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HomeMy WebLinkAbout0013 CAPTAIN BELLAMY LANE - Health 13 CAPTAIN BELL, AMY-ROAD Centerville A = 230 - 175 SIIII �aec�ctfa�o I,WMW® 2J �y IIII UPC 12534 No.2-1553LOR ��poNS�a WAITING$, MN No. Fee lea THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN 6F BARNSTABLE, MASSACHUSETTS Yes ftpliCatlon for Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 13 C4pk 6HI1 wn� Owner's Name,Address,and Tel.No. c���sv�lle Swe�N�`� Assessor's Map/Parcel 2 Qj 0 I�ns-sttaller's Name,Address,and Tel.No. Designers Name,Address,and Tel.No. A TNC Type of Building: Dwelling No.of Bedrooms Lot Size 2_C G 2 5 sq.ft. Garbage Grinder( ) Other Type of Building tnouS�e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 4 10 gpd Design flow provided y&5- ,� gpd Plan Date bI Number of sheets 2- Revision Date Title Size of Septic Tank L' c�► 00 ®n Type of S.A.S. �C�C,�►G�/ls�J C�iG�/jps$ Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1N!5FG 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 alth. igne ce 6c, Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued 0 No. // —l 7 b Fee THE COMMONWEALTq OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for DisposaY 6pstetu (Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 13 Cc.p k Owner's Name,Address,and Tel.No. Assessor's Map/Parcel v— 1 17 I°n�s^t�aller's Napme,�Address,and Tel.No. Designer,s Name,Address,and Tel.No. �7US`Cr`7 e"t '"J�CJyU^) ��dC �nr� n�� cj Type of Building: Dwelling. No.of Bedrooms Lot Size 2 t r q 5- sq.ft. Garbage Grinder( ) Other Type of Building M No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 4 40 gpd Design flow provided NG5 ,S"' gpd Plan Date 5-b", b i Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. �G � GIIDJ fLio�•1ir/S Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 t Compliance has been issued by this Board o�ealth. Signed GR Date 6,110111 Application Approved by Date /(� Application Disapproved by Date for the following reasons Permit No. `}G/1 ---7K Date Issued 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certlf irate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by Q,r !6,5:, A Zrcl"wO T..ONIC at ��(,., n�a �,{fir,,,, has been constructed in accordance with the provisions of Title 5 and tKe for Disposal System Construction Permit No.,­�jJ/"/7<Fdated W Installer g\E A 14(oLA,j Designer , ,.ri a,r ( a ►��i C #`bedrooms G/ Approved design flo 4165 , !C gpd The issuance of this permit shall not be construed as a guarantee that the system w'irc,til n as desi 1d. Date G/6�, Inspector f J �v, --- ------------------ - + ------- --------- No. -) Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS - MisposaY 6psteut Construction hermit Permission is hereby granted to Construct( ) Repair(v'jr' Upgrade( ) Abandon( ) System located at /^, f^��p ,c �./A—my 4!!�9„_,' 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 r t b7e ,pleted within three years of the date of thi permit. Date U) /� 1{ Approve by r I 06/14/2011 06:28 5Oe4775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Services Thomas F.Geiler,Director { MAI& Public Health Division '4 • Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 50&962-4644 Fax: 509-790.6304 Date:. rY J// Sewage Permit# As ar's Msp/Parvel 23 o — t-1S- Installer&Desi®er Certifiatim_ o-no �a},Gr--r 7'IC�E►�`1-�.� far . Vjer4s, Int. Installer: A* 'B�rau.rh , lvx& Address: I W. Cn, s ?r 1 al Addrem: -TWfV-F MA- dzi-y rtA on 12A ' rCl . o_c. ,_was issued a permit to install a (date) (Installer) septic system at 13 ��+ 1l crew. ` Qf-w N'based on a design drawn by (address) PU, " dates t 3 t t (designer)- 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank, Stxipout (if required) was inspected and the soils were found satisfactory. 1 certii'y 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)was'Jns ed and the moils were found satisfacto3cy. OF PETER T. WENTEE 11 s ignature) CIVIL ,9 No'35109 O (Designer's Signature) (Aim Desi ) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTMCATE F Q2WULANCE WILL NOT BE 1g.$UED INTEL BOTH T S FORM AND AS- D BY, HARNS LF,PUBLIC HEAL=PMN. THANK YOU. %%o0cc,f*rmsl ncnatAcpti 1nTonoo.dac Edward J. Sweeney,Jr. 13 Captain Bellamy Lane Centerville, MA 02632 JJ / �,.�e is jai/ �0., ., p off= /l P-• �/�j xz ?00 CZ IL 0 w - TRANS:.NO.; CrrY/TOW.N APPLICANT: ADDRESS•; 17 DESIGN FLOW: Ma REVIEWED BY: DATE: NlA . ON-_, NO .. Legal boundaries denoted 310 CMR 15.220(4)(a)] ✓ Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204(t)] Plan proper scale? (1"=40'for plot plans, 1"=20' or fewer for V/ components) 310 CMR 15.220(4)] Easements shown 131.0 CMR 15.220(4)(b)] .. System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required 310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) 310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR ✓, 15.220(4)(c)] Location and dimensions of system components and reserve areas. ✓, 310 CMR 15.220(4)(e)] System Calculations 310 CMR 15.220(4)(0] ✓ daily flow septic tank capacity(required andprovided) soil absorpiion system(required andprovided) whether system designed for garbage grinder North arrow 310 CMR 15.220 4 'Existing and ro osed contours 310 CMR 15.220 4 Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and dale of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match load m rate? E310 CMR 15.242 Certification statement by Soil Evaluator [310 CMR 15.220(4)6)] Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR c/ 15.220 4 n Address Sheet 1 of 9 N/A OK x`.; NO ' Location of every water supply, public and private, [310 CMR 15.220(4)(k)] within 406 feet of the proposed system location in the case of surface water.supplies and gravel packed p4c water.supply within 250 feet of the proposed',system location in the case within.150 feet of the proposed system location in the case of privaie water wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks fisted in 310 CMR 15211.and any,catch basins , located ivitlun 50 ft 310 CMR 1.5:220 4 1 Water lines and-other subsurface utilities located [310 CMR water 1u1e cross see 15.220 4 m 3 ITC VIR 15.211(l)[1]) Profile of system showing::invert tjevationsof all.system com `onents'and.t bottom of the SAS: 31Q,CMR1.5.22. .4. o; Siam of deli `er ;310 CMR 15.220 i 'and310 CMR 15.220 2 Stamp-of Registered Land.Surveyor.(required if construction activities-within�5 fft, of lot line: : 310 CMR.1.5,220.3 . Test Holes adequate(two in each of the primar -and reserve unless:trenches.as pernvtted in.:310 CMR 15.102(2)'or as approved for an a ; ade under LUA at 310'CMR'15.405 '1 k'' Test-hole,adequate.to demonstrate four feet of suitable material? 