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HomeMy WebLinkAbout0051 BOSUN'S WAY - Health 51 Bosun Way Marstons Mills A = =046 130 - - - FEE Board of Health, �G�vt�`��/L &- MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) - ❑Complete SystemXIndividual Components Location ,S / 13©S(/ti`I C{j��, ('1 Al��qr j�r�/J Owner's Name Map/Parcel# Address Lot# ?--& Telephone# ,y7C1 7,?3 Installer's Name ���- se Z. Designer's Name ,.1- ,ip y? Address Address � Le,,,;K 4P Lh e0t-,j/0"'i w,`//i Telephone# Telephone# SV F Z 3 Type of Building FS l d E/t-GC�7 Lot Size 7-Zi 3 sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( Other(Fixtures Design Flow(min.required) 3 gpd Calculated design flow 3 Design flow provided 3 S� gpd Plan: Date (rd/� Z Number of sheets / Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation Z 2 z D Z DESCRIPTION OF REPAIRS OR ALTERATIONSW-t Z S 4"''f5 �� I�✓ cL2 �c' Z i �e�L T`�`yG' /0V0 re�t�r,�: The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place a system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed f Date , Inspections 4 Board of Health, Vol-yr f a4 MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( Upgrade'( Abandon( ❑Complete SystemXIndividual Components Location •s / 13 p S cm- f Ctm y, /�o{r�F�►,)/hr��l Owner's Name Fl& t Map/Parcel# Q — U Address Lot# Z—& Telephone# _j-cf �'-QZ r 3 Installer's Name Designer's Name & #k rrI H iUYi Address Address 9 L e": A 4J-0- L.7 e0w- y[p4,j r��J Telephonb# Telephone# s-0 Z S 3?( z- 1 • Type of Building e S l D F/-C C Lot Size Z zi 3 sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) 3 gpd Calculated d sign flow 7 7 O Design flow provided T 3-,3 gpd Plan: Date Z Number of sheets Revision Date Title Description of Soil(s) Z Soil Evaluator Form No. Name of Soil Evaluator G: ��r i A$� Date of Evaluation z 2 p L DESCRIPTION OF REPAIRS OR ALTERATIONS -2 /7 'Gt/, g�f X it 2 - ro 0 O R/ The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place a system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections ♦ ♦ ! No. � FEE i � C®�9[�9 ONWEALT14 ®F MASSACHUS�ETTS Board of Health, ga/ 1 L�`O 6F MA. CERTIFICATE OF COMPLIANCE Description of Work: wlIndividual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ,Abandoned ( ) by: at S / l3 0 6Z.4, has been installed in accordance with the rovisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 1V O I - 1 1 1 , dated r . Approved Design Flow 3.T-3 (gpd) Installer ' r-1 A ' Designer: Inspector: Date: f/3 S/0 2 The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Now FEE STJ, s COMMONWEA LT14 ®f MASSAC14USETTS Board of Health, l�a'' �S 6 MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade�bandon( ) an individual sewage disposal system �at l Qfvy �/9 f 10�1 /til�L L-J as described in the application for 'Disposal System Construction Permit No. — dated 1 .---- PT vided: Construction shall be completed wi.tin ree years of the date of thi �� a conditions must be met. (/ Form IH5 Rev.5/96 A.M.Sulkin Co.Boston,MA Date c s m't.ard of Health / TOWN OF BARNSTABLE LOCATION _ � l O.SP/g5 SEWAGE # 1002 v VILLAGE&J&e6t W.S ASSESSOR'S MAP & LOT 0 6z/34 INSTALLER'S NAME&PHONE N0. OF f' 970 t),vc�X�g- B,y�s a SEPTIC TANK CAPACITY /Ody LEACHING FACILITY: (type) 2—JUDO �Ai/�I''�/ W10,1�ze) I NO. OF BEDROOMS 3 BUILDER OR OWNER l/ /�� � 1 PERMITDATE. 7/<f-0� COMPLIANCE DATE: i 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 X� Mv\ yS. A. s2�/01 Notice: This-Form Is.To Be-Vsed--For the RepaWOf Failed Se -Only n PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, le., E• uh, es hereby certify that the engineered plan signed by me dated, MPk CG, 0, 2,xz concerning-the property located at _-meets- -A of the ellewingcriteria: • Tfris lMled4ystem-is eonneetedle a resi There-are ao-c-emmereial-or business-uses-associatedwith-the-dweilmg- • The soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch.