HomeMy WebLinkAbout0045 SAMANTHA DRIVE - Health 45 Samantha Drive
Barnstable
A= 348 — 006 — 001
.. '�o ;
No. �Oho -3
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISIO TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Z[ppritation f isposal 6pstem Construction i3ermit
Application for a Permit to Construct, Repair( ) Upgrade( ) Abandon( ) Complete System ElIndividual Components
Location Address or Lot No. SSt 0M,4 f hA- `D 2 r er's Name,Address,and Tel.No.
3-
Assessor's Map/Parcel m 34i$ rteL ® p I Nr6 _OD/ 10ieHleW4(•14"e"45L.
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 6-07-362mINT
Type of Building:
Dwelling No.of Bedrooms f 3 Lot Size 0 sq.ft. Garbage Grinder( )
Other Type of Building �frtf�e} 'i�fQlwO No.of Persons Showers(2.) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided �6�% gpd
Plan Date Number of sheets i Revision Date
Title
Size of Septic Tank /5'00 Type of S.A.S. 5�00 r /lmj e 'O"I hms ;e
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)NSA I� 4 !SOt� 9lil�GtJ �r�fC t&AC i boy
atNC) 2 -ST00 S4//a x df'� we a-,,� pe 0 1r,1
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 Health.
Signed Date Bog D°J�
Application Approved by Date d
Application Disapproved by Date
for the following reasons
Permit No. r2-n),o ' t4L4 Date Issued 0 5J d o
---------------------------------------------------------------------------- -
No. t Feei'
THE COMMONWEALTH OF MASSACHUSETTS Entered inconip er'_T '
PUBLIC.HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
1pplicatton `foeMisposaY pstPnt Construction Permit
t t '�
Application for a Permit to Construct/ Repair( ) Upgrade( ) Abandon( ) 1 Complete System ❑Individual Components
ne 6 Z D7U
Loc`tion Address or Lot No.�q/►s.�a*U- *0f , )-r-'s Name,Address,and Tel.N ;j fl�l" "�
' Assessor's Map/Parcelr'Yi �i�PCe� f> !!^0 `! rC �1 l j . !di�
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
D, A ,9(o g N s-,NOD`7/S"� '"'�w pr` �efi�NtNd 93J h►���/sz yRin tfr E,
Type of Building:.
Dwelling No.of Bedrooms �+ Lot Size 47,0/1-/ sq.ft. Garbage Grinder( ) -
Other Type of Building J 1 A lC 1GJY rO M No.of Persons 'S j�� t Y t-ri N.
yp g Showers(` .) Cafeteria( )
Other Fixtures +:<f
Design Flow(min.required) gpd Design flow provided � _ gpd
Plan Date 5"{ /'7 20Z CJ. Number of sheets / Revision Date
Title
Size of Septic Tank /1 d q Type of S.A.S. 'Son
Gt�/f�.J ��o✓1�P/S° /.u/��i �S/�r
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)NcFG Q /S OCR ea/fc w 901/e JOY
/ of
l`c•�tLlr�S A,/J�i !.l� ✓t' ��7 P��cn/
Date last inspected:
Agreement: r
-The undersigned agrees to ensure the construction and min nance of the afore described on-site sewage disposal system iii 3
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 B�o)biealth.
Signed _ Date �� 1 0
Application Approved by 1 `7 Date / C,
- Application Disapproved by g ( Date
{,. for the following reasons
n
Permit No. 0/t 0 ' �/' .. Date Issued
-------------------
THE,COMMONWEALTH OF MASSACHUSETTS�
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS,TO CERTIFY`that the On-site Sewage DisposaFsystem Constructed( !),:t �' tRepaired(+. ) *tUpgraded
QI r�
Abandoned(. )by ' G.:.c9rox L A r:
at �,/�" „r/Lr4 `1 /R/NM4,Q/i/d has been.construcchted in accordance
t
with the provisions of Trtle'5 and the for Disposal System Construction Permit No" 1� : �1ti-J dated
S , Installer �/, �i' r {G�n1N. N:C 4'.Designer c.C/,J�p;�I�
#bedrooms 3 Approved design flow "7 f+►j�'j gpd
-` The issuance ofthl�s''p,ermit shall not,be construed as aguarantee that the system will f(unctio}n designed. Q
Date � llfj►.�r Inspector
No. f 0.2 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Mispo8al *pstetn onstrUctlon Permit
Permission is hereby granted to Construct( ) Repair( Upgrade(} )°�` Abandon( )
System located at `J 7
y %J� l/ie9 ,'�4 � �l!(W►''G9 �Y/ � �,l/,.�,�../1 a2,A# l_r110
:.