3'10 CMR 15.193(4)], Test Holes adequate to confirm adequate groundwater separation? _ 310 CMR 15.103 3 Be;nchrnarkmwrtlun-S4 75'-of s :stem 310 CMR 15.220.4 Materials spe- cifications,noted? [various sections of 310 CMR System components not> 36".deep (unless Local Upgrade Approval-or.:LUA re nested . :3:10 CMR 15.405 1 Address Sheet 2 of 9 I N/A OK NO Size OK? 310 CMR 15.223 1 Inlet tee located'ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 ✓ CMR 15.227(6)] Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR TAN 15.228 1 ( S Separation between inlet and outlet tees (no less than liquid depth) 310 CMR 15.227 2 Inlet/Outlet elevations at least 12" above high groundwater (except as descried 310 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k Minimum cover ".(Tanks.buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(0] Y Three access coyers (inlet and outlet must be 20" or greater) - middle access at least 8" 7/07 310 CMR 15.228 2 Access to within 6 of grade -one port for systems<1 000gpd, two fors stems>1000 g2d 310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR j 15.228(2)] > 10 ft from builft foundation 310 CMR 15.211 1 r� 'Buoyancycalculation Required/Done 310 CMR 15,221(8)] c% H-20 Where appropriate? 310 CMR 15.226(3)] �✓ Setbacks from resources 1310 CMR 15.211 Required when gther than single-family dwelling or flow>1000 d 310 CMR 15.223 1 First compartment 200% daily flow; Second compartment 100% daily flow 310 CMR 1.5..224 2 and .3 "U" pipe through or over baffle, outlet of each compartment with as baffle or appToved filter 310 CMR 15.224(4)] Address Sheet 3 of 9 N/A OK NO Located at least ten feet from any water line? [31.0 CMR 15.222 2 Disposal piping it least 18" below water line(when water and sewer cross, see 310 CMR 15.211 l 1 Cleanouts r uired/ rovided ? 310 CMR i 5.222 8 Thrust blocks s • ed in force mains? 310 CMR 15.221(6)(c)] 1 e Slope a of sewer line not less than 0.01 1/8 Ift 0.02 r e ferab 310 CMR 15.2 .6 Proper pitch°ori all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251 9 and 310 CMR 15.252(2)(c)] Siphon roblem/. eachfield below pump chamber Endca s or vent manifoldspecified? ✓� Size and orientation of discharge holes.specified?.(not smaller than . 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252 2 Materials specified (310 CUR 15.251(5) specifies various pipe es allowed Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffie tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if.dee ,er than 9".. 310 CMR 15.232(3)W] Inside minimum dimension 12" 310 CMR 15.232 2 Minimum 310 CMR15.232 3 e Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232 3 d Ca aci emer Inc -stora a above workin =desi flow ? 310 CN%231 2 Proper setbacks 310 CMR 15.211 same as soptic tanks Watertight.20-in miniur access manhole at least 20" MUST BE TO GRADE 310 CMR 15.231(5)] Service components accessible(not too deep with piping, l disconnects accessible Alarm floats - alarm on circuit separate from pumpsspecified? Exceeds two unio must have two pumps operating in lead-lag mode. 310 CMR 15.23 1 6 and 8 Stable Compact6d.Base 310 CMR.15.221(2)] Address Sheet 4 of 9 Buo anc calculations needed?Provided? 310 CMR;15.221 8 Address Sheet 5.Of 9 N/A OK NO Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation to oundwater? 310 CMR 15.212 Aggregate specified as double washed 310 CMR 15.247 2 System Venting required/provided?-(system under driveway or >36" deep) 310 CMR 15.241 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253 6 Each structure with one inspection manhole(if>2000 gpd must be tograde) 310 CMR 15.253 2 A ate 1'minimum- 4'maximum: 310 CMR 15.253 l 2' sidewall credit maximum 310 CMR 15.253 1 a In bed confi ration, inlet ev2g 40 N. ft. 310 CMR 15.253 6 Width 2'minimum 3' maximum 310 CMR 15.251 1 b 100 feet -maximum length 310 CMR 15.251 1 a Minimum separation 2x effective depth or width whichever greater 3x if reserve between trenches 310 CMR 251 1 d � Situated along cpntours 310 CMR 15.251 2 Breakout OK? $10 CMR 15.211 1 41 and Guidance Document minimum 2 distribution lines 310 CMR 15.252 2 a Maximum se aration between lines 6' 310 CM R15.252 2 d Maximum separation between lines and outside of bed 4' [310 CMR 15.252 2 e , Aggregate depth below discharge pipes 6" minimum, 12" maximum.. 310 CMR 15.252 2 Separation between beds 10'm irnum. 310 CMR 15.252 2 Bottom area useo in calculations only 310 CMR 15.252(2)(i)] Address Sheet 6 of 9 V OK_ Pressure Dosed System ? Provided pump and piping calculations .cam as r aired 310 CMR 15.220(4)(r)] Pressure dosing tequired on all systems>2000gpd or alternative 77 systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use ovals If used in gravelless system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd) or quarterly >2000 dgood to note on plan 310 CMR 15.254(2)(d)] Construction in fdl -Did the plan specify that the fill shall meet, the specification;of 310 CMR 15.255 3 ? Impervious barrier and/or retaining wall ? Guidance Document. Impervious bamer installation must be supervised by designer 310 CMR 15.25 5 2 b Retaining wall must be designed by Registered Professional Engineer 310 CIVIR 15.25 5 2 a Side slope not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended 10 CMR 15.255 2 e Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a�:Ote on the plan regarding the requirement for ,perpetual maintenanceagreement? l Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has _ _lic�nt submitted a copl of a maintenance a Bement? Are the variances listed on the plan? [310 CMR 15.220 4 li RLS Stamp,-necessary on plan if a component is within five feet of property line 310 CMR 15.412(4)] Address ,.:Sheet 7 of 9 New construction or.increased flow proposed [Refer.to.11.0 CMR 15.414 cz , F C, i Address Sheet 8-of9 Is the system in a Designated Nitrogen Sensitive Area (Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.210 - also refer to Policy regarding upgrades of such v existin systems Is the system proposed on the same lot as served by private well ? , 310 CMR 15.214 2 Are the'nitrogen loads proposed in compliance? [310 CMR � 15.21. 1 ._ Pumping to septic tank ? 310 CMR 15.229 Shared System 1- CMR 15.290 Address shwaa 9.of 9 A,TO F B STABLE x. LOCATION ect;A ` it v SEWAGE# JLCI I i-70 VILLAGE ( �� +��.Il'� ASSESSOR'S MAP&PARCEL APA) 3f7� INSTALLER'S NAME&PHONE NO. ; p613� SEPTIC TANK CAPACITY nwsri� !! go �GClZ aI an LEACHING FACILITY:(type) i ', (size) • NO.OF BEDROOMS OWNER S `� e PERMIT DATE: (y 11(�` V t COMPLIANCE DATE: Separation Distance Between the: VM6, 36'Qc) Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NX�0)C,+- Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Sow J 4 p 4,e 36, Town of .; B; rnsa P"# f Oepart neat of.Regulatory Services I , F Public Health Di<v><s><on Hate 9 r ibsy.h� 200`Main Street,Hyannis MA 02601 Date Scheduled /I 3, .