Loading...
HomeMy WebLinkAbout0080 CAPTAIN BELLAMY LANE - Health 80 CAPTAIN BELLAMY ROAD Centerville A = 230 - 184 i UPC 10259 �.� HASTINOS. UN. JISM& TO ALL NEW BUSINESS OWNERS D ATE:03 7 ?.�6 , Fill in pl ase: f APPLICANT'S YOUR NAME: N �iiU/2 YOU HOM A RESS: O G EGG.9/'�IV BUSINESS S08 7 ZT TELEPHONE Telephone Number Home NAME OF NEW BUSINESS I V67 TYPE OF BUSINESST �47-/N / GI IS THIS A HOME OCCUPATION? YES NO Have you been given approv 1 from th b lldingg division? YES=NO F ADDRESS OF BUSINESS t I0 C ELGfIl�7 _Al. MAP/PARCEL NUMBER �l . C When starting a new business there are several things you must do in order to be incompliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall)or if you get the business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St.—(corner of Yarmouth Rd.-B Main Street) and you will find the following offices: 1. BUILDI MISSION R'S OFFICE This indivi ual a been i r of any permit requiremen s that pertain to this type of business. _111�ft A horize nature*'' II__ COMME TS• Y to 2. BOARD OF HEALTH This individual ha bee i ormed o the permit requirements that pertain to this type of business. 4nl_ Au or Si nature COMMENTS: N� •, � c� yin .q"� illve�,�' C� v %„ h,'.r t�� eorc�r 1v� /e.��•t� /277 0t/Pd c YN 2. V !n a�n M x 0? ' j n O fH vJ ys be U,sf two O prL Q 3. CONSUMER A AIRS (LICENSIN AUTHORITY) Z�q rP� v /// .7jk.r Olt,4Az�dv!►��r�r,;�/f, d� Ovef r',,-p ��srSfP'`l This individual has been informed of the licensing requirefnehts that pertain tWthis type of business. Authorized Signature"* COMMENTS:—. -- Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. i e � �JQ r ! No. Feeh4 1 Entered,:in computer: d THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Rpprication for Migaaf *pgtem Conetruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. ?0 CC,,,i 01111l f� 1l�ryh aner's Name,Address and Tel.No. Assessor's Map/Pazcel ? `A/ ` g(/ i Installer's Name,Address,and Tel.No. Designer's Name Address and Tel.No. �I I1 S io r&rApa Car►3d Co C,1-9 t� 5"3 3.►je� r�i1;1 �.P. a 3 s 6'"o- -o. d la ct y S� deh 01 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 6 l410 3 30 gallons per day. Calculated daily flow le(00 gallons. Plan Date S/3 0J O& Number of sheets Revision Date CIA /62 Title Size of Septic Tank Type of S.A.S. Description of Soil S Nature of Repairs or Alterations(Answer when applicable) c���° cS'e�Ot✓� z°cS'/ `� 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 provis' ns of 5 of the En ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee y this Board f 1 Signed v - Date Ir Application Approved by Date 2Ty Application Disapproved for the following reasons Permit No. 12_ —2-g( Date Issued 03 No. � _ I Fee D THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplicatiou for Migogai bp!tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. IC,117 j-,ci,V 1 [3411 e7-'l 7 A0-6er's Name,Address and Tel.No. #'`!'��� Assessor's Map/Parcel `ell ) 0) !/ 0\20 Z 1.0-4 Installer's Name,Address,and Tel.No. Designer's Name Address and Tel No. I1,S tx3COTu[J Cr, Cc Ct9I'd �h®/I' (od t 3-7 ID 4 c./, S'C lh /de,7 Type of Building: Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 -�, J 10 = 3 30 gallons per day. Calculated daily flow /w Go gallons. Plan Date S 13 G/ Number of sheets Revision Date 649 451? Title Size of Septic Tank Type of S.A.S. Description of Soil S Nature of Repairs or Alterations(Answer when applicable) Sf f J"T 4J�-i C d- Y `f 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 ofTe 5 of the E ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee 'ssu •`"t"iy this Boar f �al Signed Date Application Approved by Date 2 7 0� Application Disapproved for the following reasons z. Permit No. 2100 — 'Z4 1 Date Issued 2 03. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(i) Abandoned( )by 1-111 S 43rePyrT C'Cn V.r0 , at L g a y C,Ph ��L, /� I'315 has been constructed in acc rdance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2W3—29( dated 2 P7 03 Installer E/J l� 13 r C 1 Ae l-S C Gh l4 . Designer C r j If SJ16"/J' The issuance of thist'a ermit shall not be construed as a guarantee that the system ill Date Inspector - 2----1 ---------------------------Fee 0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi5pogaf *pgtem Con.5truction Permit Permission is hereby granted to Construct(nn )Repair( )Upgrade( ' )Abandon( ) System located at �C) C9/� i yt U Y 11 S L,� L c e (',Ph,Ae,- J ' 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: Con tructnio must be completed within three years of the date of this permi . � Date:_ Z I Approved by TOWN OF.BARNSTABLE 80 CAPTAIN BELLAMY 2003-251 LOCATION SEWAGE # VILLAGE. CENTERVILLE ASSESSOR'S MAP & LOT a36 figy INSTALLER'S NAME&PHONE NO.'�aELLIS 'BROTHERS CONST. CO 508-362-6237 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -.6-.00 e-4 C4 (size) NO.OF BEDROOMS 3 BUILDER OR OWNERJUDY PAIVA / / PERMITDATE: 6/27/03 COMPLIANCE DATE:, 7/ 9/O .3 i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exiss4 within 300 feet of leaching facility) Y Feet Furnished by +' 1 A 9 f ro CRAIG R. SHORT, P.E. t--t'7/ 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis,MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER,SOIL EVALUATOR,SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS,COASTAL&BUILDING DESIGNS SEPTIC DESIGN PROPOSAL PAGE 2 PROPERTY SURVEY AND FLOOR PLAN SKETCH Please fill out this form,including the floorplan sketch,and return to us with the signed proposal and retainer. This information is necessary to properly prepare your Septic System Design. IF YOU ARE PLANNING AN ADDITION PLEASE INCLUDE THAT INFORMATION ALONG WITH THE FOUNDATION DIMENSIONS AND LOCATION FOR THE NEW ADDITION. -(�;—Total#cfRooms �Year Round Home . Seasonal Home ✓Owner Occupied !L?ORental 3—#Bedrooms /U Family Room/Den Se Living Room V"Dining Room #Bathrooms y-es �Washer/Dryer Dishwasher Garbage Disposal ✓Gas Service .Town Water i/ In-ground Electric Wires' In-Ground Oil Tank* Sprinkler* _,,6n-ground Gas Pipes* *Pleasesketch where la atedraig R Short, P.E. assumes no responsibility if in-ground components are damaged during Soil Testings, Inspections, Locations of and/or Installation of New Septic System. Cellar: t/ Full Partial(Crawl) Slab wells: �J y Main Use Irrigation only (please provide W-adon of all wells) PLEASE USE THE SPACE BELOW AND THE BACK OF THIS SHEET TO PROVIDE US WITH A ROUGH SKETCH OF THE EXISTING FLOOR PLAN(ALL FLOORS). Also include any items that should be avoided,IF FEASIBLE,i.e.shrubs, trees,patios,electric lines,tanks,etc, IF YOU ARE PLANNING ANADDPI70N,PLEASE PROVIDE THELOCATIONAND FOUNDATIONDIMENSIONS Sample, .. FAm — I .J 71rzJn' �67— /2 TOWN OF BARNSTABLE t` TION 80 CAPTAIN BELLAMY SEWAGE # 2003-291 VILLAGE CENTERVILLE ASSESSOR'S MAP & LOT 0130 M-41 INSTALLER'S NAME&PHONE NO.'AELLIS BROTHERS CONST. CO 508-362-6237 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) q 3-60 Z-e vQL2&rS(size) NO. OF BEDROOMS 3 BUILDER OR OWNERJUDY PAIVA / f PERMIT DATE: 