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HomeMy WebLinkAbout0083 MIDPINE RD - Health 83 MIDPINE RD. , BARNSTABLE A r. �I ASSESSORS MAP NO* No.A .'..��'� PARCEL NO: I® F�s.._. ° .F THE COMMONWEALTH OF MASSACHUSETTS V t. lq BOAR® OF HEALTH Y TOWN OF BARNSTABLE Appliration for Uhipmal Works Towitrurtwit Prrutit Application is hereby made for a Permit to Construct (--j"or Repair ( ) an Individual Sewage Disposal S stem at 7.. .... .._ ...... .� ........................................ ........................... L cat dress -.141-1�_- -rt�0t l ..................................... ?.6..��..... v�------- ----- Owner ress a �----------------------------------- ------- a�t� ...... _ _........--------- Installer Add ess g .V? �__ ..................... Installer feet UType of Building � Size Lot_ ____.__.�.._� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building _______________ No. of persons............................ Showers YP g--------------------------•----------__-•--•P ( ) — Cafeteria Otherfixtures// __..-•---•-------------••-••-•••••-----------•---•------•------- --------....__________---------- WDesign Flow.......................... per person erg day. Total a}ly�ow_.___.___.______............................? ga119ns.N W Septic Tank—Liquid capacity_/y7!r)gallons Length ength_'�__d__. Width�-.9..•-. Diameter________________ Depth....l�____L.. x Disposal Trench—No.......j............ Width_______ ___________ Total Length......7.4p..... Total leaching area...�7t`_!l.sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing to '-' Percolation Test Results Performed b ..--•.- � ' l� L _. Date©C7 ` � y 1 Test Pit No. I....____________minutes per inch Depth of Test Pit____ _ _____ Depth to ground water_._z�G_______:__ . f= Test Pit No. 2...G Z_._minutes per inch Depth of.Test Pit._1 ?_ `_K___ Depth to ground water_ �_�_y___. -----•••-----•--•-...................................................................................... O Description of Soil... ___f ___�L______ _............. ________ -•---•-••----•-------•--•--•--•-•----•-------•-•----•---•---.-----•-•••-----.---••------•-•--•----------------------•.----•-_-•-- W •---••-•-•-••...............•-----•-••-----------•-------•------__.•••-••-----------•-•---••-----••-----•-•--•--------------•••----•--•-••-----•---•------- ............................................ U Nature of Repairs or Alterations—Answer when applicable................................................................................................ --•----••••-•••--••••-------••••---•-----••••-•--•-••-••-----•---•-•----•-------•••-•••-........•••-•--•-----••-••---•---•-..............................-............................................. Agreement: The undersigned agrees to install the aforedes -bed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environ en�al Code— u ersigned fppher agrees not to place the system in operation until a Certificate of Comph b i ¢b the b r ealth. Signed . (/- - ---- ------- ---------'----"--"' -------- ApplicationApproved B ti' ....................... ....................................--.`... . ---......................................... " ' = --------'� Dace Application Disapproved for the following reasons: .......----' ...................'---'- ---------------------------------------................................................ ........................................ ............... ..'--' --....--"---...............--- ---- -------"----------'--- --'------ '--"-- -- ................--"-'"-'"- ' - ----------- Dace Permit No. --��....