and as described in the above Application for Disposal System Construction Perrrid The applicant recognized hi herdutyfiocomply with
Title 5 and the following local provisions or special conditions
t
Provided:Construction must be completed within three years-of the date of is permit.
"l-
S t 5#""},
- Town of Barnstable
Inspectional Services
UAS Public Health DivisionIMMM
,
MASS. Thomas McKean,Director N.
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304 3
Installer& Designer Certification Form
Date: (0 ZC1 L9( Sewage Permit# a) -3117 Assessor's Map\Parcel
Designer: DDw n fit; EnaI nmrLnc� Installer: s( .A 2trn y�Ank
Address: 9 3q Q p U C Co A Address: �-P o
Cli'rY1ljV4-\ PC r+, M A czwf y►��p
On �( (0 was issued a permit to install a
(date) installer)
septic system at Z15 Sarn axLthU- Dl. &I ran ktb10- based on a design drawn by
(address)
17an T,1 A 01 c+I A PC,KS dated 09 — 1-7— 2 02-o
(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 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 that the system referenced above was constructed in gp*iance with the terms of
the IAA approval letters (if applicable) <<oFr•,,; ,' t
DANIEL
OJALA
CIVIL
(Installer's Signature) No.46502 Q rr
�0� 18 TV
(Designer's Signature) / (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
WoMdeptAIHEALTMEWER connecMEPTICOesigner Certification Form Rev&14-13.DOC
TOWN OF BARNSTABLE
[INSTALLER'S
CATION�+� �r+Tow tf1 : SEWAGE#
LAGE C elw ESSOR'S MAP&PARCEL YE n-o06�-co/
NAME&PHONE NO.'e4 &
TIC TANK CAPACITY /6-CO b'/Q t
LEACHING FACILITY: (type) 5��) 4-10 (size) (a,8 3)(2 5--
NO. OF BEDROOMS
OWNER
PERMIT DATE: t0hu 1 COMPLIANCE DATE: o o 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) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
Q �1
t 4
y
i, t
Commonwealth of Massachusetts
City/Town of Barnstable
Percolation Test
Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
Important:When filling out A. Site Information
forms the ��`
computer,
d0r, use Code Realty, LLC, 52 Ship's Eagle Lane Osterville, MA 02655 u
only the tab key Owner Name
to move your <Samantha Drive
cursor-do not use the return Street Address or Lot#
key. (Cummaguid) Barnstable MA 02637
Cdylrown State Zip Code
m John Hutchins
Contact Person(if different from Owner) Telephone Number
B. Test Results
D e Time Dat Time
Observation Hole# 2
Depth of Perc
Start Pre-Soak
End Pre-Soak
Time at 12"
Time at 9'
1 �M�� .
Time at 6" r
Time(9"-6")
Rate (Min./Inch) M�� N _'j CZrKit` �N(i�
Test Passed: ® Test Passed:
Test Failed: ❑ Test Fa led: I]
David D. Flaherty Jr., R.S. --
i
Test Performed By.
Don Desmarais-, R.S.--
Witnessed
By:
Comments:
t5form12.doc•06/03 Perc Test•Page 1 of 1
Commonwealth of Massachusetts
G#y/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
a
i
DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must
be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use.
A. Facility Information
1. Facility InformationC�4 03 h&e./ 11
Owner Name Z&/rV A
t✓ Map/Lot �.
