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HomeMy WebLinkAbout0029 CHURCH STREET - Health "• 29 church St �- 130-016 r+ West Barnstable 7 Town of Barnstable a�WE Regulatory Services Thomas F. Geiler,Director BABNBTABLE ' Public Health Division 1 39. A � Thomas McKean Director FO Mp'l 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 01/13/0 9 Sewage Permit#Q8-So I Assessor's Map/Parcel 13 0/016 r Installer&Designer Certification Form , Designer: BSC GROUP, INC. Installer: FRiC Address: 349 Main Street, Route 28 Address: ?eA (ilox -71 W. Yarmouth, MA 02673 MY�Rsrv�u h��t�.� Inner On I Z 2 I o G S 17EQC)a.S was issued a permit to install a ( at ) (installer) septic system at 29 Church Street, W. Barnstable based on a design drawn by (address) BSC GROUP, INC. dated 11/21/08 (designer) X 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 the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. 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. Stripout (if required) was inspected and the soils were found satisfactory. Installers Signature) L A 9 No.46208 a 90� �GtSTS V. _t�� I 1°ch. G� esigner's Si a e) (Affix Dessignef p 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. gAoffice formsWesignercertification form.doc TOWN OF BARNSTABLE LOCATION C�O V C n SEWAGE# VIL .AGE W, Z4hb\a.� e ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. E-W(G %Mgf-g C ) ! SEPTIC TANK CAPACITY (OW Gval LEACHING FACILITY: size 1 (type) C -h Sc)o5� ( ) 3 �C NO.OF BEDROOMS OWNERW►e S Ccrhrc�� PERMIT DATE: Z 2 rQ 8j 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 facility) Feet FURNISHED BY tack m 7S r p j � � e No. � ��0 � a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V�I�vPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Th5ponl i�p!tem Con0tructcou permit Application for a Permit to Construct(Y� Repair( ) Upgrade( ) Abandon( ) ❑.Complete System ©Individual Components Location Address or Lot No. 29 Church Street Owner's Name,Address,and Tel.No. OrBarnstable, MA James Conroy 508-237-4846 Assessor's Map/Parcel Map 130 Parcel 16 29 Church St. , Barnstable, MA Installer's Name,Address,an6Tel.No. Designer's Name,Address and Tel.No. 5 0 8—7 7 8—8 919 BSC Group, Inc. , 349 Main St, W.Ya mouth Type of Building: Dwelling No.of Bedrooms 3 Lot Size 60, 114 sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) l Other Fixtures Design Flow(min.required) 3 3 0 gpd Design flow provided 348 gpd Plan Date 11/14/0 8 Number of sheets 1 Revision Date Title Design for sewage disposal system repair Size of_SepticTank Existing 1500 Type of S.A.S. Concrete leaching chambers Description of Soil See Plan Nature of Repairs or Alterations(Answer when applicable) None Y'i% f 9!!! 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 Environmen I Code and not to place the system in operation until a Certificate of Compliance has been issued by th' th. Signed CEPc vvav Al Date 12" 17— Application Approved by Date �.Z — —O Application Disapproved by: 6 Date for the following reasons Permit No. ®' Date Issued t No. _� 1S �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t/ PUBLIC HEALTH DIVISIOON - TOWN OF BARNSTAB'LE, MASSACHUSETTS �es 1Y)l . ' Applicattonjor �Ngpogal 6pgtem CCon5truction Permit Application for a Permit to Construct(K) Rej air( ) Upgrade( ) Abandon( ) ❑.Complete System]O Individual Components