HomeMy WebLinkAbout0114 BEALE WAY - Health 114`Beale Way
Barnstable
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Departmont of Regulatory Services
y rsxxraareate : Public Health Division Date
ASS, 200 Main Street,Hyanuis MA 02601
ApFO PAA�
' Date Scheduled Time, )tee Pd.
Soil Suitability Asses,smentf or Sewage Disposal
Performed By: A, Witnessed By.;LOCATION +� �
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. �lion Addrs /lj- .- ,_._ __� . + � , y Owner's Name.
` ! _-�---•_--,.-,:Q P� � t
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Address
Asses�s�M�ep/parcel: a?9 6�- a _ Engineer's Na
mc �d W�
NE ONSTRUM10N REPAIR Telephone I# Q� �64 J ! y
Land Use Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Arear ft Drinking Water Well ! ft
Drainage Way s ft Properly Line 1 ft. Other It
SKETCH' (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proxindly to holes)
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A - 10 (4 LA31
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Parent material(geologic) � `A- Depthlp Bedrock
Depth to Groundwater: Standing Water in Hole: ti Weeping Imil).Pi11`1l1Ae
Estimated Seasonal High GroundwaterT "
]D®ETE NATION FOR SEASONAL HIGH WATER TABLE
E
Method Used: 105., OL O peve
Depth Observed standing in obs.hole: •t-. In, Depth to 5911 31041 s: ��� lu,
Depth to weeping from side of obs.bolt: rt��M(1 V�I!1, CIrowidwater Adjustment—
Index Well#P Reading Datc: Index Well level �;- . AdJ,f}.letor Adj.GrOL111dwuter UVel
l) le eQy.�y =12.3 fi�2 .w• .
PE ROOLATION TEST � Wite d 7l A'lurn ✓o�f?�
Observation
Hole## r / Citite'ftt 9"
q5- P Thne at G'Depth of Perc
Start Pre-soak Time @ I�i Time:(9"-6')
End Pre-soak
Rate*Min./Inch
Site Suitability Assessment: Site Passed_/ > Sit,o-Failed: Additional Testing Needed(YIN) LN
Original: Public Health Division Observation Hole Data To Be Cotnpletcd on Back-- v-
*-'*If percolation test 1S to I)e conducted Wltbin 100' of wetland,you must first➢ otify tile.
Barnstable C;onserviltlon Division at ie-qSt 01113 (1) week prior to begiB➢➢h-19.
Q:1S EPTICPERC FORM.DOC
DREP,®BS]ERVA7 ION HOLE L --
Depth from Soil Horizon Soil Hole #
Soil Texture Soil Color Surface(in.) (USDA) Soil Other
(Munsell) Mottling (Structure,Stones;Boulders,
0` Con istenc %' ravel
- s /L 3/z
1Z- z� M5 l:°6Yk
Vc
Ic Wo
` f
°9 DEEP OBSER
Depth from V��g®N ®LE LOG hole#
p Soil horizon Soil Texture
Surface(in.) Soil Color Soil � Other(USDA) '' (Munsell) Mottling (Structure,Stones,Boulders.
0— f L JG,/�3IL j Consis enc %Gravel
/5-f?v Cz _SL- 1G Y�2 5114 2
4
DE EP OBSERVATION HOLE LOG
Depth from Soil Horizon Soil
oil #
S
Surface(in.)- oil Texture 5011 Color ---'—" ,
(USDA) (Munsell) Mottli Other
Mottling ~(Structure,Stones,Boulders.
Co siste c G ve
DEEP OBSERVATION HOLE, LOG
Depth from Soil Horizon Soil Texture Holt'#
Surface(in.) Soil Color Soil Other
r
(USDA) (Munsell
Mottling (Structure,Stones;Boulders,
Consi ten c a I
)Blood hgslurarwre-11ate m--
Above 500 year flood boundary No Yes ,
+ Within 500 year boundary No_ Yes T
Within 100 year flood boundary No 'Yes ,
Depth of Natlgra➢➢.y�c_ cutrrin�]�ei�vio_____us Material
Does at least four feet of nafurally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? �e5
If not, what is the depth of naturally occurring pervious malarial?
CeHification
I certify that on 'jy (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 3IO CMR 15.017.
Signature_. <. i -'�'''-c••--- b�Z! O g
Date
QASEPrIC1PERCFORM.DOC '
T N OF BARNSTABLE
LOCATION l p��W ll/G� SEWAGE# G-y�uZ
VILLAGE 1'`f'IcJ w,/ e° ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. A2rlVl
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) 5-- Jam'���/y / `(size)
!' NO.OF BEDROOMS J
f OWNERAwz°�164
PERMIT DATE: ` ® COMPLIANCE DATE: =70
It t
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
0
tl
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No. VV/
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
UBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
�\ ftPYicatiun for -MisposaY 6 stettt �onstructiorr permit
p �
Application for a Permit to Construct( ) Repair(ii� Upgrade( ) Abandon( ) ❑Complete System Individual Components
L7' n d ess Qr Lot No. LO `/ Owner's N e,Addres ,and Tel.No.
