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HomeMy WebLinkAbout0104 BEECHWOOD ROAD - Health 104 BEECHWOOD RD. CENTERVILLE A = Slll__l _� �,atic�aEoo llll UPC 12534 No. 2-153LOR AOST•CONSJ� NASTING&, MN No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliLo.tion for Misposaf*pstrm Construction permit Application for a Permit to Construct( ) Repair k Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (ot j 6c cj,4ujo®D LLD Owner's Name,Address,and Tel.No. F�trAssessor's Map/Parcel PL5 a ( (. 1'p G'WL.LLS' Installer's Name,Address,and Tel.No. 540 8- 07-F271 7 Designer's Name,Address,and Tel.No.5o8-, 7 3 CAP �h� E7uZE3¢�'LZf LTG z'eic. c-Ea� 5 Type of Building: Dwelling No.of Bedrooms �?j Lot Size tsq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) :3 30 gpd Design flow provided � t gpd Plan Date 1 - q -1019 Number of sheets ( Revision Date Title ( 04 Lte"cuaooc-r> RbAb nb tLkZ Size of Septic Tank it Uco io's Type of S.A.S. (a) CkL4.0a csws Description of Soil 1� icja l 62bUD Nature of Repairs or Alterations(Answer when applicable) U 5c 64.LLo LJ SGPZ'IG T"K, -M N 60 L�IQ D 0 K TZZ0 � 5 UD G* LEI-, N-jo �[!J�-�e�CQ3 tD.5) 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 Heal q Signed Date -[C -;L0 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Z Date Issued AA No. ? Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -,TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for Zipposal i6pstem Construction permit Application for a Permit to Construct( ) Repair k Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (6)t4 $GEUatWopD ZLD Owner's Name,Address,and Tel.No. nc"Yuc.0 Fitccfi� a kirti{13��t1Y �t Assessor's Map/Parcel a 5.'� f S(,� j O� g uaooD P4--.i <: MUX;� Installer's Name,Address,and Tel.No. $�8-�??-S�-i 7 Designer's Name,Address,and Tel.No. So$-,X7 CAPGW(Oe eXXr6CAQJSe5� ZTC, �a�G Type of Building: 22 f Dwelling No.of Bedrooms �7 Lot Size R —sq-ft. Garbage Grinder( ) 1 Other Type of Building {?t;"S i O67JTE i4(. No.of Persons Showers( ) Cafeteria( ) Other Fixtures -Des n Flow(min.required) 3.30 gpd Design flow provided s4gr� gpd Pla ,� Date I ' (4 1019 Number of sheets ( p Revision Date .Title. (0 GL-GGN kjodL AQA� Cep-C� ,Wtt.1.,, Size of Septic Tank I ,Voo GuCLArjS Type of S.A.S. (2) '5660 Description of Soil lM.h5D1 r1 9AD Nature of Repairs or Alterations(Answer when applicable) U 5cS 6W9t-fhj(�— 1.Ott 6A.LLO rJ SGTIG rtAMC' N t?u 14-ko D Gox i-nT sun� cam, o�J N a o GG -E r G,i 4ucl3 .� 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 Application Approved by ;: t Date Application Disapproved by Date for the following reasons t Permit No. ? c)(9 — 02 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.( ) Abandoned( )by (24 45�")l A[` E1QT13(QQ(S� / at 104 8GjEC4tejC) _ C t 1/11 1,�:­ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.a d/� f—at dated I -114 � J Installer �i,e�Cl �1V cT� © Designer Vic E #bedrooms Approved design flow [a gpd The issuance of this permitrsthaall/not be construed as a guarantee that the system will1 function.as design :ed Date l j q Inspector� � Fee -�� ------------------- ---------------------------•----------------------------------- ---=--- -------- No.�b( t /0U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal Epstein Construction i3ermit Permission is hereby granted to Construct( ) Repair(X Upgrade( ) Abandon( ) System located at NO A _ o p,-:b RC 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 )_ (� l Approved by reb. Z6. 1U19 h: 11NM No, 3012 P. 1 Town of Barnstable Regulatory Services • Richard V. Scali,Interim Director L WN@rA9U, ,'�'9: Public Health Division 'r0 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862.4644 fax: 508-790-6304 Installer& Designer Certification Form Date: 2�'Z6*4 Sewage Permit# 201'31-0aLI Assessor's MapTarcel Designer: LTG Tnc, Installer: _CaQe_widc L-.nF,e-rQcfs,.s Address: 2b5y Caabozr� µia—wAY Address: l5_5 comMu"W &free EaA war6Aam . N1tt e2559 Mas4,,�ee� HP oar�y9 On 1_(Lt-_A0 ft ClecwiAe. L-'nFtirQrtse5 was issued a permit to install a (date) —` (installer) 1 septic system at 10 y 6 e�lwoM �ba based on a design drawn by (address) C 6V18(r)UXzo 5 ) ToC dated sun- W, f (designer) • 1 certify that the septic system referenced above was instal led 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. l certify that the system referenced above was constructed ' e with.the terms of the 11A approval letters(if applicable) p�TN o et4& C3 JOHN L G CHURCHILL Jit. H (installer' Signature) CI No yet» !3 ,E ( lgner's Signature) (Affix Des' er mp Here) PL SE RETURN TO ARNSTABLE PUBLIC HEALT DI SION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS BUILT CARD ARE RECEM-D BY THE BARNSTABLE PUBLIC HEALTH DIVISION, THANK YOU. Q;1S0p1ic\bes1gner Certification Form Rev 8-14-13.doc TOWN OF BARNSTABLE LOCATION . 