HomeMy WebLinkAbout0882 BUMPS RIVER ROAD - Health 882 Bumps River Road
Osterville
A= 167 011
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No. W
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS K
ZIpprication for 3i6pogal *pgtem Con! truction permit
Application for a Permit to Construct O Repair O Upgrade O Abandon O ;6pmplete System Individual Components
Location Address or Lot No. Sr Owner's Name,Address,and Tel.No.
( t/J —3',,,vt` � Uev,
Assessor's Map/parcel —�
Installer's ame,Address,and Tel.No. Designer's Name,Address and Tel.No.
, o Y
Type of Building:
-0 Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title v
Size of Septic Tank 00 �D tea-- Type of S.A.S. c ��(ti�� ✓��G(�(
Description of Soil
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 iss rr --
Sig d Date (P
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. 1p Date Issued
e
No.. � ►. Fee ,�
ti /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: —
'i Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for Mizpogar �&pgtem Con5tructton Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ? -&mplete System 0 Individual Components
Location Address or Lot No. S ""� Owner's Name,Address,and Tel.No.
Assessor's Map/parcel '�7_0\\
Installer'vy)-r—'56
e,Address,and Tel.No. Designer's Name,Address and Tel.No. �,G �L p37
c sS 7 I4-( 5 i a y �- L,
Type of Building:
~ Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
q
Design Flow(min.required) (7 gpd Design flow provided gpd
Plan Date 2--\L -o(o Number of sheets Revision Date
Title
Size of Septic Tank 15 00 a� — Type of S.A.S. t << y` ✓`���l'ls
�— U
Description of Soil _ o A—"
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k
Nature of Repairs or Alterations(Answer when applicable) �' (��!e�—"
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-Bsa f Hep
Sig ed Date �0'
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. ac_<7(Q Q Date Issued r'
r' ——————— ——————————————————=————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIY at the On-site Sewage Dis osal System Constructed ( ) Repaired ( ) Upgraded (11�
Abandoned( )by /' t✓!S �� C.
at 2 ✓1v\0 S v-u- 0ser1I'l 1 e—has been constructed in accordance /
with the provisionsAf\Title 5 and the for Disposal System Construction Permit No. � � "O0 0 S 7dated
Installer � Y.���`�S Designer 'S" I
#bedrooms 3 Approved design flow 3d gpd
The issuance of this permit'shJ 11 not be construed as a guarantee that the ystem will me'on as designed.
Date o"Z I� Inspec or
————————————————————————————————————————————
No.� (0 5 ! Fee d O
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS
�Diq;pon'i *p.5tem Cow6truction Vermit
Permission is hereby granted to Construct ( Repair ( Upgrade Abandon ( )
System located at
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the d�t�ts p - fit
Date '�Jr Approvetb b�^y�
TOWN OF STAB E // !�
LOCATIOiv _
S ram%✓ SEWAGE e-zm_ j—d�
VILLAGE S�t'V' o �,. ASSESSOR'S MAP & L�r7
INSTALLER'S NAME&PHONE N0
SEPTIC TANK CAPACITY
00,
LEACHING FACILITY: (type)
;Li 1t— `. '7G'7 (size)
NO. OF BEDROOMS
BUILDER OR OWNER dlti I �
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet'of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
1 within 300 feet of leaching facility) Feet
Furnished by
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Town of Barnstable
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gulatory ulator Services
Thomas F. Geiler, Director
BMWSTABLE,
9�A M 9. � Public Health Division
AFC MA'S A
Thomas McKean Direc
tor
200 Main Street,Hyannis,MA 02601
4 Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 2-21-06
Designer: Shay Environmental Services, Inc. . Installer: Robert;Septic Services.
Address: P.O. Box 627 East Falmouth Address: 5 Trenton Street
MA 02536 Yarmouth, MA
On 2/16/06 Robert Septic Service was issued a permit to install a
(date) (installer)
septic system at 882 BUMPS RIVER ROAD, CENTERVILLE MA based on a design drawn by
(address)
Shay Environmental Services, Inc. dated 2/15/06
(designer)
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.
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-bu' t by designer to follow.
,H OF�l
CARMENs�\G�`rr
E.
(Insta is Sigffa re 01
0 SHAY N
No. 1181
G/STEREO
Y�? SgNITARINN
(Designer's Signature) (Affix Designe amp 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
v
9/16/03
Notice: This Form Is To Be Used For the Repair Of Failed
Septic Systems. Only
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM
I, S A hereby certify that the engineered plan signed by me
dated �— ?� (,, , concerning the property located at
V . meets all of the
following criteria:
• This failed system is connected to a residential dwelling only. There.are:no.commercial or
business.uses associated with the.dwelling. _.
{
• The soil-is classified as.CLASS I and the percolation rate is less than or equal to 5 minutes
per inch. The applicant may use historical data to.conclude this fact or.may conduct deep
test holes and percolation tests.at the site without a health agent present.
