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HomeMy WebLinkAbout0060 BRETWOOD LANE - Health 60 Bretwood Lane Centerville A= 168-130 S M E A D® No.24 53LOR UPC 12534 smead.com s Made to USA .AQ). jOF1 �S9SOM AM ODAMMM WWWSNPWC,R OM Fee /00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Apphration for Migpo!6a1 *pztem Cow6truction Verna Application for a Permit to Construct( , )Repair(})Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. �-,o ; 01 L V Owner's Name,Address and Tel.No. Assessor's Map/Parcel ` '�© 60 t�kl�n-wc" c,,).l Gt�TV--vkL Installer's Name,Address,and Tel.No.5 02—47Z"$�7� Designer's Name,Address and Tel.No. .�� —�7°3`O 3 7 7 C=�i?��.t chi t��•!ZL��� C�C.0 �"G �i^-C�[��a%�„tl�l�, Type of Building: Dwelling No.of Bedrooms Lot Size rsq.ft. Garbage Grinder( ) Other Type of Building 1ZG5t1D41Tu4c.- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -3- ® gallons per day. Calculated daily flow 349,4 gallons. Plan Date a©[a Number of sheets Revision Date Title (00 kE i tyOZZ L&JE CQJ�2Y[CCU Size of Septic Tank 1000 C-ui�f l Type of S.A.S. a 500 C " CEX<.kj 1. C C44XC40-5 Description of Soil /Y e__0 'r0, co 14PU56 S-P(%U l G-) 1501 t( hS,E-6� PC4&) Nature of Repairs or Alterations(Answer when applicable) U St✓ GYG[d rt gj r. [nbb Wrtc jAj&2V_ M bj&�U W-an (_-� ) s oa 69kio0i Li-a-0 L�c�-c�� ��t����3F'� _ c�t-ram__� G•r 6 s� �4�-�c�-t 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 Certifi- cate of Compliance has been issued by s Board of Health. Signed Date •..2-5 2-0W� Application Approved by Date Application Disapproved or the f owing reasons Permit No. �i3 ' Date Issued �125 2,ot3 ---------------------------------------- 2 ` A No.�t3 Fee /DV' / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS r' -� .. Application for Mi!5pogar tpgtem Con!6truction Permit Application for a Permit to Construct( )Repair()(),Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. b0 $wiwcnv VN Owner's Name,Address and Tel.No. U, G1tX1'1�?2Y/ r �4N t F__44c swas 1•fEC-�4iZ`ll� Assessor's Map/Parcel t p t 3O 4 r "� (gyp 8yt -w{,Yj� LAJ <Ae�-,T9W;U[ Installer's Name,Address,and Tel.No.5 O9-Sf77—$$T7 Designer's Name,Address and Tel.No. .SU �t-7 S-0 3 7 7 CA01Vw 1 hG t'�.►T�/�S�S U-0- �8 4 x"(O,?eaUcm-G Hwy e.153 e,vucwcE�2C�t`ftr�T {tit , Type of Building: Dwelling . No.of Bedrooms 3 .Lot Size 5.0127{ sq.ft. Garbage Grinder "`Other Type of Building 1ZE511DQ-yi14t. No:of Persons Showers( ) Cafeteria( ) ' Other Fixtures Design Flow 3 O gallons per day, Calculated daily flow 3 49-4 gallons. Plan Date q= 3- Q a(3 Number of sheets Revision Date Title (0 a A 6-rwoeZ L_ %J fc Size of Septic Tank i 000 GA.L1 Ofj Type of S.A.S. a 500 GN4L (GA,1_*1Q-. 5-0 4ktAt&S -,, Description of Soil IYEE�D CoAAS6 SAuU QQ _'Ta 1t / seg: A4 4-K) ` Nature of Repairs or Alterations(Answer when applicable) U SE EM S rmidr i x -y4LI-joJ TI[G 'r►1-�uLL• AJ taAj W-1nf/r)—SOX w! 1�C)^ >�� U 0 y 1 LrGI4[�.�-f Y/� �+L a C'= ► .� 'na (F srT !S 8. d4� r ` Date last inspected: Agreement: ' The undersig>ed 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 too place the system in operation until,a Certifi- ,Cate of Compliance has been issued by-this Board of Health. . Signed ( 1' -----Date".' ate' .49-a5-010 Application^Approved by - Date r Application Disapproved or the fcVowing reasons Permit No. 00 Date Issued 9 5 Zot.^� --------------------------------------- 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 G'ARCE 11 hG 6R/M?jfts;E& LAX— at c=3� i1 L•J ,i�L L� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Zol3"-371 dated zs Z0$ Installer 640ElQtb6_: EA.17 FR1. .C- Designer The issuance of this pe shal ;� construed as a guarantee that the sy dncti6tn g desr ned. Date Inspector ,. -.. -------------------------- No.�o1��' .G,7 ' Fee�ICa THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwigpont *p6tem Con5tructiou Permit Permission is hereby granted to Construct( )Repair(x)Upgrade( )Abandon( ) System located at 60 I.A L21c C!6-:117--A&i L = 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 Date:_��� 13 Approved by �.. ----- ---- Moo Town of Barnstable TIM Regulatory Services Thomas F. Ceiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: I1)-3-1S Sewage Permit# Z0t3 Assessor's Map/Parcel 166 / 1 3O Installer& Designer Certification Form Designer: SC En�ct)ee.ec��ti , TrC. Installer: Cc�ew;� E��terpccse.S I Address: lt54 (canbecc 1-Ic `nW Address: 1 3 ('m►y+rnl.s�rl�c_ i rosl kJc(elnavn 11A o2538 1 rya Sob-273-0377 On date - Ao 4 S was issued a permit'to install a ( ) (installer�� septic system at fO d rt4W008 L ail e- based on a design drawn by (address) IC EnStr��escn -rn�_ dated Sg4ml"4" 2311 2di3 (designer) 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as