1�'[ 300 WOOS �V SEWAGE# VILLAGE CC—NTi C—RV 1 L.LL ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO ZAMUXIJ� f�(S�$` EF77�FS SEPTIC TANK CAPACITY t l©o O LEACHING FACILITY.(type) 0-;tO U A6+3.(size) 12, X �j t NO.OF BEDROOMS 3 OWNER P-IGd-Eft � �llv( M��- PERMIT DATE: I 'I Lt-;t0(9 . COMPLIANCE DATE: Separation Distance Between the: / Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility fi 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 A 300 feet of leaching �` A��facility) Feet FURNISHED BY a ---- ��� ' (Lit Q � 38.2 c • `� 3 p C- S - 2.0 .8 L, 5 0 C = 32 .2` �O r IE Town of Barnstable Department of Regulatory Services 4 j Public Health Division Date, LAO �3 MAWS t'6Jp Al 200 Main Stroct,Hyannis MA 02601 1 Fn h11d Date Scheduled Time Fee Pd.— r;t�; Sa►zr Suita z1i. Assessment for Sewage Disposal Nl�c ,me(1��, I1, CSC Performed•By:- Witnessed By: LOCATION&.GENERAL INFORMATION , Location Addross Owner's Name iC( 4 >:iIC( �R. �9G1E d l�CC- s-l4at � R1J C`V f t.C,C R _ `'� `� Address 104 8ee*t Pb o V t",.X- ��11 d.4G61c.,4CC t"e�'Tt3ZP.ZISP�/4B Assessor's Map/Parcel: ' a� o� / �(p Engineer's Name -TC_ erjC- teJ6 A.Cx T NEW CONSTRUCTION REPAIR _ Telophone fk 1 Q Q Lnnd Uso t l o Slopes(96) 0 U Surface Stones Distances from: Open Water Body A ft Possible Wet-Area� d� $ Drinking Water Well tt Dralhagc Way I ft Property Line > i0 ft Other {) SKETCH[(Street name,dimensions of lot,exact locations of test holes&Pero tests,locate wetlands to proximlly to holes) see cj •TWG Qli r Parent material(geologic)©� Depth to Bedrook Depth to Groundwater. Standing Water in Hole: > ��0_ .. (��� Weeping from Pit Fnaa Estimated Seasonal High Oroundwater DETE ATION FOR SEASONALUMI WATER TABLE Method Used: d OY� Depth Observed standing in obs.hole: > )3g In, Depth to soil mottles: Do¢th to weeping from side of obs.polo: >l3 In. Grnundwnter Adjustment . Index Well-# Reading Date: lndex Well Imvol_:-� Adj hetbr _ Adj.Groundwater-Leval PERCOLATION TEST Dula ia-1 J Time l0;OOo Observation ' Holo fi Time at 9" Depth of Pero 5Q�7, Tlmo at 6" Start Pro-soak Time @ 16.00GYN Time(9"-6") End Pro-soak f®^Qb fxM Rata Mtn./Ioch Site Suitability Assessment: Slto Passcd V Sltp Failed: Additional Testing Needed(YIN) /V Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***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. Q:ISEPTICIPERCPORM.DOC 'DEEP-OBSERVATION HOLE LOG Hole# ` Depth from Soll Horizon Soil Texture Shcl Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stoned;Boulders. Consistency.Mbivall ��a � j;Ij M.11- Loaf Sale l Yr IM, 5D�- 132 C. Sad 15 6/6 DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Soil Color Sail Other Surface(In.) (USDA) (M-ansell) Mottling (Structure,Stones,Boulders. sl en , I f . DEEP OBSERVATION HOLE LOG Hole# Depth frond Soil Horizon Soil Texture Sall Color Sall Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistartay. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sail Texture Sall Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Flood Insurance Rate Ma Above 5o0 year f lood boundary No_ Yea z Within 500 year boundary No=1� Yes Within 100 year flood boundary No. Yts Denth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious mtitorial exist in all areas observed thrpughout the area proposed for the soil absorption system? If not,what is the depth of naturally occutring p rvlous matorlal? Certlficatiun I certify that on ��4)7 6 (date)I have,passe'd the soil evaluator examination approved by the Department of Envlronmental Protection and that the above analysis was performed by me consistent with . the required trainin ,c ortis d expericnco described in 10 CMR 15.017. Signature �'' Datb �y , Q;\REF rIC1PERCPORM.DOC Commonwealth of Massachusetts Executive Office of Environmental Affairs Dept. of Environmental Protection ki One winter Street,Boston,Ma. 02108 .John Grad D.E.P. Title V Septic Inspector or P.O. Box 2119 Teaticket, MA 02536 WILLIAM F.WELD (508)564-6813 Governor - o ARGEO PAUL CELLUCCI Lt.Governor ft�` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM'PART A /+� CERTIFICATION RrFE �E�V, Property Address: 104 Beechwood Rd.Centerville Lot 168 Address of Owner: lOW"r N, . 