Location Address or Lot No. 2 9 Church Street Owner's Name,Address,and Tel.No. WC;fBarnstable, MA James Conroy 508-237-4846 Assessor'sMap/Parcel Mal) 130 Parcel 16 29 Church St. , Barnstable, MA Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.5 0 8—77 8—8 919 �iC BSC Group, Inc. , 349 Main St, W.Ya::mouth Type of Building:. Dwelling No.of Bedrooms 3 Lot Size 0,11A sq. ft. Garbage Grinder ( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z q Q gpd Design flow provided 'A d R gpd Plan Date 11/14/0 8 Number of sheets 1 Revision Date :Title Design for sewage,disposal syttem repair - Sizeof,SepticTank Fv ing 1g; n Type of S.A.S.C^nnnrat-a laa(-hinff r•hamhPrc c . . ' Description'of Soil a f- See Pla& t. M -- = Nature of Repairs or Alterations(Answer when applicable) ATnna gr /1 7tfgA1./�' Date last inspected: - Agreement- , f The undersigned agrees to ensure,the construction and maintenance of the afore described on-site sewage disposal system in accordance with the prbvisions 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.Healt. tI - Signed / - t .�� � CEgIC ST�y2 Date 1 ^ 12 R Application Approved by / . _�,�Y K �1 �7 w� �C _ Date Application Disapproved by: V \ 'Date for the following reasons 9 - D Permit No. ��� .b. Date Issued 'gn.—:.- --- ?�.:...: -- i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( r�)`r Upgraded ( ) Abandoned( )by y�� t�. ,_l at I (2 ld)o �?V�/�ltil71!/n�ha been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 06 9 S r)f dated Id" ,2 b Installer / Designer #bedrooms �) Approved design flow gpd s The issuance of thi �plermit shall not be construed as a guarantee that the system wild function as�desigried. 1O ~gyp n /j//► �� Date //�,I/Y7 Inspector /,Al/>r�/il- �%! , �! •l f/Ai.'1./A F�.1 �i..�v ii4+Y�a-vfeF.tiV!RHI'4..A'9 RY8P109�44'R Q'%S29 P-Cd 44RL SP��?.�:!4 i?�bm --- - - •L- -l— - - _.�rJs��aFzi+�.i�+ase�as3m' ne±s%f^stv`rc`si>s mQE.a�a�esarr`4�53;s�.s.»izss.�Qp�iiasn_a` �a.r�+,'t�- No. Fee , THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Bigogarf�&pgtem CC0115truction permit ' Permission is hereby granted to Construct ( ) Repair ( �). -'Upgrade ( ) Abandon ( ) System located at ""7 c, tL f / /� /�- J and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. C / � 10) Date / >- � �� Approved by /t TO ALL NEW BUSINESS OWNERS DATE: -0 Fill in please: APPLICANT'S � � YOUR NAME: 1, � t BUS ES50 S YOUR HOME ADDRESS: S" 1k - &WU �1 l�- h r r TELEPHONE "i Telephone Number HomPh e dA „ , NAl1AP OF NEW BUSIIV_ESS .. TYPE OF E0. INESS.��.. .1� �' IS.:THIS..A:.:. O C?CGUP1�TI. N� "YES Hvyau peen gtyn approrrt firm Iujlld�irw IQ "� O AtSS::dP13SIN�I :.: , u 1V1 ►P1IC L NUM .. ::. ;. When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you.may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) and you will find the following offices: 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signatures"* COMMENTS: 2. BOARD OF HEALTH This individual has.b en info med f the permit requirements that pertain to this type of business. thorized gignature** COMMENTS: owfne� fzct- gio 6laz Mg--(rc 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual een i, med of . t)n/sg requirements that pertain to this type of business. Authoriz d Signature" / COMMENTS: � ✓"� ' — i C LLrA. f lC ing T�O7'L Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. t " Hazardous.Materials Inventory Sheet Checklist .