HomeMy WebLinkAbout0179 MIDPINE RD - Health (2) 17 h 7-')
6 ,1 t-
No.
2 OSS Fee ls�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitatlon for Biispo pstem (ConstrUttion Permit
Application for a Permit to Construct( ) Repair(K"
Upgrade,( Abandon( ) [Complete System ElIndividual Components
Location Address or Lot No. ir) a Owner's Name,Address,and Tel.No.`7a')'V-a8
Assessor's Map/Parcel ��;►�l^�� � � DaQ60
Installer'js NName��A, ddres ,and el.No.� �_.�8 ��� / Designer' ame A ess,an Tel.No. �jpg ,765-ySy
�r/0 LYl i rc, %rl�v�i' ln 3f
s
Type of Building:
�����Dwelling No.of Bedrooms Lot Size — sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) YW gpd Design flow provided gpd
Plan Date o6a Zl- Number of sheets Revision Date
Size of Septic Tank Type of S.A.S. -� [
Description of Soil
Nature of Repairs o Alterations(Answer when applicable) Q
r
IU 3 , ' W
Date last in ected:
Agreement:
The undersigned agrees to ensure the construction and maintenaln of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental C:Z� not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 7j�r:2�S� Date Issued 2
!C{ oc
nt
No. , Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V
PUBLIC HEALTH DIVISION - TOWN OF, BARNSTABLE, MASSACHUSETTS Yes
2pphration for verrnit
Application for a Permit to Construct( ) Repair( Upgrade()>Abandon(:) ®Complete System Individual Components
Location Address or Lot No. 1r) Owner's hame,LA_dd`ress,and Tel.No.?,179
Assessor's Ma /Parcel // { t `ramp`jrgt"Z�
Installer's Name,Address,and Tel.No.J`V5'y,7 lP4q Designer's-Name Address,and Tel.No. .`jp�
6ori<o ;c r fr't.G �v% Ln 5�5 x�'i. `1-7k) r/7t r! .T»c, q, y/t +gin �f'
e � • o -
Type of Building:
7�s1..�Dwelling No.of Bedrooms Lot Size 0 � •- sq.ft. • Garbage Grinder( )
Other Type of Building No.of Persons -Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) AM gpd Design flow provided �,� gpd
/��
Plan Date`1rt nlAx4AA1�(,�, GbolZ�- Number of sheets f Revision Date
Size of Septic Tank /.SlY)94.1 Type of S.A.S.
Description of Soil
Nature of Repairs or/Alterations(Answer w/hen apj?licablle),y,,rr�I�F /b�I /)*14'i rP o4 L>, raltf e jwr�i5j�r/t/CJ�✓/Ja"� �� )
(�/'Y.J!�E''l .,C//
Date last insp ted:
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 od"e a"" nd�to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. '
}, Signed Date ; /P,f `,�1..
Application Approved by Date Z�?��
Application Disapproved by �' Date
for the following reasons
- Permit No. Date Issued 'Z hzzil
r
-
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded
Abandoned( )bat�j/ ,c� »SrYde.f�'d✓Y�.._ t
has been constructed in accordance t
with the provisions of Title 5 and the for Disposal System Construction Permit No. 7iQ2i/2.` ,, �dated
l t
Installer��a F7�i f i e��A�„�� y7C- Designer ,In t..�tze_ �,n,�xtyL4g fz ,tA? ?n C,
#bedrooms Approved design flows 7 �� gpd
The issuance of this permit shall not be bonstrued as a guarantee that the system will fun�cfid°n as1 designed.
Date r 1 �-
����I� � Inspector � J,/ �ti ,,�-� '{•'
P
---
No. Y- - -- - - - - - - - - - - ---•--- --•-- -- -- ---- -- - -- ---
�10wb1)S � - _• �, Fee-
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction i3ermlt
Permission is hereby granted to Construct( ) /Repair( )/' Upgrade(4, /Abandon01
( )
System located at /T s/'/ �'l�, e1• l_ �!✓. i ?9i'�. �G!_/9'
t
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 be completed within three years of the date of this permit
Date '�, 2, 7iZ Approved by
TOWN OF BARNSTABLE
LOCATION `" !7 &-1CS kZIN SEWAGE#
VILLAGE BSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) 1i'�'A.1 Q4-- (size)
NO.OF BEDROOMS o
OWNER
PERMIT DATE: �4_•JN COMPLIANCE DATE: 3 a
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) t j Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) l�( Feet
FURNISHED BY
A-(lillip'VIR
to o
�er
1
I
s
Inspectional Services
Public Realth Division
Y IF _OrA LE,
1 C
►oss Thomas McKean,Director
ArFDMAtA 200 Main Street,Hyannis,MA 02601
i
Office:.508-8624644_ Fax: 508-790-6304 .
