HomeMy WebLinkAbout0007 MOUNTAIN ASH ROAD - Health 7 Mountain Ashy
Marstons Mills
/ A= 123 -023
1 t
TOWN OF BARNSTABLE r
LOCATION '1 M0QNI-rAQJ 454 PT-) SEWAGE# A(3(9_313
VILLAGE Mr125TWIC, H i LLf; ASSESSOR'S/MAP&PARCEL a a
INSTALLER'S NAME&PHONE NO.C',y&,.3t0 P,p C'tA.!4-, 4 51367
SEPTIC TANK CAPACITY 1 , (j00 Girc,LoOls
o
LEACHING FACILITY: (type) 4:41A c S (size) A X )e 2L5
NO.OF BEDROOMS
OWNER N iAWG dousd 441TE'EZjTy
PERMIT DATE: 9-:O-R619 COMPLIANCE DATE: - -dot 9
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility MIA A Feet
Private Water Supply Well and Leaching Facility(If any wells exist on J AA
site or within 200 feet of leaching facility) 1 IA Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within r9
300 feet of leaching facility) A Feet
FURNISHED BY
A- 1 ; 21
Q - 2 LJb.4, G oNT
`t : 5►.s` ? AA��^ ,� f� Asp
z ash, w-��•,�,�P/
.o s
41
IC -S �17 `
I Y a
No. Fee
r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for MispoSal *pstem Construttion permit
Application for a Permit to Construct( ) Repair( ) Upgrade jk) Abandon( ) ❑Complete System individual Components
Location Address or Lot No. -7 /noo-n A_-�t? Owner's Name,Address,and Tel.No.
/M4.augo, &t. j/J �r�s+ntarr8e fi6�S�►sf %�i�°ufY
Assessor's Map/Parcel /2 3 2.3
Installer's Name,Address,and Tel.No. /J 4o,%4w., *V( Sr Designer's Name,Address,and Tel.No. s'DV Z'73 p 31"7
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building '51-1"Le. L No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 3 O gpd Design flow provided 3 q i.-t gpd
Plan Date —Z�v �j Number of sheets 1 Revision Date
Title 1 49-1.>n"Ll Isa a.0al--4
Size of Septic Tank o Type of S.A.S. (2 )
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: Ag4us t
A reement:
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 Halt
O Zd
Date
Application Approved by Date
Application Disapproved b Date
for the following reasons
Permit No. �VlDate Issued
-------------------------------- - --------- - ----------------------- ------ - ----------------------------------
/ f
`No. = Entered in computer. t
a THE COMMONWEALTH OF MASSACHUSETTS
_ +,,;. , ': Yes
PUBLIC HEALTH DIVISION = TOWNij,6F"BARNSTABLE, MASSACHUSETTS
application for Misposal 6pstem Construction 3PPrmit
Application for a Permit to Construct( ) Repair( ) Upgrade k) Abandon( ) ❑Complete System .•Individual Components
Location Address or Lot No. -7 /Movn si /q5 -j Owner's Name,Address,and Tel.No.
