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HomeMy WebLinkAbout0044 LIBERTY LANE - Health 44 LIBERTY LANE, MARSTONS MILLS A o TOWN OF BARNSTABLE 0 LOCALION Z/Y SEWAGE# 'Zoo9- 37 VILLAGE In In,16 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY VOO f l-( LEACHING FACILITY.(type) 10) / i aw �I (size) �t•Zi � Z_,.33 `� 2 NO.OF BEDROOMS 3 OWNER aw,,P-) la PERMIT DATE: < COMPLIANCE DATE: 12- 1 O i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility R/J U 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) �j� Feet FURNISHED BY J(� • � J A r 3z, 31 �s•c� /tz 37.o Z bz Lr ,r A3 . s i31 93, Y #N b3 fs y �9..0 f{� glo,o 3S -73-5 No. �� ! 7 Fee V G� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: j000l PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Misposal 6pstem Construction VPrmit Application for a Permit to Construct( ) Repair ,) Upgrade( ) Abandon( ) ❑Complete System Xndividual Components Location Address or Lot No. L(�� :�2r t y �.p,,L Owner's Name,Address,and Tel.No. TA-gnc5# De)oo.Ay AaAF Assessor's Map/Parcel :t1I�AtsNj�b K43 qy L-)6"1 L-AA �r/SWn t4;11 Installer's Name,Address,and Tel.No. 07 P✓,5ej Designer's Name,Address,and Tel.No. 60 1 CL 7(-j Sag 3("1-09g4 s. u e4 Type of Building: Dwelling No.of Bedrooms I �+ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 3(o i.3 gpd Plan Date 11 4-111,o-t25 Number of sheets 2`511e Revision Date Title q`A LA.U+ Size of Septic Tank 1'000 aS Type of S.A.S. :?Z S kA,, " •1 tV^c1 r, ka&O 190 - Description of Soil D lvab Nature of Repairs or Alterations(Answer when applicable),, ^Q,.,) (7-- 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 of Health. Si a Date l 11—U05 Application Approved by 4V. Date Application Disapproved by Date for the following reasons Permit No. 7-7 Date Issued No. � o 0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Applitat on' for Misposal *pstrm" Construction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. �� rT� ��a.�.c Owner's Name,Address,and Tel No. ernes 4 De6o n o 04 F Assessor's Map/Parcel `Z, �� A/s IS N`� L' 0vT y l.An 6 `t A✓s WW M,r t , Installer's Name,Address,and Tel.No.d j ,�,;(� e-)1 vtJSP) Designer's Name,Address,and Tel.No. 6(o (e(.(n Type of Building: Dwelling No.of Bedrooms r Lot Size `�, O�� sq.ft. Garbage Grinder( ) Other Type of Building S�1,`t4 No.of Persons' Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3® gpd Design flow provided 36 j.S gpd Plan Date O 11 o oS Number of sheets 2-5Je A Revision Date Title y`a L'%b y* Size of Septic Tank I t)oo &.31 h Type of S.A.S. �� 5 l.n.�r as l!ens r� t(aDl) aid Description of Soil D/ah 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 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. n, SiWred,, n Date Application Approved by /1�,. _ 0 Date Application Disapproved by Date for the following reasons Permit No. Y U 01 - 3 7-7 Date Issued I/- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERRTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(K) Upgraded( ) Abandoned( )tby at L mot!1� 61-1 �/�s(.�,�s ( (� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 v0' 77 dated 11 r-• j r 01 Installer (' „p,,,�.(� �/9�d Q J( s q LLC Designer #bedrooms 1 Approved design flo�j C.) gpd The issuance of this permit shall not be construed as a guarantee that the system will1onctiio�n as designed. Date ;z ( �/,1 M Inspector ki ,,�(y / -A 4 � I I` C/ CID�- 3-� �-._.