� Date Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts-(le.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) Al�� Storage Information-location of storage,how long Is storage for? If none,note that. ' Disposal Information-where and who?If none,note that. Applicant Signature-understand what is listed and noted ;/ Staff Initial-any questions,know who to ask ZVehicle Washing/Rinsing? -provide a vehicle washing policy and /explain it-note that it was given I/ Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them." k F • - � / � TOWN OF BARNSTABLE Date: /D 6 TOXIC AND HA�(ZARDONOACL4(MATE IALS ON-SITE INVENTORY ^ NAME OF BUSINESS: ` `' 14,os r0 /,� BUSINESS LOCATION: V r C.h 2S s Q r'1-INVENTORY MAILING ADDRESS: C ��� 6,vu � TAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: ro EMERGENCY CONTACTTELEPHON NUMBER: 5db`a37'�8y� '�Q1'l'1�S MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDA IONS: Fire District: u�I (3ar'r1S Waste Transportation: Last shipment of hazardous.waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor & furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers IiijVU n� 2n d® t —7 0���, (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT!CANARY COPY-BUSINESS - TOWN OF BARNSTABLE LOCATION�Z f ��`ifz �/ J SEWAGE # `7 O VILLAGE� e L70 7-19, el ASSESSOR'S MAP & LOT 3D-6 INSTALLER'S NAME & PHONE NO.A cj/ SEPTIC TANK CAPACITY 1,r, oD LEACHING FACILITY:(type)L'x ,s r /3 1ocfr 4,o (size) NO. OF BEDROOMS3 PRIVATE WELL , R I,IC WA BUILDER OR OWNER Z/S-4�✓ DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �/ W X1 �O (tI � t \ UU v '�J� \� o '�- r J"vi�� �1)v/L�ri �i ASSESSORS MAP NO: No... ... .�?.� PARCEL NO: FES.... ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,� lir #iun for Uiiivuual Workii Tonti#rur#iun ami# Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: G vr�e.l S'� (M ................................... Ifocation.Address or Lot No. -- -•-------------------•------- ............ Owner Address i/ .R/�P.P..................................................... ..•----------------.........................Address...------..._....................._.._..... Installer QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms_..3..................................Expansion Attic ( ) Garbage Grinder ( ) PL4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q+ Other fixtures ................................. Design Flow...........................................gallons per person per day. Total daily flow............................................gallons. w - ro 00 W Septic Tank—Liqutd capac>ty._...__._._.gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------------------•------------------...------------........---------_.............................................................. 0 Description of Soil....................................................................................................................................... •------------•----•------------- U ----------------------------------------------------•---••------•---------•--••----------•-•--------.......---------------------------------------------.......-----•------------•--------------....... W ------------------------------------------------------------------------------------------------------------------------------------------- -------------;................. •------------------- _ UNature of Repairs or Alterations—Answer when applicable____ ° ?.