6/27/03 COMPLIANCE DATE: 7/� 103 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility _ Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exiYs.c within 300 feet of leaching facility) > Feet Furnished by A � f3IAo 143 <=Z71 COMMONWEALTH OF MASSACHUSETTS --ii y. EXECUTIVE OFFICE OF ENVIRONMENTAL FN"IIRS ✓" DEPARTMENT OF ENVIRONMENTAL PR "``IP,NI DEPT. Y a � C i FAILED INSPECTION r �O TITLE OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM .PART A CERTIFICATION Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILL 1,MA 02632 ��� Owner's Name: JUDY PAIVA �30 o� 35 Owner's Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,NIA 02632 Date of Inspection: 5/12/03 Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is e inspection.The inspection was performed based on my training and true,accurate and complete as of the time of th 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 _ Conditional asses _ Needs Fu Evaluation by the Local Approving Authority X Fails Inspector's Signature: Date: 5/12/03 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspect on.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector aqd 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. Notes and Comments SYSTEM FAILED TITLE V INSPECTION.LEACH PIT SHOWS SIGNS OF BEING FULL,HAS BEEN IN HYDRAULIC FAILURE. ****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. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 Inspection Summary: Check A,B,C,D or E/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: SYSTEM FAILED TITLE V INSPECTION.LEACH PIT SHOWS SIGNS OF BEING FULL,HAS BEEN IN HYDRAULIC FAILURE. 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a 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 structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a 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 _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a 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 _obstruction is removed ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect 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 _ 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,safety and 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 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 n/a "This system passes if the well water.analysis,performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped PUMPED LAST SUMMER BY OWNER. X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] YES (Yes/No)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 serve a facility with a design flow of 10,000 gpd to 15,000 gpd. 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) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ 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? X _ 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: Yes no X _ Existing information.For example,a plan at the Board of Health. X _ 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(3)(b)] S Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)):tea- 6 7-1 o0f 060 Sump pump(yes or no): NO _ Last date of occupancy: n/a Iv1 vJ COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information:PUMPED LAST SUMMER BY OWNER Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X 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/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1985 BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO Page 7of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 I BUILDING