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HomeMy WebLinkAbout0249 AMES WAY - Health 249 AMES WAY CENTERVILLE A = 170 236 �llll a�cvcc�o 1p Ills UPC 12534 No.2 153LORbsrs NASTiN99. UN No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpfiratiou for Mioposat*pstrm Convitrurtion 3pErmit Application for a Permit to Construct( ) Repair(t/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ;z Nf',4/yle5 W--e y Owner's Name,Address,and Tel.No. Cp.vr-flvt) ,e �i�1 JGM Assessor's Map/Parcel 0-I' w J Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ����S A ��cc�n1 c✓� --yS �" �/ �,,c�Pcr trV f� r(c 50 5 J Type of Building: Dwelling No.of Bedrooms "?, Lot Size / yp& sq.ft. Garbage Grinder( ) Other Type of Building j&!5 c)eQ"C, No.of Persons Showers( ) Cafeteria( ) Other Fixtures f, Design Flow(min.required) _ �,3� gpd Design flow provided U, gpd Plan Date /('k f 6 Number of sheets aL Revision Date Title Size of Septic Tank Type of S.A.S. ;k °5-00 GC A,) A-1() Ck.4,7A f- Description of Soil <71 y�, I- Nature of Repairs or Alterations(Answer when applicable) ,L N� f 1 C.�vtf w> f�o)c Ci'iJ I- O G'f 0rj r Date last inspected: Agreement: e The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposQsystem in accordance with the provisions of Title 5 of the Environmental Code and not to p the system in ope ati n until a Certificate of Compliance has been issue oard of Health. ate Application Approved by 14 Date\\,�� Application Disapproved by Date'` for the following reasons Permit No. Off Date Issued DNo. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION , TOWN OF BARNSTABLE, MASSACHUSETTS application for Construction Permit Application for a Permit to Construct( )� Repair(t>/Upgrade( ) Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 2 N?, ft J Owner's Name,Address,and Tel.No. Assessor's MapQrcel /h k' OM /Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. j Type of Building: Dwelling No.of Bedrooms !26 Lot Size ,C�!n/., sq.ft. Garbage Grinder Other Type of Building I No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z :3,C) gpd Design flow provided �7 gpd.` Plan Date /o f//h A Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. :g !�Va 44(4)),�) _ 10 d4o��oIC Description of Soil v� Nature of Repairs or Alterations(Answer when applicable) „ic t r_/1 G ,.vr�J r� n v 2 if - /C� 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 issuedby-t ' Board of Health. 4 1gn. , Date 2 - Application Approved by �WYAWDate Application Disapproved by Date for the following reasons Permit No. r' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS CPrtifitatr of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(Upgraded( ) Abandoned( )by at f2 q 4, has been con�fated accord ce with the provisions of Title 5 and the for Disposal System Construction Permit No _ f -^-� Installer �g�/,�� % (0(A2Nr-.,a j e` Designer #bedrooms Approved desig4ow gpd The issuance of this permit shall not be co stru�7) ddas a guarantee,that the system-will-furtct on,uas designed. DateQ µ' Inspect�� \ rt T ! \. I °-' /�-- No. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pBtem Construction Vrrmit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at 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. T Provided:Construction must be completed within three years of the date of this permit. Date�/Q . ��X Approved by Town of Barnstable Of THE Tp wti Regulatory Services BAItN5TABLE, Richard V,Sca:li,Interim Director r MAC.39• Public Health ]Division i6 �0 °tEDte Thomas McKean,Director 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Z' ' Sewage Permit# Assessor's Map\Parcel v —Z3 L PPC+er- M c J:—"-►-e.e .P Designer: Miee, 1 W6,- U k Installer: Address: IL 1n1, Address: P b`-, �&z +lc,\-Q . Mt A ZZ A4 C On_ 7 C VA G3�,,�,� tit was issued a pen-nit to install a (date) (installer) septic system at Z--q A m-e-s �U`a.