HomeMy WebLinkAbout0318 LAKE SHORE DRIVE - Health 318 Lake Shore Drive
Marstons Mills - -
030 093
TOWN OF BARNSTABLE
LOCATION L- iq k(= SknrCF b r, SEWAGE # aOOV- Sag .
VILLAGE 6Ar P ASSESSOR'S MAP & LOT 30
INSTALLER'S NAME&PHONE NO. 0 b i N S o s9
SEPTIC TANK CAPACITY 00 4
LEACHING FACILITY: (type) 3 k s"o 6 (size) I c� .S- x
NO.OF BEDROOMS
BUILDER O OWNE L t N (N &D L>--� P, y
PERMITDATE: c/o — 340`6Y COMPLIANCE DATE: —�t
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
J S Y
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
�e
No. ' 3 F y Fe$5 0 .04es
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2pprication for Migpoga[ *potent Con!Arurtion Permit
Application for a Permit to Construct( , )Repair(X )Upgrade( )Abandon( ) El Complete System ED Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No. 4 2 8—6 0 7 8
318' ale
Assessor s ap azce IShore Dr, Marstons Mills Robert Morin
30/93 318 Lake Shore Dr, Marstons Miss
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4
Wm E Robinson Sr Septic Eco.-Tech
PO Box 1089, Centerville 43 Triangle Cr, Sandwich
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder(no)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Install new Title 5 leach
system to plans of Eco-Tech #ETE-1700
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!>e En ' onmen ode and not to place the system in operation until a Certifi-
cate of Compliance has be wed b ard He a Va
Sig ed Date �c7r✓"o_
Application Approved by Date Ya
Application Disapproved for the following reasons
Permit No. P00`-11' 3 1-? Date Issued
No. 3 .- Feed 5 0.0 0
THE COMMO WEALTH OF MASSACHUSETTS Entered in computer:
Ys
,� PUBLIC HEALTH DIVISIO• -TOWN OF BARNSTABLE, MASSACHUSETTS
2pplication for 30igogar *pztem Construction i3ermit r
Application for a Permit to Construct.( )Repair(X)Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No. 4 2 8—6 0 7 8
31 $ hae Shore Dr, Marstons Mills Robert Morin
Assessor's ap u
30/93 318 Lake Shore Dr, Marstons Miks
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4-0 8 9 4
Wm E Robinson Sr Septic Eco-Tech
PO Box 1089, Centerville 43 Triangle Cr, Sandwich
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder(no)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable Install new Title 5 leach
system to plans of Eco—Tech #ETE-1700
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 ofte En ironmenidCode and not to place the system in operation until a Certifi-
cate of Compliance has beett.issued by th' and Health7 A
Sig ed Date
Application Approved by Date .
Application Disapproved for the following reasons
oo — 4
� Sl 3 2�
Permit No. � Date Issued �
. I
THE COMMONWEALTH OF MASSACHUSETTS
Morin BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( X )Upgraded( )
Abandoned( )by Wm E Robinson Sr Septic Service
at 318 Lake Shore Drive, Marsbons Mills - has been constructed ' accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 0o``-1? dated / 3 v t)v
Installer Designer �V l
The issuance of this peArut shall not be construed as a guarantee that the sys a ill funq ipn as designed.
Date u� Inspector r 7 4
No. C- `- 3 a�O
Morin THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION . BARNSTABLE, MASSACHUSETTS
Migpogal *pgtem Contruction pernYit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 318 Lake Shore Dr i ve Ma rci=nn c M i 11 c
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 condi 'ons.
Provided:Const ucq'on must Pe completed within three years of the ,ate of this pe t.
Date: Approved by
r
TOWN OF BARNSTABLE
LOCATION _ C-A k C S ka rC b r, SEWAGE # aOOV` Sag
VILLAGE ,%iS-k-6 N S S ASSESSOR'S MJAP & LOT 3O 92
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY k OO 4
LEACHING FACELITY: (type) 3 x �O 6 (size) I c3 •S- X
NO.OF BEDROOMS , y
BUILDER OX OWNE)� L t n► , on � O.",
PERMTTDATE: p ` 3,0`,W COMPLIANCE DATE: -O� - 8 el
Separation Distance Between the:
I
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
I 'sC7'e'GIC
S0
.r 1
� rr
i
Town of Barnstable
P� o Regulatory Services
s WtMABM i Thomas F. Geiler, Director
9 MASS. Public Realth Division
A�FD""P�A Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644
Fax: 508-790-6304
Installer & Designer Certification Form
Date: ;9
Designer: Eco-Tech Installer: Wm E Robinson Sr
Address: _ 43 Triangle Circle Address: PO Box 1 089
Sandwich, MA' Centerville, MA
On jC3 —C�`/ Wm E Robinson Sr Septwas issued a permit to install a
(date) (installer)
septic system at 318 Lake Shore Dr, Marstons Millated on a design drawn by
(address)
Eco-Tech dated
(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-built by designer to follow.
zl� - �� DAN 10
(Installer's Si -,HANOWR
u 1093
�� (� G�� �� �'�N1T 1►P�'
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HE 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.