�� Time ' Fee Sail iity Sutab Assessment for Sewage Disposal �- Performed By: Witnessed By: � LOCATION&z GENERAL INFORMATION: Location Address (e Address �3 eq� �� i3ej�G < Assessor's Map/Parcel: Z `%7 Engineer's Name NEW CONSTRUCTION REPAIR' X Telephone.# Land Use 1`r)�4' ` Slopes Mj � Surface Stones Distances from: Open Water BodyL ft Possible Wet Area. v ft Drinking Water Well ft Drainage Way A-' ft Property Line rj'G (QU ft .Other ft -SI0TCH:(Street name,dimensions of lot,exact locations of tesrholes&.pert tests;.locate wetlands fn,p%ximity to`holes) ff e i 1Le.,N.,1 Parent material(geologic) J Depth to Bedrock Depth to Groundwater. Standing Water in Hole: W Yv Weeping from Pit FAce Estimated Seasonal.High Groundwater 13 Z DETERAUNATION FOR SEASONAL HIGH WATER TAB> ,E Method Used: __.. Dcp.h-Observed-standing inobs—.hole: P. Depth to 591)JkIOItIeSO Ith Depth to weeping from side of obs.hole: in, Groundwater AdJIWMOnt ft. Index.Well:# Reading Date: Index Well level, Ad),factor AdJ drnutlawater Level PERCOLATION TESL' Date-`T1me Observation Hole# Time at 9" Depth ofTero: Time At 6" Start Pre-soak Time® 'rime(9"-6") , End Pre-soak Rate Minlinch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Obsery don 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:ISEPTICIPERCFORM.DOC `DEEROBSERVATION MOLE LOG` Hole# Dcp6 from Soil Horizon Soil Texture'. - SoilColor Soil Surface(in.) (USDA):. (Munsell) Mottling (Structure�'Stoues,Boulders: DEEP'OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones Boulders: Consistengyi jz 1z 3 Z. S� iol DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color -Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders: 3 DEEP OBSERVATION HOLE LOG Hole# Depth'from Soil Horizon. Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.:$tones.-Old0s. Me -Flmod:nsurdnce'Itate Mta»:,�_ :. :- - Above SOOkyear flood boundary NO Yes -- "VJifliin300year boundary No. Yes .. Within 100 year flood boundary No-'No—L Yes Depth of Naturally:Occurrin>r Peiwious iVlaterlal. Does at least-fpur feet of naturally'occurring pervious material exist in all aretis observed throughout the area proposed for the soil absorption system? -- Iot edp g-pervious material? Certtficataon I certify that on 1 . 0.�/ .(date)I have passed the soil evaluator examination approved b>y: the De artinent of Envmental Protection and that the above analysis was performed by me consstentw`ith P:. the required tra ,expertise an `experience described In 3lU C1vIR 15.017. Date f� (i Signature Q;1SLtVnC l3RCFORM.DOC No. r© r.a • Fee THE COMMONWEALTH OF MASSACHUSETTS ' Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9pplitatlon for Nspoeal 6pstem ConstrUttion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.�0�3 wf,'�},'cr'✓� Owner's Name,Ad ress and Tel.No. A/h � T A. >0 A-,,',c14 iq Assessor's Map/Parcel ,O'/_'S7i C. ��✓-e Installer's Name,/Address,and Tel.No. Designer's Name,Address,and Tel.No. T G, A4 /7o LO n 5 1/ L/7141/11'r!''r'--:. l ^-X,S -f TH< 01 h.- ,Ar XA 0171�1/9 /a? C'ry ss ,P/c/ Type of Building: Sob a91-/ -774�2 va71--.fV41eA4t9 OaG vY OrY77 5-313 Dwelling No.of Bedrooms 3 Lot Size y(�O� sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided -3%7 9 gpd Plan Date v?���J Number of sheets 04Revision Date Title O Se W se, �1, Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) r-e- 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 a Signe Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. ' u . '�� i Fee THE COMMONWEALTH OF MASSACHUSETTS— Entered in computer: Ye PUBLIC HEALTH DIVIS�ON -TOWN OF BARNSTABLE, MASSACHUSETTp� Tipplicatlon for Misposal Opstem Construction Permit Application for a Permit to Construct( ) Repair( )�Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. 3 r„f, , ,(Jv, p Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 7 q — .2 Installer's Name,Address,and Tel.No. Designer's Name,Address,/and Tel.No. T C. Au !>7 Lo s> 14, Type of Building: fy-,fV4 4,0 Oo74 `141 �0l"/'77 S3/3 Dwelling No.of Bedrooms Lot Size y�,aOO sq.ft. Garbage Grinder( ) .e Other Type of Building No.of Persons' Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) _ �� gpd Design flow provided V 7 K gpd Plan Date —x// Number of sheets Revision Date -- Title 2 Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Heath. Signed t Date F Application Approved by Date Application Disapproved by Date 4 for the following reasons Permit No. / Date Issued rr� ,.THE COMMONWEALTH OF MASSACHUSETTS �BARNSTABLE,MASSACHUSETTS t' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by d, e, & h f ,Y, o c i at Z f,-su;C /7ri�e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - 3 q dated Installers Designer h r r or h f #bedrooms Approved design flowgpd The issuance of thi pe it shall not be construed as a guarantee that the system will fun` cti8n designed. Date Inspector ---------------------------/--l---------------------------------------------------------------------------------------------------------- No. r .� %.J Fee Q THE COMMONWEALTH OF MASSACHUSETTS F PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at /�f Al 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 j/y{ Approved by il� 03/10/2011 21:22 5094775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Services Thomas F.Getter,Dirfttor MAL a Public Health Division Thomas McKean,Director 200 Main Street, Hynna*MA 02601 Office: 508-862-46U Fax: 508-790-6304 Date: i d f+ Sewage 1Permit# — 31Assessor's MaplParcel ' Installer&Designer Certification Form t uaeWt�, \r•C Installer: C. A 6,1 1-0 Address: iZ Lames r- (-ra sr �Ze k Address: I - 0 r Oa"'< 3 1--gc4,Lk MA M C I LS MR 4Z&\t F On _ ' was issued a permit to install a (date) (installer) tic stem at ` c ��', M sep sy based on a design drawn by (address) �—:7, dated h (designer) I certify that the septic system referenced above was installed substantially according to the desi§% which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (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&Loca(Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) ected arrd the soils were found satisfactory. � �,�ON PETER c MCENTE£ ee s ignatiUre " CIVIL 9 N0.35109 0 ss a (Designer's Signature) (A tic Des ere) PLEASE RETURN TO BARNSTABLE PUBLIC HRALTH DIVISION. AM OF COMPLIANCE L NOT BE ISSUED UNTIL FORM AND AS- UMT CARD ARE RECEIVED BY THE B&M LE PUBLIC HEALTHIVI I gAaft3ce fbnaMWV=ccnificadi3n f6 m.dm THE COMMONWEALTH OF MASSACHUSETTS � BOARD OF HEALTH - 'T� ~- --'8��A���------���F-���� '-_ liration for amit " " ^ ~ �. Application is hereby made for u Permit to Construct or Repair . uu Individual Sewage Disposal � System at: ��� � Location'A«dres" or Lot No. Address Installer Address � Type of Building Size .......8q. feet Dwelling--No. of Bedrooms..... ....................................Expansion Attic (^~°) Garbage Grinder (oic,) Other—Type of Building ............................ No. ofyeruouu----_-------- Sbmvc,s ( ) -- Cafeteria ( ) [)t6cr fixtures ---.-------------.---_-_-_.------.---_--____._.________________________.. ~` Design I/lmw---- ........................gallons per person per day. Total daily flow-...-��a���.....................gallons. 04 Septic Tank—Liquid ............gallons Length................ Width................ Diameter................ Depth................ Disposal Trcoch--yVo..................... Width.................... Total .................... Total leaching area.-------'--mq. ft. Sccyx�� �� l�u . --- D�oo�t�r--__...-' Z�o�6 ��m� ��e�'__-___ Iota �acb�g arca-_---__og �� _ __- �7 , ^ _ Z Other Distribution box ( r) ^^ Dosing tank ( \ ~~ Percolation Test ]leoolm Performed hr.......................................................................... Date........................................ �--j 4 Test Pic No. l..:?!n.._2~.oioutes per inch Depth of Test Pit..- ...... Depth u/ ground watec_&Q.M��--,- Test Pit No. 2-------..minutes per inch Depth of Test Pit.................... Depth to ground water........................ ,~ ---------------_--.---._----_---------'-_-'---'_-'--------------_______. O Description of _-.--_--._------' ........................................................................................... .-----------.----'---___-----.--------.-..---_----_--_---_----.-----------_----''--'---_ U Nature of Repairs or Alterations--Answer when --_-----_----.----.---'--------_-------- � --------_--------_.---_----_--'�----.---.-'------------.--------_-----_..--------..--_-_--'------ Agzecn`cor: The undersigned agrees to install the aforedescri6ed Individual Sewage Disposal System in accordance with the provisions of TLITL lZj �of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b -------------------------------------- -' --,---------- ate Aoo1icutoo Approved 8y-----' -~*��.��� L-------'- ......... --' �����s----- ^ � �um= � Aool�ut�oo Disapproved �6x fo/�r�innruuxonu:_--.-.------'------..----'-----.---.----'�----------'--- � ^^ ^ \ / ` ---'--------------'----'---'-----------------'-------------------'-----'---'--------'----------- Date ' Issued Date � � No........................ FE$.... ... .C�? THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ U✓ /fit .............OF...... .------......--------.........----- ApplirFation for Bispao al Works Tonstrnrtinn Prruat Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at ,,.�•� �yLocation-Address -; _,,, or Lo/t o. �q� ..•........r".�. 3.Fsc- rr' �''.�m�.' .e 4rtar....___. ?sel .__••.................. .. '-.-. F�- ',-�\i. :-'.may-<<i •---fav '�e�T�~tGd�'•'�y-� .._._.. .-. ._....__ ,,,owner Address F W ................� .:�.................1 1�••1� .a+wL.. ...........................�\ItN Installer Address elType of Building �. Size Lot... .......S feet U Dwelling—No. of Bedrooms____...................................Expansion Attic (h�) Garbage Grinder pa, Other—Type of Building ............................ No. of persons..,.!......._...._....__._... Showers ( ) — Cafeteria ( ) alOther fixtures .----•-......•-••----•-••------• --•---. . ---------------•------------•-•-•----•-----•---•--------•---•------------•--------•--•- WDesign Flow........... .:S........................gallons per person per day. Total daily flow--------- ,-------•-._____-___--gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ xDisposal Trench—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 ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. L.I..2 -_-.minutes per inch Depth of Test Pit.....7 ....... Depth to ground water. ---_--__. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --••------•-----......•--•-----•--••.........--•----•-•-•---•-•---------------•-....----•-----------........................................................ ODescription of Soil.....(9-=-4. ._. h = .?----•� ---'�'!:. .-._ Ji/.1�'?_z+..e' .T_atf Lew ....-----•-------------•--------•-......•-•---•----....................................... ---------------------------•-----------•------•---•----...---.......-•--•--•----•----•---..._...-•-•---------••---------•-•-----•----------•--=•---•-----•------•---------•-•-............----•---•--••- 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��be�°ee�n,, issued by the board of health. HSigned.,­t •--`•'- ------------•LlateApplication.Approved BY••-.---- --•----• -------------•- .__.._.Application Disapproved for the foll sons-------------------------•---•-••----------------•------•---••-•••-------•---•--- ........ -••-•-•••---••••-•-••--•--•-••-•-••••--•------•-••-•---•-------------•••------•-•-•------•••--------•--- -_..... -- ---- --- - Date PermitNo........... ._L.- -------•-•--- - Issued--•------•---•----- ............................... Dattee THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................OF.� �, :�b.:.� .;,. «: ................................................ up ntifiratr of TuntpliFanrr r THIS IS TO CERTIFY, ,,�"��That the Individual Sewage Disposal System constructed ) or Repaired ( ) Installer r'� a _ ; t r. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......................................... dated----------...................................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. DATE...... �� ��._/,� _._._.. inspector........_ .............•.._..-•------•-------•--••--•..........--•-•- 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH v - ...... .......................OF..... r=` -- No Dispos al Vorkv T.11nitrnrtion anti# Permission is hereby granted.......�A 5�-•-•-• •.M-=x-��;; -•------------•-••------------------•--•--._..............-- to Construct V) or•Repair ( ) an Individual Sewage Disposal System �Af'P,�/fit. .. '�t...... �i.4 _ at No. .a l r i� ' ' Street as shown on the application for Disposal Works Construction Permit N3S.5-.-_n. Dated.......................................... ........................ Q.r oar o 4-J&I DATE................................................................................ FORM 1255 A. M. SULKIN. INC., BOSTON 5.}. — ,�e..,..�•��-ems �..'� Y 20 07 �i / 6� ' V . 7 J. Z WA 1J1 \ /beta ( 14 t ' r S .M ` / �S'��,=P� �' 0� :� � � �� •ram N moj �__ /�/ 4 P. 140 7 I� r 1}A _ G( �ys�'3� �y ✓'. Y s } / 6"f �.'C1w aY''*` �< 6 '`�j �\\ l ,s � �.:.s�r .;.'k fZ��ir r .L.p�.i c`"•"'_-+r1 2 .� to s w R No. 19367 cF11$f ALE.'Li2I LEGE !,ji tgj0 c ENI>iTINA SF°OT ELEVATION OAO a c,f.,�, r A. EXISTING CONTOUR --- 0 & 's ` •'r=i " CERTIFIED PLOT PLAN xa w@ nFL , �'{NISHEO SPOT ELEVATION °�, t3 � �0 i3z:-C :F1"f SHED CONTOUR 0' Q rt G r.