V_j_ Fee •---
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
ie;pogar *p�te Cott�tructiottern�it �T
Permission is hereby granted t Construct( )Repair 7 Upgrade( )Abandon( )
System located at /Z ry PL*t 'PIZ $'TEt_✓t t-LLC
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: o T cti us(�st bz mpleted within three years of the date of t 's pe q1 -
Date: Approved by
I
TOWN OF BARNSTABLE
LOCATION 12 I DPL*fL �/0�J�L� SEWAGE #c2OOS' 6��
VILLAGE DS'MVJ�� ' ASSESS
9R'S MAP & LOT 124— 74
INSTALLER'S NAME&PHONE NO. �II 1'Yt b� lZD LLl�f2- '�� ZO�Z�O
SEPTIC TANK CAPACITY /S DD
LEACHING FACILITY: (type) 5-0 0 604I, Ct F3 e) .2, Sfl
NO.OF BEDROOMS 3
BUILDER OR OWNER f>AAL CD JIJnJELL
PERMITDATE: 10' /e' S COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 5 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) JU A Feet
Furnished by 1p"I& O d Pe�eaJZD
a $ y 41 -o
S' 44 - o
1 Z
3 33 -o
q 3g _�
34 - S(
Notice: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM
1, E �R� ���N � I,4;�reby certify that the engineered plan signed by me
dated concerning the property located at .
4 ,S�tsp 0, C,L; meets all of the
following criteria:
• Two soil evaluations excavated for detailed examination(no hand augering)and two
percolation tests shall be conducted.
{• This failed system is connected to a residential dwelling only. There are no commercial or
business uses associated with the dwelling.
• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes
per inch.
• There is no increase in flow and/or change in use proposed
• There are no variances_requested or needed.
• The bottom of the proposed leaching facility will be located no less than five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the
Frimptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
�R�LOW 1 z 'T3�;LoW BD ID C\>;X. e
B) G.W.-Elevation +adjustment for high G.W. Im
DIFFERENCE B
A J 6
SIGNED : R. DATE:
aj No.26575 \
�NaL NOTICE
Based upon'-the above information, a repair permit will be issued for bedrooms
maximum. No additional bedrooms are authorized in the future without engineered septic system
plans.
gASeptic\percexemp.doc
Town of Barnstable
.20o s
Regulatory Services
Thomas F. Geiler,Director
Public Health Division
" Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
- I
Office: 508-862-4644
Fax: 508- 90-6304
Installer&Designer Certification Form
Date:
i
DesignerAT
Installer: J; t e—SZAA-3
j L.
Address—O�
Address:
On, /a �Ik?"
(date) was issued a permit to install a
(in staller)
septic system at /2 POP`A-r 'D/u VV-
based on a design drawn by
(address)
67
dated /a , / a .
(designer)
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 t le
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 compon nt
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
taller's Signature) ���PH OF Mgs` o
MARRY 6N
EARL �1
r LORRY,JR. y
.p Na 26575 p
,(Designer's Signatur (Affix 6 Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICA i E
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND -
BUILT CARD ARE RECEIVED BY THE BA STABLE PUBLIC HEALTH DIVISK N.
I THANK YOU.
Q:Health/Septic/Designer Certification Form
i
TEST PIT f PERC. TEST
-;
ISTING
# 7,,,:GPADF:__ # 295.4 - - 95.8 ° a w ►
93.4 - - 93.8 , '• :� ,0 '�
92.7 - FILL (0-24") - 93.1 +
�_- LOAM I OYR 4/4
(24-32)
2420 L t, k p,•
cJ �0o 3
14 89' LOAMY LOCUS
SAND
,- I OYR 5/G
(32-84)
87.4 - � V1�)� - 87.8 DESIGN
APN 120 - 74
F NEI CLEA�
SAND I OYR G/4 SINGLE FAMILY DWELLING W/ 3 BEDROOMS
1 5 5 G 70±S F (84-9G) NO GARBAGE DISPOSAL
Pg 95 3j
DAILY FLOW= 110 X 3 = 330 G.P.D.
p� G SEPTIC TANK(VOL. REQ'D)
330 G.P.D. X 2 = GGO GALS
1,500 GAL.TANK-O.K. (H20)
83.4 - NO H2O NO H2O - 83.5 LEACHING AREA(5.A.5.)
DECK USE 2 - 5' X 8' X 2' P.C. CONC. L.C. 4' STONE
EFFECTIVE DEPTH = 2.0'
w g TESTED : 09/23/05 2 X [ 2G + 48 1 x 0.74 = I 10
� cp No. 1,2 1 - N _
13 X 24 X 0.74 - 231
f ON N 2 STY. j BAENGR.E EARL LAN ERY, P.E.
u m /WD; IF TOTAL CAPACITY - 341 GALS.
z T.O.F. = 100.23'
EXISTING SEPTIC TANK
NOTES:
ELEVATION = 95.78'
1500
H - 20 1 . DISPOSAL SYSTEM TO BE CONSTRUCTED IN STRICT ACCORDANCE WITH
D B 2 COMMONWEALTH OF MASSACHUSETTS ENVIRONMENTAL CODE -TITLE V.
s , MIN N - 2. ASSESSORS PARCEL NUMBER(APN) : MAP 120 - PC. 74
24' BENCHMARK: MAG NAIL
12.0' ELEVATION 100.00, 3. CONTRACTORE TO CALL DIG-SAFE 72 HOURS PRIOR TO BEGINING CONSTRUCTION AND/OR EXCAVATION.
