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0098 LAKESIDE DRIVE - Health
98 LAKESIDE DRIVE Marstots Mills A = 102 - 016 TOWN OF BARNSTABLE h LOCATION 99 ZAj )f-L5-51 J -' � SEWAGE# L(�14-'1-7 9 VILLAGE ASSESSOR'S ASSESSOR'S MAP&PARCEL a 16 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /5 00 LEACHING FACILITY:(type) NO.OF BEDROOMS � �VS�l1NCS OWNER PERMIT DATE: Z COMPLIANCE DATE: 12 T 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 ~ 3 z DID , y4 L `Z� 13' F Town of Barnsfable Pit . Department of Regulatory Services UsttaT"Le, Public Health Division b l� MAH9 ate 200 Main Street,Hy nuts MA 02601 rf� rE1►f�'1"' e,r Date Scheduled B Time D -- � Fee Pd. Soil Suitability .Assessment fog- S r po Performed By.— i 1�/��-v 0 _. -0 YY ItnCn'SCd By: ® 1 LOCATION& GENERAL INFORMATION Location Address Owner's Name Address 1�d z4AIPY,eKA- Assessor's Map/Parcel: - / . Engineer's Name R, l q b/L LAC—, NEW CONSTRUCTION REPAIR Telephbne# d ? Z .0 P 7 D J Land Use--. �F /A ( Slopes 96 3 f l^ �0 �I P (. ) Surface n Distances from: O en Water Bod N jC)-�� ` P yft Possible Wet Area-- —ft Drinking Water Well _-4//T ft �� Drainage Way.��ft Property Line .�L _ft Other �— ft SIC ETCH:(Street name,dimensions of lot,exact locations of test holes&Pero tests,locate wetlands in proximity to holes) oe zz I 2 � C> S., r' zi® sue . P kA Parent material(geologic)a �C Depth to Bedroelt /.v Depth to Groundwater. Standing Water in Hole:_y-124-_ Weeping i5•otn Pit Face Estimated Seasonal High Oroundwater C�fi 45 T DETERMNATGI IN FOR SEASONAL IIIGH WATER TABLEMethod Used: -_ /G� s®�®� ��1 V j�..• 6/01AW _:�,©7' Depth Observed standing in obs.hole: In. Depth to soil mottles: Dep'th to Weeping:om side of obs.hole: In, Groundwater AdJuHtment fC. Index Well# Reading Date: Index Well level—:_._ Adj.factor_ m A�J,Groundwater Level PERCOLATION TEST Observation Hole# Time at 4" �Do Z Depth of Pero bot _,3 Time at 6" Start Pre-soak Time @ leA9 Time(9"-6") T n1>aJ i End Pre-soak Rate Min./Inch L' 2 miN�AJ Site Suitability Assessment: Site Passed i/ Sitp Palled: Additional Testing Needmd(Y/N) N Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of Wetland,You must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:1S EPTICIPERCFORM.DOC 1 DEEP"OBSERVATION HOLE LOG Dole# / Depth from Sall Horizon Soil Texture Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,.Stones;Boulders. 01'sistency. "arivell U•-12" � S� -/09�j la r 3 �0 - /ZGi� �y S jd: 6�G DEEP 013SERVA.TION BOLE LOG hole# 2- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in-) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten `Yo ra 40 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (5tiucture,Stones,Boulders. Con i to c a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Noll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co—Wen Co—Wencv.96 Flood Insurance Rate Man: Above 500 year flood boundary No, Yes.,._ Witldn 500 year boundary No_ Yes ' Within 100 year flood boundary No._ Yes Depth of Naturally Occurrin> Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? YCS If not,what is the depth of naturally occurring pervious material? Ces"tifiication ,I I certify that on / I O (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 required tr ' ing, xperd e a d e ie a iced in�10 CNM 15.017. Signature Date Q:1S EPTICkPERCPORM.DO C / r No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes \03 Rppliration for Disposal 6pstern Construrtion Permit Application for a Permit to Construct(wRepair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. qQr LAKO-571 1 F 9 Owner's N e,Address,and Te.No. Z 0—(jZ s Assessor's Map/Parcel S�q �S p ��f( Installer' N Address,and Te. o. j-3 _y bW) D igner's Name,Addre,s,lan��iT�.l.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size 121 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3_3 0 gpd Design flow provided ` gpd Plan Date 245 " 19 Number of sheets Revision Date Title Size of Septic Tank ,!��'St c� /�(f Type of S.A.S. 2 �•0,0 G � Description of Soil /®_Y-IlAz 63'! e) 61-1 �� s ,�� �c� Nature of Repairs or Alterations(Answer when applicable) �,(l /' D!