��....: ....�..... -- --------- Issued '--.. - -- Date T r � � No...-- .d�� `© FEs............... ....�J -A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE A Iiratinn for Din nn�� � 1 Marks Tntmtrttrttnrt thrutit Application is hereby made for a Permit to Construct ( -)or Repair ( ) an Individual Sewage Disposal System,at: ............................. .-[ ...... c V I I ddress j 6pb leT 1 1_1 /�Uo,�iW!/��l�tl 4-� _..................... .....---...---..............__._...._........_..... .............. Owner Ad Tess w _..I' �'Gt ft�t �0.,,�C ,�l �r���1 S d Type .._..... ---................................................ Sq. feet � Installer Address 5 �/y�( T e of Building �^ Size Lot__e....................... U Dwelling—No. of Bedrooms...................._..__...____.___._.____._Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building [_.... No. of persons............................ Showers a YP g -•-•------------------- P ( ) — Cafeteria ( ) Otherfixtures ---------------------------------'---=--------•--•----•-----••-•----•-----•-------••••....••-------•------••--•-----.......-=---------........_-•---• W Design Flow...............____________�..�........_gallons per person per day. Total daily flow....................7 !2_----__-_-•--gallons. Gd Septic Tank—Liquid capacity_/5- allons Length__/!_:�j Width '��''_'._ Diameter______ ________ Depth_- _.� W Disposal Trench—No. ......f............ Width.......!!.......... Total Length------g;!_ Total leaching area...w �,.`-.sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank a Percolation Test Results _ Performed by...._.__ '�_ �%: %_r=f u __________________ Date %_R_ 1 � ' _ --- Test Pit No. 1....4 _.minutes per inch Depth of Test Pit---- Depth to ground water r_ (_, Test Pit No. 2__5-.-.r__._minutes per inch Depth of Test Pit._/__7 sv� Depth to ground water_T,�._..� ---------- f= -------------------•-----------------••------------•-••------------------•----•-----------•---------._-.-•----------•-••••------ O Description of Soil_. .c c �•(���i= -----=1 x f -----.-----------------------------•------------------- V -•------•-•---•---------------•----•------------._....------------_....------------•.._... .... .................................................................................................... x .................................................................:..........................................-•--------•---------••-•-----•-••-•---•-----••-••........................................ U Nature of Repairs or Alterations—Answer when applicable--------------------------------------_......................................................... --------....•-----••----••-•--•---_....-'-•---------•-•---'--•----••-•-•••-•--••-•----------------••-•---------------•------•-••-•-•----•-•--•-'-•-•----•••-•----••--•-•--••-•••'--..._--------.....---- Agreement: The undersigned agrees to install the aforedesc 'bed Individual Sewage Disposal System in aicordance with the provisions of TITLE 5 of the State En, onr� 1 Code—�Thc'u ersigned fu�-her agrees not to place the system in operation until a Certificate of Complia as be issu b the b r alth. Signed .. . ..... ........ -- ------------- - - ------- . ---- -- i %,� `2 Application Approved B -----..--tia� ` rE:...- Dvl Application Disapproved for the following reasons- .............................-------------------------------------'-------------- ----------- ---------..-..