1998 Date of Inspection: 2/11198 (If different) HfAC HD""'°iE Name of Inspector: n/a Mr.Scott f67 I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) / Company Name,Address and Telephone Number: / CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: x Passes This Inspection Is based on criteria defined In Title V _ Conditionally Passes code 310CMR16303.My findings are of how the system is performing at the time of the Inspection.My Inspection does _ Needs F ther aluation By the Local Approving Authority not Imply any warranty at guarantee of the tongevltyofthe Fails septic system and any of Its components useful life. Inspector's Signature: Date: 2113198 The System Inspector shall su I t a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A, B,C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 3W CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of CdMpliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04417197) One Winter Street • Boston,Massachusetts 021108 • FAX(617)556-1049 a Telephone(617)2925500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 104 Beechwood Rd Centerville Lot 168 Owner: Mr.Scott Date of Inspection:?N1199 _ Sewage backup or.hreakout or hioh,static water level observed.in.the distribution box is due to a broken. or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must Indicate either"Yes"or"No"as to each of the following: _ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged cesspool. SAS is in hydraulic failure. (revleed 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 104 Beechwood Rd.Centerville Lot 188 Owner: Mr.Scott Date of Inspection:2111198 D]SYSTEM FAILS(continued) Yes No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revleed 0427)87I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 104 Beechwood Rd Centerville Lot 168 Owner: Mr.Scott Date of Inspection:2111198 Check if the following have been done:YOU must indicate either"Yes"or"No"as to each of the following: _X_ — Pumping information was requested of the owner, occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this inspection. x — As built plans have been obtained and examined. Note if they are not available with N/A. x — The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. ,I— The site was inspected for signs of breakout. x All system components, excluding the Soil Absorption System,have been located on the site. x The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions, depth of liquid,depth of sludge,depth of scum. x The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue,approximation of distance is — — unacceptable)[15.302(3)(b)) (revised 04127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 104 Beechwood Rd.Centerville Lot 168 Owner: Mr.Scott Date of Inspection:211'1198 FLOW CONDITIONS RESIDENTIAL: d!bedroom for S.A.S. Design flow: 3m g•p Number of bedrooms: 3 Number of current residents: d Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yea Seasonal use(yes or no): Yes Water meter readings, if available:(last two(2)year usage(gpd): rda Sump Pump(yes or no): No Last date of occupancy: Na COMMERCIAL/INDUSTRIAL: Type of establishment: n1a Design flow:o gallons/day Grease trap present:(yes or no) No Industrial Waste Holding Tank present:(yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings,if available: rds Last date of occupancy: nra OTHER:(Describe) rds Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: rda System pumped as part of inspection: (yes or no)No If yes,volume pumped:0 gallons Reason for pumping: rda TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any) I/A Technology etc.Copy of up to date contract? Other: APPROXIMATE AGE of all components, date Installed(if known)and source Information: 1984 Sewage odors detected when arriving at the site:(yes or no) No pevlaed 04R7197) i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10413eechwood Rd Centerville Lot 108 Owner: Mr.Scott Date of Inspection:21'1198 SEPTIC TANK: x (locate on site plan) Depth below grade: 6" Material of construction:x con create—meta l_FRP_Polyethylene—other(explain) If tank is metal, list age rda . Is age confirmed by Certificate of Compliance No (Yes/No) Dimensions: t.e'6^H5•7^w4.i0" Sludge depth:t" Distance from top of sludge to bottom of outlet tee or baffle:26" Scum thickness:g Distance from top of scum to top of outlet tee or baffle:6 Distance form bottom of scum to bottom of outlet tee or baffle:g How dimensions were determined: Measured Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Septic tank and all components are structurally sound and functioning properly.Recommend pumping every two years. GREASE TRAP: (locate on site plan) Depth below grade: rda Material of construction: _concrete_metal_FRP_Polyethylene_other(explain) Dimensions: nia Scum thickness:rda Distance from top of scum to top of outlet tee or baffle:rya Distance from bottom of scum to bottom of outlet tee or baffle: rda Date of last pumpingr'd, Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) rda BUILDING SEWER: (Locate on site plan) Depth below grade: v Material of construction:_cast iron x 40 PVC_other(explain) Distance from private water supply well or suction linetown Diameter: a^ rvgmments: (conditions of joints,venting,evidence of leakage, etc.) (rsvlaed 04727)87) I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 104 Beechwood Rd.Centerville Lot 168 Owner: Mr.Scott Date of Inspection:7111198 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: Na Material of construction:_concrete_metal_FRP_Polyethylene_other(explain) Dimensions: No Capacity: Na gallons Design flow: We gallons/day Alarm level:-.No Alarm in working order?