Asse§sor ap/Parcel �����y L� ble&>>0
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
1)rpe of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(Va
Other Type of Building L® �' No.of Persons Showers(
Cafeteria( )
Other Fixtures
Design Flow(min.require ) gpd Design flow provided i gpd
Plan Date rZ Q Number of sheets / Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil 1 _4"Ag&Z-,Sx Z,
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 issued by this Board of Fjpalth
Si ed
Datebm
Application Approved by ,� Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued 121
,. _ -....r ._..,-..-r. .-..-,.a.„,..7•^-..T.,.k;.s ,...,,......g<ay�/*-'.. _ _._. ...�. .-._ .. _ _ ........--� -, ._ _„„_ •• �+�.I�..w°+a...hn*�r.y,�.,...-... . ...r,_r++.rw.,r«M..� .
No. t,
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
UBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
appYItatlOn for MI8p0saY *psteln COIIBtCUttlOn 13erlYllt
Application fora Permit to Construct( ) Repair({ Upgrade( )'-Abandon( ) . ❑Complete System Q I dividual Components
Location Address or Lot No. 'l�' t/ Owner's Name,Address,and Tel:No.
se Sons'Mapes car el I^/!5 11467,i le
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building: 1
Dwelling No.of Bedrooms 1 _Lot Size �� sq.ft. Garbage Grinder(( a
Other Type of Building / .5,WeWr6' No.of Persons Showers ( )( ) Cafeteria
Other Fixtures
Design Flow(min.required) gpd Design flow provided 3 09, gpd
Plan Date 1D ZZ//Of Number of sheets Revision Date
Title S �r° /S l�iO LY
Size of Septic-Tank ��Q� �`/,�j� Type of S.A.S. s�
✓t.Y,
Description of Soil qk�l 14/ Z-5
a
{
t Nature of Repairs or Alterations(Answer when applicable)
r
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
x,
Compliance has been issued by this Board of Health.
Si d /9' �� '' ~M Date
Application Approved by _ �/� Date /
Application Disapproved by Date
for the following reasons;
° Rai
Permit No. [ `5 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V)' Upgraded( )
Abandoned( )byivi
at 0--y eQ/e 44�-has been cons "acwith the provisions of Title 5 and the for Disposal System Construction Permit No. d
Installer Designer --7
#bedrooms Approved design flow ./`„�� gpd
The issuance of ffis pe °71) 4)
it shall not be construed as a guarantee that the system will ction as designe
Date l d Inspector � ' je_.5�
---- ----'-------------------------------- --------
No. Fe
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS
30isposal *pStrm Construction permit
Permission is hereby granted to Construct(//) Repair(0115, Upgrade( )y /Abandon( )
System located at �� //,4_w,/� !/t/l� 1/ ,��j�j"/f✓�i'� .
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 mtVt be c'm le ed within three years of the date of this permit. f
Date �� Approved by
r
TRANS. NO.:
CITY/TOWN: t-ti (-t-L►
APPLICANT: i�o✓moo�0 2�' �rn� c,�-•�,, �(r�e �i�
ADDRESS: t 1-f
DESIGN FLOW: -'3 v - bpd
REVIEWED BY: DATE:
N/A OK NO
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)]
Locus Provided [310 CMR 15.2204(t)]
Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for
components) [310 CMR 15.220(4)]
Easements shown [310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is required [310 CMR 15.412(4)]
Location of impervious surfaces (driveways, parking areas etc.)
[310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220(4)(c)]
Location and dimensions of system components and reserve areas.
[310 CMR 15.220(4)(e)]
System Calculations [310 CMR 15.220(4)(f)]
daily flow
septic tank capacity(required and provided)
soil absorption system (required and provided)
whether system designed for garbage grinder
North arrow [310 CMR 15.220(4)(g)]
Existing and proposed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes (existing grade el. on
each test) [310 CMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and (i)]
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(1)]
Percolation test results match loading rate? [310 CMR 15.242]
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)]
Observed and Adjusted groundwater (method for adjustment
given or indicated) [310 CMR 15.103 3 and 310 CMR /
15.220(4)(n)]
Address Sheet 1 of 7
N/A OK NO
Location of every water supply, public and private, [310 CMR /
15.220(4)(k)]
within 400 feet of the proposed system location in the case /
of surface water supplies and gravel packed public water supply ✓
within 250 feet of the proposed system location in the case
within 150 feet of the proposed system location in the case /
of private water supply wells ✓
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. [310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[11)
Profile of system showing invert elevations of all system
components and the bottom of the SAS [310 CMR15.220(4)(o)]
Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor (required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as ✓
approved for an upgrade under LUA at 310 CMR 15.405(1)(k)]
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103(4)]
Test Holes adequate to confirm adequate groundwater separation?