\ (ASSUMED DATUM) 4 EXISTING PITS TO BE PUMPED AND FILLED WITH SAND, AND ABANDONED.
5 REPLACE EXISTING TANK(H-10) WITH 1500 GAL. (H-20) INSTALL GAS BAFFLE
YTH15 PLAN DOES NOT, IN ANYWAY, REPRESENT AN ACCURATE, INSTRUMENT SURVEY OF THE PROPERTY, AND IS NOT
_ _ TO BE USED FOR ANY CONSTRUCTION, OTHER THAN THE ELEMENTS OF THE SEPTIC SYSTEM AS SHOWN.
3Q.O' 7. TH15 PLAN 15 NOT A RECORDABLE PLAN.
BITCO'C. � \\ - 1 8. BENCHMARK 15 BASED OIL AN A55UMED DATUM, AS SHOWN, UNLE55 OTHERWISE SPECIFIED.
KIVEWAY 18 O' �' �9� 9. 5UVREYOR: HOOD SURVEY GROUP, LLC: P.O. BOX 231 :SANDWICH, MA 025G3
10. SURVEY DATA FROM SUBDIVISION PLAN FOR SANDY LANE RECORDED AT BARN5TABI F PEG. OF DEEDS
95---L / I .3-u _ - PLAN BOOK 199 - PAGE 31
_
.72' 1 1 . 5UBDIV1510N 5URVED BY TOWN WATER
�_ _ _---/00---__ BA I CATCH 12. USE 2-8 'X 5' X 2 P.C. CONC. LEACH CHAMBERS WITH 4' OF DOUBLE WASHED STONE
BATH- �/0/__ DA51N ALL AROUND WITH 2" LAYER OF WASHED PEA5TONE ON TOP
OF
PAVEMENT 13. REMOVE ALL IMPERVIOUS MATERIALS 5' AROUND PROPOSED 5.A.5. DOWN TO EL. 88.4 (T MIN) REPLACE
EDGE CLEAN MED. TO COARSE SAND WITH PERC. RATE LE55 THAN 5 MIN5.
14. VENT 5.A.S. AND BRING RISERS TO SURFACE OF PAVED AREA WITH RING AND COVER FOR
INSPECTION AND CLEAN OUT
POPLAR DRIVE
wv
w\N ZN OF-------------
�Ab ,
'4 fr ARRYv,
y
EARL a
FIRST FLOOR SITE PLAN
IANTERY, 1R. y
EL. 105.23 �go.265754; �Q
VENT 4 FI TER
TOP OF WALL N {;
EL. 100.23 REMOVE IMPERVIOUS
MATERIAL 5'AROUND
FIN. GR. EL. 97.0 EXISTING GR. EL. 9G.0 GR. EL. 95.4 SYSTEM TO EL. 88.4
2%SLOPE REPLACE WITH
CLEAN M-E SAND
ACCESS W/IN 6"of GR ,i' �;A�,� � SEWAGE SYSTEM DES 1 G N
' 9"MIN. COVER --
\� 2"PEA5TONE ACCESS PORTS R
L• 95.0 H2 O TEST FO
F R LEVEL 2'LEVEL ��� HEALTH AGENT APPROVAL DATE MR. PAU L O'CON N ELL
EL. 94.0 1500 GAL EL. 93.7 D-BOX " EL. 92.4 0
FIELD P.C. CONC. s ° i°�• °g (H-20) 0 0 12 POPLAR DRIVE
CHECK SEPTIC TANK(H- 1 O) GA5BAFPLE �`boU�b EL 90.4 0 OSTERVI LLE MA
G"MIN. LEGEND
ft. EL92.8 0 0 08 08 •.Q°.8.88.8
ovp9 k&lga ON
G"CRUSHED STONE OR COMPACTED-I �.i--- I 0'MIN 12 POPLAR DRIVE
20 MIN. 5'MIN- I r-� 24 PROPOSED CONTOUR ADVANCED TECHNICAL SOLUTIONS
DEPTH OF LIQUID
INLET TEE DEPTH H2O BELOW 10 �` EXISTING CONTOUR CONSULTING ENGINEERS
OUTLET TEE DEPTH EL. 53.4 P.O. BOX 99
PERTITLEV DRIVEWAY E. SANDWICN, MA 02537
PROFILE OF DISPOSAL SYSTEM j2- „� FIRM ZONE DATE: IOOCT05 SCALE: i" = 20'
( DRAWING NOT TO SCALE "B"
-1