_Yes_No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) He DISTRIBUTION BOX: x (locate on site plan) Depth of liquid level above outlet invert: Liquid level with bottom of pipe. Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box etc.) 0-box Is structurally sound. PUMP CHAMBER: (locate on site plan). Pumps in working order:(yes or no)No Alarms in working order(yes or no)_Yes Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) Na (revised 0677197) 0 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 104 Beechwood Rd.Centerville Lot 169 Owner: Mr.Scott Date of Inspection:2111199 SOIL ABSORPTION SYSTEM(SAS):x (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: rda Type: leaching pits,number: 1p00 gallon leach ph leaching chambers,number:nra leaching galleries, number: Na leaching trenches, number,length: rda leaching fields,number, dimensions:rJa overflow cesspool,number:nre Alternate system:-rda Name of Technology:_nra Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) System and all components we structurally sound and Functioning properly.The leach pttwas empty atthe time ofthe Inspection. CESSPOOLS: (locate on site plan) Number and configuration: Wa Depth-top of liquid to inlet invert: nra Depth of solids layer: nia Depth of scum layer: nra Dimensions of cesspool: We. Materials of construction: nra Indication of groundwater: nla inflow(cesspool must be pumped as part of inspection) rda Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) rda PRIVY: (locate on site plan) Materials of construction: ma Dimensions: Na Depth of solids: rtla Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) nra (revised 0427)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 104 Beechwood Rd.Centerville Lot 168 Mr.Scott 2111198 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) a � Inc y� Paps ! o! 30 pwi..d 04m197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 104 Beachwood Rd.Centerville Lot 168 Mr.Scott 2111198 Depth of groundwater 12. Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health . Check FEMA Maps Check pumping records Check local excavators, installers x Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS Maps and Charts (nvlasdOWT197) page IO of 3D It �.y kk{{ � Q•. p yy rT if yti 14,E a S k a t L/Vl- " S lk F 1 LLr ' 15, ,... .gym.. _._ ev�sti,ry 1;ni.t.t._ ILA" ee NolL/� Fss........��............. THE COMMONWEALTH OF!MASSACHUSETTS BOARD OF HEALTH 4'Ca9 ...................OF..............*�? .`� .F?.�--------................._. Appliratiun for Dtivusal Works Tonstrur#tun Vrrmit Application is hereby made for a Permit to Construct or .Repair ( ) an Individual Sewage Disposal System at: =-� � ---......? wet -....Lxa----•-•C�n�e c i 1�e M p?•---••--•------•••---•---•---•---...-••-••-•------------- Location-Address or Lot No. C' �..--. ek.-'F-----•------------------------------------- wner ^^ p s Address, r W i .......... .••-.. ......... Installer Address Q Type of Building Size Lot__l4t_49Z:20......Sq. feet U Dwelling—No. of Bedroo+s. .__' SAS _.....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building Viz__Ca _e-..__ No. of persons____________________________ Showers (?-) — Cafeteria ( ) Otherfixtures -------------------------------•--------__----•---_-__---------------------------------------------------------••----------------•----__--____------- W Design Flow.......5.5..............................gallons per person per day. Total daily flow..._._.___. Q......................gallons. P: Septic Tank—Liquid capacity_tmo©_.gallons Length._& (v..`... Width.J4_' 9°f.. Diameter________________ Depth5_'_Z_''.. W Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area.....................sq. ft. x Seepage Pit No._.................. Diameter....AP:°.._._._ Depth below inlet._._._.......... Total leaching area_Zb�......sq. ft. Z Other Distribution box (%,-I Dosing tank ( ) Percolation Test Results Performed by-___LEIS-aIC. Date... aTest Pit No. ......minutes per inch Depth of Test Pit____�_�'........ Depth to ground water__.r!®'Ae:_._._-. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ aj ' __________________________________L _L_ _ ______F ..'