I&teral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. l 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. Stripout (if required) ected and the soils were found satisfactory. OF CHJONN URCMILL (ins ler's Si redl ML 4190 %esigner s Signatur (Affix De gn Here) P ASE RETURN TOBLE PUBLIC AL IVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE 1979MP UNTIL BOTH TMS FORM AND AS- BUILT CARD ARE RECEIVED R_V THE BARNSTAB E PUBLIC HEALTH DIVISION, T)<IANK YOU. gAoMee formAdeeisnercertificarion form.doc VE Torn of Barnsta ble B{p Department of Regulatory Services Public Health Division bate MAWL 00 Main Street,Hyannis MA 02601 Date Scheduled_ 1 Time Fee Pd. Soil Suitability Assessm.entfor S e Dis a� ° Performed By: k�C'Aae,( P4V12nw , eyt CSC a — Wi[riessed By:.' �s LOCATION& GENE INFORMATION :RAL INFOION � Location Address _Owner's Name �(p,(.��1 t���(�� ((�� Q�C�_WDQ� ��}l�L CC vt�� Address (00 Dy-ZO—(Wc>eo LtJ Assessor's Map/Parcel: `(00:3 Engineer's Name d4P C-47f Q6 L4_1r_ NEW CONSTRUCTION REPAIR q SC 6n5tneedtil Telephone# �f�"o2— I� — ��j�� . Sob-273-c 3 77 Land Use St,ngle S c amilr dc,,el�inR Slo es % 8'1 p ( ) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line 7 i b ft Other — ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands(n proximity to holes) Se.e ak,66r a eiavt i 2 O Parent material(geologic) Depth to Bedrock flN Depth to Groundwater. Standing Water in Hole: —' Weeping from Pit l7iICE Estimated Seasonal High Groundwater 7 3 ot, b5S n v� DETE RMINATION FOR SEASONAL.HIGH WATER TABLE Method Used: PirecF 065erua4tan Depth Observed standing in ohs.hole: >l 3.$ In, Depth to soil mottles: 7 t.3 8 In. Depth to weeping from side of obs.hole: 7 1 Lb—In. Groundwater Adjustment ft. Index Well# Reading Dale: Index Well level ___ Adj,thctor, ,- A[lj.Groundwater Level PERCOL,AT'ION TEST Date 9'�7 6 Time Observation ' Hole# ^ Time at 9" „ Depth of Pero ,52.-70i ' Time at 6" Start Pre-soak Time @ I i J 5 am Time(9"-6") End Pre-soak J!'26�m Rate Min./Inch e 2 1 Site Suitability Assessment: Site Passed ZS Site Failed: Additional Testing Needed(Y/N) N 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:\S EPTIC1PEItCFO RM.DOC DEEP-OBSERVATION HOLE LOG Hale# 1 { 2- Depth from Soil Horizon Soil Texture .Sdil Color Soil . Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones;Boulders. t onsistency,To Oravel) 6-1 S ,g-y2 Ls 16Yr31, z2-Sz 3 LS - S C. t -C S 2.5tklIG DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon, Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Scones,Boulders. onsisten % raver DEEP OBSERVATION HOLE LOG Hole## Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in-) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soli Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency. n Flood Insurance Rate_Map, Above 500 year flood boundary No— Yes _ Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in ail areas observed throughout the area proposed for the soil absorption system? eS If not,what is the depth of naturally occurring pervious material? Certification I certify that on !D-27-99 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and expeffence described in�10 CMR 15.017. Signaturew2z�z� Date Q:\SEPTIC\PERCFORM.DOC TOWN OF BARNSTABLE LOCATION (S � "�wI. ,t SEWAGE# �'U I VILLAGE Cevl- g 'VJ ire, ASSESSOR'S MAP&PARCEL �6 INSTALLER'S NAME&PHONE NO.l�ci�QQ wer.� C�1v�p�i5@S LL �71 SEPTIC TANK CAPACITY ./00 0 C, LEACHING FACILITY:(type)a 6 6,1 Le.,ki„a \ (size) x 25 Ghar4 b¢+3 NO.OF BEDROOMS 3 OWNER Jotin c�nct /=JC2Mytr-e ller4-"4V PERMIT DATE: C!'2 _ 1 COMPLIANCE DATE: Separation Distance Between the: 6tlit�ww ✓� Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility6X--)Vn*,-a-'133 Feet Private Water Supply.Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) /1/ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /q Feet /9 FURNISHED BY Ux— m - S A-(zoW �'A-6-51.5 L3-a=33;1 A 3=+- 10 ` A-5-4-9' 6-6=34,7� Town of Barnstable . , ,Barnstable Regulatory Services Department BAxn srABM `""SS. i639 Public Health Division ��+� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 0732 September 30, 2013 Mr. & Mrs. John J. Hegarty 60 Bretwood Lane Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 60 Bretwood Lane, Centerville,MA was inspected on 8/15/2013, by James D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system needed further evaluation under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • System is failed due to overloaded leaching pit. Pit will have to be replaced. You are ordered to repair/replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH 4 Thomas McKean, R.S., CHO Agent of the Board of Health • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\60 Bretwood Ln Cent Sept26 2013.