__�__�____---- Na 7-; ----------�----�-----__----------=---=---•__=Fee--=/OU=I------- --_-- THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair(4 Upgrade( ) Abandon( ) System located at t4 y 6y, _t J-4 A-% 1 vt` J-U Lk 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 m st be ompleted within three years of the date of this permi Date l (l�/q �1)Cj Approved by r TRANS. NO.: CITY/TOWN: t3!t f.,�J ST A gU: t M g4NZS-fo P5 M o LI-S APPLICANT: 7 R M S *- O C 9 D kA H ADDRESS:-4 Lu3cpr< LLOyjf:� DESIGN FLOW: `� gpd REVIEWED BY: DATE: N/A OK NO Legal boundaries denoted [310 CMR 15.220(4)(a)] V/ Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] ✓ Locus Provided [310 CMR 15.2204(t)] i/ Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] ✓ Easements shown [310 CMR 15.220(4)(b)] ✓ System located totally on lot served [310 CMR 15.405(1)(a) for / upgrades]- if not, a variance is required [310 CMR 15.412(4)] ►/ Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] ✓ Location all buildings existing and proposed 310 CMR 15220(4)(c)] ✓ Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(0] daily flow ✓ septic tank capacity(required andprovided) soil absorption system(required andprovided) whether system designed for garbage grinder a/ North arrow [310 CMR 15220(4)(g)] Existing and proposed contours [310 CMR 15220(4)(g)] ►/ Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15220(4)(i)] Percolation test results match loading rate? [310 CMR 15.242] ✓ Certification statement by Soil Evaluator [310 CMR 15220(4)0)] ✓ Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address 0 L 1URJ� L O LC- Sheet 1 of 7 f N/A OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case V of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. 310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR j 15.220(4)(m)] (if water line cross see 310 CMR 15.211 1 [1]) V Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15220(1 and 310 CMR 15.220(2)] ✓ Stamp of Registered Land Surveyor(required if construction / activities within 5 ft. of lot line) [310 CMR 15.220(3)] V Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(l)(k)] Test hole adequate to demonstrate four feet of suitable material? ✓ [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)( )] Materials specifications noted? [various sections of 310 CMR / 15.000] �f System components not>36" deep (unless Local Upgrade / Approval or LUA requested) [310 CMR 15.405 1(b)] V 1 Address � ii3CRT``{ LA 1\1t,: Sheet 2of7 r N/A OK NO q SYEP4ICTA�N rho . W411, 0 as Size OK? [310 CMR 15.223(1)] M ✓ Inlet tee located ten inches below flow line [310 CMR 15.227(6)] i/ Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR ✓ 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228(1)] Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] V Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] ✓ Access to within 6 " of grade one port for systems<1000gpd, two for systems>1000 gpd [310 CMR 15.228(2)] ✓� All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] ✓ Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] ✓ Setbacks from resources [310 CMR 15.2111 Required when other than single-family dwelling or flow>1000 ✓ gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address 44 Le U R T Y L 4 N C Sheet 3 of 7 J I 5 N/A OK NO Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211 1 [1 ) Cleanouts required/provided ? [310 CMR 15.222(8)] ,✓ Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] ✓ Siphonproblem/(leachfield below pump chamber) &/ Endca s or vent manifoldspecified? ►/ Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] V/ Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) Stable compacted base [310 CMR 15.221(2) and 310 CMR / 15.232(2)(a) V Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 / CMR 15.323(3)(a)] . Riser if dee er than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15:232(2)(b)] Minimum sum 6" [310 CMR15.232(3)(e) Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] Capacity(emergency storage above working--design flow)? [310 CMR 231 2 ] Proper setbacks [310 CMR 15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] v Service components accessible (not too deep with piping, disconnects accessible) Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. 310 CMR 15.