� ____ �"l_��._73!✓�'r_______ _________ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions QitlIT1: 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 lth. Signe' � ...... ...... Date 1 Application Approved By.............. ��-r""'— -•--•--•-------------------------------- Date Application Disapproved for the following reasons:---•----------------------------•---•-------•------------------------------------------------------........-•-- ....-•--------•--•---------•----------------------••-----------------...--•------......---•--------•------------------------------------------------------------------------------------------•------- Date PermitNo......... ................... Issued------------------nau---------------.....---....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Bi4pntial Works Tnnitrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: a. ..G/ /....5' ... ..........�........!'���- -� .................................... 1 Location-Address or Lot No. G!/A...i s. .......---••--•-•................................ ...............................•.................................................................. Owner Address Installer Address Type of Building - Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......3 3.................................. Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------------------------- - W Design Flow...........................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity! 00gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-----------.____._-_,__. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .........................-.......................................................................... ......................................................... 0 Description of Soil.........................................................................................................................-.............................................. x V --------------------------- •------- ._......... ----------- •--------------------------------- --------------------------------------------------------------------------- --------•-----.---------- W ---- ------------------------------------- -...... UNature of Repairs or Alterations—Answer when applicable__.��?_a_a_ h'_..._.S`.�'r.%c..:. ,✓. ...................... `.. G t'... ....T.Cyr. .....� --•--------------------------•------ -------------------------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITiE 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. •-------•- S�s7 Date Application Approved By............. .1 _. --•s�-- --- -----------------------•------ L Date Application Disapproved for the following reasons--------------------------•--------------------•-----------------------------------------------------------•---•- Date Permit No........ ..7. - . Date THE COMMONWEALTH OF MASSACHUSETTS ..- BOARD OF HEALTH �rrtifirtttr laf f�unt�rli�nr�e THIS IS TO CE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by--------------------------//_ E /---------...----------------------------•-------------------------------------...................------------------------............--..... <, Installer has been installed in accordance with the provisions of TITLF. 