[310 CMR 15.103(3)]
Benchmark within 50-75' of system [310 CMR 15.220(4)(q)]
Materials specifications noted? [various sections of 310 CMR
15.000]
System components not> 36" deep (unless Local Upgrade
Approval or LUA requested) [310 CMR 15.405(1(b)]
Address Sheet 2 of 7
N/A OK NO
�JUIC L.L� 1a1-iiVY1,4k. i 'Y� b. <•�.0 �`.2•`.� # ���e"3'.%�v`f�3 �."�•V;'�.�rf l..i s �t ,i r .r
Size OK? [310-CMR 15.223(1)] � •
Inlet tee located ten inches below flow line [310 CMR 15.227(6)]
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR
15.227(6)].
Outlet tee with gas baffle or approved filter.[310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)]
Separation between uzlet and outlet tees (no less than liquid
depth) [310 CMR 15.227(2)]
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5)) or permitted for
upgrades under LUA [310 CMR 15.405(1)(k)]
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (by 7/07) [310 CMR 15.228(2)]
Access to within 6 " of grade - one port for systeins<1000gpd,
two for systems>1000 gpd [310 CMR 15.228(2)]
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)]
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done [310 CMR 15.221(8)]
H-20 Where appropriate? [310 CMR 15.226(3)]
Setbacks from resources [310 CMR 15.211]
xNars+ ast,arrax we« u
1MM1 ®rxbpl faemTS
Required when other than single-family dwelling or flow>1000
gpd [310 CMR 15.223(1)(b)]
First compartment 200% daily flow; Second compartment 100%
daily flow [310 CMR 15.224(2) and(3)]
"U" pipe through or over baffle, outlet of each compartment with
gas baffle or approved filter [310 CMR 15.224(4)]
Address Sheet 3 of 7
N/A Ohl{�`l NO
h Z.
Located at least ten feet from any water line? [310 CMR
15.222(2)]
Disposal piping at least 18" below water line (when water and
sewer cross, see 310 CMR 15.211(1)[1])
Cleanouts required/provided ? [310 CMR 15.222(8)]
Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)]'
Slope of sewer line not less than 0.01 (1/8"/fl) 0.02 preferable /
[310 CMR 15.222(6)] ✓
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CUR 15.251(9) and 310 CMR 15.252(2)(c)]
Siphon problem/ (leachfield below pump chamber)
Endcaps or vent manifold specified?
Size and orientation of discharge holes specified? (not smaller `
than 3/8 not larger than 5/8 ) [310 CMR 15.251(8) and 310
CMR 15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed)
Stable compacted base [310 CMR 15.221(2) and 310 CMR ✓
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMM 15.323(3)(a)]
Riser if deeper than 9" [310 CMM 15.232(3)(f)]
Inside minimum dimension 12" [310 CUR 15.232(2)(b)]
Minimum sump 6" [310 CMR15.232(3)(e)]
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
[310 CMR 15.232(3)(d)]
Capacity(emergency storage above working—design flow)? [310
CUM 231(2)]
Proper setbacks [310.CMM.15.211 (same as septic tanks)]
Watertight 20-in mmium access manhole at least 20"MUST BE
TO GRADE [310 CMR 15.231(5)]
Service components accessible (not too deep with piping,
disconnects accessible)
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two um*ts must have two pumps operating in lead-lag
mode. [310 CMR 15.231(6) and(8)]
Stable Compacted Base [310 CMR 15.221(2)]
Buoyancy.calculations needed? Provided? [310 CMR 15.221(8}]
Address Sheet 4 of 7
r
N/A OK NO
LSOII'tT[�1f SYSTdl ( ).: �slA'T .: ? .: y `
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)]
Required separation to groundwater? [310 CMR 15.212)] .
Aggregate specified as double washed [310 CMR 15.247(2)]
System Venting required/provided? (system under driveway or
>36" deep) [310 CMR 15.241] .
Inspection ports specified and within 3"final grade? [310 CMR-
15.240(13)]
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document]
Chambers and Gal. in trench configuration supplied with inlet /
every 20 ft. [310 CMR 15.253(6)]
Each structure with one inspection manhole (if>2000 gpd must /
be to grade) [310 CMR 15.253(2)] ✓
Aggregate 1'minimum- 4'maximum. [310 CMR 15.253(1)(b)]
2' sidewall credit maximum [310 CMR 15.253(1)(a)]
In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)]
Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)]
100 feet-maximum length [310 CMR 15.251(1)(a)]
Minimum separation 2x effective depth or width whichever
greater (3x if reserve between trenches) [310 CMR 251(1)(d)]
Situated along contours [310 CMR 15.251(2)]
Breakout OIL? [310 CMR 15.211(1)[4] and Guidance Document]
minimum 2 distribution lines [310 CMR 15.252(2)(a)]
Maximum separation between lines 6' [310 CM RI5.252(2)(d)]
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)]
Aggregate depth below discharge pipes 6".m1inimum, 12"
maximum. [310 CMR 15.252(2)(g)]
Separation between beds 10'minimum. [310 CMR 15.252(2)(f)]
Bottom area used in calculations only [310 CMR 15.252(2)(i)]
Address Sheet 5 of 7
N/A .OK NO
Pressure Dosed System"? Provided pump and piping
calculations as required [310 MIR 15.220(4)(r)]
Pressure dosing required on all systems>2000gpd or alternative .
systemsunder remedial approval [310 CMR 15.254(�2) aiid I/A
Remedial Use Approvals]
If used in gravelless system-make sure jet is directed as not to `
Guidance Document
scour soil interface [ ]
Inspections once per year (systems<2000 gpd) or quarterly
(>2000gpd) good to note on plan [310 CMR 15.254(2)(d)]
Construction in fill -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255(3)?