�4"?. xa,� //VVj,0; Lk�/21arz.�{Y
Assessor's Map/Parcel /2 3/2.3 j�(� 50'..3r,+ SIT-.. ,7 h i.,$
Installer's Name,Address,and Tel.No. l f 1.o eN usr-..y+ Sr Designer's Name,Address,and Tel.No. 5�����'� p -7 •'
odrl" 13. o d..+i2 C.C . 4 , a 73 / �.• / e tit l 22S"�t C✓41 r fie.✓... /L.,t„s.�
Type of Building:
t` Dwelling No.of Bedrooms Lot Size ry L`t ;� sq.ft. Garbage Grinder( )
Other Type of Building 544 t t �n/l^� � No.of Persons Showers( ) Cafeteria( )
Other Fixtures ,
Design Flow(min.rrrequired) C �J gpd Design flow provided y`'1.• gpd
` Plan Date ft t� -` I Number of sheets I Revision Date
/� �
Title r7 1"'I.D`M' j'ti1.1
Size of Septic Tank L } Type of S.A.S. 5 �I '( L• "1
Description of Soil ,r
_ fie.,•`, •�fi��► '`�c.� �" �� 3 0'` }
Nature of Repairs or Alterations(Answer when applicable) X, S A^z
Date last inspected: AQC U_ f_ 2-011
f
Agreement:,
1 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,
`` Hear, 1 7 -y
0 d /" Date �' 7 � o I
Ct
Application Approved by 1//�i1�)s�11 w /' l,/(ffi��/ /f s�'i1 f t/f�l __ Date
i Application Disapproved by / % / 1 J v Date
for the following reasons
Permit No. 11✓ % ")o O�) Date Issued r)
- - ------•- — - ------- --------------- -------- ---- a -- ----`-- ----------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ')
Abandoned( .)by ' R11AC r_( O,,,.A �•l) . LTA4 (,_ ,
at -7 -) H*'� s M W 1 has been constructed-in accordance—)i
with the provisions of Title 5 and the for Disposal System Construction Permit No. // __ 1_dated
Installer I_20,�� 13. QC-V . CO- dLl t_ Designer
C- E;✓w ,fie ah C
#bedrooms 3 Approved design ow r, _ gpd
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.I ^
�- Date y(`tip Inspector `
- - - `-------- - -t - - - - - - - - - - - - - - •-------------------- ------
No. � I � Fee �(s'f/`�✓
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstPm Construction permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade Abandon
System located at f7 f�R O,)vt T--P)4 P? � Li ®�p,�L#-v{ I�"I49 to IV
t - e
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
must belcompleted within three years of the date of this permit. .%
Date J:' r '1 ( t•' Approved by I / 1 /
CJ I cam' r/ Y PP ✓ �• ��,
f
I
J ,�.,,��,,'�-
C
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, ,
��u• 7• LU17 z;4trivi No. 3457 P. 1
ToWn of Barnstable
Regulatory Services
Richard V.Scah,Interim ]Director
114"7 Public Health Division
eo rnny° Thomas Me.Kean,Director
200 Main Street,Hyannis,M.A.02601
Office: 508-862-4644
Pax: 508-790-6304
Installer&Designer Certification Form
Date: J-! q Sewage Permit# Z )`�J.-3 Z3 Assessor's HapTarcel I Z 3
Designer: C EnV)euun � Installer:
Address; ZS51 cra,nVm Address; 1.53 Co,mrr,dcc;t a J 5.46 h
a k w0ekaW9, Nil 0253
C Qeewi& b'mueas—,,s was issued a permit to install a
(date) (installer)
l i
septic system at 7 Mouv►•Fac n Assn { 16c'd based on a design drawn by
(address)
TG &0 1ne.E.cCn_ :Voc: dated Lu5v$k 22, 2619
(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. Strip out (if required) was inspected and the.'sbils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes
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. Strip out(if required)was inspected and the soils
were found satisfactory,
I certify that the system referenced above was construe ce with the terms
of the 11A approval letters(if applicable)
ova JOHN L
CPiUH ILLJR. t'
{I4� ;a�
�' Signatur v11, :t
N .41 7
(Affix igne smp There)
PLASE TUO BA STABLE PUBLIC HE H D S N. CERTIFICATE
OF COMPLIANCE WILL OT BE ISSUED LNTIL BOT I ORM AND AS-
BTIL�CARD ARE RECEIVED BY THE BARNSTABLE P C�IEALTH DIVISION
THANK YOU.
Q;\Septic\Designer Certification iForm Rev 8-14-13.doe
s.