SEWER(locate on site plan) Depth below grade: 18" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000 GALLONS" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: 33" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 18" How were dimensions determined: MEASURED Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): n/a Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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 WAS VIDEO INSPECTED AND APPEARS TO BE STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a R f Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system' Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): LEACH PIT SHOWS SIGNS OF BEING FULL,HAS BEEN IN HYDRAULIC FAILURE.PIT HAD 2' OF LIQUID IN IT AT TIME OF INSPECTION.BOTTOM IS AT 8 FT. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.): n/a 4 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. Iy AtI AA A6 4� A4 S� . 3 In f - Page,l 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 80 CAPTAIN BELLAMY LANE CENTERVILLE,MA 02632 Owner: JUDY PAIVA Date of Inspection: 5/12/03 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from systeln design plans on record- If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12+FT. Ii No........ Fics.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH p� ........OF..............O.1. lelv.5.7 k4 .--........------------ Appliration for Dispog ai Works Tons rnrtion Prrntit Application is herebLlmade for a Permit to Construct (11<or Repair ( ) an Individual Sewage Disposal System at• � . -----� off.. ...... 1. _.._....... ---./ � -....... -1 �, ����� 0 Locati AddressO.X ., at No. :l Owner Address a .............................. ,r r_r _.._.. ----- -... ..... •......................... '1.. ......_.... Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.........:�-------------------------------Expansion Attic (Itl)D Garbage Grinder ( ) P`4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------- ----------------------- . W Design Flow.............. 5.........................gallons per person per day. Total daily flow...............TT!2..............gallons. WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter................ Depth................ x Disposal 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 ( ) �� J � a Percolation Test Results Performed by...........................F l- _ _......_.( Date-.5-� -----_- s-------.--- Test Pit No. 1--- .5 S minutes per inch Depth of Test Pit.......1.z::�- Depth to ground water......... vows fs, Test Pit No. 2.......a:7 minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 . ............ O Description of Soil lam__ _ _.._ 0�1!'!�( t 0! (...................................... W ----------------------------------------------------------------------------------------------------------------------------------------------------•--------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------•----------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the tate Sanitary Code—The undersigned further agrees not to place the system in operation until er�yi�ca of pliance has been issued by the board of alth. , Signed............. . ...� r---- -•-------•----- ---------•- ------ ............. .. ate Application Approved By.................. . . --------------------------- ............... ate Application Disapproved for the f o to ing reasons:-----•------------------------------•-------------...