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l1047 617 � .^Ta— �a Logged In As: Pa rCel Detail Thursday, September 26 2013 Parcel Lookup Parcel Info Parcel i168-130 _T� Developer LOT 27 I D Lot Location?60 BRETWOOD LANE Frontage 224 �� I Sec _W_ - _ ..) Sec Road Frontage Village ICENTERVILLE ' Fire C-O-MM District Town sewer exists at this Road 0175 address INo Index F� Asbuilt Septic Scan: Interactive 168130 1 Map ,14 . Owner Info Co- Owner lHEGARTY,JOHN J&FLORENCE Owner F--. Streetl 160 BRETWOOD LN Street2 City ICENTERVILLE ) State FMA Zip F02632 I Country— 1 Land Info Single Fam MDL-01 Zoning�RC mm Nghbd j0106 Acres r0.35 Use Topography Above Street , Road aved _ mm Utilities I Septic,Gas,Public Water Location Construction Info Building 1 of 1 Year Roof � � ^ ^ Ext _ �- -]1983 FGable/Hip jWood Shingle Built Struct Wall Living 1377 �) Roof Asph/�---F G�s�Cmp AC Area -- Cover Type � + b, Int 9 Bed Style Ranch _ Wall�rywall Rooms 14 Bedrooms % e ' Int Bath Model lResidential I Carpet 1 Full+ 1 H R, Rooms Floor aM,r, a Grade Average Heat Hot Water ( Total 7 Rooms 04 , Type Rooms ^ '17 Stories 1 Story ( Heat F i Found- Poured Conc. _ ow .. Fuel ation Gross http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 1047 9/26/2013 I�IAI l�-S l . , r tug 15 13 09:41 p p.1 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name information is required for every Centervifle MA 02632 8-15-13 page_ . City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important when filling out forms A. General Information ������ on the computer, ���`�. OF M4SS key e to move the tab our 1. inspector: , o=� ;�'yG J cursor-do not James B I �• JAMES ams D.Sears m use the return =z' _ key. Name of Inspector c�: Capewide Enterprises,LLC Company Name '�V ( - •... ��. 153 Commercial St. '' S„►nu�P ��\\`\ _t�l ` Company Address Mashpee _.. ..-..__ MA 02649 Cityrrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification 1 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 8-15-13 JIS9pectors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days cf completing this inspection. 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ina-3f13 Title 5 of6dal I ec6on ubsurfaw SewA a DijPzge1af17�P 9 Au6 1513 09:41 p p.2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name Infrequired Is Centerville MA 02632 8-15-13, required for every page.. Cityfrown state Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E I always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15,304 exist Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "nor or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old`or the septic tank (whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is strut i,irally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ NO(Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pepe 2 of 17 Aug 15 13 09:42p p•3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name information is required for every Centerville MA 02632 8-15-13 page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cunt.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Heath in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water Q Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•-3n 3 Tito 5 0fidal Inspection Form.Subsurface Sewage Disposal System•Page 3 of 17 Aug 1513 09:42p p.4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name information is Centerville MA 02632 8-15-13 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: [Q The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"*. Method used to determine distance: " This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this fort. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to 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 dogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in sessadO is less than 6" below invert or available volume is less than day flow A t.4C1111v G 15ins•Y13 TIUe 5 Official Inspection Fam:Subsurface Sewage Disposal System-Page 4 of 17 Aug 1513 09:42p p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name information is required for every Centerville MA 02632 8-15-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of 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. ❑ 0 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. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must sere a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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 II of a public water supply well If you have answered'yes"to any question in Section E the system is considered a significant threat, or answered'yes*in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 16.304. The system owner should contact the appropriate regional office of the Department. 