----................. - - - ---------------------------------------------------------------------------------------------------------------------- --------------------------------------------- / � y� - PermitNo. ..............................................7..................... Issued - -----/---------------------------------- Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Tantylianre THIS ,T9,,,CA,FiTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .....................................�// ...... ................ ..... = �j�ssy /�/,ey/�/ op /�(�J� has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... dated Z..`..... 4?�................ .�... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTkUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ..... -- ---....... Ins ect0 �;.• � ��! .: :-�� Pr P �. THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH TOWN OF BARNSTABLE �i��rn�u1 ,nrkn �n�n�r�r#inn rruti#_ Permission is hereby granted......... , ---------------.-------• -----•-•-------•-----•--....----------• =•-------•----•---................_.... to Construct or Repair ( ) an Individual Sevcrage"Disposal System at No..e,- '�T...Al.. �-�rl_ �-----..�� �iv rl'r'v �-/ v r Street as shown on the application for Disposal Works Construction,-Permit,)Io�.r_O..';. ..C>.. Dated../"_,71!-_::-:_Zr� _- a_ f rt ��` Board of Health DATE......------------•-----•/---------.....----•--•--------•--•-................... FORM 36508 HOBBS&WARREN.INC..PUBLISHERS T OWN OF BARNSTABLE � LOCATION; iaV( /PCs[. 109A- SEWAGE #. 1L510- L� VILLAGE ASSESSOR'S MAP & LOTW29* -JC*10 INSTALLER'S NAME&PHONE NO.1- '�d��.✓.`���CPt� ivC. i SEPTIC TANK CAPACITY LEACHING FACILITY: (type) size) o�L X,!I kJ }C NO. OF BEDROOMS 3 _ BUILDER OR OWNER SrMDa� C '��,y�sti �ll�P,2Ce_ PERMIT DATE: Zn( COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 LACK bF A-605P, d _e 23 A --b ,32 c 0 ,-o-- -� 36 TOWN OF BARNSTABLE LOCATION. ��' T i�r!✓ SEWAGE #.260L, VILLAGE � � � ASSESSOR'S MAP &LOT+ X---/Y/-0 yINSTALLER'S NAME&PHONE NO. cane'Tn�t. 3B5 '5 3 SEPTIC TANK CAPACITY /S�adCT I LEACHING FACILITY: ) y /.d lLTi�i`TL�'LS (size) �o!L X ll%J XC (type) �o NO. OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: �'"'�, f COMPLIANCE DATE: Separation Distance Between the: IMaximum Adjusted Groundwater Table and 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 I , Furnished by.. , i elf— r �o9- IE tp Q., Id S.d —es r'0-�4 :j9 71�b� I S WEE T SER=ENGI1 VE ERING P.O. BOX 713—SOUTH DENNIS MASSACHUSETTS 02660 TEL (508) 398-3922 FAX (508) 398-3063 LAND SURVEYING—ENGINEERING=TITLE 5 SEPTIC`SYSTEMS . June 29, 2000 Mr. Jerry Dunning Barnstable Health Department u>jL rt 367 Main Street Hyannis, MA 02601 Re: Septic system @ Lot 109A,Mid Pine Drive,Cummaquid Dear Mr. Dunning; This letter is to confirm that on June 28, 2000 I made an inspection of the removal of unsuitable material as required by the Mass Code Title 5 and the approved plan and found the overdig to be in,compliance with the code and plan as indicated. On this date, I made a final on-site inspection of the installation of the septic system for the above ` referenced property and found the system to be installed in substantial compliance with the Massachusetts Sanitary Code, Title 5 and the approved plan by Sweetser Engineering dated December 20, 1999,revised January 13,2000 and per the"as-built" supplied by the installer. . -- If you have any questions or concerns,please call Very truly yours, Theodore A. Dumas, R.S. x _ r • r Q SOIL EVALUATOR& PERCOLATION TEST FORMS i Page I of 4 Town of� Barnstable HARN9'rABLG t Department of health, Safety,and Environmental Services �p °9. .peg Public Health Division �Eo 367 Main Street, Hyannis MA 02601 t)I I i cc: 508-790-6265 FAX: 508-775-3344 SOLI Sulu?1�)IIII y�lssesSll7ellt 101' scumilge IXs ))sal ASKSMORS MAP NQ 3 .