� /f1/� .tom/� 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 by4is Board of ealth. i e YN 49 j 6 Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. d Date Issued VVI 1 / + XV No. OV I � P Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication fior 311i8tlosal 6pstem Construction' Prinit Application for a Permit to Construct(t),"Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. q�.(� ((„$j a Owner's Name,Address,and Tel.No. UZS Assessor's Map/Parcel G Installer's Name,Address,and Te. o. Q�-j _[�6 De igner's Name,Addre s,and T No. fC-Qg,-7"]s- 1'`((� Ce/it0� v1 A L} (� U409 T, C 1 III C_ i'U 5 LA J CES Pb Z59 w -,l JAV 14-t 6 u , -_-Type of Building: Dwelling No.of Bedrooms Lot Size t 2CA 5 sq.ft. Garbage Grinder( ) Other ' --Type of Building /���lj�j?ir..'�f No.of Persons Showers( ) Cafeteria( ) { Othdi Fixtures ^� Design Flow(min.required) 33 0 gpd Design flow provided G_ gpd Plan Date A ` Z J " i i-) Number of sheets Revision Date Title 'A Size of Septic Tank �yCS(� ���/U Type of S.A.S. 2�5,_0D T Description of Soil a-" Z ._5-/ �/> L� /Z .?' Nature of Repairs or Alterations(Answer when applicable) 145AV412' 4<eL �Xr fFA,11K7-- 4e �y��j/) ��e5w ell Date last inspected: Agreement: The undersigned agrees to ensure the constructionfand maintenance of the afore described on-site sewage dispgsat 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 b.t is Board of ealth. ig e /I o 6 Date Z Application Approved by ��� f Date _ 1 Application Disapproved by \ Date - for the following reasons Permit No. ` Date Issued - -- -------------------------------------------------------------------- ------------------G=----------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,th t the On`-si a Se ages D�is-p-o�sa�sy/s�e�m,C/onstructed( ) - JRepaired( Upgraded( ) Abandoned( )by �T J/�_ ; / le / 1N IDL) �a-t'l at has been constructe i accor � with the provisions of Title 5 and the for Disposal System Construction Permit No s Installer Designer #bedrooms: Approved design flow �{ pd l The issuance of thus e it shall of b construed as a guarantee that the system wi 1 'btion designed. C L/ 1y 1 Date '/ _ Inspector / // ( ✓/ill//�.�£ t V J V v ` r - ------------ --�--------------------------------------------------------------------- No. '�7 Fee�THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstrm ConStCUrtion prrmit Permission is hereby ted to Construc ( ) Repair( Upgrade ) Abantn( ) System located at 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. r Provided:Constru 'on ust be om h ed within three years of the date of this permit. Date Approved by ` Town of Barnstable OF 1HE Tp� Regulatory Services Thomas F. Geiler,Director BARNSTABLE, MASS. Public Health Division i639• ♦0 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 2- 3 0 Designer: /\OA ;Q ��,J; �,A- ��;�{�;:� Installer: Address: P, 1), Address: fzf hWi/16,- S� On l2—/Cl — /�j ,/� � / �LjG� was issued a permit to install a (date) (i staller) septic system at stdtar, based on a design drawn by (address) /C.0 J Wf1(�C � dated (designer) VI 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. �-0OF thgS S. RONALD S . In DAME ler's Signature) CADILLAC Cn #i GU (Design Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE. JOB NO. B14-11 to NOTES Noreen.dwg N INSPECTION SCHEDULE 1. LOCUS IS A.M. 102, PARCEL 16. FOLDER SB13/65 Lakeside a- CALL R.J. CADILLAC TO 2. ELEVATIONS SHOWN ARE TOWN GIS± 0.2' (APPROX. NAVD88). Or 0 BENCH MARK-CORNER OF CONC. N�F INSPECT PRIOR TO BACKFILL. 3. LOCUS IS IN FLOOD ZONE X (FORMERLY C) ON FIRM„ PANEL 0543J DATED JULY 16, 2014. SLAB= .79.36 TOWN GISt 0.2' CONC. BOUND 4. ALL PIPES TO BE 4 SCH 40, AND PITCHED AT 1/4 PER FOOT. (UNLESS NOTED) THEW FND. & NOT HELD �5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100 ARE ON TOWN WATER. p (AT WHITE PAINT SPOT) / CcJ N 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. m N F 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". THIBEAU 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW a N 88'18'30" W D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. 