� f. ,,Lev-J Lc based on a design drawn by (address) Vl(�i rteefitri� Wcr 1,Cs ImC_ dated If I h � 1iz-, k—ZA /I F (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 in.speoted 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 requh-ed.) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed ' e with the teens of the I\A approval letters (if applicable) SMOF4hASSq�yGs PETER T. FAN MCENTEE taper's No.CIVIL r No.35109 OgJ�FGISTER�� �Q �FSSI IAI.ENG (CDesigner's Signature) (Affix Desi* erg,J= p 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. Q:`Scvic'iDesigner Certification Form Rev 5-14-13.doe I Engineers note:This certification is limited to an as-built inspection of system components as installed prior to backfill.The engineer did not supervise construction of the system.The installer assumes responsibility for all materials,workmanship,backfilling to specified grades with proper compaction and setting riserslcovers as shown on the design plan. ` 5 ' --97--EXISTING CONTOUR ea N PROPOSED S.A.S. x 100.98 EXISTING SPOT GRADE a p 2-500 GALLON CHAMBERS -1p/-EXISTING WATER SERVICE SeaRs '/ SURROUNDED W/4' STONE EXISTING SEPTIC TANK a ® circle ° (TO REMAIN) -G-EXISTING GAS SERVICEo 5 TOP OF TANK, EL.=96.69t -B.H.W.-UNDERGROUND WIRES Ames W. INV.(0UT)=95.35t TEST PIT LOCUS BENCHMARK BENCHMARK ` EOR.98.15 HEAD PL 324 pG 73 LEGEND \ a x 95.26 \ u Tar°m°c R iF 98.42 } 95.96 S 25'4T18" yy /� a Route 28 a�i 159,62' 96.42 978 � r�l wosem��sce.Rd fdcaisp / B.15 x97.54 95. 1 O 7 x 9679 /o GENERAL NOTES: LNOT OCUOSMAP x ry / T l \ i J ') "` 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL �4 96.2 BH G .38 /J --'-'-wry �-e.H. -O.H.W. BOARD OF HEALTH AND THE DESIGN ENGINEER. -----= .../// 98.20 2.ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 15' I H W- 98.04 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE CB LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: DECK .� 98.45 310 CMR 15.401 1(b): CONTENTS OF LOCAL UPGRADE APPROVAL /I I "Y -EXISTING / 3 1) A 3' variance, SAS to cellar wall(bulkhead), for c 17' setback.o HOUSE 249 I �� / o, - � ah 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR SHED i I T.O.F.=99.14- / !n TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ;/ y7 / DESIGN ENGINEER. w I 96.22 //- "� N 1 ( �`�� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 95.i7 '�5.2� x l // LOT 37 z 1 97.91 hL 1 ENGINEER BEFORE FROM THOSE WCONSTRUCTION N HEREON A CONTINUES. LL BE ORTED TO THE DESIGN Ln 4 _ ////// 98.34+ // 15,906 ±SF / `1 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. N '' GARAGE �+98�94 / 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF �96.J P/ARCEL ID. �70-23V 1 J THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 97.7 4 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. N I 6 57 / 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. TP-1 34 99.02 �� 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. , .3 ..,97 igj _ \ + / 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS \ AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE / DIRECTED BY THE APPROVING AUTHORITIES. � 97.73 TP-2 97 40 97 35 t 97,46 \ 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 19 _ 9a.79'PAVES .t ^y�' CONSTRUCTION. DRNEWAY �� / � � 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND EXISTIN6 S.A.S. 9701 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). }� _--°�� TO BE ABANDONED 3 96.52 97.97 97.36 12, INSPECTED AS BYBIYING S IPOUT OF DESIGN ENGINEER UPRIORABLE O BACKER MATERIALS SHALL BE 1 95.00' CBdh 13 THIS PLAN IS TO BE NOT CONSIDERED TTO BEED FOR SEPTIC A PROPERTY LINESTEM PURPOSES ONLY AND SURVEY. f IN19'50'20" E HYD. /-� 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC \/I��J 96.68 - SYSTEM COMPONENTS NOT SHOWN ON THE PLAN CATC I-l�5eN edge of pavement 96.50 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 95.38 SKUNKNET ROAD 249 AMES WAY, CENTERVILLE, MA 02632 Prepared for: D.A. Brown, Inc., P.O. Box 145. Centerville, MA 02632 PLAN REVISION 12/6/18 - OWNER OF RECORD Engineering by: SCALE. DRAWN JOB.NO. 1) PROPOSED S.A.S. LOCATION AHAJJAM, NICOLE & 1"=20' P.T.M. 246-18 2) VARIANCE REQUEST INCRESED FROM 1' TO 3' ABDELILLAH Engineering Works,Inc. 249 AMES WAY 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. FROM BULKHEAD DUE TO SITE CONSTRAINTS CENTERVILLE, MA 02632 (508) 477-5313 10/11/18 P.T.M. 1 of 2 TOWN OF BARNSTABLE LOCATION 4et k_MeS LJav SEWAGE# �OtB'37e VILLAGE C &J{C{VMl)f ASSESSOR'S MAP&PARCEL 0T0-ax INSTALLER'S NAME&PHONE NO.,. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ',���%A-10 C bM (size) 12- 2 NO.OF BEDROOMS _7 OWNER A 6o,:%,*�M PERMIT DATE: 1 1 - '5 -1 Qb COMPLIANCE DATE: Separation Distance Between the: NGKP Ce 1— rC 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 r T TAC K opt bwT— 2C. I _33,G`/ a.`3D/ Y h; Town of Barnstable r 45 7Y S b ' Department of Regulatory Services. �r Public Health Division Date artsrwar :: Haas. 200 Main Street;Hyannis MA 026.01 rfo�.t a Date Scheduled A I'lle, Time Fee Pd. I U dol S it ,Suitability Assessment for ,Sew,a e Disposal Performed By: Witnessed By: y LOCATION& GENERAL INFORMATION Location Address 2 4L�i (� Owner's Name 0 tGa� A I�q Jg �vl'7CYO/2 r'T Address 2'4"q A U VAS A fit-► -'e.rvi 11.E N1 Assessor's Map/Parcel: q—7 /� 6 C.�� � Engineer's Name r�� � ��� NEW CONSTRUCTION REPAIR Telephone.# Land Use' CZ,Q Slopes Surface Stones ✓� 4`�1.Q Distances from: Open Water Body NQ i� ft Possible.Wet Area /,E A ft Drinking Water Well>0�D ft Drainage Way e"'SOU ft Property Line 3 �lft;.L Other ft SKETCH:(Street name,dimensions of lot;exact locations of test holes&perc tests,locate wetlands In proximity to holes) ..._.. .v Cr-L. Parent material(geologic) "J Depth to Bedrock Depth to Groundwater. Standing Water in Hole: dr'�-( Weeping from Pit Face fg fir. Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: __—___ _ in, Depth w soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment fr. Index Well# Reading Date: Index Well level, AEI,faetor_ Adj.Groundwnter 1 evel PERCOLATION TEST Batt: Time .� Observation Hole# / Time at h Depth of Perc ✓ J6 �"7 4 Time at 6" Start Pre-soak Time @ _ �r Time(9"-6") End Pre-soak / =`tY Rate Min:/Inch r' Site Suitability Assessment: Site`-Passed � Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division _ Observation Hole Data.To lie Completed on Back----------- 'P * 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. !� QA1S EPTIOPERCFORM.DOC 1 'y IA DEEP OBSERVATION HOLE LOG Hole# / Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency.% ravel SQ.1-j DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% rave YQ y m Z.� 6 3 a DEEP OBSERVATION BOLE LOG Hole# Depth.from Soil,Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell') Mottling (Structure,Stones,Boulders. Consistency, G el DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten ra )Flood Insurance.Rate Map: Above500 year flood boundary No— Yes Within 500 year boundary No._/1 Yes. Within 100 year flood boundary No Yes 5 Depth of Naturally Oectirring Pervious Material Does at least four feet of naturally occurring pervitl sateral exist in`ail areas observed throughout the area proposed for the soil absorption system? 1 e S_ If not,what is the depth of naturally occumng pervious material?. Certification I certify that on � L(date)I have passed the soil evaluator examination approved by the Department of Environmental Protecdon and that the above analysis was performed by me consistent with . the required train•n D expertise and experience described in 10 CNM 15.017. - / Signature Date 9 QASEP'rlC�PERCFORM.DOC TOWN OF BARNSTABLE LOCATION C1 A171,C- vV t SEWAGE # VELLAGE CL/d Jam- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 1"41r,,4 ..S'e4i/-C 9 c� SEPTIC TANK CAPACITY If LEACHING FACILITY: ( ) 4.I/�'�1 774 W (size) NO.OF BEDROOMS BUILDER OR OWNER / PERMITDATE: 5/ COMPLIANCE DATE: 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 �r /N