Impervious barrier and/or retaining wall ? [Guidance Document]
Impervious barrier installation must be supervised by f
designer [310 CMR 15.255(2)(b)] a
Retaining wall must be designed by Registered Professional
Engineer [310 CMR 15.255(2)(a)]
Side slope not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements islet? [310 CMR 15.252(2) and t
Guidance Document]
At least 5 ft_ from impervious bamier to edge of SAS "(10 ft.
recommended) [310r CMR►77175.255 (�r22)(e)]
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
x
lte" r Sies ep�i I/ CLe tern ��
w Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied"and does it meet all
DEP Approval Conditions?
Is there a note on the plan'regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate`cucuits r _
Did the applicant submit an operation and maintenance,
manual?.
Has applicant`°submitted a copy of a maintenance
i�tace111 Oil 1111 11 '
Are the variances listed on the plan? [310 CMR 15.220
�RLS Stamp necessary on plan if a component is within five
feet of property line [310 CMR 15.412(4)]
New construction or increased flow proposed- [Refer to 310
CMR 15.414]
Address ` Sheet 6 of 7
i
N/A OK NO
Is the system in a Designated Nitrogen Sensitive Area(Zone II for
a public supply well)? [310 CNM 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ?
[310 CMR 15.214(2)]
Are the nitrogen loads proposed in compliance? [310 CNM
15.216(1)]
Pumping to septic tank ? [ 310 CMR 15.229]
Shared System [310 CMR 15.2901
Address Sheet 7 of 7
FROM :down cape engineering inc FAX NO. :15083629880 Nov. 20 2009 03:39PM P1
Town OUBarnstable.
Regulatory Scirvices
' 'eThormas F. f4 ilae.r,Director
Thomas McKean,Director
200 Mida Street,Ilyaannis,MA 02601
Otfice.: 509-862-4644 t Tlx:.508-790-6304
Atnstafle:r a4k Desa Netr Cer ifiaaQtion Fabfl_!
dad �,�s� `' i
1Date: ��c�a�I;c Pea°>saflad# <�-u�/Z �•(/Adwe(ascDr'%Msa1bIV'arcc.l.Z/7`
6)esi. nneir, 1-')()vJ o, J +,, , _q n 6c c:c•� 1-.
p /
Address: ( fqCc r � Address: � � . 601 r��
Ila
` d� O ^`� w�7S i55tlect a permit to instafl a
(date) (1a15 trill L1'}
4 septic stem at J A /• ] Y
X' -----.....�C.. Vv based on a design drawn by
rr (address)
1 / �^ a (Q dated .
(de.. ler}
_ l certify that tile, septic system rckrcticed above Was installed s1bAw. ially,a.ccording to
the design, w1iich may include, minor approved changes such as lateral relocation of ffic
distribution box and/or septic tank. ,
certify that the septic systemreterenecd above wivs instaJl.ed with majorchwiiges (i.e.
greaTter, than_l0' lateral relocation ofthe SAS or any vertical relocation of any component
of t.lxe septic system.) but in accordance with State &Local Regulations. Plan revision or
certified a.s-built by designer to follow. t,e,-e_tA f=a4-_t I-L( AL_Temr e
ZO J'L�sS cl" 1 a44%—�4 Cro t. x7 4r i r ti fish t *u
• - k�NUFMgs - f
�WsDA IEit A s
CIVIL b,
No 46502
Jv�v�ref°r as cti'��<�`�`
1CDl SOW E
(Designer's Signature) � 'stamp J e)T � ; r ' T
PLEASE RETURN TO BAKNS TAIil'S T'UI3LIC HEALTH IDIVISION. CERTItIC'ATE OF
COMPLIANCE WILL L N0'1. 1W ISSIU'B±D *L)N'L'LL 9iorki '1-H.IS FORM AND AS-BUILT C;ARQ ARE
RECEIVED BY THE HE UAI1NSTABLE PUBLIC HEAL'1'11 DWISIO N. '11111t"'K YOU. -�—
0:,TTea11:11/Se11LIC/T)e:'ij;ller Ceitil ICatim Form 3-2644.doc - -
FROM :down cape engineering inc FAX NO. :150836213880 Nova 20 2009 03:40PM P2
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SEPTIC AS-BUILT
PREPARED EXCLUSIVELY FOR THE HEALTH DEPT.,
LOCATION 114 BEALE WAY,BARNSTABLE
SCALE 1" = 20' NOV. 20, 2009 PREPARED FOR: .