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] o/ Buoyancy calculations needed? Provided? [310 CMR 15.221(8)] ✓ Address 44 L 113 E I2-T Y L r+Vt Sheet 4 of 7 N/A OK NO Calculations correct?v ✓ 4 feet of naturally occurring material demonstrated? [310 CMR / 15.240(1)] Required separation to groundwater? [310 CMR 15.212 ✓ Aggregatespecified as double washed [310 CMR 15.247(2)] ✓ System Venting required/provided? (system under driveway or / >36" deep) [310 CMR 15.241] V Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] ✓ Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and / Guidance Document] Chambers and Gal. in trench configuration supplied with inlet / every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate 1'minimum-4'maximum. [310 CMR 15.253(l)(b)] .o 2' sidewall credit maximum [310 CMR 15.253(1)(a)] y/ In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] s Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] ✓ 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)]' Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMR 15.252(2)(a)] s Maximum separation between lines 6' [310 CM RI5.252(2)(d)] ✓ Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e) Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)( )] ✓ Separation between beds 10'minimum. [310 CMR 15.252(2)(0] ✓ Bottom area used in calculations only 310 CMR 15.252(2)(i)] v Address Sheet 5 of 7 N/A OK NO Mfflyll I Me Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A ✓ Remedial Use Approvals] If used in gravelless system - make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year(systems<2000 gpd) or quarterly (>2000gpd) good to note on plan 310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet / the specification of 310 CMR 15.255(3)? �/ Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] ✓ Side slope not exceed 3:1 ? [310 CMR 15.255(2)] ✓ Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] '� At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended [310 CMR 15.255 (2 e ] Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface Was DEP Approval Letter provided and/or have you V reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? V Any alarms involved on separate circuits v Did the applicant submit an operation and maintenance manual? V Has ap2licant submitted a copX of a maintenance ft anima. Are the variances listed on the plan? [310 CMR 15.220 ✓ (4)( )] RLS Stamp necessary on plan if a component is within five ✓ feet of property line [310 CMR 15.412(4 New construction or increased flow proposed- [Refer to 310 CMR 15.414 Address &a L 16 E 2 T� �' �`'� Sheet 6 of 7 N/A OK NO .SWFd 9' $S `• "'y"` t-ur flu .= ; 1�itro$en�enstry rya ,gf. r x � W : Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such / existing systems] V Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(l)] lil scellaneou � mow. �M;...M� Pumping to septic tank ? [ 310 CMR 15.229] V-- Shared System [310 CMR 15.2901 / I Address 4 t" 13 L�� LA- Sheet 7 of 7 f Town of Barnstable` Regulatory Services Thomas F. Geiler, Director., Public Health,Division i6J9. 10 Thomas McKean,Director eet,Hyannis,lVIA 02601 200 Main Str Office 508=862-4644 .'Fax::508-79MM4 ;Installer & Designer Certification Form Date Designer: �o✓�Iq� ��✓✓ Installer.: Us P� - Address. _Y � ddress: PD 138X Z:(o3 y _ , 3 Cam,,;(.=���\� ►r�� o26306 On was issued a:permit to,install a.