Street AddresC ` &n,/ ,
CitylT— own State Zip Code
B. Site Information
1. (Check one) New Construction Upgrade ❑ Repair. ❑
2. Published Soil Survey available? Yes No ❑ If yes: • 2 2V C.
Year Published Publication Scale Soil Map Unit
'?' &�_fwsmv
Soil Name Soil limitations
3. Surficial Geological Report available? Yes No ❑ If yes:
Year Published Publication Scale Map Unit
SAeosils
Geologic Material Landform
4. Flood Rate Insurance Map:
Above the 500 year flood boundary? Yes ,] No ❑ Within the 100 year flood boundary? Yes ❑ No
Within the 500 year flood boundary? Yes ❑ No Pq Within a Velocity Zone? Yes
❑ No
5. Wetland Area: National Wetland Inventory Map
Map Unit Name
Wetlands Conservancy Program Map
Map Unit Name
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 1 of 7
Commonwealth of Massachusetts
Cityffown of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
r'
6. Current Water Resource Conditions (USGS) (�R+� i� Range: Above Normal Normal ❑ Below Normal ❑
Month/Year
7. Other references reviewed: 7 � � G� QviV�G/�" � //j �f✓ 1/Y
C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area).
. Deep Observation Hole Number: _ ..
Date Time Weather
1. Location
Ground Elevation at Surface of Hole t 6 "
Location (Identify on Plan )
2. Land Use: -
(e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%)
Vegetation Landform / Position on landscape(attach sheet)
3. Distances from: Open Water Body>/� Drainage Way>!00 Possible Wet Area
��f�e.�, feet
Property Line J ( ' Drinking Water Well /r'� Other �L� //w v`G► .S?'��a-r"
feet feet f7r G-
4. Parent Material: /r Unsuitable Materials Present: Yes ❑ No
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes ❑ No
If Yes: Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: f
DEP Form 111 Soil Suitability Assessment for On-Site Sewage Disposal• Page 2 of 7
Commonwealth of Massachusetts
GAy/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
inches elevation
Deep Observation Hole Number: f
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Horizon/ Color-Moist (mottles) Texture % by Volume Consistence Other
Depth Layer (Munsell) (USDA) (Moist)
(In.) Depth Color Percent Gravel Cobbles
&Stones
G - G
s - 1nyr s �
y
Additional Notes
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 3 of 7
Commonwealth of Massachusetts
6Ay/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (Cont.) 't
Deep Obse
rvation Hole Number:
Date Time Weather
1. Location /
Ground Elevation at Surface of Hole
Location (Identify on Plan )
2. Land Use:
(e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%)
Position on landscape(attach sheet)
Vegetati n Landform ,,n�11
3. Distances from: Open Water Body��� Drainage Way>/O Possible Wet Area,
e fe / fi t � Y7�1,Bel, l AL 11'r
Property Line Drinking Water Well �j5� Other "�'O!'7
eet feet
,,�/ f
4. Parent Material: -G(�TG- Unsuitable Materials Present: Yes ❑ Nog
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s)❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes ❑ No,
If Yes: Depth Weeping from Pit Dep�h Standing Water in Hole
Estimated Depth to High Groundwater.