•' "= �'.;s^ ' f ; 5N(T 'i';The -location of any existing underx.•ound sewerage, IN ytt s, ,wells,. or other utilities shown on t)'•i plan is approx- ¢ mate only as determined from records _and/or verbal �, � �\, �. `1�1a� l - information. .The contractor is responsible for the .� �,E�rs�r> 6, ;9 + v®r�fcatbn of, the existing locations in the field. SCALES / - O DATE ,�/f,t•, �'.S` {; � DRE®OE ENGINEERINGCOt ING CLIENT...------- i CERTIFY THAT THE PROPOSED 30 � � BUILDING SHOWN ON THIS PLAN i E413TERIE ZR 19TERE0 JOB N0. "�- j. CIVIL LAND . CONFORMS TO THE ZONING LAWS, aWl y GR.BY, A "A ' M - "', E 0 FuER V -------�'- OF B A R N S TA 9 L E � MASS. ' Ti2 MAIN STREET, CH. BY' 1 + �• l � .` ,, -� HYANNIS� .MASS. SHEET/' OF DA E REG. LAND SURVEYOR F • Im ft - - :] .--•.--•--'.te �_�.-+-•r--.r Y-..--••.. .... >.i-n-�....�re—�....«.............r .....+..._..—..._r..a...u...-... .. r..-t ...�.....w......... .. ..r, :.f'•,'- 'r.3.Y f ..ny;#. .. a?s'. t :t ." •v .' -w...,.x r r+ ,k X'".:cey 'i rf .>-�- •:.:'t '�:s.:..c,;. z �'f .:ti^ .rt 4"3"";. a¢'1 ,t =``]- ! a• - zr X .. kS '� i +dt t7 „+.i;, 14 .tYt N,rS.n. x' .:y s• .rt„.Ev:s h7.`1Ca L-0: a.+..y.(., - MOJ 7T, s; 4x , k ' ?D„F..T•., .MlN si t a i« + ,. �I7 LR: '.q/eE` /yoJ�E '`. !ti►^iv /2 LlFLO.?'V�, :. IJV ,Q/!OE, �,";24` O/�1METE�? coviceETE COrE,r M /sr r W'' f 'PVC PJPlr` e�' ,SNALL= *OU.SY7' 7 GArAOE:.<.4.N AXTRA � a> CONCRL:'TE + :� •". <�"�~� h+EA,Y.y`'C!�.ST'IRON GD�ER :Std�4LL BF USED M jIV.. P/TCN t JF 1/V 17RJ tiEyVA y EL SV U' COYERS �i fg'p f7 ,' • f-� r ++ d7t.�►0l< . CO YER CZ fAIV SA,-V0 _..f Q yam.. a BACX F/L L q D/A. , SCK�01440 j ��•. f. . Get L FD S>—."r . � • • R.• . . .. .• • � e � !' DIST. o � , 0 '• f • • YY•4Sh' Et. r % Pzv rT SEPrIC TA/VK 3140. d '�` • • • • • OL`PTt/ • • • ' 7. • ••: H'4Sh ED STdNE • . • � S l x Z.3"' 3-7 1 l + PRECASTS GE I-C , /IVf�CAT 44 EYAT/ONS Pl r���A � Ty 9 9� G>} • JNYERT AT Q!//LD/NG 45.7 FT. . IJYLET .SEPT/G TANK Z FT. O/�41N• G' SEE T�BLL.�770N� OC/TLET SE/�T/C Ti�NK gS•.3 FT. _ ... R : . ?� /INLET D/STR/8!!T/DN, 80X FT GROUND Js�fTE/�"TALE DUTLETOJSTR/�tlT/OlV BOX -44:v F7, SECT/O/V 4F' SEWAGE L7/SA SA t SY.5?•EM INLET tEwCNIl1�G I�iT 4-�f,6 fT. L.AEA Cf/aNG PIT DIMENSION A. _-4 3 f T -V LE CA : �4 s / -D DES/6N OgPrER/A - DIAfkwslo a: .� FT- 3 DIAIZWS/CN NL/JalLSER Of. EEDROOMS �✓+ReAGED/SJ�OSALC/J�//T �/v/✓�' SOIL LOG s0/L`TEST 7-07i4L 1r?T!/►'NTED FLO*V 3 3w GA1.1,OAY SO/L. TEST AI 50/1- 7E57-**2 j/ 6 &s'` �'UM R OJT 1,fACN/NG PITS I ELfY g8:6 E1t�Y. RATE OF 50/L.TEST. S/ SIDE 4rACH/IvG PER.P/T I S/ S , .FT ./�h4 v Ar EED Or S PVIT/ SS JOTTOM U n/ L.04CN/NG PER PIT I/3 AE LEss !INCH $q. F r. � PEr4'COL AT/D/V R.4 TaF TOTSL lEA:H1N6 AREA FT. Lv'`t "� PJFJrCOL/4T/ONMA7-,F.lk,2 "�r€/MIN�/,vCR. 4FSERYE LE�4Cid1N3 At?Ert ZL'¢SY. FT. _ y Q LDT..' / C� P7; L/�/�1,`r Vr- ALel S. No. 6' RSE T. AA(Al 10 LJrLIS:i ��i� q�.o �cCJs/!�-.�• v x �L.. .�ta .� y 7I2 MAINS � .;ky ' • e .. ! ^ ® `NO GROUND YY,4 re.V AWC04/WT1.rR60 ¢� 'v. Q G.4CDU/VL7 .LVi4TER �'IT ELL�t/ J4L3 ..,.,.,. �.- .e•:-_•_ ..,�� >. ° . a. 1 r •!i a �"•- i., e t .�' r'w. ..<.d+r« :�^• ,ham .h'.mw.s^`tR.1' ( ^S'•�Piz �?K,.ru. _ vG..�'+'+�� Y+ ;`-', ..♦ ".. r ke7 ,r,:.�,. ,,,,ym.....«.,.,..^.r:..<..�.....s,. .vk+r..re•.-..M...•.«....:.• ... fix,:- h+..r�rv>,;« u-.i:M:M ,�h.:-. .,-�, _ _ LO CAT IO �`� SEWAGE PERMIT NQ. o 6- V Coy, VILLAGE re 4 Irel,//Ile I N S T A LLER'S AME a ADDRESS J� ✓',:scd 1/ LD S o o 1?2jf-5&o e U I t D 10 OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Lj4 Eck o� .as 7.q 3R C;G �3d y j Q 1 2S TROY WILLIAMS �, y 0 SEPTIC INSPECTIONS °p q p R Certified by MA Department of Environmental Protection (50(5) 385-1300 19 Hummel Drive � South Dennis, MA 02660 A y E COPY UVCOMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292-5500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A !� CERTIRCATION Property Address: 13 C"P+- (�e 11 �+^r �cl, Name of Owner__")-k A W00174, C c h }cr , ( �t Address of Owner: yy K , N N L v 7F f /Z C/. Date of Inspection: y//6 /9 q Narne of inspector(Please Print) Troy Williams I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Nam: Trod wlliams Se tip c Inspections Mailing Address: 19 Hummel Drive, So. Dennis, MA 02660 Telephone Number: (508) 385-1300 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: ILI Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails � kupector s Signature: Date: y/i6 _27 The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty(30)days of 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 Department of Environmental Protection. The original should be sent to ttte system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system,piping or components. This inspection represents the conditions of the system on the Date of Inspection noted above. - r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (contirxred) Property Address: Owner: 13 Captain Bellamy Road, Centerville,MA Date of Inspection: Ruth Woolf April 16, 1999 INSPECTION SUMMARY: Check A, B. C, or D: A. SYSTEM PASSES: 1 have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: AV/,3 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. 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 Compliance(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 complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled 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 9/2/98 11 ,a 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Prof,"Address: 13 Captain Bellamy Road, Centerville, MA Owner Ruth Woolf Date of Irupection: April 16, 1999 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Al//1 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 IN ACCORDANCE WITH 310 CMR 15.303(1)(b)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 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 ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS 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 presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER rev ) Sr.�j PaRc 1 of I I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 13 Captain Bellamy Road,Centerville,MA Property Address: Ruth Woolf Owner: April 16, 1999 Date of Inspection: D. SYSTEM FAILS: N1,1 You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described 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 into 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 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 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). Number 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 I 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: A114 You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: 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 II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 13 Captain Bellamy Road, Centerville, MA Owner: Ruth Woolf Date of Inspection: April 16, 1999 Check if the following have been done: You must indicate either "Yes" or "No' as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. SL _ None of the system components have been pumped-forat least two weeks and-the system has been,receivingnvrrnal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. sL/ _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. 