-_Theapplicant may use historical data-to-conclude this fact or-may conduct Tweliminary4ests-at the site without-a heals pat=present. • There is no-increase in-flowandlor'6hange 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 Frimptpr method when applicable]_ ' Please complete the following: -A) Tap of1&(nmd`Surface-Elevationl-using-CdSinformation) B)-aw.Elevation- +adjustment for.high G.W. = DIFFERENCE BETWEEN A and B SIGNED G� DATE: Z, NOTICE -Based:-upon-the above infers lion;-a-repair permit will-be-issued-for 3 bedrooms maximum:`No--additional_bedrooms-'-authorized-in the fahue--without a red:septic system Plans_ n•health folder nrrrr.Ymn -i -> = TOWN OF BARNSTABLE LOCATION Z7 f30sveS 41 41 SEWAGE # 1df/2— VL.LAGE¢ &e6rOo-S 1ls ASSESSOR'S MAP & LOT 0V6- 150 INSTALLER'S NAME&PHONE NO.SOS 775t? c/aJc,of?X yC SEPTIC TANK CAPACITY /009 LEACHING FACILITY: (type) 2—,S490 ������ W15146ize) •2��( �3 i NO. OF BEDROOMS 3 , BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 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 facih Feet 'N Furnished by .d4� S• 14 s fi 'k US.u.l _ K 0 LO v T ION `s� SEWAGE PERMIT NO. Will AGE Gil t�i IN.STA L ER'S - NAME S A:.DDRESS 01 U I'L D E OR DATE P kitMIT ISSUED DAT E CO-MPLIANCE ISSUED .-�- ,�. _. T ;� r � � �� s4 .b / �� 2����� �e ��, No ...4... .. . ._ ..�. Fm$.... s............... THE COMMONWEALTH OF MASSACHUSETTS OAR® OF HEALTH. -f''-�_.!�...........O F......................... Applutttion for Disposal Works Tnnstrnrtiun Prrmit Application is hereby made for a Permit to Construct X) or Repair ( ) an Individual Sewage Disposal System at: J�/ , j i /jI r ............. .. .. .......... ........... ......... ..................... .. 1 ..5 � � oc ion-Address oe ? f S1 a Lot/ 0. ..F ? - --- ....._.%=.e_61.............. - /.�-----•-e•---------------- � d �6 v Owner Address W ` Installer Address d Type of Building Size Lot. d_®®_3____._Sq. fe t Dwelling—No. of Bedrooms._....... ...........................Expansion Attie Garbage Grinder Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ______________ W Design Flow.._.._.__ _______ ___________gallons per person per day. Total daily flow....... .....................gallons. WSeptic Tank—Liquid capacity/A ..gallons Lengthitt-Air.._.. Width... _�..._. Diameter................ Depth...6 ..... x Disposal Trench—No.................... Width-__.�.............. Total Length......_....o._..... Total leaching area/�0� :.4 ft. Seepage Pit No._----t------------ Diameter.....6..._....... Depth below inlet..._6........... Total leaching area.P7._._!._...sq. ft. Z Other Distribution box Dosing tank ( 0 J Percolation Test Results Performed by....._._/�___�__�ic i=. `►�.... _________________ Date___` ? ,1..� .......... 1 Test Pit No. I..... ........minutes per inch Depth of Test Pit.._._l��.___....__ Depth to ground water_._._____._.........._._ L% Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ I r O Description of Soil................. !! - e =r .j.................... ... _ U •-•------------••------------•-------•------------------•-•----•---------------------------•----••--.......-••--•••-•----...--•••---...-••---•-- --------------------------------------------------------------------------------------------------------------------------------------------------------------------•----------------------••---..