inches elevation
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 4 of 7
Commonwealth of Massachusetts
O+ty/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
of
Deep Observation Hole Number:
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil
Horizon/ Color-Moist (mottles) Texture % by Volume Structure Consistence Other
Depth Layer (Munsell) (USDA) (Moist)
(in.) Depth Color Percent Gravel Cobbles
&Stones
-------------
� - 321
Ll
Additional Notes
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 5 of 7
y
Commonwealth of Massachusetts
City/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
1 1� �
6. Current Water Resource Conditions (USGS) JU Range: ' Above Normal [ Nonral ❑ Below Normal ❑
MonthNear /
7. Other references reviewed:
C. On-Site Review (minimum of two holes re uired at every proposed primary and reserved disposal area
Deep Observation Hole Number: 3 /2 Q G. �W G(�/
Date Time Weather
1. Location llqle-I
Ground Elevation at Surface of Hole �
Location (Identify on Plan )
2. Land Use: �/ 11 0
(e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%)
Vegetation // Landform Position on landscape(attach sheet)
3. `Distances from: Open Water BodA0V Drainage Way>10 Possible Wet Area >G
OV
ley fee f t �Q,� U P�/1 S
Property Line Drinking Drinking Water Well l� Other � U
feet feet 6-1- 13 v lT
4. Parent Material: o /
( // Unsuitable Materials Present: Yes ❑ No a
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes ❑ No
If Yes: Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: f
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 2 of 7
Commonwealth of Massachusetts
Gity/Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
inches elevation
Deep Observation Hole Number: y {
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil
Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other
Depth . Layer (Munsell) (USDA) (Moist)
(In.) Depth Color Percent Gravel Cobbles
&Stones
3�f 1 D r g sin
pac�F v3
G 2 .s
Additional Notes
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 3 of 7
Commonwealth of Massachusetts
Gityffown of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (Cont.)
Observation Hole Number: 114 Cl
Deep Time weather
Date
1. Location 71
Ground Elevation at Surface of Hole/13 — Af -v
Location (Identify on Plan )
2. Land Use: U00)9( f � l to 1070
(e.4.w11oodland,agricultural field,vacant lot,etc.) Surface Stones Sl (%)
p1"V L I O Position on landscape(attach sheet)
egeation Landform
3. Distances from: Open Water Body Drainage Way Possible Wet Area e>10 '
f et feet I f et
Property Line =� Drinking Water Well 7 Other �Z �
feet feet err
4. Parent Material: -�`f.��[ (tii�/ Unsuitable Materials Present: Yes ❑ No2j
If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑
5. Groundwater Observed: Yes ❑ No [ -
If Yes: Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater. V
inches elevation
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 4 of 7
�L-
Commonwealth of Massachusetts
Gityffown of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
0'
Deep Observation Hole Number:____.
Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil
Horizon/ Color-Moist (mottles) Texture %by Volume Structure Consistence Other
Depth Layer (Munselq (USDA) (Moist)
(In.) Depth Color Percent Gravel Cobbles
&Stones
0- 3 0
3 - 'r�
- 13 G Z-
Additional Notes
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 5 of 7
r
Commonwealth of Massachusetts
G Town of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation
1. Method used: ❑ Depth observed standing water in observation hole A. B.
inches inches
❑ Depth weeping from side of observation hole A. B.
inches inches _
❑ Depth to soil redoximorphic features (mottles) A. B.
inches inches
❑ Groundwater adjustment(USGS methodology) A. B.
inches inches
2. Index Well Number Reading Date Index Well Level
Adjustment Factor Adjusted Groundwater Level
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the
soil absorption system? Yes 9 No❑ ��
b. If yes, at what depth was it observed? Upper boundary: ✓ Lower boundary
inches Iinches
F. Certification_
I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that
the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further
certify that the results y it a lu s indicat in the attached Soil Eval ation Yorm, are accurate and in accordance with 310 CMR 15.100
through 15.107. 0
Sign re of Soil Ev ator Date /�
Typed or Printed Name of oil Evaluator / 'Date of Soi valua r Exam
H*'44s sI�G�
Name o of Health Witness Board of Heal
Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to
the designer and the property owner with Percolation Test Form 12.
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 6 of 7
Commonwealth of Massachusetts
Q Town of Barnstable -
' Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
,a(
D. Determination of High Groundwater Elevation
1. Method used: ❑ Depth observed standing water in observation hole A. inches B inches
❑ Depth weeping from side of observation hole A. B.
inches inches
,Q� ❑ Depth to soil redoximorphic features (mottles) A. B.
VV �I inches inches
( odology) A. B.
