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HomeMy WebLinkAbout0930 RIVER ROAD - Health 930 RIVER ROAD, MARSTONS MILLS `A=045-014 J I�� TO OF BARNS T ABLE .:.� LOCATION D 17 SEWAGE # 8- 5- 9 y VILLAGE tj rJ 'ASSESSOR'S MAP& LOTp tS i- INSTALLER'S NAME&PHONE NO D SEPTIC TANK CAPACITY I O Qu t LEACHING FACILr Y: (type) a. Z2n:::9� (size) NO.OF BEDROOMS BUIl.DE OR OWNER-5-D C 0 h S 1J,Lcbwl f PERMIT DATE: Q!( O J a, ? COMPLIANCE DATE: l i 0 6 - 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(1f any wetlands exist within 300 feet of leaching facility) Feet Furnished by <. Q r eL g p Bf - Zo b2 = �� 2 =4-4 _ 37 a �3 - 14-4 = 5( . jo CD ® . TOWN OF BARNSTABLE �j Y� LOCATION Lr�a SEWAGE # VILLAGE- rS M,c L ASSESSOR'S MAP & LOT ®�f INSTALLER'S NAME&PHONE NO. Q.T. IR C u.I.Q.c ro v ok SEPTIC TANK CAPACITY 15,00 LEACHING FACILITY: (type) Roo ��SLk±na: (size) lnno GcAl Sant NO.OF BEDROOMS y S. BUILDER OR OWNER — ® LUr S1 c�� �t � PERMTTDATE: — (�q COMPLIANCE DATE: J/ 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 4- 4 f TOWN OF BARNSTABLE r Tom.--� R�� SEWAGE # LOCATION / —�� J VILLAGE f^'-'. ; Z .�. ASSESSOR'S MAP & LOT 6 '�''�T �r INSTALLER'S NAME&PHONE NO. *?� „ !`•'s'� j " SEPTIC TANK CAPACITY =` s O0 LEACHING FACILITY: (type) qO i-�6L�;na (size) 10ns,% NO.OF BEDROOMS s BUILDER OR OWNER PERMTTDATE: `f — T 7 ? COMPLIANCE DATE: A 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 j on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist i within 300 feet of leaching facility) Feet Furnished by CFA �. .� =A'V f No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH / OF hW/VID�n-�'` APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (./Repair ( ) Upgrade ( ) Abandon ( ) Wcomplete System ❑Individual Components G 1aA---C+A7-M 0 U��uign Owner's Name Map/Par cl# Address Lot# Telepho e# aller's e � Designer's Nam 61 Address Address I Telephone# Telephone# Type of Building: Lot Size 1&0 Sq.feet Dwelling—No.of Bedrooms 3 Garbage Grinder ( ) Other—Type of Building No.of persons L- Showers ( ), Cafeteria ( ) Other fixtures Design Flow( in re uired) �� gpd Calculated design flow-3 G gpd Design flow provided_gpd Plan-.Date 1 Number of sheets Revision D to Title- i (.)/l b .�`n' ' 4A4ttyri Descripti n of Soil(s)h1,_ '1 L00im t ��. '�( r.S�+-n�t Z�-�'-�.3 �' V — �y Soil Evaluator Form No. Name of Soil Evaluator • arc 4,_A cA.(,_, Date of Evaluation Ll DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and fu er agrees not�p)placefi7 system in operation until a Certificate of Compliance has been isss —1 �® vsued by the Board of ealth. Signed Date '7l P 1; Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM S/96 No. 9�50 THE COMMONWEALTH OF MASSACHUSETTS FEE t _._ BOARDI OF HEALTH . 'f 1 OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (/Repair ( ) Upgrade ( ) Abandon ( ) - /complete System ❑Individual Components Locati n Owner's Name a 4< nit o Map/Par °I# Address &JATelepho e# alter's e Designer's Nam Address Address Telephone# Telephone.