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HomeMy WebLinkAbout0025 CAPTAIN LUMBERT LANE - Health 25 Captain Lumbert Lane Centerville` A = -147•' 011002 ae UPC 12543 Nob3LOR, (1%.DwW4' Hoc+�aas IpN J No. ©� �� j Fee G THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for 33igpoga16p5tem Con0tructfou Vermtt Application for a Permit to Construct( ) Repair()o Upgrade( ) Abandon( ) 0-Complete System ❑Inddividual Components Location Address or Lot No. 2 9 (L410T A n Lv�f3tli I.A.nC Owner's Name,Address;and Tel.No l Q�l i c y a 37Fj_g 16a.11 LC/i1r��Va %k� G y,5 i"If Aq ►1 �.11✓h t7Af-'T Assessor's Map/Parcel 147 1 f_rL t d e Installer's Name,Address,and Tel.No. C A f t"; L4 ��wQ�'j2 S Designer's Name,Address and Tel.No. L tr n5 e r+✓' -7 0r6" O Z%59 Up'therr,y Nyt, y 42% Lto2$ C{.L,rtrc�,�lle az�.3z 27 3 " 3'?7 �•� .et=aA,�.t Type of Building: Dwelling No.of Bedrooms 3 Lot Size F 74 6 7 8 sq. ft. Garbage Grinder ( ) Other Type of Building Si'nalt (,am,(v No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 o gpd Design flow provided 3 3 Z. ( gpd Plan Date "13—Zoal Number of sheets ( Revision Date Title 2��t%t4d+oN, f`um4ufT a Size of Septic Tank t 00o Type of S.A.S. (2) Tbv 51A- L. t, e v 1 2'<o.id, S;Zsv� Description of Soil :Q� plan , "C f 1<2 3 i+ Nature of Repairs or Alterations(Answer when applicable) 64i s! 10oa (�41 T Ty f) -Bo Y t c. LL1 Say L- C Date last inspected: ZOOS 'kkg . Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date 2°Oe6 Application Approved by Date t- OCJ Application Disapproved by: Date for the following reasons Permit No. Date Issued �— Ly "�®© n No. v_09' 1�I i Fee A�. THE COMMONWEALTH OF MASSACA04ES Entered in computer: PUBLIC HEALTH DIVISIONT� - TOWN OF BARNSTABLE, MASSACHUSETTS Yes - 0[ppY%cation for �igpogal *pgtem Con0truction Per r i it Application for a Permit to Construct O Repair(k Upgrade O Abandon O ❑.Complete System ❑Individual Components � i Location Address or Lot No. Z S C 4P T A n Lvrh O"T I.Qr'K Owner's Name,''Address and Tel.No. M t'-k1 n��n t Ge.,,.Tf lzu; 6C °. � �) L 5 4Afr,4,h Gq.eft 6.v•r Assessor 's Ma /Parcel P l u 7 a / c Installer's Name,Address,and Tel.No. C (����'•° ���"' ��' `� 5 Designer's Name,Address and Tel.No. S�-• ��5�++c<t��r� ;, 7_7 Z`dS�l Gfnot4lelC7 uYWy Ozc.32 5 o�6" Z"3 -t13?? C• aE,�ae-t Type of Building: Dwelling No.of Bedrooms Lot Size 7� (0 7$ sq.ft. Garbage Grinder ( ) Other Type of Building 5,,jjf No.of Persons Showers( ) Cafeteria( ) Other Fixtures f i ' Design Flow(min.required) Ir 3 3 C) gpd Design.flpw provided 3 3 Z gpd Plan Date 1 3'- -to 02 Number of sheets 1 Revision Date Title Z 5' Gn,oi�i h "6.�e Size of Septic Tank (60p Type of S.A.S. (2. rao 501 t (,, C.- �,�,� t'h�` ��.[.►. S��rq Description of Soil !�Ze- D 1An., �,I(C� 3 2." i Nature of Repairs or Alterations(Answer when applicable) fuoa /I (y},r 1, 3o v e 2) iaJ' a At- L- C Date last inspected: ?,00 5 Agreement: ,}-.•. �t The undersigned agrees to ensure the construction and mainttena ce of the afore described on-site sewage disposal systeniL accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. e.. Signe Date y , 14 Application Approved by Date -OCR , Application Disapproved by: Date to for the following reasons., r- Permit No. ao ` I'1 Date Issued �`/— �� Z O0 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance r 0 THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( V/ Upgraded 1 Abandoned( )by fn_�d- A)J-(- �ln�04 0 ��c e S j i at 2 !./1 f�t�A,�, ( ,�,n„L. t l d�,_o `,e.