`.: (dat ) (installer) L rl-- n se tic system at be / L ,w based�on a design-drawn-by {address) - hu desi er I certify that the septic system referenced above was installed substantial) according to Y the design, which'may include minor.approvod changes such as;lateral"relocation.of;the di8tnb.ution:bdx and/or septic tank: I certify`ahat the septic system referenced above`was installed,with mayor changes 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:. ���,�H OF Mgssq DAUID b staller's Si afore) " COUGHANOWR No. 1093 Tt sgN1 AR\P� �S (Designer's Signature) sfi ' Stain 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 Town of Barnstable a 7-57 Department of Regulatory Services II Public health Division Q ` ��b� 200 Main Street,Hyannis MA 02601 Date p Date Scheduled Time Fee Pd �Q Soil Suitability Assessment or Se Performed.By: D r � Q. CoUGoUowz LSD f wagepisposal Witnessed By: IV f ti�I�n /fir LOCATION & GENERALS it Location Address y�� Ll Y T INFORMATION �e y (� Owner's Name IAd b t A 5 r�t'1 1�� TRIM e g 14 Address Assessor's Map/Parcel: $�}✓I1e ® . 14 tot( Bngineer's Name NEW CONSTRUCTION �"�Q REPAIR PS(�l p N , tl Telephone# - t'Q Land Use' Z� Slopes(9a). ' D Surface Stones` V\ o h e Distances from: Open Water Body1 00 't ---__ft Possible Wet Area S o —,1 Drinking Water Well —_ft Drainage Way ft Property Line 10 fi --_ft Other ft SICP-'TCH: (Street name,dimensions of lot,exact locations of test holes&.pere tests locate e wetlands in proximity to holes) GROUNDWATER ADJUSTMENT ! ®® EXISTING GROUNDWATER LEVEL / tiW BASED ON TOWN "OF BARNSTABLE GIS DEPARTMENT RECORDS. / �' e' INDICATED GW 38.0 / INDEX WELL SDW-253 ZONE C READING DATE OCT. 2009 READING 49.5 I m ADJUSTMENT 4.9 ' ADJUSTED GW 42.9 Parent'material(geologic) FO JC 6Q I Depth to Bedrock Q e Depth to Groundwater. Standing Water in Hold: n®� Weeping from Pit Face �©� Estimated Seasonal High Groundwater See 16®V r DETERMINATION Method Used: FOR SEASONAL HIGH WATER TABLE See �t.ibo ve. Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: In. Depth to 5011 mottles; Index Well## Reading Date: III, Groundwater Adjust,------- Index Weil level ^ Adj factor y AdJ,drnundwater Lcvel fr. FHole ation PERCOLATION TEST bate 11hol xltne (0 A M D t Time at 9" V)A pof Pere I h Time at 6" Start Pre-soak Time @ (0 f.0 Time(9"-6") End Pre-soak -- Rate Min./Inch :imp I Site Suitability Assessment: Site Passed V Site Failed: Additional Testin Need N r ' o (Y/hl) OP final: Division Public Health~ or 0 Observation Hole Data To Be Completed on Back----------- k.l �,•***Z.f, .er` . P olatron test iS to be conducted withba 100' of wetland, you rust first notify the. B°arnstab e le,Conservation Division at least one (1) week prior to beginning. �Q AS EPTIC)PER C FO}2M.D OC DATE OF TEST: NOVEMB 16. SOIL TEST LOG SSOIL EVALUATOR: DAVID DEC OUGHDANOWR. R.S. WITNESSED BY: DAVID STANTON. HEALTH DEPT., PERC NUMBER: 12757 TEST PIT -1 NO PAARENOTUMAATERIAL:EPROGLACA LD OUTWASH j PERC AT 60 to - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 68.85 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING . 0-4 0 SANDY LOAM 10 YR 2/1 NONE FRIABLE 4-10 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE 66.35 10-30 B LOAMY SAND 10 YR 4/4 NONE FRIABLE { 30-136 C MEDIUM SAND 10 YR 5/4 NONE LOOSE I 57.35NO t TEST PIT 2 PAARENOTUMAATERIARL- PROGLACALD OUTWASH P 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL 'SOIL COLOR SOIL OTHER 69.20 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING i � 0-4 O SANDY LOAM 10 YR 2/2 NONE FRIABLE 4-12 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE 12-34 B LOAMY SAND 10 YR 5/4 NONE FRIABLE 66.37 57.70 34-138 C MEDIUM SAND 10 YR 6/4 NONE LOOSE ^DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in:) Other (USDA) (Muosell) Mottling (Structure,Stones,Boulders. Co i to c C/ Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (structure,Stones,Boulders. Consi ten I 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 pervious material exist in all areas observed throughout the area proposed for the soil absorption system? !