Barnstable Count Health Laboratory
y y
ANALYTICAL REPORT FOR
Barnstable Housing Authority
Report Prepared for:
Barnstable Housing Authority*
David Hart
146 South Street
Hyannis, MA 02601
Order#: G0428744
No.of Samples: 1
Date Received: 12/1/2004
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
12/06/2004
M
CERTIFICATE OF ANALYSIS Wage: 1
Barnstable County Health Laboratory
Report Dated: 12/6/2004
Report Prepared For:
David Hart Order No.: G0428744
Barnstable Housing Authority
146 South Street
Hyannis, MA 02601
Laboratory ID#: 0428744-01 Description: Water-Drinking Water
Sample#: 28744 Sampling Location 7 Mountain Ash Rd Marstons Mills MA Collected: 12/1/2004
Collected by: D.C.Hart Received: l2/1/2004
Routine
ITEM RESULT UNITS RL MCL Method# Tested
LAB: Inorganics
Nitrate as Nitrogen 2.1 mg/L 0.1 10 EPA 300.0 12/1/2004
LAB: Metals
Copper BRL mg/L 0.1 1.3 SM 311113 12/2/2004
Iron 0.11 mg/L 0.1 0.3 SM 311113 12/2/2004
Sodium 19 mg/L 1.0 20 SM 311113 12/2/2004
LAB: Microbiology
Total Coliform Absent P/A 0 Absent 307 12/1/2004
LAB: Physical Chemistry
Conductance 160 umohs/cm I EPA 120.1 12/1/2004
PH 5.7 pH-units 0 EPA 150.1 12/1/2004
Based on the results of the parameters tested,the water is suitable for drinking,but may present aesthetic problems(taste,
odor,staining)due to Iron.
Approved By:
Abli,ector)
/2/ 1 o
t '
RL = Reporting Limit
MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE B,z•nst A p p R n , r
able Co'aser In
�M,6tlrj Applira#ion for Disposal Works Toy M
ruti#
sjg n
Application is h eby made for a Permit to Co struct ( ) or Repair f�) an maiv ,ge Dis_0sal
as
System at: G MTr\
=
Location- ddress � No .�-�- �................
-
/ . ..
Owne�l/a�.r_ IO� . W '� .....ress
1.4 Installer Address. t
d Type of Building Size Lot. _ ----Sq. feet
aDwelling—No. of Bedrooms.....:............... ......_..._....__..__Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures --------------------------------•-----------------•---•••--•••---•-••••---••••••••••--------•--•--•-•••-•-••••••••-•--•---•............••------•---•-
W Design Flow................... ............gallons per person per day. Total daily flow__-_-_-_--�`��...................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--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by---------------------•---•-----------•-----••--•-......-•--••......•••... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fs. Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................
O
Description of Soil...............��'�........���.........�l�_.�.._��!L.......
--�-f�---- -4rP�L`..���
x
W
x •••••-----------------------• -------•••••-••-•-••-•----••---•----•--•---••••--`•••••-•••-•-•----••------•••••••-•-••-----......•-•--•......-••••••••. .....................
U Nature of Repairs or Alterations—Answer when applicable___�,Q. l
---------------s-S .................. Z........... ......... --
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance s b en issue b;y,�.tp board of health.
Signed ........... ................ --------- - ------ -- -- . .. ................... ......
Application Approved By ---- �/._ ' .
�. - yr.
Application Disapproved for the fo lowing reasons: ------------------- ------------------------------------------------------------------------------------------.-....-
-------------------------------- . -- . ----..........
Dale
--------------................... Issued ------. . .........-----...------ -- -- ---------------------
Date
C� ... 7 �
No....!. �J C� E Fss.�- '�......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disp sal Works Tontitr - un_-jCrrmit
1 �< Application is hereby made for a Permit to Construct or Repair an Ind ict�'4Sew•a a Disposal
PP Y ( ) P ('') g P
System at: � Lh _ad .�Ga i" M�\ y
Location-Address or Lot No.
---- �n..S if---- t�J��IS� ----.....���--- LSDU �. i2�fr._ -
Owner
..Address
a s �l1�c�7r i .rT l�✓ 1� � - JiS..
....... ...... •---••---•-••-••--.- ............................................
Installer Address f
Type of Building Size Lot.�.�_:-_._Sq. feet
a ' D, elling—No. of Bedrooms.....................!_�.___................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons.............................Showers ( ) — Cafeteria ( )
Otherfixtures . ----•-----•------------------------------------------------------- ------------
W Design Flow...................._5_5�............ per person per day. Total daily flow........... ..................gallons.
WSeptic Tank—Liquid capacitye& ..gallons 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........................................
1.4
Test Pit No. I................minutes per inch Depth of Test Pit............... Depth to ground water........................
P4 Test Pit No. 2................minutes per inch Depth of.Test Pit-•-______--_----•- Depth to ground water........................
W --------------------•-•----•--- ...-----•-------------------.........................................................