15ins•3113 Title 5 Official l nspeCtion Form Sutastafece Sewage Disposal System•Psge 5 or 17 Aug 1513 09:43p p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owrtees Name information a Centerville MA 02632 8-15-13 required for every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate'yes'or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner,occupant,or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ElHas the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ❑ ® Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example,a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) . D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 ,tSins•3113 Title 5 official Irtspec ion forth:Subsurface Sewage Disposal System•Page 8 of 17. Aug.1513 09:43p p.7 ` �Lx Commonwealth of Massachusetts Title 5 Official Inspection Form UVSubsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Ownefs(Name information is required for every Centerville MA 02632 B-15-13 page• cityfro" state Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal Tank D Box and pit. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears u 2011-47,000Gais 9 ( y sage(gpd)): 2012-49,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/tndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): canons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t51ns•3M3 rive 5 ordal inspection Form:Subsur►aw Sawsp DkpmW system.Pop 7 of 17 Aug 1513 09:43p p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner ownees Name information is required for every Centerville MA 02632 8-15--13 page- CltylTown state Zip Code Date of Inspection D. System Information (cost.) Last date of occupencyluse: Date Other(describe below): General Information Pumping Records: Source of information. NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Altemative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t31n6 3Vt3 Title 5 0MCM l tnspedian Form:SL&suface Sewage Disposer System•Pape B of 17 I Aug 15 13 09:44p p•9 Commonwealth of Massachusetts Tine 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 Bretwood Ln. Property Address John Hegerty Owner Owner's Name requir required is Centerville MA 02632 8-15-13 required for every Page, City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1983 Permit#83-171 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 3' Depth below grade: feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting,evidence of leakage, etc.): Pipeing is 4" PVC SCH 40 Septic Tank(locate on site plan): 3' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ©other(explain) If tank is metal,list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal. Precast Sludge depth: NA is ins•Y13 Tito 5 Official tispectlDn Form:Suburrraw Sewage DrspwW System Page 9 of 17 Aug 15 13 09:44p p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form kv - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name Information is required for every CentervilleMA 02632 8-15-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (corn.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle NA Scum thickness NA Distance from top of scum to top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? NA Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Note:Tank located on site.Tank under black top walk. Did not open tank system is failed due to leaching. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: oawQ t5ins v W3 T le 5 Ofiamf kwoec iw Fa .SuDwrtate Sawa"Di pmd System•Pope 10 or 17 Aug 15 13 09:44p p.11 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. PropeAy Address John Hegerty Owner Owner's Name information is required for every Centerville MA 02632 8-15-13 page. Cityfrown State Zip Code Date of Inspection D. System Information (corn.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.).- Attach copy of current pumping contract jrequlred). Is copy attached? ❑ Yes ❑ No t&ns•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 2 2 o[17 Aug 1513 09:45p p.12 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface rt ce Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owners Name information is required for every Centerville MA 02632 8-15-13 page. Cityrrown State Zip Code Date of Inspedion D. System Information (cunt.