..---------- -____--------- q____-__________-___-------- -_T-_ O Descri tion of Soil.....� ?�---- Cowl-Ppf_G•` !(?-..__... Q�_..-_--.•---�----'Z M e< 1 �1 n!\ s�A_. ---------------------------------------------------------------------------------------•----•------•---..•-.-..--------------------------------------•---•--•--------•-----•••-----•--•-•-•--•-•-•....-- U Nature of Repairs or Alterations—Answer when applicable............................................................................................. --------------------------------------------------•--•-•••••-•-••-•-•-••-••••-••-•---•...................._.....•••••-...•••-••------•----•-----•-•••-••-------........................................ Agreement: Tile undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by theboard of health. igned ate Application Approv eollow�_� •----•----•-•----••••.......................•...._................._..---_.- ._$Z _._ DateApplication Disapproveding reasons:.......................................:...................................................................... _ -•-•-•--.........•-•...•-••------•---•••.............•-•----••....••-••-••...-••----._..............------•_._._......_....._.-_....•-----•-•---...---•-•••-••--••----- -••_.._..•-•-•••-•--•-•------ Date PermitNo......................................................... Issued....................................................... Date No..o...� v ... Fma..... ...Q............ THE COMMONWEALTH OP,_MASSACHUSETTS BOARD OF HEALTH ........... .<- n. k : 1. -.......................... Appliration for Uiipu,sttl Workii Tnntrnrtiun rumit Application is hereby made for a Permit to Construct (,4) or Repair ( ) an Individual Sewage Disposal System at: t 1.. --.. �� ' - c1 q ....� ------.. erv....................M....!......................................................... Location-Address or Lot o. Owner ! Address Cast c`...=C v�C._ .... LEJ.. ..................................................mot rl C�..c''� .�t r.. �J ; C, ............................... Installer r Address dType of Building Size Lot...1t. _ ......Sq. feet U Dwelling—No. of Bedrooms.........�..�.P_.....................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building No. of persons............................ Showers (?) — Cafeteria ( ) 0.' Other fixtures -------------------------------• . .3 W Design Flow........5.5.............................gallons per person per day. Total daily flow........... ......................gallons. WSeptic Tank—Liquid capacity_t®n:O..gallons Length..S.1.6 Width.A'.!.Q''.. Diameter................ Depth. x Disposal Trench, No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I_----------- Diameter.....6.Q........ Depth below inlet......�2......... Total leaching area_?- ......sq. ft. Z Other Distribution box ( Dosing tank ( 4 ) Percolation Test Results Performed by.... ? ..!../_ .. .��' ... �_ .� - ___ / •�"�"-----•--••----... Date......� - .._ �.----------- aTest Pit No. 1..<...2......minutes per inch Depth of Test Pit.....9._I........ Depth to ground water--_0-0 e-.--_ (% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•------••-----------•----•------............................ ........... .....•-•--------•-•------•---•----•------....----•-••--------.....:......... D Description of Soil.....n."_.3`..�_?v.n 1 c ......... ...... G .......f.........................................................�t y!1............... a v .._.... L.... � r f'� �� �--....��A.. � c �.�.�.= ......-•---------------------------•--•----•-•-----•--------•--------•----..........---•-••--••---- W ------------•------•--•••-•-•----••••-------------------------------•...-•------••----•-•---•----•-•••--•-•••...•-•--•-••-•--•-------------•----•-------•-•---------•-.................. VNature 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 TITLE 5 of the State Sanitary Code.— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. f igned..... .......)V..............................t C- _ ......-•---------------------- -- ` ---� .....:......... C_ \ — a e ApplicationApprov .--- . ----•--•---•-----------••------•--•--•........................•---..............--••- - at � ............ Date Application Disapproved f e following reasons:-------•-------------------•-•--.....-------•--:............------------------....._......................... -•-------------------•----------....-----••--------•----------------------•------------....._.......-•---•---•---•--•---•--------•---•-•----••---------•-------..:.--•--.....------•---•-•------••...--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OIL HEALTH .��.