D Description of Soil...............
x r �SCi �d4 - / JDr`. L
W ••••••••--••-----------•••••••----•••-•••-----•--••---••••••----•-•••••••-------••••••.....•-•••--•------•-•----•-•-••--••-••---••-••......---•••-•••••--•^••-�'-
U Nature of Repairs or Alterations—Answer when applicable___1M�--__-_--._1_/)61�_! -._P/T_Gc c _---_•.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance hasb/en�issuueed by the board of health.
Signed ----------1/-------- ------- ----------- ........ �
Date
Application Approved By ................. -�_ : . .. �..�. .__
y=------ -------
Application Disapproved for the f0owing reasons: ......................................................................................................................................
Date
PermitNo. ------- /.- 7�............------------ ---------- Issued --- - ------------------------------------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Tertif rate of Complianre
THIS IS TO CERTIFY, That the Individual Sewwaa e Disposal System constructed ( ) or Repaired (� )
by--------------------------------------- ------------------....fa�Cd"iT�--------- .....................--................................................
Installer
at ........................................................---------- �i 5 Ins GcJ.__ - ....L.� /fir
has been installed in accordance with the provisions of`TITLE 5 0t The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ....../ .-._ _ /---------------- dated ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------------ - �'-y T - Inspector ----------_-- .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No . .�= - � FEE........................
Disposal Works Tonotrurtilan t1irmit
Permission is hereby granted..................... ------ ........................................
to Construct ( ) or Repair (,g an Individual Sewage Disposal System
-----------------------------------•-------------------------------------------------
street '
as shown on the application for Disposal Works Construction Permit No_______________ _ Dated..........................................
DATE. "�G/- --•----•--•--------------------------•----. Board of Health
FORM 36508 HOBBS&WARREN,INC..PUBLISHERS
No.......................
THE COMMONWEALTH OF MASSACHUSETTS•<-
BOAR® Or HEALTH
I .N..........-_....OF.......... �".(�..N.S. .L�.�.C, r ....................
Apptiratiou for Uiivniia1 Works Tomtrurtinn Tirrmit
Application iseby %ta=X71�w?
s ct (� or Repair ( ) an Individual Sewage Disposal
System at:
0atdFlQ1t.I4L_. ... .w.'.. /ZNS���3« :__.� 1�T°��.. [cz,s_ 6� T ............
-...
Location-Address or Lot No.
S_s. �J......-- -- ���
Owner <�Address
w •-�': .................•-•--........._...-- ------. .................................? ..........-•--......-----.......
............ •..
a Installer Address
Type of Building Size Lot-.f.. . .....Sq. feet
UDwelling—No. of Bedrooms.........a...........................---Expansion Attic (too) Garbage Grinder (No)
PL4 Other—Type of Building ............... No. of persons............................ Showers .( ) — Cafeteria ( )
dOther fixtures ----------•------•---------------------�-�i r1--------------•---•---------•---------------•-------------•---------------------------------
W Design Flow............_1467--- ---------------gallons per �i per day. Total daily flow......__T-3a......................._gallons.
WSeptic Tank—Liquid capacity}Anti?...gallons Length_,6._9.---___ Width.Y.-�D.---.. Diameter................ Depth....'_5...
x Disposal Trench—No----------------- --- Width.................... Total Length________._......... Total leaching area....................sq. ft.
Seepage Pit No------- Diameter.&.............. Depth below inlet....-`2-.__......... Total leaching area.P7_9:P_....sq. ft.
Z Other Distribution box (V� Dosing tank ( )
Percolation Test Results Performed by__7.Z.na.At.2>....._/d_e_..-Gt�✓S� �R�'�.5: Date.... -----------
a Test Pit No. I... .:—__.._minutes per inch Depth of Test Pit._/2-'.......... Depth to ground water...!INGevg ---_.
Test Pit No. 2.._G L-...minutes per inch Depth of Test PitZZ-*.......... Depth to ground water._AU..OA t.49:..._...
------------•---------------------•-----•---•------------------.....
----------------------------
.----------------••---•-----------•••---------------------
O Description of Soil.--&/.._.-0._-.-�_.'.�c2.t�.r�...... .�! 5���...__- C[✓�-?-------3-- -c' r , - ----------
Vl�r --•--------- '...... a" .• V _'^_
WCOA.1-�SZ-"--------SAt�_-b-------- ------------------------------------------------------------------------------------------------------------------------------------•--------
VNature 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 iITL L 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.