5.of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..__.�-J....___3__0..�j... da.ted_............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ` �' DATE........................ ..'.1...�....-:.�...............--------....... Inspector......... ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD - F HEALTH ..... .✓.....................OF.............r. ✓-..✓....r..... FEE........................ Disposal Vorkg Tnnotrnrtilan rrmit Permissionis hereby granted........:! ...................................................................................................................... to Construct ( ) or Repair (�an Individual Sewage Disposal System at No. c .. 5.. T Street as shown on the application for Disposal Works Construction Permit No.-<a-7k3.. Dated.......................................... ------•-•-----. --.---- Board of Health DATE_ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Town of Barnstable P# Department of Regulatory Services tu►snernsrs, Public Health Division Date et,►es ASS 200 Main Street,Hyannis MA 02601 s� 'alFO MA't A L 1 ITDate Scheduled j Time Fee Pd. 9-- .0 Soil Suitability Assessment for Sewage Disposal Performed By: J .S C 6�Q 0 V p Witnessed By: / "—/-r r��YO O I LOCATION& GENERAL INFORMATION Location AddressO S Owner's Name—r„ r-Q, Address Assessor's Map/Parcel: �,�O/O i(p Engineer's ame 3 Q, u ra CSC, �' f;Iv,C.. W NEW CONSTRUCTION REPAIR Telephone 9, �i* '7 7 Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well 110 3 I ft t Drainage Way ft Property Line d ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) zo rri �v (ZI w Co 4 > . w 4"' r Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Az a&k Weeping from Pit Face Estimated Seasonal High Groundwater S�G r J" li �✓ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: _ Depth Observed standing in obs.hole: //0 _in. Depth to soil mottles: �/ in. Depth to weeping from side of obs.hole: >1/ tY in. Oroundwater Adjustmen ��C tt. Index Well# Reading Date: Index Well level. Adl,factor,,,,,.,,� Adj.Groundwnter Level T PERCOLATION TESL' Date 08Time.� Observation Hole# T� Time at 9" : 4 a Depth of Perc 5 Time at 6" I I - 4 Start Pre-soak Time @ I t a s Time(9"-6") End Pre-soak Rate MinJlnch Site Suitability Assessment: Site Passed�[_ Site Failed: Additional Testing Needed(Y/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:\SEPTICU'ERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# TP 1 Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,% ravel $ SA%AD i` LOA V1 10 313 10 - 31 �w Iv;oy LofM kd" 56 3t -tag+ C, WAMV &A O'Q S DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) 0 11 P SMt t;' LOAM 1D e, 3 3 t1— q 5w SAND'-, Lz)Am aY ' h — a41 - \"40 C, LOAM _SM40 r 5 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. onsi ten .r Flood Insurance Rate Mau: Above 500 year flood boundary No X Yes Within 500 year boundary No= Yes Within 100 year flood boundary No X Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the c area proposed for the soil absorption system? 1 r.CJ -- If not,what is the depth of naturally occurring pervious material? Certification I certify that on to—d - (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. Signature Date Q.\SBprncvERCFORM.DOC i REVISIONS � SOIL TEST PIT DATA: P-� 23s3 SEPTIC TANK DETAIL: 1 ,500 GALLON DISTRIBUTION BOX DETAIL: NOT TO SCALE LEACHING DETAIL: H-20 NOT TO SCALE R EVEVNO. DATE DESCRIPTION USE EXISTING: USE EXISTING: 17.0 1. 