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land surveyors l 70 ---- —�.. r
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YAR'MOUrrinnRr MA o7575 DATE REG. LAND SURV UR
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141 � 7
Town of Barnstable P#
03 _ 0 D3 Department of Regulatory Services
• Public Health Division Date
aetutarABrE, �
MA &
200 Main Street,Hyannis MA 02601
�p�EDM1t�
Date Scheduled : 0 Time ' t tee Pd..
Soil Suitability Assessment for Sewage Disposal
Performed By:_Ddig:� Witnessed By: Z�K
LOCATION& GENERAL INFORMATION.
Location Address // KJ Owner's Name
I ��ill.
/ I
Address '
Assessor's Map/Parcel: p� 9 j�o °� Engineer's Name -✓� f ce/
NEW CONSTRUCTION REPAIR r Telephone# �S� J 6A
Land Use 1t, Slopes(%) Z r �� Surface Stones
Distances from: Open Water Body ft Possible Wet Area>2�U R Drinking Water Wellft 7
Drainage Way/> i ft Property Line ft Other
SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands fn proximity to holes)
G
Parent material(geologic) Depth to Bedrock
C&f�
V1
I t 41
Depth to Oroundwater: Standing Water in Hole: eping from Pit Pnce
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TARE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles:_ ,: In.
Depth to weeping from side of obs.hole: In, droundwater Adjustment fl.
Index Well# Reading Date: Index Well level Adj.factor_ Adj.Oroundwater Level
PERCOLATION TEST Date IY a
Observation Time at 4"
Hole#
�l Z1�.�
Depth of Pere lime al 6"
Time(9"•G"
Start Pre-soak Time
@r )
End Pre-soak 5_44.1n� t
Rate Min./Inch
.t,« ' 'a 4
Site Suitability Assessment: Site Passed_ Site-Failed: Additional Testing Needed(YIN) }
Observation Hole Data To Be Completed tin Back=----------
Original: Public Health'Division ' \
***If percolation test is to be conducted within 100' of wetland,you must first notify the, !f
Barnstable Conservation Division at least one (1)week prior to beginning. V I �(� �
Q:\SEVrIC\PERCF0RM-DOC
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,,Boulders.
Co i ten Gravel)
r
V ,
DEEP OBSERVATION HOLD LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color
Surface(in.) Soil Other
(USDA) (M.;scl;). l.iatlliag (Structure,Stones,Boulders.
Co sis a 96 Ora 1
- 0 �� S 2� s- •
G �
{ DEEP OBSERVATION HOLE LOG Hole#Depth from . Soil Horizon Soil Texture
` Surface Soil Color Soil Other
(USDA) (Munsell) Mottling (Structure,Stones,Boulders.
C i tencv,qo Oravetl
-------------
DEEI
Depth from OBSER VA 7 ION IOLI LOG �
,
H ol e#
Surface(tn.) ;Horizon: Soil Texture Soil Color Soil
r
• (USDA) Other
(Munsell) Mottling (Structure,Stones;Boulders,
onsi r. r.
�r
-----------------
Flood Insurance Rate Map.,
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No_X Yes
. -ate:� .:.' M:W. .. .. ....;. _., , ._. »:a > ,•..., k i' ;
Depth of Naturally Occurrine Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? _
If not, what is the depth of naturally occurring per sous material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Env' on ental Protection and that the above analysis was performed by me consistent with .
the required train', ,expertise an a erience described in 310 CMR 15.017.
Signature �� 2
Date T
Q WEPT10PERCFORM.DOC
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Town of Barnstable P#
0
3 _ O D0 Department of Regulatory Services
u,18TA81X : Public Health Division Date
MAB& a 200 Main Street,liyamnis MA 02601
FD xU't
/ vv
Date Scheduled ' 0 � �Tiine Fee Pd.
Soil Suitability
yyAssessment for Sewage Disposal
Pcrfonned By:_ aJ v `i✓L _9 2-- Witnessed By:
LOCATION&GENERAL INFORMATIONr.
ll`fLocation Address ,/Q� L,J _ Owner's Name 1 ! �
Address
vr✓✓ 61� % I /
Assessor's Map/Parcel: .t�7 9 6 1" Bngineer's Name
NRW CONS'I'RU,CT70N REPAIR 7 Telephone a SoJ ,3
Land Use' �� �l k� Slopes(%) G y.) Surface Stones CCC'gS/p/'7�a
Distances from: open Water Body Z B Possible Wet Area/ Z fl Drinking W`a�te{r Wcll
Drainage Wny/>2' _ft Property Line�0 fl Other •"" / (��r�" `
d�QY z�'✓
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locale wetlands in proximity to hates)
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<Si��H SHoW S Iz-11-1 joy AND 11 J28 f of TES
F'ov9. 03GGAVA7 0PJ HO�-eS
Parent material(geologic) f Laq dxff 3,;�S Depth to Bedrock Al
/r
i Depth to Oroundwalcr:Standing Water in Hole: W cplug IYom Pit Pace
Estimated Seasonal high Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole.- __T T W ht, Depth to soil ntuttles:
Depth to weeping front side of obs.hole: -,-.._,.,-�Ih, tlrotindwnter Adf d.9lhlcnt—ft-
index Well a Reading Date: Index Well level._;- Attl.factor Adj.Grout denier Level,,,,.,
PERCOLA'I'IUN'I'I:S'I' Wig J1.2 urn :OG'r9r
Observationw1tN
Time nt 4"
' Holca
Depth of Pere !yv ll�✓l Time At G"
' Start Pre-soak Time @ Time ff'- )+S 1
j End Pre-soak_ 1 J 41I/v PO
Rate Min./inch -
Site Suitability Assessment: Site Passed_._, , Site-railed: Additional Testing Needed(Y!N) ,
Original: Public Health Division Observation Bole Dala 1b Be Completed on Back-----------