Sign-dr- ................................................. . -
/)
W ........
Date
----------
Application
Approved BY i Date
-- - •--•----•-------
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•-•••-
--------------------------------------------------------------------------------------------------•••••••••-•-•------------------•--•-•••-•----------------••--••----••....•-•••-•••-•--•••.•--
Date
PermitNo--------------------------------------------------------- Issued_-----------•-------------------I...........-----••-•--•-
Date
No......................... Yuic
THE COMMONWEALTH OF MASSACHUSETTS—
BOARD OP HEALTH
.................OF......... ..................................
Appliration for DiSpatial Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct K) or Repair an Individual Sewage Disposal
System at:
A6� .............................................................
73 A4 0,; A 13 41Z 4 0 7'
...............................................................
Location-Address or Lot No.
................................................................................................. ..................................................................................................
Owner Address
................................................................................................... ..................................................................................................
11nstaller Address
Type of Building Size LotR-ly;?---C/..91......Sq. feet
U Dwelling—No. of Bedrooms___....:?..............................Expansion Attic (aja) Garbage Grinder (Apo)
04 Other—Type of Building ................ No. of persons___....._._............._.._ Showers Cafeteria
04 Other fixtures .......................................................................................................................................................
<11 'pv•M
Design Flow............Z4a......................gallons perj6sio'lnper day. Total daily flow-----lr.X Q........................gallons.
04 Septic Tank—Liquid*capacity4wa...gallons Length46_0......... WidthY 1�4....... Diameter................ Depth....5L
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No...... ---------- e
biameterd............... Depth below inlet.._26............. Total leaching areaA,.Pq.....sq.,f t.
Z Other Distribution box Dosing tank
14 Da'te.-.-R.
Percolation Test Results Performed by..7?.Oz�Ae_?�..........4.......e",................ ............................
Test Pit No. ----minutes per inch Depth of Test Pit_44 ............ Depth to ground water..Aik��......
fi Test Pit No. 2 '....rninutes per inch Depth of Test Pit ............. Depth to ground water. ........
1
P4 .............................................................................................................................................................
0 Description of Soil_29'Z_--n--n.3,....... .............. . . .............
0 �& 2-
............................. ------- -------------
a...........4.A�eh!�#
---------------------------------------------------------------------------------------------..........................................................
U Nature of Repairs or Alterations—Answer when applicable................................................................................................
............................... .............................................................a........................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I T I-E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
0.peratiod'until a Certificate of Compliance has been issued by the board of health.
Signpol....................................................................................... . ........................... .... . .
Date
Application Approved '2
By....../I-- ................. ....................Da-Date
........1.-
Application Disapproved for the following reasons:......... ......................................................................................................
.....................................................................................................................................................................................o--------------------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTHF MASSACHUSETTS
BOARD F HEALTH
.........................................OF..
TwWrtifiratr of Tomphaurr
.;H I TO C TI�FY,,7hat t �Individual Sewage Disposal System constructed or Repaired
by.. ........................................................................ ----
I t, Ile/
C. ......
at.. ....
has been instilled in accordance with the provisions of E' 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit ------------------ dated___71---7�---- ---------------
THEJSSUANCE OFTHIS CERTIFICATE. SHALLNOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM"VILL FUNCTION-'SATISOACTORY.*
DATE-------- ................................................. I-ilspector.......)......6...................... .......................................
el
THE COMMONWEALTH OF MASSACHUSETTS
BOARD Y0 HEALT
(�7�f ........._0F.,,;...
No.........................
FEE........................
Permission jij1hereby granted..... ........ ..... ...
---------------------------------------------------------.......................
to C011.. 110) or Repair .In &i d u a 1 Sew e Dispo System
I K_ '.( . _440 .......... ...................
at No.. 411 4 . ................ .......
Street
as shown on the application for Disposal Works Construction Perm- NO.. Dated...... .............