----------------------------------------------------------- -------•---------------------------•-------------------- ------ .....--•---------------------------..._--------•-•---•--------------------------------------------------------...---------------.-•-•- Date PermitNo......................................................... Issued-.............-....-----................................ Daze No....< 2 Fins.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH pl c -1a -.........oF.............13.�i.RJf.?!.-S-.l�"�: Applira Lion for R-sp ual Works Tomitrurtion Permit Application is hereby made for a Permit to Construct ;,< or Repair ( ) an Individual Sewage Disposal System at: .... _ ......---••-....1••`��................•-- - --� :-.. ------- -' ' y� ...................... Locati Address or Lot No ,r� Owne� / 3 py y Address ----...•----•--•---------------- /�.rJr�:-.r...... �?r -----. ..--------------.....------... '.^..�c. Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..._.____ __. Expansion Attic Garbage Grinder ( ) ----------------- -- aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------------------------------------------------------------•-------------------------------------- W Design Flow.......,... `. .........................gallons per person per day. Total daily flow..............`3_ ._0...............gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-------------------_ Diameter-------------------- Depth below inlet.,................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by 4r �� (, Date. _ a Test Pit No. 1...(-:r_S j.minutes per inch Depth of Test Pit------- Depth to groun water- i Test Pit No. 2._.__ `minutes per inch Depth of Test Pit..._................ Depth to ground water........................ ......................................................... --- ...... .-----------------------------......----.----- �. �� O Description of Soil---------------------------------- �. ._,.. L! _ _aa �.. U ------------ ....................... - ». (-� ..... "' W ••------------- ----------------------------------------------•-------•-••--•-•-•--•-•-----•----•-•------•--•••------------------••--••--•----------------------------------------•-................... UNature of Repairs or Alterations—Answer when applicable................................................._._._.._..............................._........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation unti 'Cer ' �c of mpliance has been Issued-by the board o ealth. Signed----------- ��`-_-•----�-----`-`-'-`�"•`-'ram' -------•- �--------r'f- t, rra ate Application Approved By................. -- - - --------- . -- --------------------- ------_-----� ate / Application Disapproved for the f to in reasons---------------------•--•---••-•---------------------•........................................................ .............................................................. .............................................----------•-------••------••---•----------............................Date•----...._.... PermitNo........................................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 7 BOARD OF HEALTH A.-A............OF...............;./.. ✓/��'' �C''.......................... wrtifiratr of TomptiFanrr .HIS IS TO CERTIFY, That the Individual Sewage Dispy. 1 System constructed of Repaired ( )T by-------------------------------------------------- ' _ ................. nstaller �r at.. ------. - ' ..----- ......