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. The size and location of the Soil Absorption System on the site has been determined based on: Existing information. For example, Plan at B.O.H. �L _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)) _ The facility owner (and occupants,if different from owner) were.provided with information on the.properxnaintanaace_of SubSurface Disposal Systems. revised 9/2 !9r PageSofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: 13 Captain Bellamy Road, Centerville, MA Date of Inspection: Ruth Woolf April 16, 1999 RESIDENTIAL: ROW CONDITIONS Design flow: /I O g,p,d./bedroom. Number of bedrooms(design): Number of bedrooms(actual): Total DESIGN flow 330 Number of current residents: is Garbage grinder(yes or no):_j�=5 Laundry(separate system) (yes or no):A10; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use (yes or no):—yes Water meter readings,if available(last two year's usage(gpd): 9fJ= 9 3,OUO Sump Pump (yes or no): /VO Last date of occupancy: S G" x S "0 c. L C cx T h S COMMERCIALANDUSTRIAL: A11A Type of establishment: Design flow:_ qpd (Based on 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present:(yes or no)_ Non-sanitary waste discharged to the Title 5 system:(yes or no)— Water meter readings,if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: )VO a%J& .` C-L + 13c�r-.,s -AU � r� T�� �,,,� System pumped as part of inspection. (yes or no) A/o i If yes, volume pumped: gallons 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed of known) and source of information: r C's- b" 1 f. Sewage odors detected when arriving at the site: (yes or no) NO P.R,6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Address: 13 Captain Bellamy Road, Centerville,MA Date of inspection: Ruth Woolf April 16, 1999 BUILDING SEWER: (Locate on site plan) Depth below grade: / Material of construction:—cast iron V 40 PVC_other(explain) Distance from private water supply well or suction line N/o Diameter_ / Comments: (condition of joints, ventin evidence of leakage,etc.) L P I I N• �., ♦ li.+� ✓r a. '� �w1 e_. O 7'e/ SEPTIC TANK: (locate on site plan) i Depth below grade: Material of construction: concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age ls.age confirmed by Certificate of Compliance_(Yes/No) Dimensions:_ IX 9 j 6 Sludge depth: •rr Distance from top of sludge to bottom of outlet tee or baffle: Q r Scum thickness: /VoNG Distance from top of scum to top of outlet tee or baffle: N0 C- vtI Distance from bottom of scum to bottom of outlet tee or baffle: n!o 5 c v vr•i How dimensions were determined: Pi r) , Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level In C- relation t outlet invert, structuret4ntegrity, evi once of leakage,etc.I JIV —re- � ; N 1c G. 7 o v+I` `r< Cr-.v C.cl T- u -ti✓►, o" GREASE TRAP: /!/ ,yl (locate on site plan) Depth below grade:_ 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: 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.) revised 9/2/98 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address'owner: 13 Captain Bellamy Road, Centerville,MA Data of kispectio, Ruth Woolf April 16, 1999 TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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/day Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: e J c Comments: (note-f level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box; etc.)..- PUMP CHAMBER: (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) revised q /.) /Cof PAge8OfII I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 13 Captain Bellamy Road, Centerville,MA Date of Inspection: Ruth Woolf April 16, 1999 SOIL ABSORPTION SYSTEM(SAS):i/ (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) 1f not located,explain: Type: leaching pits, number:_,, leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields, number, dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure, level/of ponding, damp soil, condition of vegetation, etc.) fig -S J S w H a.-.-<-A S-10 H / / jJ G� Ci i1 ✓M Gt O� J� Lvs S �L N v� � G �G 4-- /VO 1J✓ O✓-o� ✓M J �HST h.�� a S �- .J� rn T w T- � � CESSPOOLS: N/,9 - �-e «, �,. (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: N�q (locate on site plan) Materials of construction: Depth of solids: Dimensions: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) .�ci 9/2/98 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: owner: 13 Captain Bellamy Road, Centerville,MA Date of Inspection: Ruth Woolf April 16, 1999 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 2-0 yo p-tax i;000 y era �wh k is 66 r revised 9/2/98 Page 10of II i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contirxu�ed) Prop"Address. 13 Captain Bellamy Road, Centerville,MA Date of Inspection: Ruth Woolf April 16, 1999 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked 2.oNP 9 y.0 4 J Groundwater depth: Shallow Moderate Deep ✓ SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 15'}Feet Please indicate all the methods used to determine High Groundwater Elevation: V Obtained from Design Plans on record Observed Site JAbutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records. Checked local excavators,installers V/ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) H b-c, K G 1'j A w y t1 Ctrv,,wc� t✓c� t.� /c.,5��. nev i ,eci c 2 .198 R -- 98 -- EXISTING CONTOUR equacjUet La x 100.98 EXISTING SPOT GRADE allke 102 PROPOSED CONTOUR 'a Qc�9 -W EXISTING WATER SERVICE y °k � LOCUS -G EXISTING GAS SERVICE o Qom a BP°4e Dr /rsfkb r � ro ya U UNDERGROUND.WIRES PB 3g5 PO 90 f c o a ° TEST PIT ° e nP/P 7 fie 11 tom' 3 Great Marsh m BENCHMARK Rd e�y Route ZS LEGEND EXISTING LEACH PIT Route 28 Qr West f Main CONTRACTOR SHALL PUMP, � St BENCHMARK FILL W/ SAND AND ABANDON. LOCUS MAP TOP CONC./SONOTUBE NOT TO SCALE EL.=45.39 (Assumed) EXISTING SEPTIC TANK (TO REMAIN) TOP OF TANK, EL.=41.73E(VERIFY) lNV.(OUT)=40.40t(VERIFY) -PN 230- �77 APN 230- 174 S 12'35'55" W - 125.00' 0 N i + 42.48 I44,07 0 4.1 I to x 57 l 41.87 Gorq.6n 'A0 I 4.37 � SPIK eo9P• �� Q APN2.30- 176 �I 3 35-�\ �f j. 42.79 41.25 + ,41.38 43.85 i � + ....... .......... .+ . 40,77 i I I + i . 3.5---{. . .. . . .... + 45 i f.. O ;.