❑ .Groundwater adjustment USGS j meth
inches inches
2. xIndex Well Number Reading Date Index Well Level
•
Adjustment Factor Adjusted Groundwater Level `E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the
soil absorption system? Yes No❑ /J
b. If yes, at what depth was it observed? Upper.boundary. Lower boundary:
inches inches
F. Certification
I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that
the above analysis has een performe by me co istent with the required training,expertise and experience described in 310 CMR 15.017. 1 further
certify that the result my soil eval io i ated in t ached Soil Evalua-on F rm, are accurate and in accordance with 310 CMR 15.100
through 15.107. a�
Signature of Soil.Effaluator / Date
Typed or Printe Name of-Soil Evaluator 'Date of S it Eval #tor Exam
Name of Board of Health Witness Board of Health
Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to
the designer and the property owner with Percolation Test Form\12.
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 6 of 7
Commonwealth of Massachusetts
GRylfown of Barnstable
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
lug
Use this sheet for field diagrams:
DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 7 of 7
367 MAIN Sr
HYANNIS, MA 02601
N 29 26'Gl2 E 153
\ / 220.42' / /
106
I �
45,
/
NOA: LOT\5 Ml6T INP
A� DRIVDWAY WITH / Lot 6
"-3 TS3&4 UE FIRE DEPT. FIURLWDING RIVEWAY BYA DARDs/ Area=4 ,��±4T014 S Ft? Fm 0WNES- Nqr
Or
—�.Or
1.13 Acre TH-4 / — — —/ '�j/1 .00 Acres
SHAPE-19.7 / D40TE: Ell D' E .
FUTURE GRADING AND DRIVEWAY BY / '�°° I \ �. /HOUSE 9, TTERS ANfl
HOMEOWNERS- NOT IN CONTRACT / / \ �, DRIVEW Y DR MN
T.
SCHEM9 e SHOWN FOR REFERENCE ONLY I 1��1�� \ 2P / DRYWIS.CONN�CTED TO 1
/ I GJJi LEA T 5
• \ I 3 °. a CLEA _ IT EA LIMIT
N2 29N29 6 0' E I R
IV ZX \ ` 736 \ - .93' L� 7
N 29 26'6}�" ClE> l T� E
CLEAR-LIMIT
NOTE: LOT 2 MUST NOT / b AR_LIMIf \
? 2E DRIVEWAY-WI fH— J / J 'a$
3&4—DUf TO FIRE DEPT. ,�0 \ —
/ STANDARDS �/ s
CL
R )A CONTRAGRr��O TO )PROVIDE
//2 OF RTICIN
CO
Lot / MMDRIV� (S)SAP�PAR 0 — — —
ADCONSTRUCTION CONTRACT. 1 I� —
/ _ RROVIgE HAYB/jlci`S AS INDICATED/ �N — —
// /A�rea� 3'933± Sq., t /g" LOAM & 0oHYDRO�CED AREA 2
/ Or/ _ / /1 / �/ �/ // L AR. I
r
' ' 13'4
� Town of B A rnsta.ble � P#
Department-of Regulatory Services
Public Hea Division Date
rth
�e$XKAft
200 Main Street,Hyannis MA 02601
Date Scheduled ' Time /'u' Fee Pd., J
Soil Suitability Assessment for Sewage Disvosill,
Performed By. Witnessed By:
LOCATION&GENERAL INFORMAT N
` Location Address i owner's Name
Address
Assessor's Map/P4md: Engineer's Name
NEW CONSTRUI;I'ION REPAUt Telephone#
Land Use ft Slopes(%) ` Surface Stones
Distances from:-'Open Water Body ` 0 ft Possible Wei Area ft y Drinking Water Well ? �Vft
/ L
.+Drainage Way ` ft. Property Line ✓ ft Other ft
SKETCH:($treat name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
q Wl _
+ O
i <= x` e
(geologic) U"�G Depth to
Parent material � Bedrock A/ -�•t +.
Depth to Groundwater. Stan mg Water in Hole:' �/ I f Weeping from Pit Facej -L-
Estimated Seasonal iFligh Groundwater a m
D TERMYN TION FOR SEASONAL MGH WATLR TADLR
Method Used: Ia.