TOWN OF BARNSTABLE LG ATION i� � A�L�S WAV SEWAGE # qq �qL5- VILLAGE ASSESSOR'S MAP &LOT � 0— INSTALLER'S NAME&PHONE NO. i (AV SEPTIC TANK CAPACITY -r LEACHING FACILITY: ( ) 141J41 WA Wk S' (size) NO.OF BEDROOMS \ rt BUILDER OR OWNER + h .f PERMTTDATE: G� COMPLIANCE DATE: 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 .ACC No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprtcation for Migpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System LAInividual Components Location Address or Lot No. tNM5'-5 t v Owner's Name,Address and Tel.No. L'E Nam'1�R..Ju\ Assessor's Map/Parcel ��,�✓— Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �r ,IK 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 '�73C�P gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank �i �--`BZ127�5 Type of S.A.S. ��k C�10CA!:L, I�t76 �f Description of Soil Nature of Repairs or Alterations(Answer when applicable) '� S__VIGA &c,U — oc Lc. — ak S i 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 En ' nmental Code and place the system in operation until a Certifi- cate of Compliance has been' Signed Date 5_(C'l:9�3l Application Approved by Date�� � n . Application Disapproved for the following reasons Permit No. — Date Issued NO. d-1 J ✓ Fee •. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Zipprication for ]Digpogar *pztem Con.5truction Permit'�i, Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System Uldnividual Components Location Address or Lot No. �,-21{C\' AYNt-j 14- Owner's Name,Address and Tel.No. L K NT 1=�2.J41� Assessor's Map/Parcel t-1 0- -:�(o s Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. VK-\V-C-W <-.- Z�6 ^i Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design Flow gallons per day. Calculated daily flow 7!�,_�k gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 1A Ca 67 Description of Soil 0.�Svlt� Nature of Repairs or Alterations(Answer when applicable) 'w5 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 ESY4,16nmentall Code and noM place the system in operation until a Certifi- cate of Compliance has been ' is Signed Date 5— Application Approved by Date Application Disapproved forte following reasons Permit No. — Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( )Upgraded(V,_ ! Abandoned( )by m` D—G'A S en k C_. at 'RC,%\V_:S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ,5�?_ 2.7_5__ dated Installer Designer .✓ /� e t, / .� /11 f n The issuance of this permit shall not b onstrued as a guarantee that the�s3 stun will func ioma/s desig"Id! / Date ) Inspector / % li11._ ���/l./ ') 01./j'"' --------------------------- No. ?/ - Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwisspogal *pgtem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade Abandon( ) System located at c l i;S u_t4,_k_ and as described in the above Application for Disposal System Construction Permit. The applicant recognizes 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: ,S— `� C�— g Approved by�T�� 16 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, \ i�, hereby certify that the application for disposal works construction permit signed by me dated �`��`l�?'j , concerning the property located at ;L Wl ES (A, (A meets all of the Mowing criteria: The failed system is connected to a residential dwelling only. There are no commercial or business ,,uses associated with the dwelling. ,,uses soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. tjw l here are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system ere is no increase in flow and/or change in use proposed •/Mere are no variances requested or needed. •Thebottom of the proposed leaching facility will not be located less than five feet above the The adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor me when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) qoj g B) G.W.Elevation �+the MAX. High G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back]. q:health folds.cent G M No...... �-........ Fis.... :S_� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEA TH Z�..'7.............OF....... i' .a? `�� --- .......................... Appliraiion for Dispvii al Works Cnnnitrnrtiun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ••. •-•- ........... Lo l Address t No... 7 . L r _a£- .. . . __j..... Owner Adss W •---•-•-••------•-•----------------------- -•-- ....` ..... - -•-•- ..... ... !t�_a.................... Installer Address Type of Building Size.Lot/ a?.....Sq. feet Dwelling—No. of Bedrooms____________________________________________Expansion Attic ) Garbage Grinder '4 Other—T e of Building No, of persons____________________________ Showers — Cafeteria a' Other fixtures ............................ . W Design Flow.......... '` ...................gallons per person per &Ly. Total daily flow__________ WSeptic Tank—Liquid capacity .gallons Length_7.t r__ Width___-6........ Diameter________________ Depth.... x Disposal Trench—No_ ____________________ Width_____d............. Total Length_____._____.._._.__ Total leaching area....................sq. ft. Seepage Pit No--------it .... Diameter.___C�-- ....... Depth Depth below inlet....j6... ....... Total leaching area__a..V 1...sq. ft. Z Other Distribution box (/) Dosing�tan-° A�' ko '-' Percolation Test Results Performed by-___f!--=-°__ 7_r' .__.__._.-I_�krn-___________ Date_._.J,._ 14 Test Pit No. I.__.___..minutes per inch Depth of Test Pit______40_________ Depth to ground water..... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil s .. ------ ------------------- U ---.._..-•-•-• �-✓- - �-�----------- --- .��._--._....�`�-� Y----- -......_�'__.....-------------- W •---------•----- ......................................................-•---•----•---------•--••--------•-•-•--------•--•----•-•--------•••----•---••---•-•--•----•--•-----------------••-------------- UNature of Repairs or Alterations—Answer when applicable............................................................................................... •--------------------------------------------------•-••---•----------------=--------....-•-........_...---...-----•----••••---•-----------------------••••----•--------•-•----_.._..----------....----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIEd 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued " 4--= - rd of health. igned �c Date Application Approved By........ . ... -/yg!- ........... / Date Application Disapproved for the following reasons:................................................................................................................ Date Permit No.............................. - Issued..... 1 ..................... e Fe�No.._... -....: Fims.....ZS._............ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH r.z .. ......_ ., , :........................... Appliratiun for Bigpos al Marko Tonstrnrtion ramit Ap J lcation is hereby made for a Permit to Construct 4 or Repair ( ) an Individual Sewage Disposal Syste�at: a2�Jei-v . ..... .. Ll_T7 F.....A rf ... .[........... . ...... ......•-_e Lo io Address / L L or t No. • D .�1 ... Y..e.1 _-T7.............. �. /C.1�.[1 la!0 .e �....../'1 �................/."./../G!S S�cJ2•t / Owner Address ......... . ::..�r4�. ..... --- f x'+. f.�k.. a Instalier Address g `� �� -• q• Q Type of Building Size Lo ._.__ � S feet Dwelling—No. of Bedrooms ..............••------•-...Expansion Attic) Garbage Grinder Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ............................ . W Design Flow........N -------------------gallons per person per�ay. Total dailyr flow.......... ._...___.__._..gallons. W Septic Tank—Liquid capacity .gallons Length_,!_!_..._.. Width---/2......... Diameter_______.•.__•-_. Depth.... ........ x Disposal Trench—No..................... Width . ....... Total Length.............V---- Total leaching area....................sq. ft. Seepage Pit No......../.......... Diameter.... .......... Depth elow inlet................. Total leaching area..R.V...sq. ft. Z Other Distribution box (�) Dosing to '-' Percolation Test Results Performed by ..".:._ :..t?)7.C.Y�........Z.�-G'............ Date__-_./��e � .__. Test ,Pit No. ...... per inch Depth of Test fit...... ......... Depth to ground water W. .....�f J... Test..Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ---------------------•------------------------------------- 0 Description of Soil-- --• . ?r. ..--••-- ....... -T �� .S s�� ---- x ----••-----•--------••--••......-••••-••-•---•••-••••-••------•-••••-•-•----•-•-••••---•--•-•-•-----•-•------•......--•-----•••---•-••-•-----•--•-••----•-•-•---•---•••--.......-•--•.................... U Nature of Repairs or Alterations—Answer when applicable............................................................. ............................... ..-----•--------------------•-------••-----•-----------•---•---•--------------------........-•--_...•---------•-•----•------•-•---•----•-••--•••--•-•--•••---•-••-••.......-•-------•--....._....--•-•• Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT?.w. . 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issuedth oard of health. Signed T- /� • ............................................................ ............. ---- -•---- Dat Application Approved By......... ......_... ✓�'"� =.T ........... Date Application Disapproved for the following reasons:.............................. .................................-•--------------•----------------------------------------•--------------•---••.....-•-----••---•----•-----•--......----•------•••----....----------------------------- Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................OF....... / ,/... .. ............................................... (Irdifiratr of ToutpliFanrle THI TO RTIFY, That the Individual Sewage Disposal System constructed ( �or Repaired ( ) by---•-•. •-- .._.,.'............................................................................ at nstaller has been installed in'accordance with the provisions of 41 � 5 of The State Sanitary Code.as described in the 'Z---------- dated---- '" '!!'7 ----------------- application for DisP.ol Works Construction Permit No._` ____ _________ g THE.ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTE4 WILL ,FUNCTION SATISFACTORY. DATE................................................................................... Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD�F HEAL H 7� ........��'.. . .............O F...... .......... ..... ..----........................ - N a:F'2'.. FEE... .......... �to�rouu /��(J�)q]��[J}�-r _.._-•�on��rnnr�ion� rrmit . Permission is hereby granted=-"---- •--- ...:-•--------------••----•----------------- ........................................ to Cons ct or Rep ) an I u�dual Sew Di S tem at No. . Street as shown on the application for Disposal's orks Constructio er N ----_--_._- _ Dated-----,��:./..'''....q............. 01 d oar B ` •--•-•-----•----•-•--•-•-- ...... Board Xea-lih DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS �,xr.� 4" r r r � � a _ o Z N _ A N a v v 11 N / N a I N p � It �a 0 �. '� 6 �� � � 23��o w 4V �. dF • i �I II I!f,li I i I!!li l ll I ;I llll'! IIIII it lr!I I l'I' Ljll�l II: I:I i!!Ijllll IIIII 1 I I � Iji'jllilll il!I,I - I I:a.ui.j ':Illil itij - - I Ii!Iii(I'll II IIIII. I I I j I I :,III � II II I j I I Il I I II , II it l i !• i (l,! I I ! Ii,i I I� i•:II I I I Ilf i,l!! ,11111 I! IDO I IjI'll i'1 I �II�I I I ,II I I Ii'il I 1 I II !II � II!I!lil l lll� 1 ® �� III; . 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I III I II III' ill-i.11 �,Il li i. li�lll II :ill j ll I i, III!I Ill I I', I I yy d� eR D }� PROJECT: T 24q AMES WAY CENTERVILLE, MA Zooks ARCHITECTURAL. GRAPHICS . m 10 ARt7 LANE HYANNIS, MA o?.W p ELEVATIONS N� �-mac W 4'-O' W i Q N � i -r a Q 4 Q a 4 -4o , u � r„ 1 1 — 4 i i I 1 L_ s.'