***If percolation test is to be conducted within loll'of Welland,you nulst first Hotify t11e.
Barnstable Couservalion Division al least one(1)week prior to bcgiuning. p( 2
Q:\scpTl0PrRCrORM.DOC �/� 1 17t' ✓ ,
DEEP.OBSERVATION IIOLE LOG Hole#
Depdr from Suit horizon Soil Texlure SdiI Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
on i ten Qravell
/U
DEEP 013SERVATION ROLE LOG Hole#
Depth from Soil Ilorhon Soil Texture Soil Color Soil Other
Surface(in.) - (USDA) (N R:nsell) 6:utL'iab� (Structure,Stones,Boulders.
Consistency.%GravcR
r 3 3 /Av
DEEP OBSERVATION DOLE LOG Hole#
Depth from Soil Horizon Soil Texture Surface(in.) (USDA) Soil Color Soil Other
(Munsell) Mottling .(Structure,Stones,Roolders.
C n islertcy.7u Omvell
DEEP OBSERVATION HOLE LOG Hole At
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) M011ing (Structure,Stones,Boulders.
onsistency.96 0ravpJl
Flood Insurance Rate Map: 02.
Above 500 year flood boundary No-- Yes
Within 500 year boundary No X,_ Yes
Within 100 year Road 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
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring per sous material?
Certification
I certify that on Z 7,00 (date)I have passed the soil evaluator examination approved by the
Department of Env'on enlal Protection and that the above analysis was performed by me consistent with
the required train' ,expertise an a perience described in 310 CMR 15.017.
Signature t�-r Date 7f7v
Q:15.B1'TIC\l'RRCpORM.DOC . . 2 4 3
i I
I _
i.
Town®f Barnstable P# J
Department of Regulatory Services
]Date a Public Health Division.
J Q
200 Main Street,Hyannis MA 02601
Date Scheduled
2 Time ` H Fee Pd./}
Soil,Suitability Assessment f®r°Sewage P,jsposal
Performed By:
1/UCfiY! � �n[✓ Witnessed By v'
- -
f J LOCATION&GENERAL
ca INlF OI2MATIOIV,I
��"1 ,J2�IP �/ OwnersName ��inc�yP(�
lotion Address wta/y (Jlt/ / -
Address.
/ Engineer's Name fi7OUJ4l
Assessor's MaplParcel: 2�� ��1--GU2 .
I
NEW CONSTRUCTION �_ REPAIR Telephone#
GC.CA l5/PtW/9L
Land Use n ^��"'t�"""-" Slopes(`Yo) 2—S U Surface Stones -
t ]GYJ� ft Possible Wet Area Z�tft DrinkingWa[erWell
Distanr from: Open Water Body i
`Ia o t()i
ft Other
Drainage Wy ZGGftfper1yLne
SRETCH:
1
(Street named m sions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes)
1 11�17
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LOCATION SEWAGE PERMIT NO.
pBeale Way, Barnstable, T` .a. 85-645
VILLAGE
Barnstable
INSTALLER'S NAME i ADDRESS
CASH'S TRUCKING INC. . Bx 7 . off Uhion St . .XarmouthPort
B U I L D E R OR OWNER `
Stephen Hinckley, Owner
DATE PERMIT ISSUED 7/9/85
DAT E COMPLIANCE ISSUED
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Town of Barnstable P# o 7
Department of Regulatory Services /
•.nat+area14
Public Health Division. Date ° D
rosy. a 200 Main Street,Hyannis MA 02601
.�
/sp
Date Scheduled 2 l? b Time ''1� Fee Pd.�—
Soil Suitability Assessment for Sewage isposal
nn n ''
Performed By:V ULf/Y1 t��t[��1nn���,,,,''- -Vnc- WimessedBy: J=-�
LOC QATION&GENERAL INFORMAT,I1ON
1,=tionAddress ��.(.� {1`/� �JH Owner's Name J7jnCI�P�J .