11/21/08 SYSTEM I & TEST PIT -j i TEST PIT #2 T T FINISHED GRADE o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o WATER LINE GRD. EL. 69.0 GRD. EL. 69.1 NO 0 SCALE o 0 0 0 0 0 0 0 0 0 0 0 0 "o 0 0 ° 0 0 LOCATION REMOVABLE 2" WALLS NOTES: ° ° EST. HIGH GW. 58.7 EST. HIGH GW." N A 1. INLET AND OUTLET TEES TO BE CAST IRON. COVER �` 0 0° SCHED. 40 PVC OR CAST-IN-PLACE CONCRETE. , o o " + 1. DIST. BOX TO WITHSTAND H-10 LOADING o - - c 56 12 -1O GENERAL NOTES: TEES TO BE CENTERED UNDER MANHOLE COVER. �:•v.. ,v:•v..+.9:•v....,:•v.:: 2 ° A �1p TUNLESS UNDER PAVEMENT, DRIVES OR 00 ° 1. THIS PLAN IS FOR DESIGN AND SANDY LOAM SANDY LOAM 2. INSTALLER TO CONFIRM TEES AND REPLACE OR T TRAVELED WAYS WHEREIN H-20 LOADING 0 500 GALLON LEACHING DRYWELLS 0 o CONSTRUCTION OF THE SEWAGE 10YR 3/3 10YR 3/3 HIGH GROUNDWATER COMPUTATION UPGRADE WHERE NECESSARY. EXISTING SEPTIC 2-24" DIA CONCRETE MANHOLES 0°00 0 0 00 00 00 00 opo 000 000 000 000 00 00o0 0 00 0 000 0° DISPOSAL FACILITY ONLY. BASED ON TP#1 TANK TO BE PUMPED AND CLEANED. W/ METAL HANDLES BROUGHT '� � 15 SHALL APPLY. " T 6" OF FINISH GRADE 2• ALL CONLS�SHALL CMETHODS TAND MASS. 10 11 " TEE TO BE UNDER " 6' 8 I 2. PROVIDE INLET TEE OR BAFFLE WHERE 25.0' DEPTH TO BOTTOM OF HOLE 124 1 MIN. ` L SLOPE OF PIPE EXCEEDS 0.08 FT. OR D.E.P TITLE 5 AND LOCAL BOARD M.H. OPENING v T /� PLAN VIEW LEACHING CHAMBERS SANDY LOAM SANDY ~ 'm✓ .+ . •ftxl , �. IN PUMPED SYSTEM. OF HEALTH REGULATIONS. 10YR 5/6 1OYR 5/6 BOTTOM ON LEI- 2" 3. FIRST TWO FEET OF PIPE OUT OF DIST. 3. ALL PIPES LOCATED UNDER PAVEMENT RAISE M.H Wf.�- BOX TO BE LAID LEVEL. LOAM & SEED DISTURBED AREAS OR TRAVELED PAY SHALL BE SCHEDULE SEWER BRICK _- STABLE BASE 6 MIN. 3//4 TO 80 OR EQUAL 31" 29" .• .,;. •�. •.: .-:., .:..- : 1 1/2 CRUSHED , do MORTAR : " . CROSS-SECTION STONE BASE 4• ALL PIPE CONNECTIONS AND CONCRETE 3 MAX, COMPACTED FI L 36" MAXIMUM,12"MINIMUM 4. THERE ARE NO KNOWN PRIVATE WELLS EL = 66.42 EL = 66.5 NORMAL WATER LEVEL 12 ,- CONSTRUCTION SHALL BE WATERTIGHT. 0 o LOCATED WITHIN 150 FT. OF THE o ° PROPOSED LEACHING FACILITY NOR oa 3" 5. FILL ALL UNUSED KNOCKOUTS WITH MORTAR. ° c 0 � 0 M I= 0 ° < PEASTONE ANY KNOWN WELLS PROPOSED WITHIN PRECAST SEPTIC TANK 10" 14' T O Q 0 150' OF ANY KNOWN LEACHING FACILITY 54 INLET TEE 30 1/2" 36" 24" 0§ 0 O O O 0 EXCEPT AS SHOWN ON THE LOCUS. 0 0 0T 5. WITHIN LIMIT OF EXCAVATION REMOVE C C . 4'-0" MIN. ao- aM . 15 1/2" DEPTH �0 0 0 � O 0 O 0 ALL TOPSOIL, SUBSOIL AND OTHER z' LIQUID DEPTH % IMPERVIOUS MATERIAL LOAMY SAND LOAMY SAND - - t�s U `` = 0 O M O PRECAST DIST. 1 6. REPLACE ALL EXCAVATED MATERIAL WITH 5Y 5/4 5Y 5/4 _ .} BOX 3 4" 1 1 2" CLEAN GRANULAR SAND, FREE FROM ORGANIC INDICATES .� . 56" ASHED STONE MATERIAL AND DELETERIOUS SUBSTANCES. 124" Y;4;: :� : �:`` :do - e_o:•; _'' MIXTURES AND LAYERS OF DIFFERENT CLASSES EL = 58.7 EL = 59.1 120 v ESTIMATED SEASONAL HIGH •c BOTTOM ON LEVEL STABLE BASE •� 12'-10" OF SOIL SHALL NOT BE USED. THE FILL SHALL GROUND WATER PLAN VIEW '7 1/Z' NOT CONTAIN ANY MATERIAL LARGER THAN DATE: DATE. 6 MIN. 3/4 TO TWO INCHES. A SIEVE ANALYSIS. USING A �14 9-22-08 9-22-08 INDICATES 1 1/2" STONE SAW CROSS-SECTION VIEW/ 4" PLAN VIEW CROSS-SECTION OF CHAMBER SIEVE, SHALL BE PERFORMED ON A REPRESENTATIVE SAMPLE OF FILL UP TO 45% TEST BY: TEST BY: -� I ..'F;' RETAINED