� PARCEL NO• NO. Date:_ / I'erfonned By: �p}L Dale• - Witnessed By: Location Address i Owi •r's Name_ 7 Address,and Leta:/ 2P, ., 02630 Assessor's Map/Parcel: Telephone a NEW CONSTRUCTION REPAW Office Review Published Soil Survey Available: No Yes Year Published �g3 Publication Scale :Z Soil map unit Drainage Class _ Soil Limitations —. Surftcial Geological Report Available: No Yes X Year Published L7 Publication Scale Z!2,4dZV Geologic Material(Mal)Unit) _—C� -.--------- Landtorm __LJ109cc � %Dv Tw¢.�—v��tC��ii/�2P -----._-..-._. Flood Insurance Rate Map: Above 500 year flood boundary No Yes )4- Within 500 year boundary No Yes — Within 100 year flood boundary No --- Yes Wetland Area: National Wetland Inventory Map(map unit) � - Wetlands Conservancy Program Map(map unit) — VI — Current Water Resource Conditions(USGS): Month a Range: Above Normal _ _ Normal 11clow Normal _— Other References Reviewed: Ulil'APPROVED FORM-12/07/95 _ l!� r FORM11 - Soil, EVAIXATOR FORM Page 2 of 4 Location Address or Lot IJo. 1 O,t-site Review Weather --I � Deep Hole Number Date: Time: on site plan) Stones Location (identity slope (%) Sur�ae1� Land Use Vegetation Landform . Position on landscape (sketch on the back) . Distances from: feet Drainage Way feet open Water Body feet Property Line feet Possible Wet Area feet Other Drinking Water Well P DEE OBSERVATION HOLE LOGS other Soil Color Soil Soil Horizon Soil Texture (Mansell) Mottling (Structure,Stones,GoauVelirs. Consistency. Depth from (USDA) Surface (Inches) ["1 /8 t4 to ,ea �IR s� 0� rr / to pepthtoBedrock: (L e - Parent Material(geologic) Weeping from Pit Face: ON -- De th to Groundwater: Standing Water in the Hole: Estimated Seasonal High Ground Water:_ 11tv APPROVED FORM 1210719S L 0 Cc c� . s Ir o � 'Ile o� Scan, t:vn�,un rc�rz rc�ttnt Page 3 of 4 Location Address or Lot No. 35D Determination for Seasonal High Water Table Method Used: © Depth observed standing in observation hole I to� inches ❑ Depth weeping from side of observation hole inches a } Depth to soil mottles inches ❑ Ground water adjustment feet Index Well Number Reading Date ... .. Index well level ... g Adjustment factor Adjusted ground water level �V£E,� c oAls r2&cT- .5�pvE 70 cum?£rL w 1 ri-t iM P�2v�ao5 Depth of Natural) '0ccurrin Pervious Material So r�s Does at least four feet of-naturally occurring pervio us'material exist in-'all area's observed throughout the area proposed-for the soil absorption system? ems_____ } If not, what is the depth of naturally occurring pervious material? OUT- � E Q�r�� /� ST42i� T �S Ste _ 5 vl T/f/3G L- Certification cU/L�,�cC GvigT�/z I certify that on �zc 11`14—(date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Date 7 Signature DEP APPROVED FORM- 12/07195 FORM 12 . PERCOLATION TEST Page 4 of 4 a Q Location Address or Lot No. l f • COMMONWEALTH OF MASSACHUSETTS Massachusetts { Percolation Test Date: Time:, -Observation Hole 0 ;�F Depth of Perc °�� ' � Start Pre-soak f 1-,!F�l End Presoak Time at*" Time ate �� y Time aw `-Time W-V) Rate Mir":/Inch• 4 ------------ ' Minimum of 1 percolation test must be performed in both the primary area AND reserve area. SitePassed site Failed ❑..............................................................................................................�-�.w_.........__....__......_ Performed By: Witnessed 1BY: • Comments: �,�....