f
_ Installer&Designe► Certification Form
Date:
SewagePermit# �(�a- `0 �� Assessor's MaplParcel ,�
3Q
I
Designer:__iVWN C�tP� SIN dKC� 6NC_ Installer: VQklowrn-CG)ur)OON
4 Address: Address: 4T INW 0
&MOU M POUT MA 07,475- tr-Tariy �uT�
On / ba was issued a permit to install a
j (date) (installer)
septic system at kEP,L based on a design drawn by
(address)
i
DJ�I�rI � dated rev
-AN(
� (de rgner) _
I-cer'tify*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 soils
were found satisfactory,
I certify that the septic system referenced above was installed with major changes (i.e.
- -greater than 10'-lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State &Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify thJat the~sytemjreferenced above was constructed in i ce with the to rms of
the 1 approval`"letters(if applicable) t�
DANIELA.
O.IALA
------- CIVIL
(Installer's Signature) No.46502
4-
��^ �G!S 1`
t
G�1 SSIUNAL
—4�es—:igne Affix Designers Stam Here
rs—Signature) ' ( g p )
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
BTH THIS BUI T CAND LIAAREC)JYVED BY THE BARNSTABLE PU LICHEALFORM
TT� V [AND AS7
ON.
TABLE
i
THANK YOU.
11toa\deplsNHEALTli1SEWEti conneeMEP'I'fCkDes16ner CoNincation Form Roy&•14-13,DOC
i
SYSTEM PROFILE MARKED
SYSTEM COMPONENTS SHALL BE NOTES
MARKED WITH MAGNETIC TAPE OR Rt 6A
(NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS NAVD 88
3
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 2. MUNICIPAL WATER IS EXISTING
\ TOP FOUND. EL 50.5' FILTER FABRIC OVER STONE Sondysid
3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Locus
49.0 MINIMUM J5' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 49.0'
Ecasr H-�o WATERTE$T D'BOX FOR LEVELNESS BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST o 0
` 2ispERs (iYP.) MIN. 2 CKNESS PRECAST RISERS UNITS TO BE AASHO H-]Q y Dennis
4"OSCH40 PVC MORTAR ALL
INVERT IN 45.17' c
PIPES LEVEL 1ST 2' T1COMPONENTS
A & B :- �4' S. PIPE JOINTS TO BE MADE WATERTIGHT. Q Pond
4'
ENDS (1�-) SIDES ¢6.0' e
SAME EL. - �*47.92t 10" 1500 GAL H-10 14" oo o
P°�0 °�" 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE
°°0000°° ° . - r _ °°°°° °
46.78 TEE SEPTIC TANK TEE ® WITH 310 CMR 15.000 (TITLE 5.) a
46.53 °°°°° °C°° 6" MIN SUMP oo0 oQ0 . ® ®�® BB®®®®® '00000000
°°°°°°°°°°O 12" MIN. INT. DIM. °°°°°°°° � ®®®®�B®®® ® 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND
GAS BAFFLE °�o„g °°°°°°°° ,°o°g°o°o
sooga0000 �B® ®Fin ,
®®®®®®®®®�En °o°ga m ,?
NOT TO BE USED FOR LOT LINE STAKING OR ANY
4' LIQ. LEVEL (ACME OR EQUAL)' 46.07 45.9 >°°°° ° ° ?.%%°° 43.17 OTHER PURPOSE. o
o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o Q X!t 7
'a00n �`��" " °?•'°O°O°°°°°°°`�����"��-°�O°°�- 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. H-10 500 GAL LEACHING CHAMBERS BY ACME PRECAST OR EQU 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC. � '�
ALL AROUND PRECAST STRUCTURES (3) UNITS REQUIRED m
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 33.5' X 12.83' 9. COMPONENTS NOT TO BE BACKFILLED OR Route 6
COMPACTION. (15.221 [21) c^o CONCEALED WITHOUT INSPECTION BY BOARD OF Yarmouth
L0 HEALTH AND PERMISSION OBTAINED FROM BOARD Campground
(7.1 9G SLOPE) ( 2 x SLOPE) (7.3 X SLOPE) OF HEALTH.