�N N z fPP, O 01 A� OLo 5.56 Ilk' �� x 41,44 1 W C01 ' 4• ,02 04 cn �` 142.56 -J : It � x 44,74� N z + 42.54 r-- ---1`\ �\ BM x 4 12 §ro over on x 43,39 x 4 3.02 - 49,46.01 \ ` DECK � �---- EXISTING x�46,26 H0USE(#13) �� 47.23 T.O.F.=49.7t x I 47.79 47..48 ) x 46+ 44,95 4B'. i 48.8� � ---v RICK WA L 49.06 \\�� Lot 4 LA P PAVED APN 230-175 DRIVEWAY 20,625±S.F. J s0 ��150.39 5 50.29 --- _ ,' 118.36' c� S 12°35'55" W CB x 50.47 x 50.31 51.15 51.42 51.13 49 98 50.17 edge of pavement Q� 9� 50,95 51.41 52.00 0� PETER T. yP CAP THIN BELLAMY LANE M CIVILEE No. 35109 OWNER OF RECORD L SWEENEY, EDWARD J JR. & DIANNE E 13 CAPTAIN BELLAMY LANE CENTERVILLE, MA 02632 J Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 1"=20' P.T.M. 154-11 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET No. 13 CAPTAIN BELLAMY LANE CENTERVILLE MA (608) 477-5313 5/13/11 P.T.M. 1 of 2 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 t NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:39.4 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET INSTALL WATERTIGHT RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" OF FINISH GRADE FOR INSPECTION PURPOSES AND SET TO 6" OF FINISH GRADE. T.O.F. PROVIDE ACCESS TO GRADE OVER OUTLET COVER COVER SET TO 6" OF GRADE F.G. El: 42.7(MAX.) EXISTING F.G. EL.=42.6t F.G. EL: 42.4t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. L = 13' L = 23'(MAX.) S=1% (MIN.) ® S=1% (MIN.) 4'SCH40 PVC 4'SCH40 PVC s tol as $ as 14" s BaaBaaaaa EXISTING 48" LIQUID aaaaaaa LEVEL ADD 4' 5.2' 4' GAS BAFFLE INV.=39.57 PROPOSED INV.=39.40 INV.=40.40t D-BOX EFFECTIVE WIDTH = 13.2' EXISTING INV.=38.90 EXISTING SEPTIC TANKS (FIELD VERIFY) 3-500 GALLON LEACHING CHAMBERS r� SURROUNDED WITH STONE AS SHOWN H-=10 RATED TOP CONC. ELEV.=39.7t BREAKOUT ELEV.=39.4 NOTES: INV. ELEV.=38.90 WOUE33 aaaa Ba0a eaaaa 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BBa6 aaaaa I/ w) INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=36.90 4' 3 X 8.5'=25.5' 4' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 33.5' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED T.P. EXCAVATION OR G.W. STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO GROUNDWATER, EL.=30.7 - 4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" TO 1-1/2" DOUBLE OUTLET TEE AND REPLACE IF NECESSARY. I WASHED STONE SEPTIC SYSTEM PROFILE 3" LAYER OF 1/8" TO 1/2" DOUBLE WASHED STONE N.T.S. (OR APPROVED FILTER FABRIC) GENERAL NOTES: SOIL LOG 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL DATE: MAY 13, 2011 (REF. P#13,274 BOARD OF HEALTH AND THE DESIGN ENGINEER. SOIL EVALUATOR: PETER McENTEE PE, (SE�1542) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS WITNESS: DONALD DESMARAIS R.S. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE HEALTH AGENT LOCAL RULES AND REGULATIONS. ELEv. TP- 1 DEPTH ELEv. TP-2 DEPTH 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 41.9 A 0" 41.7 A 0" ^ DESIGN ENGINEER. SANDY LOAM SANDY LOAM 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 40.9 10YR 4/2 12" 40.7 10YR 4/2 12 B B FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. SANDY LOAM SANDY LOAM 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 10YR 5/4 10YR 5/4 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 38.9 36" 39.0 32" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF C C HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. M-C SAND M-C SAND 2.SY 6/4 2.5Y 6/4 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 22. GRAVEL 22. GRAVEL AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE & COBBLES & COBBLES DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION_ 30.9 132" 30.7 132" 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS NO GROUNDWATER, PERC RATE: <2 MIN./IN. IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY THE DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND ®®®® 0 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. ®®®®®® ®®®®® 33" DESIGN CRITERIA N Z ®L-a®®®® ® ®®®® NJMBER OF BEDROOMS: 4 BEDROOMS SOIL TEXTURAL CLASS: CLASS I 102" DESIGN PERCOLATION RATE: <2 MIN/IN DAILY FLOW: 440 G.P.D. DESIGN FLOW: 440 G.P.D. 4" KNOCKOUT GARBAGE GRINDER: NO 20" DIA. COVER LEACHING AREA REQUIRED: (440) = 594.6 S.F. •74 4" KNOCKOUT / 4" KNOCKOUT 62" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS USE 3-500 GALLON LEACHING CHAMBERS IN SERIES 4" KNOCKOUT SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES SIDEWALL AREA: 2(13.2' + 33.5') X 2 = 186.8 S.F. BOTTOM AREA: 13.2' x 33.5' = 442.2 S.F. 500 GALLON CAPACITY, H-10 LOADING TOTAL AREA:..............................................................629.0 S.F. CHAMBERS DESIGN FLOW PROVIDED: 0.74(629.0) = 465.5 G.P.D. N.T.S. Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. NTS P.T.M. 154-1 1 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 13 CAPTAIN BELLAMY LANE CENTERVILLE MA (508) 477-5313 5/13/11 P.T.M. 2 of 2 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 102 PROPOSED CONTOUR —W— EXISTING WATER SERVICE- y c o� `04`��.. LOCUS s EXISTING GAS SERVICE v U UNDERGROUND WIRES G 90 s Qa ecj'e- or yy��,b IS TEST PIT PB 3g5 / P 'a a ` ale � DePo� 3 BENCHMARK Great Marsh Rd �y o� 2a LEGEND Route 28 Qr\�o R to EXISTING LEACH PIT west CONTRACTOR SHALL PUMP, Ma'^ St BENCHMARK FILL W7 SAND AND ABANDON. TOP CONC./SONOTUBE LOCUS MAP EL.=45.39 (Assumed) EXISTING SEPTIC TANK NOT TO SCALE (TO REMAIN) TOP OF TANK, EL.=41.73E(VERIFY) IN V.(OUT)=40.40t(VERIFY) APN 230- 177 APN 230- 774 S 12'35'55" W 125.00' T 44,07 -P 42,48 x ,57 + 41.87 Garden (D4'.+37"'. SPIK e Q APN 230— 1 76 3,3.5- a9P• o� . 42. 41.25, ,. -I-•. .......... .......... .+. 1,38 43.85 -F• 4 40.77 +T„�p� i---PROP-. '--'� . ... ..... + 45' 3a5 I•.• A:5'' p: 0 P. 1 0 1 ri r� z Cn A6 O O v _ — x 41.44 W 5.56 \ O o `-I- -— 42.02 .LO _.--- - z 2.56 x -- 4 t` x 44.74, _ N z — -1- 42.54 -- - - I BM - Q� x 4 .12 x 4 3.3 9 x 4 3.02 DECK W EX/S17N�i x 46.26 - 47.23 '� ('4 - HOUSE(#1J) J Q Ti T O.F.=49.7± . to r✓✓✓ _. _ 47.79 j�7,48 j x 4 ,46 44.95 V .,-U� x/ i-'48,8� Ao, 0 C)V. J /` 7G 6 Ul� RICK WALK 49.06 Lot 4 LAMP PAVED a APN 230-17 DRIVEWAY A� 20,625±S.F. _ !(� IN -Az J1-50 s (D( L5C,29 0 .11836' S 12'35'55" W CB x 50.47 x 50.31 51.15 51.42 51,13 OF CB 50.17 edge of pavement y 49,98 50,95 51.41 52.00 0� PETER T. CAPTAIN BELLAM Y LANE M CIVILEE 35109 GISTE��� OWNER OF RECORD ( SI ENS f` SWEENEY, EDWARD J JR. & DIANNE E ( ) 13 CAPTAIN BELLAMY LANE CENTERVILLE, MA 02632 �l ZlJ II Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC--__SYSTEM----UPGRADE PLAN Engineering Works, Inc. 1"=20' P.T.M. 154-11 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 13 CAPTAIN BELLAMY LANE CENTERVILLE MA (508) 477-5313 5/13/11 P.T.M. 1 of 2 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 Mr&Mrs Edward J Sweeney Jr. 13 Captain Bellamy Lane CBnterville,MA 02632 N Old Falmouth Rd LOCUS oss -off Mst'c Q Drive v � 25 30. � o �O6'85, W s� lo 8F Cammett Ln s Vo e Cammett Wy LOCUS MAP w NOT TO SCALE - 98 -- EXISTING CONTOUR o x 100.98 EXISTING SPOT GRADE x o CD 103.6 , � � � x 92.75 102 PROPOSED CONTOUR -W EXISTING WATER SERVICE -G EXISTING GAS SERVICE I I r U UNDERGROUND WIRES o TEST PIT ; k BENCHMARK LEGEND ;' ,i (LQ'T 60) I - ' 'N' /�70-062 x("04.4 i It/ 46,'000/S.F.f 2 y I d / / x 89 tap 91.88 I x 88.95 LAJ i 1 `� \� ' I ' M �+ ` W W I 91 'it'�9, (pl Z i i i 9 x 03 86 3 `���� EDGE, 0 I I f •. - O / 1 �c`BO 4 ti--- --- 90.39 j x 95.22 I I )\ .y x 90.18 �, �{ BtNCHMARK SET 1..