�. ...................OF............. c?�1 t I(�s � ....................... ........................ . Trrtif irate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( S.) or Repaired ( ) by... 9.6f�:....:..... -:".....G_'o = .'-\c... -----.R........... ........----•-•--.-- Install at ....1'`� .......... . !'.----_-----•----..-----_-•- has been installed in accordance with the provisions of TI, 5 fjT,pe State Sanitary de s es ied in the �°to l� application for Disposal Works Construction Permit No................F._.__........_.__....,. dated_...... ____ ...----_._-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................... -.,1 -` Inspector. . ' THE COMMONWEALTH OF MASSACHUSETTS // BOARD OF HEAL`THl_ y iJ !� .1:�� ?.✓ .................OF.............. C.rl- T. .��d.5. r- frc /r No.....-••................ FEE........................ Rapostt1 Vorkii Tuntrurtion rautit Permission is hereby granted.....Zok_.S:A__....OvC...... ... :ft.'.c -------------•------------------•-----------•--......................... to Construct ( )Q or Repair ( } an Individual Sewage Disposal System at No....L`.k......ia-...... ..........Cf_-A.cr.:_*4_;.! _....... Ai Street 0.00 as shown on the application for Disposal Works Construction Perm* . .................... Dated......1_?...I....���....bA.. ............. .... ••-................................................................................ ; O[/ Board of Health DATE-------------•-•f.!;.? FORM 1255 A. M. SULKIN, INC., BOSTON r �r o 93 . i ux y f .ls` ;t "3p/lv�Io >�)f3gcc�s \ 9 °` 3Epr,c 9 rr� c Nv " F O ?Waite j 9S ;.A p�oT ?c•w 97t W� �j(oA. �:. t, -g q3 b w Y p r z�4 � - 7 9 h .� x a x �k r , ,,:n2 b �' •7 rt z o 5 f. x t S►y p 1„—.1.3. "�'. ,y-' :;6n +� O 1`!. f. .. �K Loy- iG7 99 . Lnr � G9 , '� �, o b--,�C/1� •E a '� � , �TQ M D-0-L,:b \ O R+ E 0'Y17 0 OF ri \ T ',A�VMENT �p�* ORSE v► ., 'F ,d t 5J q EGN lac OQ '0 9 L7 f SRUCE J'=+ a GJi4 Y� ELCRE LEGEND., ` EXL>dTiNA ' SPOT ELEVATION`'" �_ ,:0,�0 : 's,rE�``o� 'EXL1'iTINa, CONTOUR "--- 0 _ 4IVo sad ,FINISHED •',SPOT ELEVATION 'INI.S.MED `CONTOUR:-- O----- CERTIFIED PLOT PLAN " NOfE The` location of an°y exisaing undexgroundsewerage, r wells,.-or. othex utilities shown.: on tr.is :plan .is appxcax L_or 1GB � ECHO„ OOD._R�__C' � mate only as .deterrnined from t.records `anl%or`Verbal: IN n 'ofoxmation. The contractor is responsibl@for the cation of the existin locations in 'the ":field •` assume no responsibil' tygfor' damages aricurred as + r° 2AItA� �'�"��������� result`of any utilities''omitted or.inacc,pr,r ly shpwn, gCALEr" 30� DATE dA�►�-25K 84 DREDGE ENGINEERING Ca ... .._ C41ENT I CERTIFY THAT THE PROPOSED EG.ISTERE RE01STERED y 40g'NO ?,,; 3 BUILDING SHOWN ON THIS PLAN "CIVIL ° " LAND ` CONFORMS TO THE ZONING LAWS ry DR 8Y D-.-- -r�- BNSTAeLE , MASS. . ENGINEER URV OF AR ' z 712 MA1.N STREET `, A .HYA NN I Si MA$.S ' t. gHEETs._ 4f" .' ATE REG. LAND SURVEYOR .. )Oil 20 FT. MIN• /V07 /i E/TNER 7Ne.SEPT/C TiIiVK OR • LEACN/ooYG P/T ARE MORE TNAIV /I NeELOW c�RAAW.0 A R4'O♦AM ET.ER CONG'.t.�T.•r COi/Eir ^ .0 PYC Pier SWALL ®E AAPOLMi YT TO 6/fAD,E.�AN AFX7—,f'A Et�v !00-5 CONGR�E ' Y - liEAvy C^ST IRON co✓�R .S/1.gL.L DE USEO ' COVERS M/N• P/TCJ�, /F/N DR/VE/VA y ib PAW jar. . 2 41#V. CO/VCRE TE .Q1 a of Co rER CL AA Al SANG • . . . gACX/=/LPL , _ L/QU/D LEYEL � x, 2"LAYER /�'P��rrT SEPTIC TANK D/ST. q • • • • . • • • • • • o , l'YASHFD S7?�NE ry ecx B_. ::•a� r s�EFJ�ECT C : • • y ., . r • • DfPTH• • • v• WA5NEQ STOA/E' • • • . • • •• . o • ` • • . • • • •• • o .r PRECAST SEE.PJ�GE ry, 1 1 25 377� d 7 x _ RT CL E.✓�1T/oHs I/3� t.:n l . 3 0 ., •• . �.E v G o 0 1 d� � R EQU/ /NIiG .y. a /NYERT_AT-Ql//"/NG _L v FT 90:5 °17.�r 7�98!/LAT10N K` .Ti4 WX`<- ��FT INLET .SEPT - _12 FT. O/�4JrJ. C SEE O/JTGET SEPT/C 7'AIVK -" /INLET D/STR/$!?/ON BOX /'`f FT GROVAW WA7. l� Tit E SECT/®N OF Of"ZAL ws toon Jv eox AGE `.DI.SPD�SA L .SYSTEM' y0�p SE'w %/vLET t.f aC/�r/aiG PiT 7A' -�eT/O/Y h _ LEACH/NG P!TT dt.iLED♦MEN.S/ON..' gs •' t 1 DES/6N CR/TERM DIN.es+vS/ow 8—�AT f NUM/dER,OF BEGeR00/+!S; 3 D/MENS/ON . C FT MJAJ •Re GE-ofsAM"A.uiv/T A)m r SD/L. LOG TOTAL EST/MFITEQ F40AV33Q.G.4L D .SOIL TE3T ., �4`Y $O/L TEST/1►/_.. SOIL TFST2 _< f NUMSER OF LE4ClWjM6 o/T3_L fFCEY. 93 3 �LEK DATE OF SO♦L TEST S/DE LrACH/NG PER P/T 1 L_.SYg fT., D -3 ,q LTS iVJTNESS dY-�o �_F.�.e ,, , coal ES[/ E� OOT'tOMA.Z4CN♦IVGPlfRP/T i.c S4. FT COr�PAGTCD _ �'RCGLI4T/ON' /CATS / G 2 !yJ/1�JINCK. TOTAL lEACN/NG REA:''2 G4 SQ. /FT;': .Toa .Sa�rr FErtCOL�T/ON RATE Az MJ/V�INCH` R�ESERI�ELE4CN/,V6AREA 2G4 SQ. FT., a'f AND" . .: �. ` !lc 3T <� ��V s9p - .7?t/tes.,, �EEGINWODD �6MTe�ctVt1.L6 ELL)REA sE N : FLG►RED6E'EINGlN.6 00 ING. Na 1095v 6 f �•�. EIxv Ef1 7♦2.MA1IW s�F, f/YA�IF/V/9, M.4Ss. kp Sll � tsT �,� N0 6` OfJN YY}iTtit E/VCOtJ/1hTLr>CEdy CL/ENT c ; K QATE g4 .