.......... ----------------------
if Board of Health
DATE........................................................ .......................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
T WN OF BA NSTABLE V
LOCATION -- SEWAGE # 9/— 37/
067Aeo/6
VILLAGE ASSESSOR'S MAP & LOT3
INSTALLER'S NAME & PHONE NO, &M970-60-N7 Cam"
-. SEPTIC TANK CAPACITY 00
LEACHING FACILITY:(type) ,SITS f a (size) ,,-'ox 16,
NO. OF BEDROOMS PRIVATE WELL OR fEECB C .WAT
BUILDER OR OWNER G6 �)C)CSIA4!�Y
DATE PERMIT ISSUED: Z-
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
L
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/�G���
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LOT -1 TEST HOLE 'S
a9 ,Z4.9 0," RESERVE
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T.O.F. EL.= 60.1'+ FINISH GRADE OVER D-BOX= 58.4'± FINISH GRADE OVER CHAMBERS= 582 - 58.6' GENERAL NOTES
PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM
REMOVABLE WATER-TIGHT COVER OVER 3/4"TO 1-1J2 DOUBLE WASHED 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION
- WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE STONE TO CROWN OF PIPE
OUTLET TO WITHIN 6"OF F.G. 4"SCHEDULE 40 PVC ACCESS BOX WITH COVER TO GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
FINISH GRADE 5"DIA. OUTLETS) MIN SLOPE 1% 2"OF 1/8"TO 1/2" DOUBLE WASHED
@ FND. EL.= 59.3 (SEE NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES.
F.G.-OVER TANK EL. = 5$.$ ± STONE OR GEOTEXTILE FILTER FABRIC
2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
PLACE RIISERS ON ALL
DESIGN ENGINEER.
TOP OF SAS= 56.33' CHAMBERS WITH
EXISTING 4" PROPOSED 4" 9"MIN. 9"MIN. „ 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
- SCH. 40 PVC 36' MAX. 55.50 36"MAX. ' INLET PIIPES TO 6 OF
SEWER PIPE BREAKOUT EL= 56.00 SYSTEM UNLESS OTHERWISE NOTED.
SEWER PIPE � FINISHED GRADE
' -- � 3" DROP MAX _ �+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
6 3 2"DROP MIN 3 9 L 60_ PROVIDE WATERTIGHT ELEVATION=56.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
MIN_SLOPE@1% o
1 4" PVC IN FROM JOINTS (TYP.) oo 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
14" \\-*j6.$'± SEPTIC TANK 4"PVC OUT TO 0 0 0 O 0 C� 0 0 0 0 O 0 _ THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
CONTRACTOR TO PROVIDE O LEACHING FACILITY o0 00 > 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
SPECIFIED DROP BETWEEN oo = = 0 0 0 C� 0 0 0 0 0
INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL , 12" 6" 2' o0 0 0 of 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
OUTLET TEE 55.$7 MIN. 55.70 0 0 °° 0 00
SHALL VERIFY SIZE 48 VERIFY CONDITION OF o 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE 00 o a FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION.SYSTEM IS
EXISTING SEPTIC AND REPLACE AS o 0 0 0 0 0 0 0 0 0
OVER MECHANICALLY o _ NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL'FROM BOARD OF HEALTH
TANK NECESSARY COMPACTED BASE
_ 4.0' AND DESIGN ENGINEER.
4.0' 8.5' (TYP) � 4.0" 4.0'
5 OUTLET DISTRIBUTION BOX 4.83 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK#1 ELEVATION OF
IL
TO BE INSTALLED ON A LEVEL STABLE 25.0' (TYP.) 60.00' ESTABLISHED ON THE CORNER OF A BULKHEAD& BENCHMARK#2 ELEVATION OF
BASE. FIRST TWO FEET OF OUTLET 53.50, GROUND WATER ELEV.= < 47.73' 12.83' 58.28' ESTABLISHED ON A CONCRETE BOUND AS SHOWN ON THIS PLAN.
PIPES TO BE LAID LEVEL. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS-PRIOR TO CONSTRUCTION
EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS 5' MI". CHAMBER END VIEW
. .CROSS SECTION VIEWTHROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
"CONTRACTOR TO VERIFY EXISTING SEPTIC TANK PROFILE �o TYPICAL CHAMBER PROFILE /� 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
ELEVATION PRIOR TO ANY WORK& D I S I R I S U f I O N OX D E I A I L CHAMBER DETAILS TO THE DESIGN ENGINEER.
NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
. � �' PERC NO. TPT-19-116
- . :° INSPECTOR: David W. Stanton, R.S.
APPROPRIATE AUTHORITY.
EVALUATOR:John L. Churchill, Jr., PE; PLS
12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
C.S.E. APPROVAL DATE: Fall 1997 TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
43,
• ,• / DATE: August 20, 2019 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
a TEST PIT#: 1
r 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
EXISTING LEACHING PIT TO BE • �� `� _ ,
�} � ELEV TOP 58.40 -----MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL-SIDES OF LEACHING FACILITY.
PUMPED FILLED WITH CLEAN t1
REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
./l ` ELEV WATER= <47.73'
COARSE SAND, AND ABANDONED �i .,µ, FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
WELL /
bAto
/ ;\ n�r,rl - `�1t '~' - - PERC RATE <2 min./inch 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
EXISTING DISTRIBUTION FROM THOSE PRIOR TO CONTINUATION OF WORK.
ch \ ,� SITE CONDITIONS RO T OS SHOWN O
Cl) I BOX TO BE ABANDONED
DEPTH OF PERC= 40"-58"
w I r h0' . t- \ t . 16. PROPOSED PROJECT IS LOCATED WITHIN:
C� cs \ CB ; O TEXTURAL CLASS: 1
Q I EXISTING 1,000 GALLON 8 \ F x ASSESSOR'S MAP 123 LOT 23
a y SEPTIC TANK TO BE \ '` hl
N / UTILIZED..IN.THIS DESIGN \ LOG'US OWNER OF RECORD: BARNSTABLE HOUSING AUTHORITY
Oil 58.40'
Loam Sand
A 10Yr 3/1 ADDRESS: 146 SOUTH STREET
,� 6„ ,
MAP 123 \ // ' ,' 0 Q 57.90 HYANNIS, MA 02601
LOT 21
9 / t g Loamy Sand FEMA FLOOD ZONE X
O y _ COMMUNITY PANEL# 25001 CO542J
(2)4" / �` G� I 1 w;: 30" 55.90'
p° / \ / �` �o \ O I 17. DEED REFERENCE: BOOK 3291, PAGE 247
10 " f ® 181, -►� �s o / ;'. 40" 55.07'
16 O^ \ ? s / ® \ GRAVEL '�a / `' 18. PLAN REFERENCE: PLAN BOOK 250,•PAGE 133
_ w 6 a
/ \ ` \ Perc
DRIVEWAY 1..- ' . 58" 53.57'
/ 19. ALL DISTURBED AREAS `3HALL BE RESTORED TO ORIGINAL CONDITION.
1 \ / Benchmark#1 2a„ / *; 'S
\ / Corner of Bulkhead QJy \ \ ' / / Benchmark#2 Medium Sand 20. PROPERTY LINE INFO_RMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
Elevation=60.00' / \' \ / 22" / To of Concrete Bound \� '� C 2.5Y 6/4 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
�op.o 2 #7 I` �: / / p = FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
Approx. M.S.L. i \7�
Elevation 58.28 ,
EXISTING I Approx. M.S.L. e ., Q
<<�� 3-BEDROOM I �a 8 - c ` 21. A 4"PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A'VERTICAL POSITION TO A
-6p DWELLING l 24" TP 2 GCB/D DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A
TOF -60.1'+ 58 � PROPOSED INSPECTION PORT REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
- I LOCUS PLAN
22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL
\ / 24" N d REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
s" rr o SCALE: 1"= 1000'
128" 47.73'
59 PROP. ✓�-' No Mottling, Standing or Weeping Observed
D-BOX '• CB/DH TEST PIT DATA
� APPROX. WATER SERVICE 59-� �
LINE LOCATION o''y TP 1 O a / DESIGN DATA
58x4' a / PERC NO. TPT-19-116 LEGEND
-
of PROPOSED TWO (2)500 GALLON
H-10 LEACHING CHAMBERS WJ NUMBER OF BEDROOMS (EXISTING) 3 INSPECTOR: David W. Stanton, R.S. 50xO' EXISTING SPOT GRADE
SURROUNDING AGGREGATE EVALUATOR:John L. Churchill, Jr., PE, PLS
MAP 123 NUMBER OF BEDROOMS (DESIGN) 3 --- 50 --- EXISTING CONTOUR
c» cr_ \ ✓ , C.S.E.APPROVAL DATE: Falb 1997
SWING-TIES LOT 9 o - o DESIGN FLOW 110 GAUDAY/BEDROOM r50 PROPOSED CONTOUR
m S ,8WV
y/ BATE: August 20, 2019
HC-1 HC-2 8� / TOTAL DESIGN FLOW 330 GAUDAY 50 PROPOSED SPOT GRADE
_ - TEST PIT#: 1
DESCRIPTIONql�, QO DESIGN FLOW x 200 % = 660 GAUDAY
CORNER OF STONE (1) 32.3' 45.1' a /� �O
ELEV TOP= 58.60' GAS EXISTING GAS LINE
MAP 123 / �� USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER <47.93' 0/HAW EXISTING OVERHEAD WIRE
CORNER OF STONE(2) 50.T 46.7' P�
LOT 23 /
F STONE 3 � / � PERC RATE_ <2 min./inch W W EXISTING WATERLINE
CORNER O O 58.5 59.0 24,248±S.F.