q 16'
B 40' SEPTIC TANK 23' D' BOX 12' LEACHING 37.5' BOTTOM TH-1 10. CONTRACTOR CALLING DIGSAFE SHALL-8888344 RESPONSIBLE
OR
NO GROUNDWATER FOUND VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS MAP
(_.9__X SLOPE) OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF
WORK. SCALE 1"=2000'f
/ 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 356 PARCEL 15
BE REMOVED BENEATH AND 5' AROUND THE
/ PROPOSED LEACHING FACILITY. LOCUS IS WITHIN FEMA FLOOD ZONE X
a 12. EXISTING LEACHING FACILITY SHALL BE PUMPED (AREA OF MINIMAL FLOOD HAZARD) AS
J AND REMOVED OR PUMPED AND FILLED WITH CLEAN SHOWN ON COMMUNITY PANEL #25001 CO559J
LEGEND SAND. DATED 7/16/2014
[_ o r /
99- EXISTING CONTOUR tK'��
X 99.1 EXIST. SPOT ELEV.
PROPOSED CONTOUR
198.4] PROPOSED SPOT EL.
TH1 GO
6 SYSTEM DESIGN.
TEST HOLE y�' � / � 49
1 SLOPE OF GROUND GARBAGE DISPOSER IS NOT ALLOWED
�S-
J f H2
C-O-) UTILITY POLE DESIGN FLOW: 4 BEDROOMS 0 110 GPD = 440 GPD
FIRE HYDRANT ' USE A 440 GPD DESIGN FLOW
NOTE- NOT ALL SYMBOLS MAY APPEAR IN DRAWING O Dc� S
SEPTIC TANK: 440 GPD (2) = 880
TH 1
' PAVED USE A 1500 GAL. SEPTIC TANK
j DRIVEWAY LOT 126 LEACHING:
TEST HOLE LOGS
/ 28,567t S.F. ` SIDES: 2 (33.5 + 12.8) 2 (.74) 137 GPD
CRAIG J. FERRARI, SE: #13871 �� �� �' ( BOTTOM 33.5 x 12.8 (.74) = 317 GPD
ENGINEER: , LP,
DAVE STANTON c/o �� TOTAL: 614 S.F. 454 GPD
WITNESS:. '�-
DATE: 1/14/22 , O
USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
PERC. RATE = < 2 MIN/INCH BENCHMARK: A WITH 4' STONE ALL AROUND
SPK SET p
CLASS I SOILS P# 21-334 ° =50.2' NAVD88 LP EXISTING
C/o DWELLING
ELEV. ELEV. 52
��;----�� TOF = 50.5
0" 49.0' On `� ' 49.0' o
w---_ a MA
A B APPROVED DATE BOARD OF HEALTH
FILL LS s ) TITLE 5 SITE PLAN
10YR 3/2 �
9" 12" CO �� OF
d-
A B
LS Ls ��,��� c 0 179 MIDPINE RD.
14" 10YR 3/2 7 83' 36" 10YR 5/8 46.0' �� 01 CUMMAQUID, MA
tXS PREPARED FOR
LS
o BORTOLOTTI CONSTRUCTION
36" 1 oYR 5/8 46.0' DOROTHY PALMER
FS
DATE: JANUARY 26, 2022
C �� -2- w"'w REV. FEBRUARY 15, 2022 (SETBACK DIMENSIONS)
�OF Mq F
'A.a� c t�,�� N'gSS•e„a!�
PERC
2.5Y 7/4
1� �� �a• q�� ; � spy��
FS -1
�ANIELA. off 508-362-4541
iF o OJALA" 'w� A.
_�I fax 508-362-9880
2.5Y 7 4 d _ I
` " �`^ CIVIL" > downcape.com
Q 46502 `�'d) s30
k,.. ° 0 d'owo cope en keerhq, Inc.
120 39.0 138ti o
37 ti ,IE
.5
.+ wmNA �Scale:1 20' civil en9 ineers
"= n n t
NO GROUNDWATER ENCOUNTERED 2�0�-�-� \ �'� land surveyors
939 Main Street ( Rte 6A)
0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
DICE #2 , -�4'74 21-474 BORTOLOTTI-PALMER.DWG
j it