# Type of Building: Lot Size 1&0 Sq.feet 1. ""Dwelling—No.of Bedrooms Garbage Grinder ( ) j Other—Type of Building No.of persons Le Showers-( ), Cafeteria ( ) Other fixtures Design Flow( in re wired) gpd Calculated design flow33 C> gpd Design flow provided '1 . gpd Plan:nDate Number of sheets Revision D to Tit1eJ b �n 1 Descripti n of Soil(s) ''_ " Z =1 � iced Soil Evaluator Form No. - Name of Soil Eval tor' Date of Evaluation It P 9dO3 DESCRIPTION OF REPAIRS OR ALTERATIONS r " { w The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fu er agrees not laceLJ system in operation unfit a Certificate of.4 mpliance has been issued by the Board of Liealth. Signed Date ,f / � Inspections FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. V-- 9,yI THE COMMONWEALTH OF MASSACHUSETTS FEE Ilan �x BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date f The issuance of this certificate shall not be construed as a guarantee at the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 i No.� I-1 THE COMMONWEALTH OF MASSACHUSETTS FEE _ BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) -Upgrade ( ) Abandon ( ) an individual sewage disposal system at as described r� in the application for Disposal System Construction Permit No. 9�l'.5� t/ dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARREN TM PUBLISHERS- BOSTON �-t Town of Barnstable 3 Department of Health,Safety,and Environmental Services t"E," Public Health Division Date 367 Main Street,Hyannis MA 02601 BARNSTABMMASS ` (y AtEDMId�`� Date Scheduled ,� Gq Time 1100 Fee Pd. (� Soil Suitability Assessment for Sewage Disposal Performed By. itnessed By: C LOCATION & GENERAL INFORMATION Location Address Owner's Name�� / o L, Address �f C 1 Assessor's Map/Parcel: wia/p 45 px/Lz� 14 -Engineer's Name ca fo W Ut NEW CONSTRUCTION ✓ REPAIR Telephone# Land Use ly o a j e of Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) l w cam / Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FORMASONAL NIGH WATEit'I ULE Metiud used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION;TEST: Dale�/i Time Observation _04/ Hole# Time at 9" Depth of Perc //8 Time at 6" Start Pre-soak Time @ // 2 o Time(9"-6") End Pre-soak e3 Rate Min./Inch L Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Iq Original: Public health Division Observation Hole Data To Be Completed on Back-� Copy: Applicant DEEP OBSERVATION HOLE LOG Hole Depth 11rom Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistencv.° o _ �� `r G/G o/ d ,P.2-el— 3 Z s�K �D �r•cr/r✓)4r DEEP OBSERVATION HOLE LOG Hole# L- Depth from I Soil Horizon Soil Texture Soil Color Soil I Other Surface(in.) (USDA) (Munsell). Mottling (Structure,Stones,Boulderes. Consistency.%Gravel 41F- /I-c� ✓HLl4J/v' DEEP OBSERVATION HOLE LOG Hole# Dcpth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°° ravel DEEP OBSERVATION HOLE LOG Hole # Depth from Soil I lorizon Soil'texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.% 'ravel i I Flood Insurance Rate Mao: / Within 500 year boundary No r Yes Within 100 year flood boundary No Yes n�� ^:Y➢ © i^iTid[ip➢��: v�r cur ding Per vile -S Tat-ter;$I Does at least four feet of,naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Y{ f If not, what is the depth of naturally occur:ing pervious material? Certification I certify that on (date) 1 have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date S YS TEM P OFIL-E NOT TO' SCALE TOP FNON FINISH GRADE. FINISH GRADE OVER EL . s " FINISH GRADE 7�. r FINISH GRADE OVER DIST. BOX �'2• OVER TRENCHES SEPTIC TANK ;.off O;ao00 � s °� 12" MAX. 7/7/7 ZV777M c o'4p. a:...o;:;�fy: ;cQ•:ac.Dh;o•:,p•o�dp• :o• oo.Ydao�•.p,•. � .e'1•c.