( _5 If not, what is the depth of naturally occurring pervious material? Certification �0J "! I certify that on , (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 training, expertise/and experience described in 310 CMR 15,017, OFlyq Signature ��" Cam-- -SE Date Wou L7, 2 DAVID cy, D. COUGHANOINR QAS.BPT1C\P) RCFORM.DOC �O 110ENS O 04` EVALUP� t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION :. p Parcel 00 ' (J� Permit# Health Division _2 f pP f"L�y Date Issued Conservation Division A 11 00,Qft Fee Tax Collector SEPTIC SYSTEM MU ST BE Treasurer INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE Date Definitive Plan Approved by Planning Board TOWN REGU AND LA ODE Historic OKH Preservation/Hyannis Projecir Street Address Village _ 'rn Cc r S To a S r- Owner,�p, Address Telephone L-1 Permit Request CA(,A X Square feet: 1st floor: existing�56� proposed 2nd floor: existing proposed Total new Estimated Project Cost 33 000,—_Zoning District Flood Plain Groundwater Overlay Construction Type V1 DO Lot Size _X)000 !k Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 12( Two Family ❑ Multi-Family(#units) Age of Existing Structure r Historic House: ❑Yes Uallo On Old King's Highway: ❑Yes CA No Basement Type: UkFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) a 6V Number of Baths: Full: existing :;t, new 0 Half: existing /0 new C� Numb:;:of Bedrooms: existing_ new _D Total Room Count(not including baths): existing new�_ First Floor Room Count 3 Heat Type and Fuel: Lb,G`as ❑Oil ❑Electric ❑Other Centr=l Air: ❑Yes L4o Fireplaces: Existing New Existing wood/coal stove: ❑Yes Erl o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name fi�_v- �. P 1 d l ar Telephone Number Address '0. �C?,2�-3��-� License Pe r t_1 IIQo, _ Home Improvement Contractor# I 1 0 1u24,-.T f3 cA r r, SEQ114 Worker's Compensation# 3�o 11 W o\9- ALL CCNSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v� SIGNATURE DATE 4 Day" Awffm MAIN IRAN f 79RMI" P110P�AEii<D ' 4 Site G"T MA (i 2448 ANDERM EX r J 1 �� b. OF BARNSTABLE v LOCATION LOt I� L,�r �l� LAM SEWAGE # gZ,-Z9 VILLAGE Mel i 5 d yis tm vkl� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 7 J; 0 C ,S[d'O 7 I ' IOil SEPTIC TANK CAPACITY 1;d o6 y a 11o4S LEACHING FACILITY:(type) �.p,i1yL� P'• T (size) NO. OF BEDROOMS- '� PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER �A y I� Qj, DATE PERMIT ISSUED: I l Q -L DATE -C-( PLk-4C Y:ISSUED: VARIANCE GA, TED: rY s , . No :.. Ld 1 3 � 1 R ' o No.... FEB.... �y........... THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH earnstabb W=rucftn Q ------- 0F... _ ..----------..................... - 9,2 Appliratiou for BitipasFal Works TvuiiUUrt4flMrapt # Application is hereby made for a Permit to Construct (v�or Repair { ) an Individual Sewage Disposal System at: ... .t Lot ---............. ----•-------------------. --••-....---•--•---••--•-•---•------- •. Location:Address or No: ... Owner Address W Installer Address Q Type of Building Size Lot--- ......Sq. feet U Dwelling—No. of Bedrooms..._._-�............. ._...Expansion Attic ( ) Garbage Grinder ( ) ~ No. of persons............................ Showers — Cafeteria p., Other—Type of Building � . .................. p 1 ( ) ( ) a4 Other fixtures ................................. W Design Flow.............. .....................gallons per person per day. Total daily flow-------�>�� ._..........._..........._gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ xDisposal Trench—No..................... Width.................... Total Length.................... Total leaching area......:.............sq. ft. Seepage Pit No....1--------------- Diameter----L ......... Depth below inlet...... ?_.......... Total leaching area..._A-3.2_...sq. ft. Z Other Distribution box ( &�4 Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date--------............................... Test Pit No. 1.....y_.......minutes per inch Depth of Test Pit.................... Depth to ground water-___/ G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•••--••-•••--•----•-•-••-----------••---- -------------------•-•----•-•----•-............................................................................ ODescription of Soil---------------- a........ ------------------•-----...-------------------------------------------------------- U ::1 C---------- 4....&A ----------------•----•---------------------------------------------------------..._..-------- W ----------------------- ---•----------------•-••-•-------------------------------------•------------...----•-•----------•••-----••--•-----•---------•-••-----••--------•------------------•---•-•..--•-- UNature of Repairs or Alterations—Answer when applicable___________________________________________________________________________________•-----_--__. -•---------------------------------•------------------------------------------------.............-•---------••---------------------------------------------------------------------------------•-------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with TT�'Ia•• the provisions of .T t LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a-Certificate of Compliance h4bbeen ' 4bby bo rd of health.Signe ��.......... .... .• DateApplication Approved By----•---- ...........................:. Date Application Disapproved for the following reasons:.............................................................................................................. ....................................................--------------•---•---...-----•--...........---------.._......_........-•-----•---------------•------------------------------•------•---•-------•-•--. Date Permit No........•-`L `....I .....----••--•-----._ _ Issued--•------------------------ Date No....� .._... � FE$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF !HEALTH ,ram ApplirFation for DiopooFal Workii Toaaotration Prra it Application is hereby made for a Permit to Construct (IX or Repair ( } an Individual Sewage Disposal System at i Locaton.Address � or Lot No. ...........�� � 1 •s................................................................ .................................................................................................. {3~ Owner Address W Installer Address b f d Type of Building Size Lot.. .:... . ............Sq. feet U 'ZIDwelling—No. of Bedrooms....__ ________________................Expansion Attic ( ) Garbage Grinder ( ) `k Other—Type of Building !!A No. of persons............................ Showers P., YP g ----=-=---=-�------------• P ( ) — Cafeteria ( ) Q' Other fixtures .-----------•----••-------•--------------•••-- W Design Flow............. ......................gallons per person per day. Total daily flow.......I I-)..................._...•__gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.:...___.._._....... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No.j............... Diameter----L�%.......... Depth below inlet......'........... Total leaching area... .'.`_....sq. ft. Z Other Distribution box Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date.---••----••------•--•-• a •--••---------- ,tom ,.a Test Pit No. I......y--------Minutes per inch Depth of Test Pit.................... Depth to ground water--_ :.._._:_._.._.- Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil �= e..•....... ••-•--••••.•••� �`=------------------------•----•----------------•-----•--------•----------------._.........---•• V ................................................ y:.. W UNature 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'TTL. p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beers ued by he bo rd of health. Signed __.:: . '%'• --- 4 `�/`..... ._ �.----••... t fJ �✓ Date Application Approved By.......... �� .. �.. ---•- ................ = / f� f - ------ �.. ate Application Disapproved for the following reasons:.............................................................................................................. ----------------------------------------------------------------------------------------•---......------.._.....__....--•--------•----------------------------------------------------•-----•---••------- DatePermit No------- ,----+�-�----------------------•--- Issued........-------•-----------------•-•------ ��c ------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH x..._ Tntif iratr of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,--4 or Repaired ( ) ----------------------•—`f `'i...... •--- Installer at. ----•-........ ---•------------•--•--------•----•-------••----------------------- has been installed in accordance with the provisions o�TI T E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----------51�3 _----0\7........ dated-...--.......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � �I Inspector. -•---- DATE..... n� p`� 2-......-- ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No...�r�. ..�f••.. FEE.... •49,0 Ropmal Worhp Tonotrudion Vanfit Permission is hereby granted................. ......... .......................t `- to Construct (�l�/) or Repair ( ) an Individual Sewage Disposal System at No. . .. - s e a 4 r r = - r-- --------r:.­:__G_.•_r • -- -•-------•-----•-----••---•--- Screet as shown on the application for Disposal Works Construction Permit No..0t.:.;V__ D ted.......................................... 1 .----------------------------------- q, DATE..................... .�ll_:-1.1.--'-----------•------------------- Bo r f Health. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ��51 sJ yAATA ; ----- _ FAAAlLY 3 $EDVzOW : : !�0 6AI�ACsE 6eltJ�E>Z Io /� t vo ao SEYIIC TANS. 336 915167. 4,qG &Po :..... �\\ �, �� IS ,04� DlSPoSd L PIT - use lovo Ga t_/2�STouE 51DEW4 L. AWFA = 188 sF 1 1 20T OM Aaak TOTAL-Da- 16N = S4e G{Fp, TOTAL. DAl l�j �Uk! 33D TrP�aLATIDN QATE;.= l'�►(J ZMiN,o�.L�S Dw�t.[^ , _._.. In fro. 297733Olf lr.vo 7 Q i n�� 35 ff �,a 43, � t6 r._ P:7 790 -71 j.._ -19-91 TF —7rrR�7 LOPtN P v'e' tnty. 000 INV. _ -f-•z DKr tw. tug - GaL � � t o00 tNd: ►uv Bo�c �. ��� S�rlc � - GAL TtiN e- PT ..i SQub WM,I�Ep 1: - sToIJE ; = EL=G'L . _ �--- , .. i pNELOPED' 1 Ilo go SGAL�- FLAN t CQzT�I F�j 1tt:Tt{E tD_ i)LG VJIT T-►IJG= 5i10'�,� NErzEaN :<_o T�1 (_ 5(�Ii�JE o • - :_aitD. 15:- °�cT�'`l=oG,4'C'E'� . I't' I�I I-=t�-q z-- _ � G ��y�,� '�,d X�EiZ �• AYE INC, �..,. _WK . FLA0 IS- Nor T3A/© oN AA M11?WELJl- - c%.�t L_ ti E�JGt LI rE2; �UrLVe`j..- ArJD TNT oFFSeFs � o�La t,lU(' Z3E o5( 2vILLL titA�� , IPPt IC. ALL RIFE SPECIFIED ARE INVERT FL ATIONS ON PROFILE EXPRESSEDLINV DECIMAL FEET NOT FEET AND INCHES.TIONS _E VENT RAISE COVERS TO WITHIN PIPE TOP OF FOUNDATION 6 in OF FINAL GRADE EL_ _ 71.6210 +- r 69.50 � 1 /D—UO/� 5 INSPECTION /3" DROP �/� MAX PER TRENCH) g _FLOW LIN I I 65.46 1 'e'4 �Nu (�i 10 14 ` EXISTING -------------------------- L1 +�� BAFFLE 66.50 6 in -=___=== ___==_ STONL65j-- -- - - --- -- - -- BOTTOM OF EXISTING EXISTING 66.15 BASELEACHING SOIL ABSORPTION SYSTEM 1000 GALLON L64.91 EXISTING GALLERY 5.00 ft+ SEPTIC TANK 12 ft of 4 ft -SEE DETAIL ON REVERSE 6) 12.5 f L 42.9 ADJUSTED SEASONAL HIGH \ GROUNDWATER / \ h 0)Z. (j u -+Q A / \ Ti 0 (n O r \\\ m omzN a� r �vi = CD i rn y � m-Zi �p0 m / 0 I m0 0 _9 m 6� Z I rn z FTI 2 �' rTl > m 0 M02] 2: z mo 0 M E: TIE N , \ � CTrnoCD/N\ ul 0 zx / > � � n z cn m o cn� L tII (D O G� ro- o-c-9Z w =z ® � m ® \� �� 3` z i C czi�o m 0- f Tl 0 (00 � 0 G� � r m- I > `� tom-ir�rl N m N� �� �° 3 ��_DO CD Co uln O i 9�D�z � wm coMMO� m0 a ,lozz O z oc ,o Gao sv o= �Zmn z n N m > l U > -4 n < o rn m m z v a� o z -i O —I X ~X m z==c O O (1� O 9y�F w �,� o �c �l Rl �l �' m ��cz m rn a �� Z rn � .J o S���a � mnm mo y �� �m� s momo-i N 3 m O fT1 Sll� 3 r Q�p C n ti 5 yN G1 u) cn C Z z M n X O 3 m A o0o O I Z 5.Z O �y 0,�c N m (n O O cn ; c7 C '� f z y 0 0 cn o o m n y coM,y rn rn O y r Z r�n3mrnA T N O Rl -I 5 ON r �� y f �a�o� m 3 O z r .S �.