O THE FILL SAMPLE MAY BE �_ OBSERVEDBY THE BSC GROUP. INC. THE BSC GROUP, INC. GROUND WATER ' BENCHMARK / THE #4 SIEVE. SIEVE ANALYSES � � �' ALSO SHALL BE PERFORMED ON THE FRACTION WITNESSED BY: WITNESSED BY: STAKE & NAIL SET / OF FILL SAMPLE PASSING THE #4 SIEVE, SUCH INDICATES r _ k; ELEVATION 69.00 , DESIGN CRITERIA: ANALYSES MUST DEMONSTRATE THAT THE D. MIORANDI D. MIORANDI PERC. , MATERIAL MEETS EACH of THE FOLLOWING SPECIFICATIONS: PERC. RATE: PERC. RATE: TEST i DESIGN FLOW: SYSTEM 11 100X MUST PASS #4 SIEVE _2- MIN./INCH _Z-MIN./INCH rx 3 BEDROOMS AT 110 G.P.B. D 330 G.P.D. 10%-100% MUS4.75 mm EFFECTIVE PASS 50 SIEvcVEE SIZE) INDICATES - - _ SOIL EVALUATOR SOIL EVALUATOR !- _r. --- - -. --- - -- - --- - - -- -:: .~- - - ( ) UNSUITABLE .�~ - '� ' 0.30 mm EFFECTIVE PARTICLE SIZE B. RGATIAN B. YERGATIAN - Q ' TELEPHONE ;yy OX-20X MUST PASS #100 SIEVE MATERIALS WIRE TO BE yo (0.15 mm EFFECTIVE PARTICLE SIZE) ' RELOCATED ^� �.,/ OR-5X MUST PASS #200 SIEVE SOIL CLASS: SOIL CLASS: w / uR REQUIRED . SEPTIC TANK. • - (0.075 mm EFFECTIVE PARTICLE SIZE) ..._ - 330 X 200% - 7. EXISTING-- - S E S NG WHERE SHOWN w 660E E SHO GAL. ,COUN IN THE DRAWINGS ARE APPROXIMATE. L.T.A.R. L.T.A.R. _ _ . �t TY�,,gy►OUT SEPTIC TANK PROVIDED: 1500 GAL. 0.74 G.P.D./SQ.FT. 0.74 G.P.D./SQ.FT. may. -�, �,"' O f _ � ' �`, THE CONTRACTOR SHALL BE RESPON V S53-35 31"E 270.5f. , f ' o l k' ° SIBLE FOR PROPERLY LOCATING AND ' { ' ,� COORDINATING THE PROPOSED CON- ,�•. f S 14 SIZE OF LEACHING FACILITY RE UIRED: STRUCTION ACTIVITY WITH DIG-SAFE • I A 1 T 1 J Q DATUM: ? ; A w rsr� , AND THE APPLICABLE UTILITY �k _ + I < h.. r t ; : 47 2i•E DESIGN PERC. <Z COMPANY AND MAINTAINING THE 5 1334. C RATE: MIN./ INCH • h' '__ I c� ' e 1 , _--._ EXISTING UTILITY SYSTEM IN SERVICE. VERTICAL DATUM: ASSUMED 1929 - TOWN OF BARNSTABLE GIS SYSTEM .. �m . . r, } _ nr s LONG TERM APPL. RATE 0.74 G.P.D S.F. DIG-SAFE SHALL BE NOTIFIED PER SYSTEM II / BENCH MARK SET: STAKE AND NAIL SET ACROSS STREET `` NOTE �� ° BENCHMARK THE STATE OF MASSACHUSETTS W -+ �``�,- -- -'"' ` ,� 200 f � • CONCRETE BOUND ~ WELL LOCATION 106' _ ».,,. s ✓ 01il TO A�ELL ' - STATUTE CHAPTER 82, SECTION 409 ELEVATION 69.00 Q NOT VISIBLE. 1 a.: . ,� ELEVATION 78.73 330 GPD '!' 0,74 GPD/SF 446 S.F. AT TEL. 1-888-344-7233. THE `~ OWNER PROVIDED s _ i f J n € r. ENGINEER DOES NOT GUARANTEE Q '^--��:,F LD LOCATION. #29 EXISTING r 3 ( • ,' � � , , EXISTING THEIR ACCURACY OR THAT ALL ,,� EXISTING SEPTIC TA �.._...m ' WELL UTILITIES AND SUBSURFACE STRUCTURES PROFILE: NOT TO SCALE �, I SIZE OF LEACHING FACILITY PROVIDED: ARE SHOWN. LOCATIONS AND .,. 3 BEDROOM & 'D' BOY TO J � s -. to F .,,:_,,: �,....�•-----••----7 DWELLING -•�,. 1 REMAIN I � 5 _ 1 - - J _ ELEVATIONS OF UNDERGROUND UTILITIES EL-A ,.. _..,.��._ I �.�, r I �.� �: _ � USE C2) 500 .GALLON CONC FIRST PIPE LENGTH y' �.-. ,... r J s w ; _ : TAKEN FROM RECORD PLANS. THE TOP FOUNDATION COVERS TO WITHIN TO BE SET,LEVEL ; i LEACHING CHAMBERS 12.83'X2`X2S' CONCRETE � _ ' EL.=EXISTING. - / 4 6 OF.FINISHED .GRADE. fOR�MIN. 2' . ,: - .,:.., .. ,; I CONTRACTOR SHALL VERIFY SIZE, FINISH GRADE - = - LOCATION AND INVERTS OF UTILITIES " SIDEWALL - L(12.83`+G''S`) X �L' = 151 AND STRUCTURES AS REQUIRED PRIOR EL=69.0- .8 TO THE START OF CONSTRUCTION. 4" PVC SCH 80 _, "' , M 2.8 - a _: .,.._ :} _: 0 1 3 25 l X 4 l r 4" PV = M u' 4 d,� - 5 a 471S,F, 8. THIS SYSTEM IS NOT DESIGNED FOR SCH 4 PVC LEACHING CHAMBER TOP 66.9 r � . THE USE OF A GARBAGE GRINDER. 