Address
AssessoesMap/Parcel: 2 l' (�(o�-�U2 Engmeer'sName Po WA Cu�CO J�i�
NEW CONSTRUCnONp_� REPAIR Telephone# P Y-<'6 2`V;(1
Land Use tiX9M Slopes(56) -S U Surface Stones (3GCf}f5/U�Y/4�
Distan from: Open Water Body ZQY- � ft Possible Wet Area Zl-1-1-ft Drinking Water Well�
ZGo¢ line rU f It Other his{^r, ry10.W� ft
DrainageWay� ft Property r —t
(S�ooldl(!•Q R4lOCti-�fv�l
' SKETCH:(Street namee.,d m stons of lot,exact locations of test holes&pere tests,locate wedjaands in proximity to holes) /
' 1 � t1A?o`i '
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i I :
ti
Jj
0
�o \ ttNo Vk
r5'
Parent material(geologic)q c t �� -Depth to Bedrock 300
Depth to Groundwater.Standing Water in Hole: g Q oz- Weeping
/from Pit Pace A1.4 mz4
Estimated Seasonal High Groundwater 9i✓�/ /'r�Y^-` '"1 Z'3)fir `
I DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: Of!5?9L4-1`,ff2&J OLU Q'Y<a L 5- 04V"i u
Depth Observed standing in obs.hole: *_In. Depth to Soil mottles: —la• ' gs ii i 1 t
Depth to weeping from side of obs.hole: 11), Groundwater Adjustment .ft.
Index Well# Reading Date: Index Well level_ Adj.(actor ®�Aru,Arou dwater level 7eI ;?-5
PERCOLATION TEST Date 1110 Tit a tgli 6L' II:35i
Observation �I i.D?,.
Hole# I Time at 9"
Depth ofPerc
Sz r r. Gy"P/�cf '7 Time at 6"
Start Pre-soak'l'me Q - 'O:'.t' - 'lime(9"66')0•32' -
i
End Pre-soak 1Of37
RateMinAnch !!A7,A-111"44-
6n Ne
eded
ea /N
1 Testing )'Dona (Y
X ire Failed. Additional g
Site Suitability Assessment: Site Passed S ,
Original: Public Health Division Observation Hole Data To Be Completed on Back-
'' � l�Gy 2u�to Yt•/oCc� rucl'f?{` 1�'1Q-ri�� /v'f�oryl sy57'E�Y7
***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; -7
QASEPTICIPERCFORM.DOC p# 1 o�I
lr"�P( 2
DEEP OBSERVATION HOLE LOG Hole# Zo,.
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) I (USDA) _ (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
w - c7
DEEP OBSERVATION HOLE LOG Hole# Z 0 z/
Depth from Soil Horizon Soil Texture Soil Color
Soil (Structurther
e,Stones,Boulders.
Surface(in.) #L (USDA) (Munsell) g n•stenc ravel
,may 13Z , G
w ' wo-
-
rti<b z-
DEEP OBSERVATION HOLE LOG 'Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other•;
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Grav
�.
, o
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other _
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
on iste ra I
i
Flood Insurance Rate Map: :P4 ,p'i�-7
Above 500 year flood boundary No—
Within 500 year boundary No_ Ycs._.:_ - -
Within I00 year flood boundary No— Yes
Depth of Naturally Occurring Pervious Material.
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
iyi4 y N•e.e%f -�o r c lGcwt- w4 f-v-) rj•J wt n,t �,/�' �Mw,7"C) `
Certification
I certify that on t" 9`•l (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 CMIIt 15.017.
/�C� � Date
Signature �� t
2 0�
Q:\SBPTIC PERCFORM.DOC - -
,
SYSTEM PROFILE MALL SYSTEM ARKED WITH CMAGNETIC T BE NOTES
TAPE OR
PROVIDE 20" MIN. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS NGVD
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE
PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 2• MUNICIPAL WATER IS EXISTING Barnstable Harbor
\ 23.3 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED VER SYSTEM
4. DESIGN LOADING FOR ALL PROPOSED PRECAST
PRECAST H-10 2" DOUBLE WA��H D P TONE o
IEI UNITS TO BE AASHO H-Q
RISERS
4"0SCH40 PVC OR GEOTEXTILE FA R o Locus
21 .37 ' °Q
PIPES LEVEL 1ST 2' 19.0 5. PIPE JOINTS TO BE MADE WATERTIGHT. Cb
Ad
,00y
10" EXISTING 14" o0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE �� � 9§1
I000 GAL H-Io 0 18.5' 8 310 CMR 15.000 TITLE V.
TH
TEE SEPTIC TANK TEE 19.9 f*'
(RE-USE)** °°°000°°°o°° 6" MIN. SUMP ( )
GAS BAFFLE °0°°°°°°°°°° 12" MIN. INT. DIM. Q 12�8016.5' a
°°°^ °^° o�oZS$ oo 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND o°
18.68' 18.51' H-20 3050 INFILTRATORS NOT TO BE USED FOR LOT LINE STAKING OR ANY �ol2�oa eoc
OTHER PURPOSE. d Qg
3/4" TO 1 1/2" DOUBLE WASHED STONE 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 40' X 10.25' 9. COMPONENTS NOT TO BE BACKFILLED OR
COMPACTION. (15.221 [21) 5.2' CONCEALED WITHOUT INSPECTION BY BOARD OF o
HEALTH AND PERMISSION OBTAINED FROM BOARD
(2.4% SLOPE) ( 1 % SLOPE) OF HEALTH.