_._. ' e . '~ a�`- �'��`+,1"' has been installed in accordance with the provisions of TI_TIF of The:State Sanitary Code as d cribed in the ,0. application for Disposal Works Construction Permit Nod _-_...... ..___._......... dated_._.._. . _..Z __ ................ • THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRIIE® AS A GBJA(RAN EE THAT THE SYSTEM WILL FU CTKPN SATISFACTORY. DATE... .... , .. .................................... Inspector........... --------------------•-.------ THE COMMONWEALTH OF MASSACHUSETTS ,s BOARD OF HEALTH ... ................. Bilipnsatl Marks �aanrnr#ilan cer Permission is hereby granted........................ .. ?. .....I .................................................... to Construct k or�Repair ( ) an Indiv d 1 Sewage Disposal System r at No................................................. . . = '�:• - 1! . ..._ - . G Str �_ as shown on the application for Disposal Works Construction Permit No��'_- 6..().o ate .:_.._.:_�. .. .�5_ _...__.... ------------------ -- .....----- o d ealth DATE..------ ))ULKIN, . .._FORM 1255 INC., BOSTON 3�'��� '��r.; } ' / P�, 't✓ - `" ice: I' HALBERT Gj-�, . 'f' �� l Ch 0 •�� nnoRsE ,� 3' q J . ¢� ..S— i. tfQNl a #fir; �tN.QF ROBE RT �Gs ` C I ul V -AIN ELDR �. Nv :jB3Fi7 4 e G ( e V. 4 C ' (2S W,oT,,N Zs�. d �b�U r rlZ�sTGr�o�✓ C2 fa'RT 2-�. ,, V" v J��/ 166 R 50 ? 1� pl Or /2 � LEGEND EX14TINW.-SPOT .ELEVATION _0„0 r CERTIFIED PLOT PLAN �FXISTIO : CONTOUR 0 -- P`111t -SHM- SPOT ELEVATION CA0r• /3 r- 4AA44C Jf lmrOo CONTOUR 0 - � P✓/�4E QTEµTh �locataon of any existing underground sewerage, 1 w�lis,M _r,other utilities shbwnL on th.is plan is approx.- IN { �tCe °only as-de-ermined from records and/or verbal *7nfQrmaton. .The contractor is responsible for the ' { uerfcati'on= of the existing locations in the field. SCALE -Vp ' DATE ,QREDGE °£NGINEER/NG Ca IN CLIENT. I CERTIFY THAT :THE PROPOSED } E4ISTERE REGISTERED JOR NO. 83 BUILDING SHOWN ON THIS PLAN f } ' }' iVIL LAND CONFORMS TO THE - ZONING LAWS :r A- ./i .M, O N E RV OR DR.BY� pF BARNSTABL , MA3S01 . G K H t t( T12 MAI N STREET CH. BYEgs— ': ' • MYANN IS, MA9S. A . v r SHEET' OF 2"• 0 TE REG.. LAND SURVEYOR ' - y� a, ..... ..v ...,. 2 dr.. _.. ,.. :,,.d*�," ,,....a. a.. .^,. w-�„ .,,:. -,, w. ; .r.,.. >•,3 a:k .m-., ... .".. _',� '°>.., - ci' H'Y-:- "'X`-t:::3ay r -<` :na'�.«�rw .�..,4�;r:.. v-as_�•. a h. .-�„ x.Y, ...+'"'.,k- - W'w'. ,.. ., ,. #::.. ,:k'.....�... ... )-.,& r ay.�n f-_- .S - .,y e'�y. %- ,...�. ,N 1,'. .s:-�x.- �.•--,.- krt'R I`i�;a'y;,.�. ..�r .ye y. � .i .�"eI,�+ v.#:.f :"Y'-b> :.'k.. ,.p •.:i`•: S -•t 1.. i�.'w. 'T'.,p•.i' _�� N -.,.:Z` ti. _:. `�, -34 .. .. _. ,�a..,.. .., �`: •�,5� `,.,-�"}�"y,3 i,`"�..°"�$a-�-'!"�'..1*-�{,"v; ,;,-t^����w�s .�.. ,['�'` s`�"''�',. t�� ....x s i• �+�i .,•a, 3- t � : ' .ray t�;ts.,, .J-,.,;. Xis s .a�,, .'`-,�.,,ec. T..d•.:i�;.�4 �ab•°� ��'^�.�, ,>"�.9„>-?� fi �xSrrx tx �.�_, 1 •,:, sr�. . alvq?T _ ., 4 r a,:',': t.gro - 3. ,.>r- -;k.: '+;w_:v 1±t, -,::q a. :, ^;� '•'„� e� rye :r .,g 14.-�r :u: ry, t , ,.Y � , _ ,. s ��:,. r � � F I TNGR�.T.i1� T..0 T.4 N�C R .�� •. ,v .F.r .�,�,;�:�:�er�ta :t�P y+.. �. „, °:��,. �� 'k.$ ,°�. ,- .- -. "5 ..:. ..: ;.-.,td,,w ,.,�.+t�' a�*.' .,yF ,�,';'..�?. ,,, �.r.. �t ± 3-r ,#:.-•rf: .a. +�,5..:.,...++ v1�'t .. '1�':-Fr\� .kt'r, vi+-.. „s.. '7, - 1.. e;r -,'MOM ,, � .... .,.,�.,..H,fh*,t .,ems=< ,l•;..... �, t.:�d.�T r�1n�' � � ` ,- �RF. >,tlN� �2"•QELD L T .4 Jt O �,:'vw,''`+. _,,., x-• a`.. ,ti .Y. „,:,� '�. S ,�.:' .a;,:�,r., .v>!'c;4,,. "*ca,!�.:<xr-, .. 