�-V„•...�,..-,..,-,......�..w_,_,.�Mw.�.�._..._w....�..�..�.�-_-.-w�.. of AMOVO FORM.lunn! FFELEV. FOUNDA TION — - - 20 FT. MINIMUM FROM CELLAR -_- DATE SOIL TEST = 10 FT. MINIMUM 10 FT. MINIMUM FROW SLAB OR CRAWL SPACE SAND SOIL TEST DONE BY �y CONCRETE �. WITNESSED BY COVERS-- �\ LOAM AND SEED OBSERVATION HOLE i ELEV.= — OBSERVATION HOLE 2 ELEV.- � _ 4' SCHEDULE 40 PVC PIPE PERCOLATION RATE MIN./INCH PERCOLATION RATE MIN./INCH AT�� INCHES MIN. PITCH 1/8" PER FT. - 2' LAYER OF DEPTH HORIZ TEXTURE COLOR T MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER \ d!f 1 WILD 1/2 ' — WASHED STONE 4' CAST IRO MINPIPEIMUM - -------- - ;-i - 9 7 VENT � I rN (OR EQUAL) L �' _ NOT REQUIRED �� ¢ PITCH 1/Al� l _� `� Z 1 CU. FT. OF CONCRETE � JYvrMI J jr'A .� OW LINE ANCHOR - . �y _ --- cLyY - _ ELEV. _ . _ � 2'0' ° V. LEVEL �, ° , o r ELEV. BAFFLE 6' SUMP ELEV. _ 2D-Ib°ELIV. = � -ELEV. jti.✓�f.4d DISTRIBUTIONL1GUiC OUTLET --- I�Kc� HICh ;-APACi TY INFIL IRF.TORS AlTH � 04P /^ '- � 9 y QEPD� -----___�F.E (TO BE PLACED ON FIRM BASE) BOX STONE IN AN ---�- 3 � �.-`t 4 FEET 14 INCHES 10 BE WATER TESTED TRENCH FORMA":'ION K 5 FEET 19 INCHES IF MORE THAN ONE OUTLET — 6 FEET 24 INCHES 1500 GALLON WATER ENCOUNTERED AT _ ELEV. _ �' 4J6 WATER ENCOUNTERED AT ELEV. 7 FEET 29 INCHES (TO bE PLACEli ON FIRM BASE) SOIL ABSORPTION WELL WATER FEET 34 INCHES SEPTIC TANK % ZONE ��yC�i+7ri, \ 3%4' '0 1 i/2• SYSTEM (SAS) INDEX _ t �� ,,,��� ��-t c ;u�•p, WASHED STONE c ADJUST _ L_EGEND- DESIGN CALCULATIONS NUMBER OF BEDROOMS SEWAGE DISPOSAL SYSTEM PROFILEO OBSERVEDUWA PROBABLE( WATER Bl1' EELLLEV. _ EXISTING CONTOUR V. = EXISTING SPOT ELEVATION 00 OOx� GARBAGE DISPOSALUNIT NO _ NOT TO SCALE BOTTOM OF TEST HOLE: ELEV. = FINAL SPOT ELEVATION 0 TOTAL ESTIMATED FLOW FINAL CONTOUR- — ( 110 GAL/BR./DAY X BR.) GAL/DAY SOIL TEST LOCATION REQUIRED SEPTIC TANK CAPACITY GAL UTILITY POLE -_0_ ACTUAL SIZE OF SEPTIC TANK 1500 GAL / TOWN WATER —W W SOIL CLASSIFICATION I C � / � CATCH BASIN �®� DESIGN PERCOLATION RATE < 5 MIN./IN. i f lj �� CAS JNE EFFLUENT LOADING RATE 0.74 GAL./DAY/S.F. CLEAN OUT — ---' LEACi1t�G AREA Y `` S0. FT. CESSPOOL C.P. 0 LEACHING CAPACITY (AREA X RATE) GAL/DAY r ` RESERVE LEACHING CAPACITY GAL/DaY 14 1 A ALL uNSUITABIF MATERIAL 94ALL BE REMOVED FROM UNDER AND NOTES: FOR A MMM OF s' AROUND SOIL ABSORPTION SYSIEM AND BE 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. REPLACED WITH MATERIAL AS SPECIFED M 310 C1Nt 10.2S3C(3j. TITLE 5 AND THE TOWN OF _ ' RULES AND / +ti REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6. OF FINISHED GRADE. 2� 3. ALL. COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF r WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE a t USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. aNY VASONAPY UN17"' _)SED TC BRING COVERS TO GRADE SHALL BE MORTARED iN PLACE. G� 5. NO DETERMINATION HAS BEEN MADE AS TO COMPUANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS TO CALL 'DIG-SAFE" AT 1-SM-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER O r 0All" \ , \ IMMEDIATELY. / � C� ` �► sir ` �� 8. PARCEL IS IN FLOOD ZONE _9. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL 4ti p .►ps� oa ,,, v t � �' � f APPROVED : BOARD OF HEALTH �fr3y �i 5��4 1.pry ��N. ` ,`�✓` I 0.� DATE AGENT - - � ^114 PROPOSED SEPTIC DESIGN, � L � _ ; FOR \ ., FF OCATION L '! 1 ? oil S WEETSER ENGINEERING 235 GREAT WESTERN ROAD P. 0. BOX 713 �pT � ;► ! /: —.� �`� j faGOS� 2 SOUTH DENNIS, MASS. 02660 DUMPS UJ Q DATE W SCALE _ REVISED -7 .�, LOCATION MAP [_' E_VIS ED FSHEET OF 01999 SWEETSER ENO"'`