•• E ,. 6UTSpE CORNER OF SLATE ; p_1 K fxllic 90.50 90.35 x z• , PA 770 STONE -11% 1 p� g EL:r91:68'(ASSUMED-DATUM) _ 1 1 - g ' - ' II: 11 TR92.06& / _-�`\ x 90.8�` I x 97.29 EXISTING LEACH PIT x 0 I s TO BE PUMPED, FILLED W/ i :Cb cp + 041 / SAND AND ABANDONED \ 0 92. t 91.22EXISTING SEPTIC TANK 91A �'x 9a.2.83 r;96.27 /)=88.50 90.80INV(OUT .38x (FIELD VERIFY) 101.6o x /97.60 BOVE (x 0:Q1 gq, 1 91.50 91.26 PATIO IBELO X 9 9Q; x � 973 (walk out bsmnt.) // .88 � � l r Fl 92./f/ 79 8�. 98.31 1EXISTING ® 98.33 HOUSE(#683) X 98.04 T.0.F.=99.37t 0 � C/96.77 / x:98.04 9 .47 98.86 102 ,1 U3 > 96.88 G 98.34 �0 98.85 98.57 99.31 x 99.63 l ( 98.78 98.87 98.90 07 X 101.31 PA VED 99.18 99.53 X 99,19 DRl VEWA Y 99.46GS 99.56 /� , x 100.46 99.34 99,71--� x 100.38 x 100.5 100t95 0 100.72 L L i P -}90-- - / \ ------1-00'------- L=186 43' START •100.00 R=424. 2' 99.60 98.44 98. 99.42 PK SET 98.68 98.70 98.95 EDGE OF PA-0-- MISTIC DRIVE o PETER T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN M CIVILEE N 683 MISTIC DRIVE, MARSTONS MILLS, MA 35109 Prepared for: J. C. Aalto, P.O. Box 339, Marstons Mills, MA 02648 A E��`� OWNER OF RECORD 9FF GISZ Engineering by: SCALE DRAWN JOB. NO. ' P.T.M. Engineering Works, Inc. 1 '=30110-11 KVICALA, ALBERT J & MARY C I I 683 MISTIC DRIVE 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. MARSTONS MILLS, MA 02648 6 1 (508) 477-5313 2/8/1 1 P.T.M. 1 Of 2 n i NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:86.3 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL INSPECTION PORT OVER END UNIT T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE CHARCOAL EXISTING F.G. EL: 92.3(MAX.) VENT F.G. EL.=91.0t � F.G. EL: 91.0t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. d5 �WAMI I = 22' L = 8'(MAX.) INSPECTION ® S=l% (MIN.) p S=1% (MIN.) PORT 6" 4"SCH40 PVC 4"SCH40 PVC to"I 6 14• 11.3" TO IA EXISTING 48' LIQUID INVERT r LEVEL I I GASADBAAFFLE INV.=86.97 PROPOSED INV.=86.80 r4 ROWS OF 4 UNITS AT 6.25'/UNIT INV.=88.50t D-BOX INV.=85.94 EXISTING 4 OUTLETS (MIN.) SOIL ABSORPTION SYSTEM (PROFILE) EXISTING SEPTIC TANK ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS NOTES: BREAKOUT EL.=TOP EL. 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP ELEV.=86.33 :_• INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=85.94 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM ELEV.=85.00 ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 2.83' STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5 MIN. ABOVE BOTTOM OF T.P. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.3' EXISTING SUITABLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL=-/ - MATERIAL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. _ 4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS WITH NO SEPARATION BETWEEN EACH ROW & NO STONE SEPTIC SYSTEM PROFILE TYPICAL SECTION KLS N.T.S. SOIL LOG GENERAL NOTES: DATE: FEBRUARY 4, 2011 (REF#13,191) SOIL EVALUATOR: PETER McENTEE PE 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL WITNESS: DAVID STANTON R.S. HEALTH AGENT BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ELEv. TP-1 DEPTH ELEv. TP-2 DEPTH OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: 90.7 0 92.1 0 -310 CMR._15.405(1)(b):, 2 FILL FILL 1) A 3' variance to the 3' maximum cover requirement, for 6' of 89 A 18" max. cover. S.A.S. shall be H-20 and vented. SANDY LOAM 89.6 A 30" 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 10YR 4/2 t 88:7 24.. _ SANDY LOAM, TO INSPECTION AND APPROVAL-BY-THE-'BOARD-OF HEALTH-AND THE - ` DESIGN ENGINEER. B 891 10YR 4/2 SANDY LOAM g 36" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 10YR 5/4 SANDY LOAM FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 86.4 C1 52 10YR 5/4 ENGINEER BEFORE CONSTRUCTION CONTINUES. 86.3 70" 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. C1 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF MED. SAND THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 2.5Y 6/4 MED. SAND HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 2.5Y 6/4 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 79.2 138" 80.6 138" 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. PERC RATE <2 MIN/IN. (IN SAND)-TOWN RECORD 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS NO GROUNDWATER ENCOUNTERED AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. 75" 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND a@& REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 76 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. PROFILE 13. POOL SHALL BE DISMANTLED AND MOVED TO PROVIDE ACCESS TO THE EXISTING SEPTIC TANK, IF NECESSARY. 16" 11 34" �{ DESIGN CRITERIA SECTION I END CAP NUMBER OF BEDROOMS: 3 BEDROOMS 16" HIGH CAPACITY (H-20) BIODIFFUSER UNIT SOIL TEXTURAL CLASS: CLASS I MODEL 16" HICAP UNITS MUST BE STAMPED H-20 DESIGN PERCOLATION RATE: <2 MIN/IN LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT DAILY FLOW: 330 G.P.D. EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY DESIGN FLOW: 330 G.P.D. SIDE WALL HEIGHT 11.2" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. GARBAGE GRINDER: NO OVERALL HEIGHT 16" LEACHING AREA REQUIRED: (330) = 445.9 S.F. OVERALL WIDTH 34" 4640 TRUEMAN BLVD .74 13.6 CF pff4z. HILLIARD, OHIO 43026 EXISTING SEPTIC TANK: 1000 GALLON CAPACITY (SEE NOTE 14, SHEET 1) CAPACITY (101.7 GAL) ADVANCED DRAIWE SYSTEMS, INC. PROPOSED D-BOX:: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED USE 4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS PROPOSED SEPTIC SYSTEM UPGRADE PLAN Wf NO STONE FOR AN S.A.S. WITH DIMENSIONS 11.3' 'x 25.0' 683 MISTIC DRIVE, MARSTONS MILLS, MA HIGH CAPACITY (H-20) INFILTRATORS MAY BE SUBSTITUTED Prepared for: J. C. Aalto, P.O. Box 339, Marstons Mills, MA 02648 SIDEWALL AREA: NOT APPLICABLE Engineering by: �T SCALE DRAWN JOB. NO. BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.7 SF/LF OF BIODIFFUSER) Engineering Works, Inc. NTS P.T.M. 110-11 16 UNITS x 6.25 LF x 4.7 SF/LF = 470.0 SF 9 9 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 x 470.0 = 347.8 GPD (508) 477-5313 2/8/11 P.T.M. 2 Of 2