•.r :D TOTAL LENGTH OF TRENCH 2$ o.'o'•P. OUTLET PIPE LEVEL 3 FOR 2 FT. MIN. QO:OQ p e ® Ole •'•w: :. D:' :d• b o . eq• bb; oO 3r :•:nd o OW d C. I. OR PVC TEESIf tEL CAP END .� o b p p• e• o :i o a ;: 1500 GA L L ON D D.TS TPI U TION BOX BSMT FL ---- EL . G 7- s :e ': �° INSTALL ON LEVEL BASE "500 GALLON DR YNEL L S " ° PRECAST CONCRETE •opa i :e• ' :.a�a.p:e►•i'p••,: e� H— 0 REINFORCED D' o• a4. v � e iq:a b.o .o' d'. e::o n Q r"' dp:o .,• o .r., .•o•v • .p•n•. .o'o .D..a..s. .A Pr•.bh, '•4•Y .p•4: SEPTIC TANK TRENCH SECTION r . INSTALL ON LEVEL BASE NO TE' EXCA VA TE TO EL EV V. /''/'-� OR LOWER TO REMOVE_ ALL IMPERVIOUS MA TERIA L BENEATH THE LEACHING AREA 4~ DIAM. 12" MIN. REPLACE EXCA VA TED MATERIAL WITH 3" OF 1/8"-1/2" CLEAN, CLAY FREE SAND . b •:n. J✓ASHED PEASTONE 3/4" - 1-1/2" WASHED 6 "� •: �� CRUSHED S TONE GENERAL NOTES r-r TRENCH WID TH - ,66'12'05"E 1 . ALL EL EVA TION.S SHOWN ARE BASED ON ASSUMED NUMBER OF TRENCHES 1 �-- i 70 -2. $ :.,ALL,-.,,,PIPES 'IN: THE ;SYSTEM it!US,T- BE -CA5.3 �'RC;� NUMBER Oi" DRY YNELLS 2 OR SCHEDULE 40``P vc. 3. THE BOARD OF HEAL TH MUST BE NOTIFIED OBSER VA TION PIT .WHEN CONSTRUCTION IS COMPLETE PRIOR PERGOLA TION RA TE.' 4. ANY CHANGES.<IN THIS PLAN MUST BE <2 MIN./IN. TO BACKFILLING APPROVED BY THE BOARD OF HEALTH AND CAPE 6 ISLANDS WI TNESSED B Y.• -'' SURVEYING CO. INC. GERRY DUNNING 5. MA TEP,IAL S AND INS TA L A TION SHAL L BE IN BARNS. BRD. OF HEAL TH DESIGN DA TA COMPL IANCE WI TH THE STA TE SA NI TAR P j CODE - TITLE V'` - AND LOCAL APPLICABLE DA TE: AUG. 21, 1998 a: RULES AND REGULATIONS / r s ti b� � ` �- 3 _ — r7Z•r,) NUMBER OF BEDROOMS / moo' 3 L77.S cd o 6. NORTH APRON IS FROM RECORD PLANS AND y" �!- a ,, _ GARBAGE DISPOSAL NO IS NOT TO BE USED FOP SOLAR PURPOSES M a ,y, I N a 7. .FL DOD HAZARD ZONE NON-HAZARD aY sa H d Y 2 S/� 330 GAL . 3 DA IL Y FL Ohl ti o / ti 8. WA TER SUPPL Y TOWN WA TER a� c z� 1500 GAL . SEPTIC TANK PEG D. Z I `' SEPTIC TANK PROVIDED 1500 GAL . � I o LEACHING RE®UIRED 330 GPD. •I I � o r r ; ti 1 ° Y SIDEWALL AREA = 152 S. F. P 152S. F.X 0. �4G/S.F. = 112 GPO. I �� � BOTTOM AREA = 322 S. F. c 1 LEGEND 329 S. F.X 0 G/S. F. = 243 GPD 1.5-2 " LEACHING PROVIDED = 355 GPD o PP: OSED EL EVA TION C�/ � CG�, �� A-125.00 R-603,e4 —— —- E TING CONTOUR S INGL E FA MIL Y RESIDENCE b' �,Y a �3-+�--- 4- `'` — OB �RVA TION PIT ;� ay s Q DI,�TPIBUTION BOX AAA` RI vER ROAD t a PROPOSED SE NA GE DISPOSAL SYSTEM en�_.._..F'I r/C fl /',w9,✓ ` v4 U SE�TRAND PREPARED FOR 288b4 SE,;7'7-I TANK ` �i`t,� I�•TCQ'�' �Fa��.[r' - 5-1.1 a../V NS TRUV TI®N A, ° HOUSE NO. 930 PI VEP ROA D RE, ` 'RVE AREA ,t, OF BARNS TA EL E — MA PS TONS MIL L S 9, P IN EL EVA TIDN CH avaD . SAMCKI DA TE: -5 CAPE <6 ISLANDS ENGINEERING PLOT PLAN �* 1 V SCALEAS NOTED 133 FA L MOU TH ROAD SUITE 2EC SCALE• 1 � MA SH,AEE, MASS. s9 � - PLAN NO. za q Q f g� '_ ` xA SEC PCL LOT HSE_, ` ` - - ''. Ili -. .....•; ,.....•« .,.. .. ...:... .. s SYST EM PROFIf NOT TO'!SCALE TOP FNDN. FINISH GRADE .EL . 