0 0 o ai o 0 0 0 0 0M7 �,... _ I � � 1129-A `'-. o m o 0 o c o 0 0 0 A GARBAGE GRINDER IS NOT __ o m o 0 0 0 0 0 0 0 _m � E POOIL a BEDRIOOM 471 S.F x 0,74 GPD/SF = 348GPD RECOMMENDED DUE TO RECOGNIZED B RE-USE EXISTING 1 I=G O . ( \ PARTMEN "�`��"` ADVERSE IMPACTS TO THE LEACHING EI=E H ` w OVER FACILITY. 1=C OUTLET ,. f _.:. GARAGE _ DESIGN FLOW: r 5 1=F5 L SYSTEM DIST. BOX �'O 1 9. EXITING INVERTS ARE TO BE CHECKED BY ..w� .:.� ;,� �,: 1 M 110 SEPTIC TANK 5.z SEPARATION �, 4 ,._' R a _.., 5 a t BEDROOMS AT G.P.B. D 110 G.P.D. THE CONTRACTOR PRIOR TO CONSTRUCTION. CONFIRM LOCATION do NUMBER OF INVERT S. EST. HIGH GROUNDWATER } SHED N D K 0. THE ENGINEER IS TO BE NOTIFIED OF O, u ANY FIELD CHANGES THAT MAY BE REQUIRED. INVERT ELEVATIONS: ti. 000 GAL` f LOCUS INFORMATION C o SHED ` y�L tip- TANK O SYSTEM I (1987) . y , CURRENT OWNER: JAMES & NANCY CONROY MC GROUP 4 <, APPROXIMATE N TOP OF FOUNDATION 70.9 LOCATION Of , ' APSEP7ICNT TITLE REFERENCE: DEED BOOK 7365, PAGE 145 349 Route 28, Main Street, Unit D 4 INVERT AT BUILDING EXISTING ,�� W.Yarmouth Massachusetts :� :` ',. ', I PLAN REFERENCE: NO RECORD PLAN 0267 4 INVERT AT SEPTIC TANK (IN) EXISTING s ti r 3 1 � i a ASSESSORS MAP: 130 508 778 8919 4 INVERT AT SEPTIC TANK (OUT) XI T NG ,s s t PARCEL: 16 4 INVERT AT DIST. BOX (IN) 66.75E >. PROJECT TITLE: F y ` ZONING DISTRICT: RF 4 INVERT AT DIST. BOX (OUT) !6�$ '� 3 f �„� SETBACKS: FRONT 30't DESIGN FOR SIDE 15� INVERTS AT LEACHING FACILITY: TOWN OF BARNSTABLE REQUIRES AS-BUILT # REAR 15 SEWAGE DISPOSAL CERTIFICATION. SOIL EVALUATOR TO :f N�SS ,: m_.,w MINIMUM L SIZE: 87,120 S.F. ►, INSPECT BOTTOM OF EXCAVATION PRIOR 4 , �, EXISTING LOT AREA: 60,114t S.F. (1.38t AC.) SYSTEM REPAIR 4 INVERT AT BEGINNING F LEACHING CHAMBER 65.9 G BREAKOUT ELEV 66.4 TO ANY INSTALLATION AND ALSO PRIOR oag OVERLAY DISTRICT: WP TO FINAL BACKFILLING. .---- ' SYSTEM II AT BOTTOM �� � NITROGEN SENSITIVE ELEVATION B �` _ _ i� cRAlc A. ♦ ZONE: YES - ZONE II 63.9 H .... OF LEACHING CHAMBER �:._�-�` ~i � � #29 8 � FEMA FLOOD FIELD an t No•�� r ZONE DISTRICT: "C" DATED 7/2/1992 PANEL #250001 0011 D CHURCH STREET _. I�+o r NO OBSERVED GROUNDWATER BOTTOM OF HOLE 58.7 J FOYER W. BARNSTABLE LOCUS PLAN: NO SCALE MASS. a�' M ASSACH U SETTS LIVING HIGHWAY BEDROOM BEDROOM o BOUND FOUND /��� 0 6A VARIANCES REQUESTED. _ BEDROOM GARAGE � c►+of,� c PREPARED FOR: BATHROOM ��� BRIAN G. y 149 MR & MRS JAMES CONROY o YEaGAT1AN H ST. #29 CHURCH STREET DINING BATHROOM " CIVIL y HALL HALL tia 9�Nn.462060 CEDAR ST• CHURC WEST BARNSTABLE TOWN OF BARNSTABLE WELL SEPARATION LIVING ROOM R �,� a/STEP LOCUS MA 02668 Fss� EN TO ALLOW A LEACHING SYSTEM TO BE INSTALLED 106' FROM A -KITCHEN , 6 (508) 237-4846 PRIVATE WELL ON THE SAME PROPERTY. KITCHEN OPEN PLAN VIEW s?s�- _ � ' DATE: OCTOBER 11, 2008 150' REQUIRED, 106' PROVIDED, 44' VARIANCE IS REQUIRED. ATHRoo i,t a FAMILY BEDROOM -TO BELOW COMP. DESIGN: K. HEALY ROOM SCALE: 1' = 30 FEET s CHECK: B. -YERGATIAN 1 (MEETS TITLE 5 MINIMUM OF 100') DRAWN: K. NEALY MAIN HOUSE MAIN HOUSE GARAGE GARAGE o is 30 6o FT, FIELD: D. GAZZOLO / N. MERCIER N FIRST FLOOR SECOND FLOOR FIRST FLOOR SECOND FLOOR FILE NO. 9375-SEP.DWG INTERIOR FLOOR PLAN PROVIDED BY OWNER: NOT TO SCALE DWG NO. 5925-01 JOB NO. 4-9375.00 SHEET 1 OF 1 I - -- -