- Wk f- ✓OD'::/�0:',�3i'v3 :R�1,�1�OIP,,,?„. ? ...... a ... s ,,.. '.. r• .-.^nr. L O CATION /®1f SEWAGE PERMIT NO. L t//- ef - VILI�ACE INS A LLER'S NAME i ADDRESS bo d �j N U DER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �a-�-K � � 3 � `�� �� i T.O.F. EL.- 75.4'± FINISH GRADE OVER D-BOX= 69.7'{ FINISH GRADE OVER CHAMBERS = 68.9, - 69.7, PROPOSED VENT WITH CHARCOAL FILTER TO ABOVE GRADE GENERAL NOTE SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6" OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS FINISH GRADE OUTLET TO WITHIN 6"OF F.G. MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 72.0'± F.G. OVER TANK EL. = 71 .rj�± r-5" DIA. OUTLET(S) STONE OR GEOTEXTILE FILTER FABRIC CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE f TOP OF SAS = 65.50' PLACE RISERS ON ALL DESIGN ENGINEER. 3.8' MAX. EXISTING 4" PROPOSED 4" 4.2' CHAMBERS WITH MAX. 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE SCH. 40 PVC (SEE NOTE 23) 64.50' (SEE NOTE 23) BREAKOUT EL= 65.00' INLET PIPES TO 6"OF FINISHED GRADE--'' SYSTEM UNLESS OTHERWISE NOTED. - —, SEWER PIPE , -.. 6�' 3" 3" DROP MAX L=30'± 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN - -7 1 2" DROP MIN 3 9 MIN.SLOPE PROVIDE WATERTIGHT o o ELEVATION =65.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM JOINTS (TYP.) oo�� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF !i 14" �*69 g' SEPTIC TANK 4" PVC OUT TO � � 0 � � � � U o o °° 0 0 � � 0 0 0o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE j LEACHING FACILITY o0 0 0 CD 00 0 5, SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN oo 0 0 INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 64.90' MIN. 6 64.73' 2 00 0 0 0 o 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF o0 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 4" PVC TEE 6" CRUSHED STONE 0 0 0 oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS l OVER MECHANICALLY oo 0000 _ o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY I COMPACTED BASE 4.0' _8 5, TYP 4_0 AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 4.0 �P,) 4.0 8_ ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 70.00' ---- TO BE INSTALLED ON A LEVEL STABLE 25.0' ( ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 62.50' GROUND WATER ELEV= < 57.50' 12 83 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON H-20 CHAMBERS 5' MIN. CHAMBLr� L �U V IOW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. *CONTRACTOR TO TO ANY SEPTIC TANK PROFILL H-20 DID I ��<,IL)u I ION ESA DETAIL CHAR? '7R DETAILS ELEVATION PRIOR TO ANY WORK & NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. -- n 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM NOTES: - APPROPRIATE AUTHORITY. < / 1. MAGNETIC MARKING TAPE SHALL BE PLACED 1� - PERC NO. 15847 S, g ) \� ! 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED � INSPECTOR: Donald Desmarais, IRS ALONG THE TOP EDGE OF EACH SEPTIC SYSTEM „- Q UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR \ COMPONENT. L iS \ • EVALUATOR: Michael Pimentel, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. C.S.E. APPROVAL DATE: Oct. 27, 1999 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN 8 h h` '� 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. THE LOCATION OF THE PROPOSED LEACHING FACILITY f DATE: December 10, 2018 OO�O��l �/ \ TO ENSURE CONSISTENCY WITH TEST PIT DATA r; , r y TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE l �" - ��P ��� / � � � SHOWN ON THIS PLAN. REPORT TO ENGINEER AND �''�� � MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. � l LOCAL BOARD OF HEALTH IF SOILS ARE NOT �•�- a d ELEV TOP = 69.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, OF CONSISTENT WITH TEST PIT DATA. �= ELEV WATER - < 57.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). G� �� \ • . • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN Cb 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ��' ZONE 2 PERC RATE _ < 2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. U I g5°� �o�� ' ^ \ GROUNDWATER PROTECTION OVERLAY DISTRICT& 00 ' '� r. GRAVEL / MAP 252 THE ESTUARINE ZONE WATERSHEDS. DEPTH OF PERC = 52 - 70 16. PROPOSED PROJECT IS LOCATED WITHIN: co / DRIVEWAY / '� � �� ®� -. �' o _ / LOT 155 " . -• TEXTURAL CLASS: 1 ASSESSOR'S MAP 252 LOT 156 N ! / 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED '4 • _ - 9 ; LOCUS x OWNER OF RECORD- RICHARD K. & KIMBERLY N. MEE I / / ONLY AS A COURTESY FOR THE INSTALLER. ` a �� a \ j 1 ' / INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS ' �- ♦ ADDRESS: 104 BEECHWOOD ROAD r 1 / o / le IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. Gooseberry �' ' • 0" 69.00 CENTERVILLE, MA 02632 CONTRACTOR SHALL NOTIFY ENGINEER IF J I MEASUREMENTS APPEAR TO BE INCORRECT. Island • +.,,� • f// Fill FEMA FLOOD ZONE X . ! 