-•---- 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'LIT- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issue �rdhealth. Sign --- -----• .--•-- ...... ......................•••--......... J" .- Application Approved By __:.A ,1 rl ..... Date Application Disapproved for 1he following reasons----------------•--......----------------------------•-----------------------------------------•----------.._. V Date PermitNo...........--•-•......................................... Issued-._ -' `_ ---w ........... Date X ....... r Fzic........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEEA -T 40 'k-1 A/ AO 4? 4, r .................. ........................OF.................. Appliration for Disposal Works Toustrurtion Prrmit Application is hereb made for a Permit to Construct 9() or Repair an Individual Sewage Disposal System at: ..........Zj�, . ... n-Addr s................................................... ..................;...... ............r--Al.................. ioo Lot a- 1, .......................A......................................... .......................................................................... Owner Address Installer Address Type of Building Size Lot........A.p 10.j......S q.Wf ;t Dwelling—No. of Bedrooms............................................Expansion Attic 4A4 Garbage Grinder P4 Other—Type of Building ---------------------------- No. of persons............................ Showers Cafeteria Otherto es..................................................................................................... ............................ ....................... rrA 11 -_ Design Flow....._ S-7 ...gallons ons per perso Per dp. Total tilt'!'flow.__.._V r # .....................................V�ns. 1:4 Septic Tank—Liquid capaci ............gallons Lengt4ri..Ar..... Width................ Diameter-_.__________- Depth_.. ...... Disposal Trench—N-6..................... Widt Total Length... Total leaching area_ sq f t. 1--------------- V....... Seepage Pit No______/............ Diallleter.....�__ ............ Total leaching area..�q*ft. .............. Deptll-below inlet.. Z Other Distribution box O Dosing taA Percolation Test Result Performed by.......P�.!......... Date...jllh�.�rl-77 I—----------*-------- ............. . .......minutes water.__.....__.__.__....._.. Test Pit No. 1.... in tesper inch Depth of Test Pit......6V........... Depth to ground P� Test Pit No. 2................minutes per inch Depth of Test Pit............__..._.. Depth to ground water._.....__..........._... P400_�------------.......-------------­------------------------------------------------------------------------ 0 ----------5............/------$-------- Description of Soil.................. 4v Yo v e.( ..............................I....................... ........................I.................I.,..............I................................. -------------------------------------------------------­7------*-----------------­­­­-------*...*-----------------------------------------------I-----------------------*1111­11111------w.... .................I...................................................................................................................................................................................... 