9. DEPTH OF COMPONENTS NOT TO EXCEED 3% OFF VENTING MUST BE PROVIDED. NOT TO 62.05' 86,10 COVERS: BUILD UP COVERS TO -6" BELOW GRADE--2 ON TANK, 1 ON D-BOX, 1 ON LEACHING SCALE x 80.8 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LOCATION MAP 0.7 0 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, i x CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. / 0, 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING x 60.5 IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). TEST HOLE 1 (\ FSF `\y 41 13. PUMP AND FILL ANY EXISTING CESSPOOL/LEACHPIT. REMOVE ANY CLOGGED SOIL, BLOCK, 80.6 1,z, / / S2R AND STONE IN LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet) / 79,6 6., - 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. p 79.6 X�p /fH 1 TH 2 9 OAR, A layer 10yr 3/3 / _079,3 x 78.3 NO GRADE CHANGES TEST HOLE/DATE: P# 14553--11/18/2014 12" silty loam PERFORMED IBY: Ron Cadillac, Soil Evaluator 3 '60 9.7 ( 0�),9 ARE PROPOSED WITNESSED BY: Donna Miorandi, IRS B layer 10yr 6/6 LOT 9 C� G'7 ��\ PERC RATE: <2'-00"/inch (Cl layer) sandy loam -"' 0 12 095�S.�. 7 30 7 ( X , SOIL SURVEY(1993): Marrimac sandy loam „ 0 9.7 O 9 36 76.6 / o Invert 77.78 GEOLOGIC MA�P(1986): Mashpee pitted plain deposits d oo 7 i ,�`� �, � � 80.95f C1 layer 10yr 5/6 CONT INO o n 79\6 7,9 Top Foundation Existing med. coarse )� 53' loamy sand ` 79.3 Invert 77.60 Invert 77.25 X 79.4 i F 30% ravel `L o k%st ? 79,4 2 DRY WELLS g F•1'/ , e 78.2 flk Existing Proposed Invert 76.35 70" some fines S` 'Deck 8 Use Gas Baffle Top Conc.=77.1 73.8 9" min. cover Proposed To Peastone Filter Cloth=76.7 C2 layer 2.5 6 4 h'0 % S=1/4"/ft P / Y y / 0 bqs 98 F i �79.13 , 78.8 Proposed S=1"/ft / ,>/ -�6" Max. med. coarse sand 7...i...::.. eme i / i 1500 Gal. S=1 8 ft Invert 77.50 min. --• h� �'� �x ` \� � Septic Tank 78.81 Proposed ----------779 no water 78,9 78,0 j 24 132„ 68.6 7 8.6 3 / / o� ^�o I i 74.3 CONC. BOUND 78,1 C\ 78,7 ' �78.6 / '\ i I Invert 76.52 Invert 76.30 Bottom FND. & HELD / 77 / i i 6 Stone or compact Proposed Proposed 6 TEST HOLE 2 77.3 / x 79, I , I , I I 1 x 7 / 8'0 I-7-•I 5 �- 10' -� I �'�--4--I Bottom TH2=68.3 DEPTH inches ELEV, feet u R�y3 77,8 Q` 8.03 I I I I I I < I 0 Ala layer 10 3 3 79.3 ) A� 6 7,5 // 76,72 ° 7Z3.24.2 74,2 '6 a °s' s �° // DESIGN DATA `° silty lam / HORTON BEDROOMS: 3 B layer 10 6 6 �3, GARBAGE GRINDER: No sandy loam ,05 LEACH AREA / 5,65 i REQUIRED CAPACITY: 330 GPD „ '\73, 7 8 USE 2 DRY WELLS WITH 4' OF STONE 36 76.3 SEPTIC TANK: 1500 GAL. C layer 10yr 5/6 Rs p BOTTOM LEACHING AREA: 325 SF ALL AROUND TO MAKE A 25' BY 13' med. coarse - OF 2 BENCH MARK--TOP & CENTER loam sand SID o WIDE BY 2 DEEP LEACH AREA.. y CONC.'BOUND CONC. BOUND= 75.05 GISf0.2 [(25 X 13')] 30% gravel FND. & HELD 4,5 SIDE LEACHING AREA: 152 SF 70„ 73.5 some fines 773, [2(13'+ 25') X 2' DEEP)] C2 layer 2.5y 6/4, DESIGN CAPACITY: 352 GPD 73,34 [(325 SF + 152 SF) X .74 GPD/SF] med. coarse sand / 132" no water 68.3 NOTE: THIS IS A SITE PLAN SURVEY BY THIS OFFICE AND SITE PLAN NOT A COMPLETE PROPERTY LINE SURVEY. CONFLICT WAS FOUND IN ADJACENT SURVEY POINTS. FOR THIS PLAN IS A VALID COPY. ONLY T IT BEARS DIBUONO SEWER. & DRAIN AN ORIGINAL RED ST M AND SIGNATURE. LEGEND LOT 9, 98 LAKESIDE DRIVE, MARSTONS MILLS, MA V�H OF M,q6 �P�ZN OF 4,1 O TH 1 TEST HOLE LOCATION, NUMBER9cyG „ , W WATER LINE MARKINGS �� RONALD s RONALD s� NOVEMBER 25, 2014 SCALE: 1 =20 E OVERHEAD ELECTRIC WIRES (IF SHOWN) a DAMES o DAMES CADILLAC `� " CADILLAC G GAS LINE MARKINGS # 1060 #35779 x 9.5 x8,7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) ° �G o`' �-6-� EXISTING CONTOUR - � `ST�R� �� F ° SURv � RONALD J. CADILLAC, PLS, RS, P.C. SANITAR�N ���SS��y 8 PROPOSED CONTOUR '( 1 PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN UTILITY POLE (IF SHOWN) P.O. BOX 258 ® EXISTING' DRAINAGE CATCH BASIN x - FENCE (IF SHOWN, NOT ALL SHOWN) WEST YARMOUTH, MA 02673 TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE O (508) 775-9700 2014 BY R.J. CADILLAC PAGE 1 OF 1 C - - - F� --