-a o� �w = °y PRCUECTi - 249 AMES WAY CENTERVILLE, MA GADzooksARCHMWTURoAL GRAPHICS N 10 SEABOARD LANE HYANNIS, h1A 020a PLAN ' PHONE 508-775-0631 4 4'-0• I all �I —� jM i I Il�lilil�i''� p � Ili i�il i � i Illai� :it K Il !. i;ii '' L J wa ! l� is hii i� W. p. A D m 2*1 AMES HAY J CENTERVILLE, MA GADzooksAACHMECTURAL GRAPHICS a � � [Ell w 10 SEABOARD LANE HYANNIS, MA 026CA 211 f PLAN PHONE: ° - � e 24--0' =- -------------------- „- - ----- ----------- I I ,� I ` I lit I . I I � rt i- -------- -- -------i 1-4 4 I IrI I { i N Q PROJECTS 249 AMES WAY CENTERVILLE, MA GADZO&S ARCiHITEMRAL. GRAPHICS 10 SEABOARD LANE HYANNIS, MA 020a PLAN PHONE 508-7754W r A'-O. 44'-O' s I y i 1 I 't aR 3 • y Sit a La A'40 R a I � �• R D a PROJECT,249 AMES. WAY CENTERVILLE,r MA GADzooksAQCHIT EMRO&L GRAPHICS n � 10 SEABOARD LANE HYANNIS, MA 02601 P •, STRUCTURAL PHONE: 5 -775-OW r -—97——EXISTING CONTOUR ea N PROPOSED S.A.S. x 100.98 EXISTING SPOT GRADE ��` 2-500 GALLON CHAMBERS W coQ° ® Seans u SURROUNDED W/4' STONE EXISTING SEPTIC TANK G EXISTING GAS SERVICE EXISTING WATER SERVICE o ��`r Circle �° TOP 0 o TANKAI EL.=96.69t --�H. W. - UNDERGROUND WIRES" Ames Way N INV.(OUT)=95.35t TEST PIT LOCUS BENCHMARK o e�%d ets b ore path � BENCHMARK 3 LEGEND BULKHEAD 1COR./ 32�� x EL.=98.15 Rd F�^ ��c� 95.26 a jarampO �`c 98.42 S 25'47'18" yy /� a Rout p 95.98 e 28 a / BM 159.62' 96,42 97.8 // Westminster Rd Gocecy� 15 . . . . . x 97,54 _ 95, 1 ( ;7 96,79 I LOCUS MAP �o Un GENERAL NOTES: NOT TO SCALE x '�' x o 04 N/tq ✓ 1I \ i O M 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL / 9 5 / Gi J �-D� p to _� �J �/ BOARD OF HEALTH AND THE DESIGN ENGINEER. 96 2 BH �! 7 38 / ---� �'H• 98 20 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 15 Q I,/ H'. 98.04 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE CB LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: �'�/ � / •�7 310 CMR 15.401 1(b): CONTENTS OF LOCAL UPGRADE APPROVAL I DECK 98�45--EXISTING �� 3 1) A 3' variance, SAS to cellar wall(bulkhead), for a 17' setback. HOUSE(#249) 1� 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR SHED I I / T.O.F.=99.14- / a to 9' TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE / Q u0 / DESIGN ENGINEER. w I I 96.22 i 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING co FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 0 95.'7 �5,2 x I // LOT 37 z l 97,91 1 ENGINEER BEFORE CONSTRUCTION CONTINUES. `r _ 98,3gi, / 15,906 ±SF / "It 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. GARAGE 1 / q 98,94 ' / 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 96,E P/ARCEL ID: 170-236 f THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 97,74 _ HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 6,57 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 9. 34: 99,02 � 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS I 3 97,97: ;...•. ' ";'..`;, \ / AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE Q� / 97,73 DIRECTED BY THE APPROVING AUTHORITIES. n"TP-2 97,35.' ..' 97,46 \ / 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY I 97.40 ` ..' ` , THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING ; PAVED ;..` : .. + CONSTRUCTION. \ Df?IVEWAY. _.:,. / 98,79 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND OF REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). TO l BE ABANDONED +� �\`� MAS9C' 97,97 97,36, c�,� `r,y NG 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE \ 96,52 3� G INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. \ 95.00' CBdh o PETER T. �, McENTEE N 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND HYD, v NOT CONSIDERED 19'50 20 E CIVIL TO BE A PROPERTY LINE SURVEY. /_ \ No. 35109 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC I ® 1 96.68 EG/S(ER``� � SYSTEM COMPONENTS NOT SHOWN ON THE PLAN CATCH Bfi�S�N edge of pavement 96.50 `S/ ` PROPOSED SEPTIC SYSTEM UPGRADE PLAN 95,38 � SKUNKNET ROAD U�L 249 AMES WAY, CENTERVILLE, MA 02632 Prepared for: D.A. Brown, Inc., P.O. Box 145. Centerville, MA 02632 PLAN REVISION 12 6 18 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. f / 1) PROPOSED S.A.S. LOCATION AHAJJAM, NICOLE & 1"=20' P.T.M. 246-18 ABDELILLAH Engineering Works, Inc. 2) VARIANCE REQUEST INCRESED FROM 1' TO 3' 249 AMES WAY 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. FROM BULKHEAD DUE TO SITE CONSTRAINTS CENTERVILLE, MA 02632 (508) 477-5313 10/11/18 P.T.M. 1 of 2 v NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL.=93.0 FOR A DISTANCE OF 15' FROM THE EDGE SEPTIC TANK OF THE PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & PROPOSED D—BOX PROPOSED S.A.S. EXJSTING\ OUTLET AND SET TO 6" OF F4NISH GRADE INSTALL RISER & WATERTIGHT INSTALL RISER & COVER OVER ONE CHAMBER AND U GARAGE HOSE249& COVER SET TO 6" OF GRADE SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT T.O.F.=99.14t T.O.F.=99.14 F.G. EL.=97.0t F.G. EL.=96.7f F.G. EL.=96.1 t F.G. EL.=96.0f ff MAINTAIN 2% SLOPE OVER S.A.S. S=191(MIN.) ® SL 1% (MIN.) 2" LAYER OF 1/8" TO 1/2" N �� EC O 4 SCH40 PVC 4 SCH40 PVC" " 6,. DOUBLE WASHED STONE P _gip as as (OR APPROVED FILTER FABRIC) LA 1o"I 14" 6- E3 1SOaa CT A, W EXISTING 48" LIQUID aaaBBaa �3/4" TO 1-1/2" DOUBLE `ti3r'` W LEVEL ADD 4' 4.8' 4' WASHED STONE ��'�•�� GAS DAPPLE INV.=94.57 PROPOSED INV.=94.40 EFFECTIVE WIDTH = 12.8' INV.=95.35f D—BOX i O O EXISTING INV.=92.50 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP CONC. ELEV.=93.3f INVERTS, PRIOR TO INSTALLATION. BREAKOUT ELEV.=93.00 ease SEPTIC LAYOUT INV. ELEV.=92.50 Baaaa 2) D-BOX SHALL BE SET LEVEL AND TRUE TO aBaaaaaaaBa GRADE ON A MECHANICALLY COMPACTED SIX aaaaaaaaaaa INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=90.50 4' 2 x 8.5' = 17.0' 4' 310 CMR 15.221(2). 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. PERVIOUS MATERIAL 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W. ®®EO® 0 AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W., EL=84.5 — LEACHING SYSTEM SECTION ®®®®®® ® ®®®® 33 D_ ®®®®®® ® ® ®®® „ SEPTIC SYSTEM PROFILE N Z ®�®®® ® ®®® N.T.S. 102" DESIGN CRITERIA SOIL LOG DATE: OCTOBER 9, 2018 (REF#15,795) 4" KNOCKOUT NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER MCENTEE PE(SE#1542) WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT 20" DIA. COVER SOIL TEXTURAL CLASS: CLASS I ELEV. TP- 1 DEPTH ELEv. TP-2 DEPTH / DESIGN PERCOLATION RATE: <2 MIN/IN 96.0 A o" 96,1 A 0° 0 4 KNOCKOUT 4" KNOCKOUT 58 DAILY FLOW: 330 G.P.D. LOAMY SAND LOAMY SAND 10YR 4/2 10YR 4/2 DESIGN FLOW: 330 G.P.D. 95.5 B 6" 95.6 B 6" 4" KNOCKOUT GARBAGE GRINDER: NO—not allowed with design LOAMY SAND LOAMY SAND 10YR 5/6 10YR 5/6 LEACHING AREA REQUIRED: (330) = 445.9 S.F. 92.5 C 42" 93.1 G 36" 500 GALLON CAPACITY, H-10 LOADING .74 PERC CHAMBERS EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 31'/49" PROPOSED D—BOX: 1 INLET, 3 OUTLETS, H-10 RATED N.T.S. MED. SAND MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 2.5Y 6/6 2.5Y s/s SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 249 AMES WAY, CENTERVILLE, MA 02632 SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145. Centerville, MA 02632 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:.............................................................. 471.2 S.F. 84.5 1 1.138" 84.6 138" Engineering Works, Inc. N.T.S. P.T.M. 246-18 PERC RATE <2 MIN/IN. "C" HORIZON 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD NO GROUNDWATER ENCOUNTERED (508) 477-5313 10/11/18 P.T.M. 2 Of 2 �C� . v J? C Gam f'7 ty'� 3 2 7,' / Gov ;Yr M - �elm: G /7 \, j ? i 00 o tr plt 4 ^ h �oiP oo s Gt!' 4" © .� n la r7 i u LPL. L e..ss T 44 F7 ,� 1pn 177 o _ '6 pa Z /i9u y ru zi FRANK r Gam' i at�.: FRANK m MM 0 CONERY p�No. 6L7PL0{� No. 6232 O �+ IS \�� 01 fk 141 • \/ONA;Fa 4�e su afir, 5 k/A OWNED BY FRANC CONERY 5 TRE'1.1TON ST. w HYANNIS, MASS. 02601 e ` R£G19TERED ENGMEER & L_AND SURVEYOR p\Q SCALE t IN FT. /Y17 t ,