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 T I T LZ 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 health. Signed..................................................................................... ............................... Date applicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:................................................... ........................................................... ......................................................................................................................................................................................................... Date Zd-- Permit No......................................................... Issued............. ............r.................... Date THE COMMONWEALTH F MASSACHUSETTS "71_e_,WPA80ARD qi&K4MTH ...... ....... ...OF..................................................................................... Tntifirab of Toutpliaturt THISJS,1?0 C T the Individual S I e Disposal em str - e or Repaired - I t /Z/ ...... ...... by_- Ma- .!.. .......t'.441 ................................................... Install �t - , ........... at................................................................................................ 1 ­ ­244otw............................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.."..................................... dated-----------------------•........................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL Ft_(NCTION ATISEA S qJPRY. DATE.........................................7..........---------------------------- Inspector.............L...................................................................... 4THE COMMONWEALTH MASSACHUSETTS : 4 Y 044190ARD OX?40"H ..........................................OF........... .................................................................. No......................... FiE.... ............. t or Lion r Permissidt,eier y atited ...........A-... ... .............................................. Y-1() I an u 4epair_ __;1' s to C Individual Sewage. posal ystem atNo.................................................................................................. ................................... ...........;�Z......... as shown on the application for Disposal Works Construction Pe it ............ ...... Dated.......................................... - K,V�* ...... ....... lei` ..............................q •............Board..6-f.H.ealth........................................7 7 'DATE.......V--------/............................................................ FORM 1255 HOSES & WARREN. INC., PUBLISHERS ....-;,.. .:�..I�.. r% ..1 11�1-. .1 . I , - " , C— ,,Ii�....: 1.�..I%;..I .I'...�.I �-... ��. . ...,.�..J . I... �I .-�I. -. r. q � ,,"7 :: -� L ,1 " 1 - �, - "fflq1. I " v �, , �, 1 1 ,-, �,- �. 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I o �Af M MASS. *��H OF 1,f.4 $ t� OF II,�Jy;�cy OWNED BY -_-. - FRANK r rn `� FRANK �� �O S a P 14 /e� /s 'N/ Z0' tlt �a COVERT i oCONERYa� It z� e 9 No. 6573�O No. 6232�o FRANK CONERY 5 TRENTON ST. r �` n / i �o��GrSTEP _,� -' �Q�ST�� oa HYANNIS• MASS. 02601 S / 0 �`• + „S z�o"..r FSS/QN �� 4A'D g��N MMISMMM LTlOINSZR R LAND sUMVEYCVR `h SCALE I IN =20 T. - N 61 N Design GoIcuIations Number of Bedrooms: 3 Z�G Bosun's Garbage Grinder: No Qj � Leaching Capacity Required: 330 Gal./Day \ SITE �� �<\ Leaching Area Required: 330 Gal./(0.74 Gal./Sq.Ft.)=446 Sq.Ft. \"0 Proposed Leaching Structure: 1 -25'L X 13'W X 2'D Leaching Trench Q ems ' Leaching Area Provided: 477 Sq.Et. 0 St. C.B, -E ncl aye 95 Pro Proposed Leachin Ca acit 353 d > 330 d. re 'd. Sohool \ P 9 Capacity: gP gp q a' Hamblins 4' 5' 4• Hayway 91 2" OF 1/8" TO 1/4" PEASTONE (WASHED) op4,%� cn 'J g8 ® �g ® © 1=824" MIN. 41 2 H-10 500 gal. chambers 3/4" TO 1 1/2" WASHED CRUSHED STONE 9 4.3 9' X--" Q �` C cA O TRENCH GROSS—SECTION LOCUS GO (D O NO SCALE NO SCALE ° GENERAL NOTES C C 1. ADDRESS: 51 BOSUN'S WAY 9' X \ 2. ASSESSORS NUMBER: MAP 046 PARCEL 130 3. DEVELOPER'S LOT: LOT 26 G Q 4. TOPOGRAPHIC INFORMATION WAS COMPLIED FORM AN ON THE GROUND INSTRUMENT SURVEY. t y1 5. WELL WATER IS PROVIDED TO SITE. MUNICIPAL AND WELL �� WATER IS PROVIDED TO SURROUNDING PROPERTIES. L \e \eJ Q� 6. REFERENCE PLAN: PLAN BOOK 273 PAGE 22 0 e / OyQQ� �e 7. NO WETLANDS ARE LOCATED WITHIN 100 FEET OF SAS. 8. NO POTABLE WELLS ARE LOCATED WITHIN 150 FEET OF SAS. Q'L e\\°� �' �O N T R T I N N 0 T 5 96 a X '98.8 C CD S UC 0 E WeEi, house Q O / t �� � 1. Contractor is responsible for Digsafe notification 9g L and protection of all underground utilities and pipes. 