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert NA Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box,etc.): D Box locate on site. Did not open as system is failed due to leaching Pump Chamber(locate on site plan): Pumps in working order. ❑ Yes ❑ �* Alarms in working order. ❑ Yes [] No` Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: 15ins•3/13 - Ti6e 5 OrHdw Umpeman Form:Sdmoam sesup Disposal syseem•Pape 12 of 17 Aug 1513 09:45p p.13 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Fonm -Not for Voluntary Assessments s 60 Bretwood Ln. Property Address John Hegedy Owner Owners Name information requited for every Centerville MA 02632 8-15-13 page. Cityrrown Stale Zo Code Date of lnspecUort D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altematnre system Type/name of technology: Comments{note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Leaching is a 1000 Gal. Precast pit .Pit and cover at 7 below. Level in pit at V'below inlet. leaching is failed. Need to replace leaching. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15Ino.3n3 Taro 3 OlBdei InaperOW Forrtt SLOViftCO Saaape Oisposai System•Pepe 13 of 17 Aug 15 13 09:45p p.14 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Flegeq Owner Owner's Name information is Centerville required for every .MA 02632 6-15-13 Page. City/Town state Zip Code Date of Inspedion D. System Information (cunt.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note-condition of soil, signs of hydraulic failure, level of ponding,-condition of vegetation, etc.): t5kn•3/13 TWO 5 Olfldal Inspection Force Subsufaee Sewape 04=1 System.Page 14 11 T Aug 15 13 09:46p p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owners Name irrtorrnatioo Centerville MA 02632 8-15-13 required for every page. C41TOVM state Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System:Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks_Locate all wells within 100 feet Locate where public water supply enters the building.Check one of the boxes below. ® hand-sketch in the area below ❑ drawing attached separately 0-0 � a c� B a = 3'F _3 =3� ❑ � o �V (i 1 fS M•3H3 _ Tine 5OnfdW nspeadon Farm:Uftwraw Sawapa Disposal srAem-Papa 15 of 17 Aug 1513 09:46p p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner Owner's Name Information is Centerville MA 02632 8-15-13 required for every page. CRylrown State Zip Code Data of Inspection D. System Information (cons) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: NA feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150.feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators,installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: System is failed due to leaching. Before filing this Inspection Report,please see Report Completeness Checklist on next page. Wrns•3113 Title 5 OlNdel Inspection Form:Subswlec a Sewage Disposal Sysiem•Page 1B cf 17 Aug 15 13 09:46p p•1 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Bretwood Ln. Property Address John Hegerty Owner owner's Flame information is required for every Centerville MA 02632 8-15-13 page. Cityrrown State Zip Code Date of tnspedion E. Report Completeness Checklist ® Inspection Summary:A, B, C, D,or E checked Inspection Summary D.(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5bu•3/13 Title 501Hdal Foml:Sibs aCe DI I •Page 1T o/ Inapedbtt SeweQe spore System ap 17 THE COMMONWEALTH OF MASSACHUSETTS BOARD F H% :Poll Application is hereby made for a Permit to Construct or' 'R air an Individual Sewage Disposa ep 9,17 1-ee or rjo. ddress Installer Address Dwelling—No. of Bedrooms-.-,- Septic Tank—Liquid*ca��y/ gallons LengthY, Disposal Trench Z Other Distribution box Dosing tank Test Pit No. I...Z-0....minutes per inch Depth of Test Pit----12......... Depth to ground water..e' ---''------ ------'----------'--------'—''----------- Agreoozcut: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions ofIZ'=4 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ` operation until u Certificate of Compliance has bee issued b the board of health. -~-''-------.--- Date-lo _ J) . a Application Approved By ---'-----_^.�'��o�u^z^a��---m��«�~ . --'��--��y�'��'��.��� n"* Application Dioupproveir. 7or the following rmaso --_----------'--- � ---------'-------------'-------------'--'��----'—~' -'--°~-'`"—'—'—'--'�~---'------''6��------- | ' u Por� /m ' Date ' Fizz THE COMMONALTH OF MASSACHUSETTS BOARD OF HEALTH ............. ........................................................... Appliration for Bitiphoal Works Towitrn.rtion Pjamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ ----...--------------•-••--...---.._..------•----......------------•------.........-......------•- Location-Address or Lot No. ......................—.......................................................................... ..........-•...................................................................................... Owner Address (sa Installer Address Type of Buil�ng Size Lot............................Sq. 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............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Tench—No_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ......................................................