FOUNDATION- EXIST. SEPTIC TANK 50' D' BOX 3' LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP
FACILITY CALLING DIGSAFE (1-888-344-7233) AND
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT VERIFYING THE LOCATION OF ALL UNDERGROUND &
BOTTOM TH-1 11.3 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NOT TO SCALE
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE WORK.
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 279 PARCEL 61-2
SHALL BE REMOVED 5' BENEATH AND AROUND THE
PROPOSED LEACHING FACILITY. LOCUS IS WITHIN AP DISTRICT
+20.39 v20.94 I o 12. EXISTING LEACHING FACILITY SHALL BE PUMPED (NO CONSTRUCTION PROPOSED)
LEGEND �� I AND REMOVED OR PUMPED AND FILLED WITH CLEAN
I0 J X SAND.
X 9 99 _ EXISTING CONTOUR I w 9 94 _-� IX 20.04
21.77 �m c�
X 99. EXIST. SPOT ELEV. MH W 79.83'
99 PROPOSED CONTOUR N + .85
5' REMOVAL OF UNSUITABLE 22.31 2
(98 4 SOIL/SYSTEM/STONE REQUIRED AROUND 653
PROPOSED SPOT EL. PORTION OF PERIMETER OF LEACHING FACILITY
TH1 (AREA OF EXIST. SAS), DOWN TO SUITABLE I+22m3 20.08 1 21.46
SOIL LAYER. REPLACE WITH CLEAN MED. SAND, I
TEST HOLE TO MEET SPECIFICATIONS OF 310 CMR I > 20.3J
2>_ SLOPE OF GROUND I I EXIS SAS BENCHMARK
COR. CONC. BULKHEAD SYSTEM DESIGN:
UTILITY POLE a 1 + ELEV. = 22.4'
1
co 23. .31 1 i 21. 6 �+20 � � GARBAGE DISPOSER IS NOT ALLOWED
FIRE HYDRANT m 1 1 I I Z
Y > 22.28 I 1 -i 21.3i +10.36�
NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING r - _ I 2 n�c lnnl rL�l�l. ocnonOk,,AS f I non = z zn non
-� \.. I / GL .. r. r7c,"n r 1 \.. : 3 ✓� 11",VIyiS � I i VI v
rn 22. vvy wii v
I 3 18 1 +T .44 L2.87 USE A 330 GPD DESIGN FLOW
20 22
TEST HOLE LOGS D 22.28 TH 1 + 7 2 09 1 21 7 SEPTIC TANK: 330 GPD (2) = 660
-c
ENGINEER: ARNE H. OJALA, PE, SE +22.7 I TH 2 22 55 2z68 23 89 DECK RE-USE EXISTING SEPTIC TANK**
22.86 SCREEN LEACHING:
WITNESS: DAVID W. STANTON, IRS PORCH 22.45
OCTOBER 21, 2009 SIDES: 2 (40 + 10.25) 2 (.60) = 120.6 GPD
DATE:
PERC. RATE _ < 5 MIN/INCH EXISTING I BOTTOM 40 x 10.25 (.60) = 246 GPD
DWELLING I TOTAL: 495 S.F. 366.6 GPD
CLASS II SOILS P# 12732 WSO Y TOP FNDN
+21.Y-W W ELEV. = 23.3'
+21.91 W o 21I USE (5) 3050 INFILTRATOR CHAMBERS
ELEV. z ELEV. I +21.26 I I WITH 2.25' STONE AT ENDS AND 3' AT SIDES
Opp 22.3' p" � 22.3' � 2z67 I
A A I
+21.45 22. 7 I i�
LS LS I�21.28 0 MA
1291 8
1OYR 3/2 1OYR 3/2 I 3326 UG ELEC.ELMET I ri SITE
DATE BOARD OF HEALTH
B B
TITLE 5 PLAN
I
MS MS N OF
2691
20.1 26 20.1 N 10YR 7/4 10YR 7/4 I
W 114 BEALE WAY
I
LOT AREA: 44,491t SF BARNSTABLE
C1 C1 I
(1.02t ACRES)
APPROX. EXIST.
MS MS I DRIVEWAY AREA PREPARED FOR
48" 10YR 5/8 18.3' 48 BORTOLOTTI CONSTRUCTION/rr 10YR 5/8 18.3' I I
GREEN
PERC i OCTOBER 22, 2009
T I
C2 C2 I �ZN OF MqS N OF MgSs9 � syc off 508-362-4541
DANIEL �G I fox 508-362-9880
SL SL �s �! �� DANIEL A.
,®0 I C I o OJALA `" A' --Adowncape.com
CIVIL Noo.0980 down co a en inee�in
JALA
10YR 5/4 10YR 5/4 I I No.465 8 g /nC.
132" 1 1 .3' 120 12.3' I I Po��Sc/S NG��� �qNo U P Civil engineers
NO GROUNDWATER ENCOUNTERED Scale: 1' = 20' I 'O��' land surveyors
�a'�_ 939 Main Street ( Rte 6A)
0 I DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
0 9-2 3 5 0 10 20 30 40 50 FEET
I 09-235.DWG(SBO)