55;.:+ t� : xW. .s.0 ,.,+. •t,. !11 M R; O M RET.E 'CO i/ER ��. xs •<w a ' w: r ..rR/4DE ` �4 FTE NC r ww /N r .y +..-:. Y ./ •ti'- a..r s _ / .1 tt :x,., rFi• SR:!l L L' ,erF{a9 RO.U6 T TD Gf�A-aF J, �1:!✓. X7RA,t. `'. - y 4 ,. 4:.= .t JYE:+4Yy..G'�5T'IRo%Y, CCYER $HA, L t' BElJSEa COVERS r� .p IFf%V DR/YEh/�4y; G '' t , Ie � `" t x�L Mir/ CGNCRI�TE ' RCOYER GLEAN 'SA/V!� _ L/4>UID LEYEL / . q"D/I!. - z�LAYEk. 4 SCHED ucrs - PKC. ai/PE 106 Q p e G.�IL. o i • . . • •'r a WASHED STCNE' :a /,'l//V.P/TLM `.D/ST. • %W PrR >? SEPTIC TANK BoX o 8 �:p .�* •, '�. .e EFFECT/✓E . c . ': p • � � • ,�o 1i�.4SHFD STOiYE X z s_ - ¢7 - . . PRECAS T SEEA4GE K s;a E FYATioiVs y jr. . -! :G fT. /N,//ERT':AT O[/ILO//VG /o f7. 4Ph4) /. C(SFF rA gWL.4T/vN� INLET .SLEPT/C T�4NKa 'FT. DlJTLET SEPTIC r.4,vK . �4 C FT. lA/LErO/STR/8UT10N BOX �4 Z�T TSECrION O GROvND /sl�lTfi'� TALE o�TLETn�srRlsvrio/v eo�X F� ,fEyYAGE, 01 SAWA 1. SYSTEM . INLET LfACN/1VIr PJT' f.T Tj1�lJL14TlDN LASACHIIVG_'Ip/T OIMENJlD1V DESl6IV CR/TER/AIr Al 1cA�E 401NE vs/oiv S NLlMQER Gf drE'D�ROOMS - . GAROrtGEo/sPo �t VAeIr ,rn*e� SOIL- LOG TOTAL:E1T// T`EG FLOK/ 30 0.44.10AY 30�L TEST SOIL TEST /IfI SOIL Ti�ST2q. wUMQE,P of hEApVlNZ PITS I f`ELEY. SS3 j`"ELEY. ,OAT,B OF $OIL TEST ' 'S/OEr LtACHI NG OIER P/T 1 9� SQ, �7. _ Gts s I NCH . $ CaLAT/O!V /G4TE / 1�7JJV�/ DOT'TOM A.04CN/NG'PER PI T 7..., $Q. A•T. 1_0 TOTi�iL LEACH/NG .AREA Z��' S FT. .Sc�/3So�,�- co RATE�E2 MhN flNCN 4.; RESEItYE LE4CNlNS A/?EA 2b�' S4: F Tor 71= o' � \ .camE ��,<N l3F �� � ...��P�. SSti,'�'y "M L D. >=/'NE • �,pr•.m'l3 G.it,l�T•13C--t_L-f4-�,y. pIgERT G.\ SH4✓ti: :C��✓��J2C//LLB f RO$ERT q. CJe A Vi— SSE cn� v ELDREQGE - Pr1C,0951 Z' ! JJ1aG s, No. ' pNo. 4 �L D�Y 'D6E.EAAGlIYRI � w' 7t2 '+AJA/N 97� n/YY.�NN/'J,,JN!'+�'S ` . . .. - Q,��3.LG�p �=;� - wtJNAL. !J/VTEREO � tL/f�/T��rzE6✓�3RIE2-G6�T �.. G*bViVO y✓.ATER s/tT ELE✓ ,MfG�T.��� ' "t d m..�...:......—.:....n�.»..:Y,-'�..—..-......_....- ..- „- .Y- _.—.:.—e._..._..�.�,_,._.-........._.'.:r..: .. :rr=.•M:++W.vr++Mw.�... r'+^'..'+�.x�w15'+WwSwMR - LO'CAT10N SEWA� E /PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS e U I L D E R OR OWNER (, c�e2V, ,ac � DATE PERMIT ISSUED © DATE COMPLIANCE ISSUED _ � _ � 1 � � Ism V r � � 2J ` s V l �,,^ M �� 5� � DESIGN CALCULATIONS 3 BENCHMARK 20 FT. MINIMUM FROM CELLAR TOP OF FOUNDATION NUMBER OF BEDROOMS - - ELEV. = 100.00 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND GARBAGE DISPOSAL UNIT ---- C- TOTAL ESTIMATED FLOW (ASSUMED) CONCRETE \ 3 x //o C.Pa 330 GAL./DAY COVERS LOAM AND SEED IPE REQUIRED SEPTIC TANK CAPACITY �La GAL. 4" SCHEDULE 40 PVC PT. ACTUAL SIZE OF SEPTIC TANK EX`"sT L GAL. MIN. PITCH 1/8" PER FT. 2" LAYER OF SOIL CLASSIFICATION _ _ F 1/8` TO 1/2" WASHED STONE DESIGN PERCOLATION RATE < f MIN./IN, ,, E L 9 7.2 S" Amax VENT EFFLUENT LOADING SATE GAL./DAY/. F. 39 4" CAST IRON PIPE EA �•'�/+��� NOT REQUIRED LEACHING AREA /3�X P3 t 2X 7L Z SQ. FT. (OR EQUAL) MINIMUM PITCH 1/4" PER FT. z LEACHING CAPACITY (AREA X RATE) 3Sz GAL./DAY 477 X 0. 