-...................................................................................................... 0 Description of Soil.................................................................................................................................................................... x W 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 TITIE 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. iga------••-------•--------•................•--...._..---••--------------------•-•-•----- .......................... Date Application Approved By___ G ....................................... Disapprov f r the following reasons-----------------------------•--------------•----------•------------------------------..._...---------------••-- --.......-••--•--------•••-••-----------------------•---------•-----•-•--...•---•---------------------------------------------------------------------------------•------------------------••----------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... Turrtifiratr of Tomplianrr T S'IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by----- - --=-------•-•---• .......... -•-----•--•---------------------------•-•-•--------------•-----•------------------....._..------------------------------- Installer at__ .. G... . 'z7zu ....`-=-- .•------------------------------------------------------------VCode �es ------• -------------- has been installed in accordance with the provisions of Tk 5 of The State Sanitary in the application for Disposal Works Construction Permit No. _.. ____/-�,�__________________ dated_-. ____ __._.___.___. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR E® AS A GUARANTEE THAT THE SYSTEM`W( L� UNCTION SATISFACTORY. DATE._.. ........ Inspector. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH aa 7'�7 OF............................................................. No.................�._ FEE_____................... Ito � Works Ton,strnrtion rrmit Permissionis e Y gran ---___'_-'....1""------------------------------------------------------•----------------------------....--•------......._........ to Construct or Re air `- iic� S . to e Disposal System 7AiStreet as shown on the application for Disposal Works Construction Permit No............ ed_. .......... / ---------------- .. ..... ........................................ Board of Health //// Y/DATE.......................................---f3 •------ -------- ........... ��.. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Gt'cr)f315,� s .1 109 S7 \: ov I O 113. ?+•�\c .\ no.o 15t 22,i..• 6 .Q 14' PQo(�sED 3 B�. 0 � Gn1ELLIub 2 FIlb EL l i 1.5 a a' �I PIT "_epnc.TAwv- 1\ 0'�3� i (v'.. CA7cH 1•{ M� p ( \� -. .'1 .'�. t00%QiTse"a O i a zt p , Oki ;q- NJ uw l l o 15, 000 S. (= 1 I OOP W f D-(l—E I 2 F- s. L3, �.� 7 \ zN OF if, f: .3 3.5 w g a ` 29874 v suR`+�� LEGEND OFM4,p CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION Ox0. ° EXISTING CONTOUR ---- 0 -- - o� ti� L.0-r 2_ /.31067 .��o��J` ��N2= FINISHED SPOT ELEVATION ` rl I,? ►//�.L_ FINISHED CONTOUR 0 No.1o95 o IN APPROVED , BOARD OF HEALTH 9oFs��svtiN���``` DATE AGENT SCALE= /"=:its, . DATE, T3.42 n/s. LDREDGE ENGINEERING CO. INO CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO. 3 B 4 BUILDING SHOWN ON THIS PLAN' CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEY R DR.BY OF BARNSTAB E ASS. 712 MAIN STREET CH. By, In j N YA N N I S, MASS. 2! 03•�l •83 ,.._�.2...c�' t SHEET—L OF DATE G. LAND SURVEYOR ?O FT. MIN.' /VOTE /F E/TNER TILE SE OT/C TANK OR t- �EAGtI/NG P/T .4R,- IJORP THAf'/ /2"BELOW I /O fT•;Mew. iR.�10E, .4 24 'O/II M ETEQ CONCA -7 COVER' SNALL BE BROUGHT. TO 4/TAOF:�r4N EiYTR4 CO/VCRCTC 4'PYC.PJPC �ye,4VY CAST /A-0/Y Coj/ER SHALL 3E USED MIN-.P/TCN EL I f 1.5 COVERS ► • /F/N OR/VEyVA Y M_,M CO/VCR677E A : :rr— G1G�OE CO J/ER CLEAN .SA/V.0 rp LQt//O LEVEL ., 'A; : . -_ •. .4 CAST to 00 GAL.. o Aim,P/TGN DJST. o • e . . . • . • p •4 WASHFO S7ONE VIVO Pl•R!rr SEpT/C TA/IK 1 . I • • • • • • • • a • BGX - n • t $ r r 1 • • • .�• • s �� t • •EFFECT7✓C • • •r 314 - �2". WA 5,YAFD _ •: 0' / • • • • / /• 1 Ooa .. � • :• • t • • .. • • • / • l50.8 x 'L.5 317 f.=.(D ». • s.. , a • . • • • o v PRECAST SEEPAGE 6 •. • • • • s • • • • s 1 P/7OR AWL/IV. J)VkZ'ArtLEYAT/ONs, . f13• I x ! • o = II3. G! D' • • s t_= R4. 8 /NYERT.AT 4U/LD/NG 103.5 FT., nn YiT CAPAc►N. :. 