• There is no.increase in flow and/or change in use proposed
• There are no variances requested or needed.
• The bottom of the proposed leaching facility will be located no less than five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the.
Frimptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information) Ako, 00
B) G.W. Elevation +adjustment for high G.W. 2—_ �G
DIFFERENCE BETWEEN A and B
SIGN)rD : ��. - DATE: Z_
NOTICE
Based upon the above information;a repair permit will be issued for bedrooms
maximum.. No additional bedrooms are authorized in the future without engineered septic system
plans.
gASeptic\percexemp.doc
;NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. hAtt01AWALLY „ p
1
SECTION A -A 0' min, from Au.OUTLET'rlrEs FROM THE
Existing Foundation house to septic tank asTRleltTtoN sox sNAu eE r
0-BOX covet ,� be PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET lEVF1 FOR AT LEAST 2 FT. tr CONCRETE COVER So
TOP OF FOUNDATION = ELEV. 100.00 Assumed Septic tank covers hest be p.ati
(Assumed) within 6 in. of finished grade within 6 in. of finnshed grads
` Grade over Septic Tank-97.50 Grade over D-Box-96.00 over SAS-96,00 3• of 1/8" - 1/2" Washed Peast _ 3-5'OUTIET �'._`••:•i•= a �«���
3/4" to 1 1/2 " Washed Crushed Stone - KNOCKOUTS
S- 0.02 !! OUTLET 12' INLET
3 HOLE EHOX 0 3' Maximum Cover MSTALLED PVC` AND,1 BE VATHiN 6 CTM OF GRAD r , _ 8' '
Top OF System-EJev -95.75
EF
o ,r NEW s=o.ot ar Greoter
x« �
ExisT, rtrE ut 1,500 GAL ss per root ' a" - SCH. a0 T :
FROM EXIST. i OUPIDAT,W SEPTIC TANK is, o.OT" 0"EffectWe Depth 15 s• t.7s' ` f a -`` ;} .`'
n on o s PLAN SECTION CROSS-SECTION � ' \?a `;!
CONCRETE FIAT.FOUNDA n H-10 a r•i 4.
5 Units; a 6.25' = 30'
• nLSm o ; 0 0.83' (10 inches) 1 S
31.2s 3 HOLE H-10 DISTRIBUTION BOX A,w
YSTEM PROFILE � 6 In.of 3/4"-, ,/2" m n ; � � 3
C Compacted stone > O O at N ��:
Not to Scale - c o n • 37.25' NOT TO SCALE E � i.
3.5' n Effective Length ® raw Vtctart:cwnan}o�o�Rrlrtio
3' o SOIL ABSORPTION SYSTEM (SAS)
0' GENERAL NOTES
8 in.of 3/4"-1 1/1/2* p 1 n
oompacted stone < Effecitve vmth INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE m 1. Contractor is responsible for Digsafe notification, Verification of Utilities
p (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes.
W Bottom of Test Hole, Gov.-85.00 " 2. The septic tank an distri
Groundwater observed - NONE OBSERVED NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18 /EFFECTIVE HEIGHT IS 10" n g, ution box shall be set
level o 6" of S an 1 p2" stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
PERCOLATION TEST 4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
Date of Percolation Test: FEBRUARY 10, 2006 with Title V of the Massachusetts state code, the approved plan
Test Performed By. CARMEN E. SHAY, R.S., C.S.E. and Local Regulations.
Results Witnessed By. WAIVER (Per Barnstable B.O.H.) 6. If, during installation the contractor encounters any
EXCAVATOR: Shay Env. Svcs. soil conditions or site conditions that are different
Percolation Rate: Less Than 2 MPI 0 36" from those shown on the soil log or in our design
Test Hole installation must halt & immediate notification be
Test Hole LOT #53 LOT #52 LOT #51 made to Carmen E. Shay - Environmental Services, Inc.
No. 1 No. 2 7. No vehicle or heavy machinery shall drive over the
DEPTH SOILS ELEV. DEPTH SOILS ELEV. septic system unless noted as H-20 septic components.
0 96.00 0 97.00 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
sandy Loam Sandy Loam 91% 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
,o YR 3/2 10 YR 3/2 / 10. All solid piping, tees & fittings shall be 4" diameter
Ae 95.25 0"-6" A. 6.50 �, Schedule 40 NSF PVC pipes with water tight joints.
Sandy Sandy �� 125.00 ---- ��96 11. Municipal Water is Connected to ALL OF The Residence and Abutting
Loom Lit Properties Within 150 Feet.
,o YR 5/6 ,o YR 5/6 �.'' �.