99891 01 99 O O ti1O 2. The septic tank and distribution box shall be set level on 6" of 3/4"-1 1/2" stone. 9 p �e` P� 3. Backfill should be clean sand or gravel with no stones over 3" in size. 98 99,10#1 �,o �� 4. This system is subject to inspection during installation by Glen E. Harrington, R.S. 5. The contractor shall install this system in accordance 0 , _ \/ 7 t n v O > D with Title V of the Massachusetts Environmental Code CI a Ching I rl /\trench U S in g and the Regulations of the Town of Barnstable. O6. Provide a Acme Precast 5—Note D—Box with 2 H-10 500 gal. chambers or equal. H - 10 500 gal . chambers t/,/I t h 7. No vehicle or heavy machinery shall drive over the 2 99^ septic system unless noted as H-20 septic components. 4 of Stone on sides CSC 'ends, 8. Install gas baffle or equal on septic tank outlet tee end. 0 X 99,03' 9. All existing inverts and site conditions shall be verified by contractor. Gj 0 9, N 10. Existing leach pit to be pumped and backfilled. V 11. Existing 1000 gal. septic tank to be pumped and inspected for structural �> ///��� X integrity prior to re—use. / LO T � � �� o � 1-20"DIAM. ACCESS MANHOLE v y Q s �C AREA = 22 ,003_f SO.F-T. 5 SOIL EVALUATION �� r Date of Soil Eval.: February 22, 2002 Test Performed By: GLEN E. HARRINGTON, R.S., CSE \ 1 0 rM ® ® ® 34 4„ " Excavator: Joe's Septic Service �/ Test Hole O �V NO 1 STEEL REINFORCED PRECAST CONCRETE 2 H-10 500 gal. chambers EPTH SOILS JELE7 \ PLAN VIEW END—SECTION 0 99.10' H-10 500 GALLON CHAMBER O/E NOT TO SCALE 6" 8.60' USE ACME PRECAST OR EOUAL BdWv 36" r' rovesla"n 96.10' SITE PLAN �yjNOFM,gs PROPOSED SEPTIC SYSTEM UPGRADE C 1, med. SCALE: 1 "=20' � PREPARED FOR coarse son 2.SY6f4 BENCH MAR ON CORNER OF S R � � ERIK K. SEITH ET UX 144" B�10 \ BULKHEAD ELEv.=1oo.00' (AssutvlED) LEGEND c„ AT NO GROUNDWATER ENCOUNTERED o.��70 O % EXISTING PUMPED &EACH PIT T BE 9cc �� 51 BOSUN S WAY s �isTE�` a *NOTE: ALL PIPES ARE TO BE 4" DIA. SCHEDULE 40 P.V.C. EXISTING 1000 GAL. �N�TAFI�P BARNSTABLE (MARSTDNS MILLS), MA 10' min. from *NOTE: INSTALL GAS BAFFLE OR EQUAL ON SEPTIC TANK OUTLET TEE. O a H-10 SEPTIC TANK house to septic tank Finished grade over system=2`e slope away Septic tank covers must be DENOTES EXISTING PREPARED BY: ExistingHouse within 6- of finished grade 5 HOLE x 104.46 SPOT GRADE I R D-Box cover must be DIST. BOX one chamber cover must be E H R R I N T 0 \ within 6" of finished grade within 6" of finished grade Existing Grade Elev.=99't GLEN A V 9 S. fX/STt I' ADE 9 .., -95 -----..__.. EXISTING CONTOUR Q full s= 0.02 Min. 2"-1/8"-1/2" 12" in. J L E D A ROSE LANE washed stone 36" max. Level for 2' DEEP TEST HOLE cellar o 8' EXISTING s=D, Tap Elev. MARSTONS MILLS, MA 02648 SEPpOC;ANK M N 12' nve t v.= 6,10' TEL: 508-428-3862 o Tf H H-1 r co 24"MIN. v rn m c o C3 o C3 ottom of Leo h GAS BAFFLE m O a h OR EQUAL x u 6 II 25• Trench Elev.= 94.10' v �, FAX: 508-428-3862 N_ LEACH TRENCH 7- 6" OF 3/4"-11/2" STONE u cc II .Bottom or T.H. #1 Elev.=87.10' SCALE: 1 "=20' DRAWN BY: GEH MAR. 10, 2002 SYSTEM PROFILE 6" of 3/4"-11/2" STONE > DATUM: ASSUMED FILE: SEITHI .DWG SHEET 1 OF 1 Not to Scale