4 9 O 6 I D - (Z FT. O/Ah'1• C SEE TABUL:4 TION, INLET SEPTIC rXMK OUTLET SEPTIC TANK. tot• 3 FT.. y /NLFT D/STR-lBt/T/ON BOX Q s - . SECT/ON OF' GROWND J 17ER TADLE odzzErv/STR�et/TioN MX.t 90 F SEI�trAGE L7/sP4 'A L SYSTEM INLET LEACN/IVG PIT 98,g FT. LEACHING Al/T TAel1L.AT! N D SCALE O/MENSION A:. DES/G/V CAI TEA 1A D/Af.ENS/ON 84 _FT. rn'�N N[/MDER OF 9EDROOMS 3 DIMENS/ON C` _FT. ' GAReAGEO/SPOSAI-UNIT TOTAL EST/MATED =w*v 3 3 0 GAL.lDAY -SOIL TEST SOIL 71CST2 S®/L TEST NUMBER OF LEACXlN6.P/TS_L_ f`ELt-Y. IO�L•8 -ELFY, PATE OF SOJL TEST /O 3 tI S/DE(EACH/NG PER P/T 150.8 S(A RT. _ RESULTS i�//TNESSED 1�Y '�f r r" 90TrOM 4z4cHl wa PER P/T 1 15. I �; FT. L� M PERC04A r10.N AA770,0/ MINA//)VCH TOTAL 1EA'CN/NG AREA 2b3.9 Sip FT. PEIICOLAr/ON RATE T"'14- �MIN.11NCH �'vi3 sc i c_ RESERVEG�gCH1N6ARE^ 2b3.9 SQ. FT. �ySH OF!!l,�..� ���� of,t�q M n i v 1 L v 7 27Down j ram,1 c Cj L rd n/�C rill" y o RSE ti o �A�W4 o A p�No.10951 oO EL DREDGE ENCr/NEfR/NG CO.,/NC. �A�gR�pQ 9o�FSGrgT�N��� i=L= 90.8 7/2 "Al" ST. , hlYA.viviS. "AS.S. ` A'O SioNAI VSU ® R7 V, / DfITE 3 G,-T 0 UvD HA TER AT EL E✓. _ N "�r>-7 � /Ff Fs 3 JOB NO! �3 y4 7_ SHEET�OF LOCATION SEWAGE PERMIT NO. -_ o VILL(A�GE ` IN T, L11R'S NAME i ADDRESS J 1 Oqtqg,4 � i Ill UiIDE R OR OWNER 4q A L�l I lk s F DA T E P E.ItMIT I S S U E D DATE COMPLIANCE ISSUED 1 , ( ; o `� `���� �.— �. � g �_ 3 � s �- ' I FINISH GRADE OVER D-BOX= 30.1 ± , PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE T.O.F. EL.- 38.4�± FINISH GRADE OVER CHAMBERS = 29.0 - 31 .5 GENERAL NOTES f PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED REMOVABLE WATER-TIGHT COVER OVER . WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS STONE TO CROWN OF PIPE 1 UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION � FINISH GRADE '± OUTLET TO WITHIN 6" � " MIN SLOPE 1 2"OF 1/8"TO 1/2" DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL SLAB=31.0'± @ FND. EL.= 30•9 F.G. OVER TANK EL. = 30.8 ± 5 DIA. OUTLET STONE OR GEOTEXTILE FILTER FABRIC S) BOX TO F.G. (SEE NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. _ - --- --- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE TOP OF SAS - 2j,rj0� PLACE RISERS ON ALL DESIGN ENGINEER. CHAMBERS WITH PROPOSED 4" 4• 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL --EXISTING 4° PVC SEWER PIPE 4" PVC TEE SEE NOTE 22 24.50' SEE NOTE' A22 ' INLET PIPES TO 6"OF SEWER PIPE _� - ��JBREAKOUT EL= 25,00 FINISHED GRADE SYSTEM UNLESS OTHERWISE NOTED. " 3"DROP MAXqrF _ �+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT B 6 3 2~ DROP MIN L 13_ PROVIDE WATERTIGHT E LESS THAN ELEVATION =25.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE �4,� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 10" 4" PVC IN FROM JOINTS (TYP.) 14" *27,8°± SEPTIC TANK 4"PVC OUT TO 0 0 O O D 0 D O o 0 0 O o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE O LEACHING FACILITY To0 00 � 0 5. SLOPE ALL SOLID PIPE AT 1. ° M SPECIFIED DROP BETWEEN " op 0 0 C� 0 /o INIMUM. 00 INLET AND OUTLET CONTRACTOR CONTRACTOR SHALOUTLET TEE 24•87' M N• 6 24.70� 2� 0000 00 o� 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION 0 0 0 0 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY 60 0 0 0 0 NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 5 4. 8.5' (TYP ) _ I AND DESIGN ENGINEER. OUTLET DISTRIBUTION BOX 4 0 4.83' 4'0 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 26.00, -- TO BE INSTALLED ON A LEVEL STABLE 25.0' (NP') ESTABLISHED ON RIM OF EXISTING LEACHING CATCH BASIN AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 17.50' /2"2.50' 12.83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTIONEXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 5'MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 2 - 500 GALLON H-20 CHAMBERS CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE H-20 CHAMBER DETAILS TO THE DESIGN ENGINEER. 'CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE I NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. 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 I • a r ��' •• PERC NO. 14127 APPROPRIATE AUTHORITY. - ��,� • _ � �. "" �f • INSPECTOR: Donna Miorandi 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS • • • r ( 00 EVALUATOR: Michael Pimentel, EIT CSE LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE y " ' IS �� • Oct. 1999 THEY SHALL WITHSTAND H-20 LOADING. • • . ► NstC ry • C.S.E. APPROVAL DATE: C ~ • # . DATE: September 17, 2013 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. • 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. ZONE 2 ' '~�� '" ELEV TOP= 29.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV WATER- < 17.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PROPOSED 4" PVC VENT PIPE; - $ �� 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN EXACT LOCATION PER OWNER PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PROPOSED INSPECTION PORT ti` " . • i DEPTH OF PERC = 52"-78" 16. PROPOSED PROJECT IS LOCATED WITHIN: OOO � O 1EWALK EXISTING LEACHING PIT TO BE PUMPED, REMOVED OFFSITE AND �t� LOCUS «' TEXTURAL CLASS: 1 ASSESSOR'S MAP 168 PARCEL 130 REPLACED WITH CLEAN COARSE SAND PER 310 CMR 255(3) L_12S a • OWNER OF RECORD: JOHN J. & FLORENCE HEGARTY - '34� \`�?