24" 67.00' COMMUNITY PANEL# 25001C0562J Fuller �(^'►► 1 s • . ;� Loamy Sand \\ MAP 252 z `I / • , +► • . �� #° , A 10Yr 3/1 17. DEED REFERENCE: LAND COURT CERTIFICATE#155499 ` 26 66.83' \ • • LOT 156 l / • ; • • //�. 0�� 18. PLAN REFERENCE: LAND COURT PLAN#20239-C 14,028 + S.F. i ' CONC. / 2 a . • , ' ./1 - Q'!/ Loamy Sand �j - DRIVEWAY 1 ^ / o • . . • // f; B 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 1 ,) 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 6� 52" 64.67' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY \ / / `P - .� • . ��, Q i "' Perc FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. \ / lT • • • �� ,• II 70' 63.17' 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A s 1 ^ `L i • �, �/� DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A .ft' REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. Medium Sand \ 9 \ Ah f C 2.5Y 6/6 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL \\ \ I / / / LOCUS PLAN REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. \\ \ \ FFE = 80.4'± �1� / 23. IN ACCORDANCE WITH 310 CMR 15.401 - 15.405,THE FOLLOWING LOCAL UPGRADE APPROVALS ARE REQUESTED FROM 310 CMR 15.221 7 �\ s \\ �' ##1 O4 SCALE: 1"= 1000' ( )� 13' 138" 57.50' (1.) A 1.2' WAIVER (3.0 -4.2') FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. 17" CEDAR o ' 77_ -_ 3-BEDROOM / � 'EXISTING ' No Mottling, Standing or Weeping Observed (2.) A 0.8'WAIVER (3.0 -3.8') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. 't'Vlk \ DWELLING -- - -- - - ------- ---- \` 16� ' , 12- DESIGN DATA TEO'T Pi � Lji-� I LEGEND -' 8" MAPLE �- �� PERC NO. 15847 50x0' EXISTING SPOT GRADE / NUMBER OF BEDROOMS 3 (EXISTING) INSPECTOR: Donald Desmarais, RS HC-1 EVALUATOR: Michael Pimentel, EIT, CSE - - 50 - -- -- EXISTING CONTOUR TOF= / - - - - _ PROPOSED 4" PVC VENT PIPE; NUMBER OF BEDROOMS 3 (DESIGN) Oct. 27, 1999 75.4'± 71_ EXACT LOCATION PER OWNER C.S.E. APPROVAL DATE: / BFE - _� _... -72 �' i' DESIGN FLOW 110 GAUDAY/BEDROOM December 10, 2018 Z PROPOSED CONTOUR DATE: MAP 252 _ _ /// 72.0'+- O� i -I� \� TOTAL DESIGN FLOW 330 GAUDAY TEST PIT#: 2 50 PROPOSED SPOT GRADE LOT 37 DESIGN FLOW x 200 % - 660 GAUDAY i / PROPOSED ELEV TOP= 69.00' G/ -- - EXISTING GAS LINE L� INSPECTION PORT USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER- < 57.50' O/H/W EXISTING OVERHEAD UTILITIES �� \ PERC RATE = W EXISTING WATER LINE �� ���-��� O o' �0� INSTALL 2 - 500 GAL. CHAMBERS w/ AGGREGATE DEPTH OF PERC = \ �� �� , /i PROPOSED H-20 /1 TEXTURAL CLASS: 1 TEST PIT LOCATION DISTRIBUTION BOX SIDEWALL CAPACITY (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) GAL/DAY -- EXISTING 1,000 GALLON SEPTIC TANK �1 / EXISTING 1,000 GALLON SEPTIC � , � �� (25.0' + 12.83') (2 ) ( 2' ) ( 0.74 GPD/ S.F.) =112.0 GAUDAY TANK TO BE UTILIZED IN DESIGN i 0 (2) ,1 �- 0" - 69.00' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE 25" CEDAR i iLP (4) - - BOTTOM CAPACITY Fill ❑ PROPOSED H-20 DISTRIBUTION BOX (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 24" 67.00' 2 ,'�: �� (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY A Lamy Sand O PROPOSED 500 GALLON H-20 LEACHING CHAMBER 0 EXISTING LEACHING PIT TO BE PUMPED AND I MAP 252 10Yr 3/1 FILLED WITH CLEAN SAND &ABANDONED 1 69x0 Zlbo i LOT 157 26 66.83 _ - - � ' i TOTALS. Loamy Sand N x , B REV. DATE BY APP'D. DESCRIPTION i 10Yr 5/E TOTAL NUMBER OF CHAMBERS 2 (3) 1 TOTAL LEACHING AREA 472.2 SQ.FT. 52" 64.67' I PROPOSED SEPTIC SYSTEM UPGRADE / \ TOTAL LEACHING CAPACITY 349.4 GAL./DAY . 21" CEDAR PREPARED FOR: CEDAR o� , CAPEWIDE ENTERPRISES SAND PIT `-PROPOSED 2-500 GALLON H-20 8" PINE/ \ LEACHING CHAMBERS W/ SURROUNDING AGGREGATE Medium Sand LOCATED AT 15" CEDAR / � � C 2.5Y 6/6 104 BEECHWOOD ROAD _- -- _ / •., FIRE PIT - - _1 0 632 Benchmark rolb / SCALE: 1 INCH = 10 FT. DATE: JANUARY 4, 2019 SWING-TIES Nail Set in Tree ' r 138" 57.50' O�'i tH OF 0 5 10 20 40 FEET DESCRIPTION HC-1 HC-2 Elev. = 70.00' ��5 No Mottling, Standing or Weeping Observed Approx. M.S.L. �,L ��`L _ _. - -- JOHN L. �� PREPARED BY: __ r ,�O CHURCHILL JR. CORNER OF STONE (1) 22.0 31.3 MAP 252 RESERVED FOR BOARD OF HEALTH USE �, CIVIL JC ENGINEERING, INC. CORNER OF STONE (2) 34.7' 41.2' LOT 158 NO. 41807 2854 CRANBERRY HIGHWAY CORNER OF STONE (3) 39.9' 34.4' 1 1 EAST WAREHAM, MA 02538 SITE PLAN 5" CEDAR,. _67 - __ _ ___ 508.273.0377 � CORNER OF STONE (4) 29.6' 21.6' i - - - SCALE: 1"= 10' // Drawn By: SJI Designed By:SJI I Checked By: MCP I JOB No.4337