0-HenIIh/SerticMesiener C'erlificatinn Pnrm
No...... .. -•-------• Fig..1..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH
...'......... �. . ----.OF....... -------------------------
Application for DiiiVasat Workii Tomitrur inn Pumit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
Syst at• II,,
�a'� 4
4 /
Loc ' n-Address No.
•----•--------- ................................. .......................
...............
Owner -•----•--------•....................•.......Address
Installer Address
Q Type of Building/ Size Lot............................Sq. feet
U Dwelling NO. of Bedrooms............ _________________________Expansion Attic ( ) Garbage Grinder ( )
`4 Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures ........
-•-•---•-•--
............................................ --------
W Design Flow........................��. _.._ .gallons per person per day. Total daily flow.............Al .--...........__......gallons.
WSeptic Tank/-Liquid capacity) gallons Length---_----------- Width---------------- Diameter---------------- Depth.._-_----__-___-
x Disposal Trench—No............ ....... Width------------- T ng Total leaching area_.--:_::_-_--__/ sq. ft.
Seepage Pit No....... ---�_. ameter/ P__ t w ' 1 ................... Total leaching are l� _"L___sq. ft.
Z Other Distribution box ( Dosin tank ( )
aPercolation Test Results Performed by........................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.__-.-_.--_----__-__..
r14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
-- -----------------
-
-S__
O Description of Soil--------- ---------- /-_,� _ c._.' _2. %---- --- -
/p •• { -------------
U ----- -- ______ ------------
-
W
.-_----.•--------------------------------------------------•-------------------.--------------------_----_-----•__-.------_---_--_--___•-_-_•-_-_____________________-___-----__---_______-__________--.
V Nature 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be issued by the boa a1th.
Sign, - = 2-
-A 7
•--••--••-•-.....••.--•-_
Da
Application Approved BY----- " •,Z ---- -------- --- gil d, r----. -- -
ate
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------•-------••------------------------•-•-------------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued........................................................
Date
r ru
No..... :.A........... Fm@..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® )OF HEALTH
OF....... ; ... . litz -- -------------------------------
App iration for 43hipmat Iforkii Tonfitrnrtion Prrmit
Application is hereby made for a Permit to Construct (" or Repair ( ) an Individual Sewage Disposal
Syst at
Loca on-Address o4d ,,.64s
No.
................................... ..__---•-- .. _.:_...-------
f Owner
- e�
4 --- ----:
---
InsTaller Address
QType of Building o Size Lot............................Sq. feet
U Dwelling O. of Bedrooms------------ ........................Expansion Attic ( ) Garbage Grinder ( )
`4 Other—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 k Liquid capacity ` 'gallons Length................ Width---------------- Diameter.--------------- Depth................
x Disposal Trench—No..................... Width..................je To ,1 ength _________ .___. _ Total leaching area....................sq. ft.
iameter/1-1t. ._� ep4b 1 1�t .. Total leaching area .�.�__sq. ft.
Seepage Pit No._____.�.�••_ _'�
z Other Distribution box ( Dosin tank ( )
Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................
Test Pit No. 1................imnutes per inch Depth of Test Pit-------------------- Depth to ground water--._--_-.__________-....
G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_-___-___--__---_-.___.
----••••. --- -- ---- •-- . -- = .................... ----------------- -
O Description of Soil = _ = ,+�7--- -------------
rJ ------ ----------------------
.. --
-
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 Article XI of the State Sanitary Code—The.undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be issued by the board-of health.
i
Stgne + *re f . . ---------
Da
Application Approved BY----- �" - =
Application Disapproved for the following reasons-...............................---------- ...................................................-•----------_-----
------------------
Date '
PermitNo.......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF FIPALTH
�.......... A' OF..................... .: ..C&A . ..:.... .-..:..............---..
Tntif irate Lit Tnunpiianrr
THI S TO s E TIF hat the Ind Ida ewage Disposal System constructed ( r Repaired ( )
Installer io
at
haeen installed in acco cce with the provisions of Article X' of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No............. s °-- _ j
---------------------- dated---- - ---" `'-- -a A;,�------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..........................................------------------------------------ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF, 0ALTH /.�
Dinvilli / k1i T� nptrn.�ti.� rr
Permission Is reb ranted_____________ +�=-•_.-._--_ -_...._._-__. - ,: =_-_ s_
'4— Y.6 •----------------
to Cons, ct ( or Repa ( an In i al Sewage Disposal System d" /
at No �. _. f d---u- - _ -- ��-- -- f.