� R= 0 v 7 ,26x7' PROPOSED 2 - 500 GALLON H-20 '1 Q • 0 0" 29.00' lq 36-- 12" 8.. LEACHING CHAMBERS WITH AGGREGATE m •' • +* ADDRESS: 60 BRETWOOD LANE , f r 26x4' Benchmark Fill CENTERVILLE, MA 02632 1� O f�, • TREE P -- a • ' " y FEMA FLOOD ZONE Catch Basin Rim � � �:. 18" T 1 BUSH (TYP) w + A Loam Sand C 3� u = Elev. =26.00' x0' 1 k ^ 'Z`a r , + 22„ 10Yr 3/1 27.17' COMMUNITY PANEL# 250001 0016 D Q r, 'f� Approx. M.S.L. ,J L.P. I O a) \ ty / + "J ' 17. DEED REFERENCE: DEED BOOK 3711, PAGE 270 PROPOSED H-20 DISTRIBUTION BOX 129 U' �. r�, B Loamy Sand i �� "// - � l 1 10Yr 5/8 18. PLAN REFERENCE: PLAN BOOK 316, PAGE 61 �z ELEC 3`t \ -- "- 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. G� `y -�_ELEC ��I� 26x2' �L -. `, 52" 24.67' Perc 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 30 %o0 0 r Al , . d}- 70" 23.17 ASSUME ANY LIABILITY FOR SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL NOT SCREEN PORCH ON DECK P�� / �� O,n % O "n.r FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. o ,p 9� O + • #60 �� w FG�Cc yL `�-- ° Med. to Coarse Sand 21. A 4" PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A EXISTING C/O �'� �32' �' (P. �� `1 7,, --" C 2.5Y 6/6 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A CP.3-BEDROOM \� ao ,� \�2 O (loose) REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. DWELLING TOF = 38.4'± ,er34' o" \ J 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE LOCUS PLAN APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7): SLAB=31.0'± r,C (1.) A 1.30'WAIVER 3.00'-4.30' FOR THE MAXIMUM COVER OVER THE DISTRIBUTION Tic F� SCALE: 1" = 1000' ( ) ( ) BOX. N 7'-,C \ 138" 17.50' (2.) A 3.00'WAIVER(3.00'-6.00')FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. NEW EDGE T/c�<F No Standing, Weeping or Mottling Observed E UTILIZED IN THIS DESIGN (EXISTING BIT.XISTING 1,000 GALLON SEPTIC TANK TO BE OF BIT. DRIVE , TEST PIT DATA LEGEND G E N D DESIGN DATA DRIVE OVER TANK TO BE REMOVED& i MAP 168 REPLACED w/GRASS AS SHOWN IN HATCH) PERC NO. 14127 PARCEL 131 NUMBER OF BEDROOMS(DESIGN) 3 INSPECTOR: Donna Miorandi 50x0' EXISTING SPOT GRADE EVALUATOR: Michael Pimentel, EIT, CSE - --- - MAP 168 DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E.APPROVAL DATE: Oct. 1999 50 EXISTING CONTOUR PARCEL 130 DATE: September 17, 2013 I-5� TOTAL DESIGN FLOW 330 GAUDAY 7 PROPOSED CONTOUR .r1 15,227±S.F. �6,�02 . DESIGN FLOW x 200 % 660 GAUDAY TEST PIT#: 2 r-5-01 PROPOSED SPOT GRADE `11 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 29.00' - --f=Lr=C EXISTING ELECTRIC LINE SWING-TIES SCALE: 1"=20' ELEV WATER= < 17.50' T/C- EXISTING TELEPHONE &CABLE LINE PERC RATE = MAP 168 DESCRIPTION HC DC CBN W W - EXISTING WATER LINE PARCEL 129 CORNER OF STONE(1) 36.9' 27.7' 36.8' INSTALL 2 - 500 GALLON H-20 CHAMBERS DEPTH OF PERC = � � CORNER OF STONE(2) 18.7' 37.3' 57.5' SIDEWALL CAPACITY TEXTURAL CLASS: 1 TEST PIT LOCATION CORNER OF STONE(3) 30.9' 47.6' 53.0' (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY - EXISTING 1,000 GALLON SEPTIC TANK (25.0'+ 12.83')(2 ) (2' ) (0.74 GPD/S.F.) = 112.0 GAUDAY 0" 29.00' CORNER OF STONE(4) 44.3' 40.5' 29.4' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE BOTTOM CAPACITY Fill (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY A 18" Loamy Sand 27.50' O PROPOSED H-20 DISTRIBUTION BOX ls� (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY 22„ 10Yr 3/1 27.17' NO PROPOSED 500 GAL. H-20 LEACHING CHAMBER 00 B Loamy Sand o R/11 4 TOTALS: 10Yr 5/8 � REV. DATE BY APP'D. DESCRIPTION�<,9y � 2 TOTAL NUMBER OF CHAMBERS -- ------- - (3 CST TOTAL LEACHING AREA 472.2 SQ.FT. 52" 24.67' PROPOSED SEPTIC SYSTEM UPGRADE O �50, J TOTAL LEACHING CAPACITY 349.4 GAL./DAY (2 O 4) PREPARED FOR: 28.0' CBN CAPEWIDE ENTERPRISES o HC-N /�001 1 C Med. to Coarse Sand (loose) LOCATED AT VO (1 60 BRETWOOD LANE 0 0 CENTERVILLE, MA 02632 SPECIAL NOTES: SCREEN PORCH ON DECK o 3 \ 138" 17.50' SCALE: 1 INCH = 20 FT. DATE: SEPTEMBER 23, 2013 � #60 Om ';; 0 10 20 40 80 FEET 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC EXISTING No Standing, Weeping or Mottling Observed w/>, - -��r CHU \ - - - SYSTEMCOMPONENT. _ __ -- N i_ PREPARED BY: 3-BEDROOM - JOFf DWELLING RESERVED FOR BOARD OF HEALTH USE F+�LL JR. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED TOF = 38.4'± iv18 JC ENGINEERING, INC. LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. SLAB=31.0± 2854 CRANBERRY HIGHWAY REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH ��� TEST PIT DATA. EAST WAREHAM, MA 02538 l 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. S PLAN 508.273.0377 SCALE: 1"=20' Drawn By: MCP Designed By:MCP I Checked By:JLC JOB No.2525