9`- 36
" Bw 93.00 s"- a2` B• 93.50 �, THE PROPERTY LINES ARE APPROXIMATE AND
Medium/Coarse Medium/Coarse , COMPILED FROM THE SURVEY PLAN GENERATED BY
33.67 i BAXTER & NYE OF OSTERVILL.E, MA
end Sand i ENTITLED "SUBDIVISION PLAN OF LAND IN CENTERVILLE. MA,
2.5 Y 7/4 25 Y 7/4 �,' DATED SEPTEMBER 12, 1963, PLAN # 31043-A
132 c, 36"- 132 C, W.00 TEST HOLE 11 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
4" PVe IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
ELEV.= 96.00 Ven
Failed D-Box ' THE SEPTIC SYSTEM INSTALLATION.
.' �. '
��. ; , -r+r►,.tf:"3�;-:-s�. ,,,% �. , EXISTING CESSPOOL TO BE PUMPED OUT AND FILLED IN PLACE..
Cesspool--,
_ ,, .j i NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
FROM THE EXISTING CESSPOOL TO BE DISPOSED
� O at- - ---- 7•z5' 27' OF AS PER BOARD OF HEALTH SPECIFICATIONS.
TEST HOLE #2 ,
Perc #1 ! NEW 1500 GAL,' ELEV.= 97.00 i THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
Depth to Perc: 42" to 60" -SEPT --TANK 2 .5' ,'
Perc Rate= 2 MPI ��' f �� - ,' ASSESSORS MAP 167 PARCEL 011
Groundwater Not Observed ' l i �1 11'
No Observed ESHWT LOT #25 ;- o LEG EN D
ADJUSTED H2O Elev. = None ; /� ��� ' o LOT #23
DENOTES PROPOSED
' PROJECT BENCH MARK 104X1
EXISTING SPOT GRADE
/ TOP OF FOUNDATION
3-24-DRAM. ACCESS MANHOLES i 3 BEDROOM EXIST DENOTES EXISTING
to•-6- / ELEV. = 100.00 (Assumed) X 104.46
-;�.t ��--:��•; ,1,:`•,•�-,: i HOUSE GARAGE SPOT GRADE
S 4882 PL PROPERTY LINE
I
ett 1' 1 `: 96P PROPOSED CONTOUR
INLET Oul
THE ACCESS COVERS FOR THE SEPTIC TANK. I 1 \ 1
1 I 1 - -- -- -97 EXISTING CONTOUR
i. DISTRIBUTION BOX AND LEACHING COMPONENT
".�.`r Tj�,•.z .r -. SHALL BE RAISED TO WITHIN 6" OF
x FINISHED GRADE. / \ \\
STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS f LOT #24 \\ i `� DEEP TEST HOLE &
PLAN VIEW ON ALL OUTLET TEE ENDS ; 7,359 Square Feet +/- i _ .--�� �\ PERCOLATION TEST LOCATION
\
3-24"REMOVALtl.E COVERS i % _ _ ___4--1 6 FOOT STOCKADE FENCE
9$
3"min. dearance
AILET tY min. Ir mh.Inlet to outlet s. tS sstT '�i / \ \
OLE ,o-mh -e-i�.' u - OUTLETP T ' ��' i EXIST. \
s' -7• -
96 s -r ; - -� DRIVEWAY \\ \\ P LOT P LAN
.6$ °" T L,ILU*quld nth i i EXIST.
' OF PROPOSED SEPTIC SYSTEM UPGRADE
I32
i DRIVEWAY/ 1 ��� `\
r. •i,. . •:�=-L -�- .:, -_ , 1 ` `\ PREPARED FOR
9t,, �' \\\ �'� MR. JOHN A. LEMOS
CROSS SECTION END SECTION , , 1 125.00 ` °'
\ AT
TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK I I ; ; #882 BUMPS RIVER ROAD
NOT TO SCALE C E N T E R V I L L E, MA
Design Calculations ------------- ------------------------------------- ------------- N OF 4fq
B UMP AS' R I VE'R R OA,D C E s�cyG PREPARED BY:
Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) CARM�'N E. /SH�1 Y
Garbage Grinder: No
Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) (60 FOOT RIGHT OF WAY) H N
Septic Tank : - 2 x 330 Gal./Day = 660 USE NEW 1,500 GAL Septic Tank. g� ENVIRONMENTAL SERVICES, INC.
SOIL ABSORPTION AREA: Using percolation rate of <2 min.�nch
Bottom Area: 0.74 gal/sq. ft. x 372.5 sq. ft. = 275.65 gallons /STF P.O. BOX 627
Sidewall Area: 0.74 gal./sq. ft. x 78.72 sq. ft. = 58.25 gallons 0 20 40 50 SANITARIPN
Providing: = 333.90 gallons EAST FALMOUTH, MA 02536
Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, TEL/FAX 508-539-7966$GALE: 1"=20' DRAWN BY: CES ATE: FEBRUARY 14, 200
TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE SCALE: 1"=20'
ON THE ENDS. NO STONE UNDER. PROJECT#SD860 FILENAME: SD860PP.DWG SHEET 1 OF 1