Street
as shown on the application for Disposal Works Constructio Permit' o.___ __ Dated_._. _.. .:_ -,
s { Board of Health
JJ
DATE........... - - ------- -.
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
7
FLOW PROFILE
TOP OF,FOUNDATION RAISE COVERS TO WITHIN
6 in OF FINAL GRADE
EL - 1062
2- LAYER OF 1/8'
/D-BQX 1/2- STONE
/3- DROP Jo`
0( VFLOW LINE
3/4'-I I/4'
10• 0
14 PRECAST x> STONE
EXISTING 48- GAS; ' ORYVMELL
BAFFLE 8r "
t'y"~' x seNrr. BOTTOM OF
102.10 t 6 i n
STONE LEACHING SOIL ABSORPTION
EXISTING BASE f01.63 SYSTEM
EXISTING 101.80 GALLERY
f0,50
1000 GALLON (END VIEWS 99.Sa 5.00 tr
EXISTING SEPTIC TANK 18.2 ft / / al 12.8 ft ,
b1 S /�
Y ESTIMATED
SEASONAL HIGH
GROUNDWATER
160.00 Ft
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SOIL TEST LOG � � � .C .
ALCULATIONS
DES I G N
DATE OF TEST: JUNE 29. 2004 it
SOIL EVALUATOR: DAVID D. COUGHANOWR. RS
WITNESS REQUIREMENT WAIVED - NO VARIANCES SOUGHT DESIGN FLOW: 4 BEDROOMS X 110 GPD - 440 GPD
NO GROUNDWATER ENCOUNTERED SEPTIC TANK: 440 GPD X 2 DAYS - 880 GALLONS
TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH
PERC AT 50 in : 2 MIN/INCH IN C SOILS
ELEVATION - 105.20 ;- USE EXISTING 1000 GALLON SEPTIC TANK IF IS SOUND STRUCTURAL
CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED)
DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER _ x DISTRIBUTION BOX: USE 3 OUTLET D-BOX.
(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING
SOIL ABSORBTION SYSTEM: A 33.5 f t x 12.5 f t x 2 f t LEACHING GALLERY CAN LEACH
0-12 AP LOAMY SAND 10 YR 3/3 NONE FRIABLE Abot - (33.5 x 12.5 1 - 418.75 sf
12-38 B LOAMY SAND 10 YR 4/6 NONE FRIABLE Asdw - ( 33.5 + 33.5 + 12.5 + 12.5 ) x 2 - 18 4.0 a
Atot - 602.75 sf
38-56 CI COARSE SAND 10 YR 4/4 NONE LOOSE, 15% GRAVEL Vt 0.74 x 602.75 - 446.03 GPD
56-132 C2 MEDIUM SAND 10 YR 6/4 NONE LOOSE USE A 33.5 ft x 12.5 ft x 2 ft GALLERY. Vt - 446.03 GPD > 440 GPD REQUIRED
GROUNDWATER I FACHING GALLERY CONSTRUCTION
DETAIL
ADJUSTMENT WIGGINS CONCRETE 500
EXISTING GROUNDWATER LEVEL GALLON PRECAST DRYWELL
BASED ON BARNSTABLE GIS LEACHING UNIT OR
DEPARTMENT RECORDS EOVIVALENT STONE
INDICATED GW: 55.0
INDEX WELL: SDW-253
f, �F - DEr r" 33.5 f t
ZONE: . B
�n
, • ,,, READING: MAY 2004
LEVEL: 50.4 r
M
r'
ADJUSTMENT:TM NT: 4.6 ft o
}'= ADJUSTED GW: 59.6 `A J "�
E S CV In N
a`
C
"' . WITH THIS DESIGN -
NOT ALLOWED W x �•
RIN ER O
R AG "�G D
INCH PER FOOT MINIMUM.
2) ALL LINES TO BE SCH 40 PVC AND PITCH AT I/8 C
• REQUIREMENTS 33.5 f t ,
M
3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM
OF SACHE US TTS TITLE 5 SEPTI
C CODE (310 CMR 15)
MAS 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES
BEFORE EXCAVATING FOR SYSTEM.
5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED
6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE
X TO RUN LEVEL FOR 2'-0' BEFORE PITCHING DOWN N
TIN D-60 PLAN
7) LINES EXITING G SEWAGE DISPOSAL SYSTEM L
8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES -TO SERVE EXISTING DWELLING
AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK
9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT LINDA C. CONWAY
PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM.
10) 1NSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 318 LAKE SHORE DRIVE MARSTONS MILLS. MA
11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL ECO-TECH ENVIRONMENTAL
STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH
SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING 43 TRIANGLE CIRCLE SANDWICH MA 02563
12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED
FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. ETE-1700 JUNE 30. 2004 2/2