Depth dbperved standing;in obs.hole: In. Depth to Sall Adjust:
Depth toiweeping from side of obs.hole: + in. oroundwater AdJuettneat
Index Well# Reading Date: Index Well Ievel _ Act.faetor,
Ad).O wundwaterl.avel..,�..
I
PERCOLATION TEST '
Observation �/ I Tune at 9"
Hole#
Depth of Perc t0 [ r_ Time at b" ......�..._-
r .
Start Pre-soak Time.C� ^' Y __ Time(90.01 -- -- ----•—
End Pre-soak ✓�""r� --F--t—
Rate MinJlnch i
I
Site Suitability Assessment: Site Passed Site Failed Additional Testing Need(Y/N)
Original:.Public H41th Division Observation Hole Data To Be Completed on Back '
***If percolajion.testis to be conducted within 100' of wetland,-you must first notify the
Barnstable C4servation Division at least one(1)week prior to beginning.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
.Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
r Consistency,%Gravel
Ate
LS , Gy
c L-S �:t
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistoncy.%Gravel)
14-IE �- V, If
G L S GNl
DEEP OBSERVATION HOLE LOG Hole 3 --
Depth from' Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistengy.%Oravell
S D wa
3 lqq C L's
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.
0 D
D i� N"°
- L S N.r 0
Flood Insurance Rate May:
Above 500 year flood boundary No_ Yes ,
Within 500 year boundary No K Yes
Within 100 year flood boundary No Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervioup material exist.in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pe—rviolZ material?
Certification
I certify that on j D Z (date)I have passed the soil evaluator examination approved by the
performed b me consistent with
Department of Envir nm tal Protection and that the above analysts wasp y
the required traini expertise a d experien a described in 3.10 CUR 15.017.
Signature
' Date
Q.%EPTIOPERCFORM.DOC
SYSTEM DESIGN. S 1 STEM • PRO ILE ALL SYSTEM COMPONENTS SHALL BE
MARKED WITH MAGNETIC TAPE OR
LEGEND PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT to SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. NOTES
GARBAGE DISPOSER IS NOT ALLOWED ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE Rf 64 a
2" PEASTONE OR GEOTEXTILE 1. DATUM IS NAVD 88 0
99- EXISTING CONTOUR TOP FOUND, EL. 113' FILTER FABRIC OVER STONE � F�
DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD \ 110'
X 99•� EXIST. SPOT ELEV. MINIMUM .75' OF COVER OVER PRECAST 2� SLOPE REQUIRED OVER SYSTEM 1 10' 2. MUNICIPAL WATER IS EXISTING
Sandysid
USE A 330 GPD DESIGN FLOW NOTE: 2" MIN. WALL 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
-[99]- PROPOSED CONTOUR :. PRECAST H-10 BLOCKS OR c
RISERS (TYP.) THICKNESS REQUIRED PRECAST RISERS
(ss,4 SEPTIC TANK: 330 GPD (2) = 660 2'0 4"OSCH40 PVC MORTAR ALL H-10 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS C o°
] PROPOSED SPOT EL. ••..':•: 6" MIN. SUMP PIPES LEVEL 1ST 2 �--4 COMPONENTS TO BE AASHO H-]Si ,� Dennis
USE A 1500 GAL. SEPTIC TANK =� I ENps (TYP.) o Pond
TH 1 12. MIN. INT. DIM. ( ) w EL. 107.0 • 4'-• 5. PIPE JOINTS TO BE MADE WATERTIGHT.
SIDES
10" o 0 0 o Or ?