`o^ n m o� a yn ® '� ZO o �o�p o 3 omz��> a '—' O C-) cr) m v y Zo �7O Z p �o Zo A r p F 'u O � a z = vD ~ off mZ o�� l� N N r (!) = m �a mm crnzn� O N �] O Y o xoc-<m p N 3 m z l off, u3s�aoa� ° m� N CO ❑ O O m 3 G� o °c mzo-Iz CO > Z O r A z > o o Z 3 0 ��--,�, DATE OF TEST: NOVEMBER 16. 2009 A I A I I S O I L T E S T L O G � L�tVALUATOR: DAVID D. COUGHANOWR. R.S. DESIGN C / \ L C L / \ T�T'C"�i" V S WITNESSED BY: DAVID STANTON. HEALTH_ DEPT. PERC NUMBER: 12757 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD NO SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS I TEST PIT PARENT UMATERIAL:EPROGLACIRALD OUTWASH USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL CONDITION. PERC AT 60 to - 2 MIN/INCH IN C SOILS IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING SOIL ABSORBTION SYSTEM: INSTALL 10 ADS HIGH CAPACITY BIODIFFUSERS (160OBD) 68.B5 10 UNITS x 6.25 Ft / UNIT = 62.50 L.F. 0-4 O SANDY LOAM 10 YR 2/1 NONE FRIABLE 62.50 L.F. x 7.90 S.F./L.F = 493.75 S.F. 4-10 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE 493.75 S.F x .74 G.P.D. / S.F. = 365.3 GPD 10-30 B LOAMY SAND 10 YR 4/4 NONE FRIABLE USE 10 HIGH CAPACITY BIODIFFUSERS AS CONFIGURED BELOW 66.35 - Vt = 365.3 GPD > 330 GPD REDUIRED 30-136 C MEDIUM SAND 10 YR 5/4 NONE LOOSE REFER TO DEP APPROVAL LETTER TRANSMITTAL # W000052 FOR CERTIFICATION 57.35 OF ADANCED DRAINAGE SYSTEMS BIODIFFUSER SYSTEMS. NO TEST PIT PAARENOTU MATERIAL:EPROGLACIRALD OUTWASH 2 MIN/INCH IN C SOILS ELEVATION LEA CHING GA L L ER Y No To 1000 GALLON SEPTIC TANK DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SCALE DIMENSIONS AND DETAIL NOT TO 69.20 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING CONSTRUCTION DETAIL USE EXISTING H-10 L"T SCALE 0-4 O SANDY LOAM 10 YR 2/2 NONE FRIABLE USE ADS HIGH CAPACITY BIODIFFUSERS (#1600BD). GRAVELLESS INSTALLATION - USE DEP APPROVED INSTALLATION PROCEDURES. SEPTIC TANK IS TO BE PUMPED DRY 4-12 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE AT TIME OF INSTALLATION AND IS TO BE EXAMINED FOR STRUCTURAL 12-34 B LOAMY SAND 10 YR 5/4 NONE FRIABLEINTEGRITY INSTALL NEW PVC31.25 f t TEE EQUIPPED WITH A GAS BAFFLE UTLET 66.3 34-13B C MEDIUM SAND 10 YR 6/4 NONE LOOSE k 1 In 57.70 _J N TAPER co GROUNDWATER ADJUSTMENT � , 0 CD 0 ao O �1 EXISTING GROUNDWATER LEVEL m �+ BASED ON TOWN OF BARNSTABLE ro Lo GIS DEPARTMENT RECORDS. 31.25 f tINDICATED N INDEX'-WELL W ; SD.W-253 6 �t'6 In A ��, ZONE C CROSS SECTION VIEW ?.',• READING DATE OCT." 2009 INLET ourLEr READING 49.5 COVER COVER ADJUSTMENT 4.9 USE H-20 ADJUSTED GW" 42.9 4 In O —► "OK' °FLOW LINE 16 11.3 RA TED UNITS FROM 10 = I4 To 1n BUILDING In EFFECTIVE in D�x DEPTH 4I3 ^ .' LIOLQD GAS w LEVEL BAFFLE NO T - 34 In 12.83 FL) 68 In 15.66 FL) I 34 In 12.83 f tI I CROSS SECTION VIEW 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 21 FORTIC TANK STRUCTURAOLB INTEGRITY.DDRY AT INSTALL TIME PVCOOUTLET SYSTEM TEEREPAIR EDNWITH GAS BAFFLE.CHECKED DISTRIBUTION BOX 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS DIMENSIONS AND DETAIL USE SHOREY D8-3 H-10 OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED OR REMOVED. NorCALEE MIN I2 in S 6) SEPARATION OF INLET AND OUTLET TEES SHALL EXCEED LIOUID DEPTH. —' —� -TO SERVE EXISTING DWELLING FROM ­ Z) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES O c TANK < < TO AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. O `° sAs JAMES AND DEBORAH HANF 8) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT 44 LIBERTY LANE MARSTONS MILLS. MAs ,,, sroNEeASE PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. � i� ECO-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL 155 in 1�' CROSS SECTION VIEW STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-32671 NOVEMBER 17. 20091 1212