7� �//a FLOW LINE �TL 9�.25 N 20 RESERVE LEACHING CAPACITY __y_ GAL./DAY t0" ELEV. = 9G_7'f 2 ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ T -iMIN. uT1I ELEV. = 9�`r- LEVEL °oo ° ' ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 00 0 96.0 4 1 GAS 9-�.9 2 ELEV. _ i____ o ° 96.4 '�//� f� 6" SUMP .9.75 ° ` I ELEV. _ -_� BAFFLE ELEV. ------ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 2' o F<<,q DISTRIBUTION ELEV. - / °° o°° ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ ❑ a 00 0 = cl7•S " 96.0 LIQUID OUTLET -' BOX _9..3,SO -� ELEV. 96 2 �j,/ DEPTH TEL (TO BE PLACED ON FIRM BASE) 4 FEET 14 INCHES TO BE WATER TESTED 2 - 500 GAL DRYWELLS WITH STONE 0 ! r � c 5 FEET 19 INCHES 1000 GALLON IF MORE THAN ONE OUTLET w Ai ��•�,, X z ' DF&#W fD4JY61WV j WELL j4.0 F 7 FEET 29 INCHES S ZONE-�- ! L � 96�596.a 8 FEET 34 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) / s 3/4" TO 1 1/2" CLEAN J SOIL ABSORPTION INDEX existing DOUBLE WASHED STONE ADJUST � 9" FREE OF FINES & SILT SYSTEM SAS LOT 13 AREA 25, "46 f S.F P � ' i USGS PROBABLE WATER TABLE ELEV. _ 1 SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATT (� TEST HOLE ELEV.H 96.8 r� h? T. NOT TO SCALE BOTTOM \+ r r ! iG 96.8 /97.3 U) OD 97, - DilT 43OX a ` y d 97.6 >, 981 , SOIL TEST NOTES: r i G 3 - - /( g)� \ \ r p DATE OF SOIL TEST Lge! 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 7'8 '(9 6) SOIL TEST DONE BY ro�� l_So i t TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE ------ _ EX/,tT�wC, #1 .. ---w ,,, o,tJ. , �so� s� DISPOSAL OF SEWAGE. I \ T p!✓ `�/�.v. WITNESSED BY _�_�_ -_-- S ffPT1c , \ �' . 2. ALl COVERS 70 SANITARY UNITS SHALL BE BROUGHT TO T13'1.-17 OBSERVATION HOLE 1 ELEV.=-27 3 WITHIN 6" OF FINISHED GRADE. I Ili9> 1 _ - PERCOLATION RATE _<2__ MIN./INCH AT INCHES 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF I �° I A gg,� ���� � DEPTH � HORIZ TEXTURE COLOR MOTT. OTHER WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE r I ILoa c /t USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 98 2 �. 4 -7 d 41, _ 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL 98:1 �Z-E-� T'i2 � � �-i �"`.' ,�' I I � o y� i BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH C3 7/ 4- E-L 93 8 DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 15 TO L/IJC, N OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. r �. Y t 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR ,. �. < 2 M�� IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS 98.0 C sa -o �! `/S PRIOR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS x 96 5 SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION DECK Mom(, �, Y2 �� IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER r J 97.4 C-z 7�L IMMEDIATELY. x L - I -`cam ck 8. PARCEL IS IN FLOOD ZONE -_C �� • 96.3 ! 3 g, _1 9. LOT IS SHOWN ON ASSESSORS MAP - AS PARCEL _ 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND o t� N0 WATER ENCOUNTERED AT ELEV. FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEN., 97 6 AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) ' 96.2 (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. 11. EXISTING LEACH P17 TO BE PUMPED AND FILLED MATH SAND �\ 96.2 OR REMOVED • 96.2 r2. pXOPO4rD co,v.tT.evcT,ofv is r� �EA�nct a 97.2 ` APPROVED: BOARD OF HEALTH 4�U <,o , DATE AGENT A: LEGEND: t EXISTING SPOT ELEVATION xO.0 PROPOSED SEPTIC DESIGN EXISTING CONTOUR ----00---- FINAL CONTOUR FINAL SPOT NATION 0 .� � FOR SOTILITTE POLE CATION STRq�& J JUDY PAIVA • 98.2 TOWN WATER -W�• 7-'N�'i p D T*x j� T T I� / T '�� GASCLINEASIN C G��j = h'i�� Ra LOC. S O CAPTAIN BEY L 1 CESSPOOL CENTERVI LLE, MASS CLEANOUT --ems C.O. '9 2 CRAG R SHORT P S. Q 235 GREAT WESTERN ROAD 508- SOUTH DENNIS, j8612 ,� .! LOCUS �0 398-8311 0260 GRAIG ��� DATE „ _ � �P MAY 30. 2003 SCALE 1 - 20 98.0 tViL i a l 0 r \ - s Nlo. 27483 ' L of REVISED ' ' , 01-0971 :�1^v JOB NO- Y gB 3 U TN R LOCATION MAP REVISED SHEET 1 OF 1 r A l' 0 C. 5$ PROD 457-00 dw ?457-OO.OWG 0 2002 CRAIG R. SHORT., Q.a