TEST HOLE 1500 GAL H-10 TEE ®p®® ®®�® ®®®® -®®®® °o°o°o° o z
107.70 TEE 107.45 ° ° ° ° ° ° ° ° 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH
LEACHING: SEPTIC TANK
2%„ SLOPE OF GROUND SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD a' LIQ. LEVEL '0000$o$00000 WATERTEST 'BOX o >00000000 ®®®®®®®® ®® ®® ®®®®®®®® °0°0°000
0 0 0 0 0 0, ° ° ° o �e ®��� ®® ®���®®�® ,00000°°° 310 CMR 15.000 (TITLE 5.) / o
ACME OR EQUAL GAS BAFFLE '-oo°o°�°�°- FOR LEVELNESS N i0000°o°o ��CI®���® ®® ®®®® :°o°o°o°o
Ookmont &
UTILITY POLE BOTTOM 25 x 12.83 (.74) = 237 GPD 107.27' 107.10' °°°°°°°° °°°° '
°°°°°°°° °oo°0000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO ?
BE USED FOR LOT LINE STAKING OR ANY OTHER m o
:..,.: o;0000000000°000000000;0;,0oococ0000000co� PURPOSE. z
� FIRE HYDRANT TOTAL: 472 S.F. 349 GPD 10C000�0�0�0n0°G°0°o° ° °�°�°o°�CDopCQ°0o00 H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. Locus Q� xil 7
9 �1o°o°o_o_°_o_o.n o 100000 00 °-°_°_°.o.o 0 3/4"-1-1/2" COUBLE WASHED STONE 4' MIN.
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING ALL AROUND PFECAST STRUCTURES (2) UNITS REQUIRED 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. Route 6
USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED ROU16 6
WITH 4' STONE ALL AROUND
COMPACTION. (15.221 [21) 0 Yarmouth
,� WITHOUT INSPECTION BY BOARD OF HEALTH AND y 1010und
PERMISSION OBTAINED FROM BOARD OF HEALTH.
*THE INSTALLER SHALL VERIFY THE 10. CONTRACTOR HALL BE RESPONSIBLE FOR CALLING
LOCATIONS OF ALL UTILITIES AND ALL 100.0' BOTTOM TH-3 DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCUS MAP
BUILDING SEWER OUTLETS AND ( 2.5% SLOPE) ( 1 % SLOPE) ( 1 w SLOPE) NO GROUNDWATER FOUND LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES
PRIOR TO COMMENCEMENT OF WORK.
ELEVATIONS PRIOR TO INSTALLING ANY SCALE 1"=2000't
PORTION OF SEPTIC SYSTEM MA FOUNDATION 22' SEPTIC TANK 18' D' BOX 12' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
APPROVED DATE BOARD OF HEALTH FACILITY
REMOVED BENEATH AND 5' AROUND THE PROPOSED LEACHING FACILITY. ASSESSORS MAP 348 PARCEL 6-1
ZONING SUMMARY
�J v ZONING DISTRICT: RF-1 DISTRICT
MIN. LOT SIZE 43,560 S.F.
MIN. LOT FRONTAGE 20'
MIN. LOT WIDTH 125'
TEST HOLE LOGS MIN. FRONT SETBACK 30'
- MIN. SIDE SETBACK 15'
ENGINEER: DAVID D. FLAHERTY JR. MIN. REAR SETBACK 15'�
MAX. BUILDING HEIGHT 30
/ N1 S5'�6.00"E WITNESS: DON DESMARAIS SITE IS LOCATED WITHIN GROUNDWATER
220.4 0 DATE: 7/12/2006 PROTECTION OVERLAY DISTRICT
PERC. RATE _ < 2 MIN/INCH
L w CLASS 1 SOILS P# 11347
O bD N 1110.7]
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10YR 6/8 109.2' 39" 10YR 6/8 --
D G 109.61 32" 109.3
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1 0 137 100.6 132 101 144 100 132 100
49,014 S.F.
4V Lq rvko NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED
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DOUBLE WASHED STONE " �° No.4-0930
No �,550� q ^N off 508-362-4541
2' MIN. AROUND PITS �,'a �o
& 6" UNDER PIT �F `� �w FESs\O p' M fax 508-362-9880
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DRIVEWAY DRAIN SECTION °�' �� ��� �� � " R��I •
NOT TO SCALE D" r�owa caps eftginee/ing, 18c.
civil engineers
A land surveyors
/ 939 Main Street ( Rte 6A)
DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
LICE #20-001
20-001