CORNER OF STONE 4) 43.6' 57.7' �P OJ INSTALL 2 500 GAL. CHAMBERS W/ AGGREGATE DEPTH of PERC 40 58 � TEST PIT LOCATION
TEXTURAL CLASS: 1
SIDEWALL CAPACITY LP EXISTING LEACHING PIT
fk �� `p0 (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPDJS.F.) = GAUDAY „
6`L 10� 0 �� 25.0' + 12.83' 2 2' 0.74 GPD/S.F. =112.0 GAUDAYoff
PROPOSED 4 SOLIDI SCHEDULE 40 PVC PIPE
O p �� Loamy Sand ® ® EXISTING 1,000 GALLON H-10 SEPTIC TANK
A
�5 BOTTOM CAPACITY 6„ 1 OYr 3/1 58.10'
HC- 'P`l��
(LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 0 PROPOSED DISTRIBUTION BOX
ks (25.0 x 12.83) (0.74 GPD/S.F.) - 237.4 GAUDAY g
r'� Loamy 10Yr 5/6 PROPOSED 500 GALLON LEACHING CHAMBER
\. MAP 123 •ok� -
#7 LOT 23 30 56.10'
EXISTING \ - TOTALS. '
3-BEDROOM 24,248±S.F.
2 REV.. . DATE BY APP D. DESCRIPTION
DWELLING TOTAL NUMBER OF CHAMBERS - p p pp qq
TOF=60.1'+ \ TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE
TOTAL LEACHING CAPACITY 349.4 GAL./DAY
{2 PREPARED FOR:
Medium Sand
r.. o
C 2.5Y6/4 CAPEWIDE ENTERPRISES
�MN
cP NOTES:
3 . 3) /
O 15.1� 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF LOCATED AT
HC- p EACH SEPTIC SYSTEM COMPONENT.
7 MOUNTAIN ASH ROAD
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE MARSTONS MILLS, MA 02648
(4 °36 p0 - PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT - -
\ ENGINEER LOCAL BOARD OF - SCALE: 1 INCH = 20 FT. DATE: AUGUST 22 2019
DATA SHOWN ON THIS PLAN. REPORT TO ENG C
�'� 128" 47.93' �� � 0 10 20 40 80 FEET
'o- HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA, of
No Mottling, Standing or Weeping Observed
WV 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE GROUNDWATER JOHN L. `".� PREPARED BY:
PROTECTION OVERLAY DISTRICT AND THE ESTUARINE WATERSHEDS AS CHURCHILL JR.
WELL AS A DEP APPROVED ZONE 2. CIVIL �' JC ENGINEERING, INC.
RESERVED FOR BOARD OF HEALTH USE N0. 41$07 2854 CRANBERRY HIGHWAY
4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY Cr
EAST WAREHAM MA 02538
FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS � '
SWING-TIES PLAN SITE PLAN IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL 508.273.0377
SCALE: 1"=20' SCALE: 1"=20' NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT.
Drawn By: BSM Designed By:SJI Checked By: AC JOB No.4778