7s• C' FINISH GRADE 7-?- s' FINISH GRADE OVER FINISH GRADE OVER O VER TRENCHES •q•`io SEPTIC TANK 7-3./ - DIET. BOX .;.a. erMylZA 12" MAX. 4 :Q p T o'..o:b• °e�f.a fin:... �y• ;oe':4oa4'::aO�we :ao-on.ydao�.,�. . :a c:o . d TOTAL LENGTH OF TRENCH 2 s v o.'o'•P, e 3„ OUTLET PIPE LEVEL FOR 2 FT. MIN. •--� " ,�1 o: G 9.95 s'; x o0 ;e p' 9y CAP END C. I. OR PVC TEES b G 9 5"d %�'� �9 `" 66,90 $ ® ® ® ® ; 0 0 �E A o 1500 GALLON � S TR. BUT.TON BOX BSMT FL . °' a o'o ;f n. EL . "500 GALLON DR YWEL L S " ,,co o• INSTALL ON LEVEL BASE PRECAST CONCRETE 76 H—1 0 REINFORCED o ` � �•�1?:gi7.d:0'.0' d'n•'D: O �.A•;d.QY. Vp:D'D. e•.•e• - •°' • : •.•o.v` .o•e� .o o 'a•:D..e:a• •�.O Pr :ob�'o .•V.Y.O,i�7+4. TRENCH SECTION SEPTIC TANK INSTALL ON LEVEL BASE NO TE. EXCA VA TE TO EL EV V. OR L OWER TO REMO VE AL L IMPER VIDUS MA TERIA L BENEA TH THE L EA CHING AREA 4" DIAM. 12" MIN. REPL A CE EXCA VA TED MA TERIAL WI TH 3" OF 1/B"-1/2" CLEAN, CLAY FREE SANG •a°ta}o e„ :.; .•b....p,. •o::o HASHED PEAS TONE 3140 - 1-1/2" WASHED CRUSHED STONE °o� 0 � c 9 �v N l 7 z GENERA r NO TES TRENCH WID TH ~, i 1 ALL EL EVA TIONS SHOWN ARE BASED ON ASSUMED NUMBER OF I, S-66.12 05°E TRENCHES 1 125.00 ?p 2. `:4LL '`PIP` 5 � /1/, sy--E'TL'°M.-MUST BE CAST Tt70N NUMBER OF DRYWELLS 2 oR scHEDUL E 40 n VC. OBSER VA TION PIT 3. THE BOARD OF HEA L TH MUS T BE NO TIFIED P-9203 WHEN CONSTRUCTION IS COMPLETE PRIOR le"o �,-I,,"w �✓ ��,s TO BA CKFIL L ING --- ------ --------__ ---- ---- --- • PERCOLATION RA TE.' -- - - ` _�./ � ��o s'G 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED <2 MIN./IN. BY THE BOARD OF=.HEAL TH AND CAPE ig ISLANDS WI TNESSED B Y.* ( SURVEYING CO.. -INC. . GERRY DUNNING ' 5. MATERIALS AND INSTALLATION SHALL BE IN BARNS. COMPL IANCE WI TH THE STA TE SA NI TARY BRD. OF HEALTH DESIGN DA .TA DA TE. AUG. 11, 1998 1 CODE - TITLE V - AND LOCAL APPLICABLE - - - - =��''L RULES AND REGULA TIONS z- NUMBER OF BEDf�00MS '3 W �o S6• 3 Tcs .L/o�cs 6. NORTH APRON IS FROM RECORD PLANS AND c7�.s a �� ��� -� C7 IS NOT TO BE USED FOR SOLAR PURPOSES -- __. .__.._-_ y GA RBA GE DISPOSAL NO " i r• : 7. •FL OOD HAZARD ZONE- NON-HAZARD Q a y sa H r ,o y,� /� 330 GAL . DAILY FL OIV SEPTIC TANK PEG 'D. 1500 GAL . N ti 3 - 1 ~ a, B. WA TER SUPPLY TOWN WA TER 2y" — zy'' a I SEPTIC TANK PRO VIDEO 1500 GAL . i 330 GPD. LEACHING REQUIRED vI o m M �cl ;u ,•r .SG r ' o y R 619 SIDEWALL AREA = -452 S.F. 15,2S. F.X 0. 74G/S. F. = 112 GPO. �- BOTTOM AREA = 329 S. F. L EGEND 329 S. F.X 0. 74 G/S. F. = 243 GPD LEACHING PROVIDED = 355 GPD o ' PROPOSED EL EVA TION A-125.100 R-603.e4 �� ——7 Z —— EXIS TING CONTOUR —' --- �— oGER VA TION PIT SINGLE FA MIL Y RESIDENCE C e� ray` 0 DISTRIBUTION BOX RI VER ROAD �h OF 9 � PROPOSED SEA GE DISPOSAL SYSTEM S3 BERTRAND PREPARED FOR ff 29856 Aw o o SF, Trc TANK 5—D CONSTRUCTION HOUSE NO. 930 RIVER ROAD RESERVE AREA BARNS TABLE — MAPS TONS MILL S of ' DAVID 9. PIPE INVERT EL EVA TION M� �HARLES C DA TE.' .sue SANICKI CAPE 6 ISLANDS ENGINEERING PLOT PLAN SCALE AS NOTED 133 FALMOUTH POAD — SUITE 2E SCALE., 1 . 3ca , �; - �� 9��0 ci�_sr ° s 9 MeP SEC PCL LOT HSE EL:A:N NO. sQ 9 i.9& MA SHPEE, MASS. oATAPRINT 60505$ --,- — - - -- - - - -- -- -- - --