� ,,ll w has been constructed in accordance R with the provisions of Title 5 and the for Disposal System Construction Permit No. 9-OoX I�r�j dated Installer 6 ` (Q -64 i i e t Desi ner , 1���1 ,J..2 .t—may g #bedrooms Approved design flow If gpd The issuance of this permit 1 not be construed as a guarantee that the system wi u ction as designed. ( P� Date Inspector i -- ------------------------ ---1- ----� No. C3 r 1� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS j h lwigpool �bpgtem Cootruction Permit Permission is hereby granted to Construct ( ) Repair (V/) Upgrade ( ) Abandon ( ) System located at G,a,0 i 4,., L a,,ye 6&LJTA•:t t( and as described in the above Application for Disposal System Construction Permit.The applicant reco zr —"his/her duty to comply with Title 5 and the following local provisions or special conditions. `Provided: Construction must be completed within three years of the date of this ' . Date — f"( _d Approved by TOWN OF BARNSTABLE LOCATION 64y►+I2e� �' CEsn� SE GE ' VILLAGE Eon fPiru< be ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. ("stop Gt,! let pa" SEPTIC TANK CAPACITY 1Q6U LEACHING FACILITY:(type) �?) 1410 CGS 00 (size) /L Y LSD NO.OF BEDROOMS OWNER 6A,cty 1—F.jr PERMIT DATE: COMPLIANCE DATE: 4 IL6-16r Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Jog �/ � 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 pfZ 2u'3 i 1 4 � �� SO,5 1 orwn of isarnstable ego story Services _ t ABLE. 'Tlji mas F. Geiler, Director 51 Public )Health Division y QMl4T� �- Th: mas McKean, bir+ector 200 .M4in Street,HyRnnis, MA 02661 Office: 508-861. 4644; Pax: 508.790-6304 Installer 66 Deslaner G-extifleatid orm i Date; -1(e•.0 N Designer: "SY�ri r�C c t1 'v�C . Ictataller: C y� r�r4S Address; Z F S y Crnn�,er°r Nw Address; C,j " — E ►.Ucu f;�c�rV� n(� t12 5:3 t; T Cfi _ `U was issued a e ate p txx�it to install a septic system at a based on a design drawn by dated (designer) Z certify that the septic system referenced above was:in8i ailed substantiallyaeeordin t the design,:which may include minor approved changes such as lateral reocation of he distribution box and/or septic tank. I certify that the septic systort► referenced above was in%alied with major changes i.c. greater than 10' lateral relocation!of the SANor any vertical relocation of arty comportont of theseptic system) but to actordanct wittate& Local Regulations° Plan revision or certified as*built by designer to follovsr V"OF JOHN RHURCHILL a r ( s llcr:s Sigture} JR. CIVIL. 41aQ7 i (Designer's aturej �.-. Af Deal s Stamp Here) PLEA '�")f t! T 11<ARNST E PU IC ALT 'VI l( C TIF ATE OF O NOT HIL GT'VE HUA L P AL D YI I(JN. ANK YOU. Q: Hesith/Septic/0 signer Certification Form 1 0 d L92,0 £ZZ 80S -9N I8i33N I°J' N3:3i' ' WV 9£: T T 800Z-9 T-2!lci�J 5/18/2021 ShowAsbuilt(1700x2800) TOWN OF BARNSTABLE / LOCATION SEWAGE# bsf� VILLAGE, ion F6n.,it, ASSESSOR'S MAP&PARCEL /t(7- //.0 2 INSTALLERS NAME&PHONE NO. t�,cg t.,4 L,1,,,pn SEPTIC TANK CAPACITY /an e) a�ie LEACHING FACILITY:(type)lQJ /410 GC S 00 (size) /I X LS^ NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .14111i Fee Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet _ Edge of Welland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY A A /4.3 Pft zu'3 t M �t.0 34,0 https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuiIt?mp=147011002&sq=1 1/1 Town of Barnstable P#_ 1 / 1 Department of Regulatory Services :� /©: i Public Health Division Date' L_ i 1 A�� 200 Main Street,Hyannis MA 02601 M1d Date Scheduled ' Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: �I i s Ma x 1 t i avl2ll�c `.� C 5-46� Witnessed B �-- LOCATION& GENERAL INFORMATION '✓�� Location Address Z� C npt,.., Owner's Name (k:d—_W e Address �7 �`4P� i�1 Cc.cxgsyiiJ/h�l(.2p Assessor's Map/Parcel: `Z(7`0 I i l o-L- / Engineer's Name(f4.¢�� NEW CONSTRUCTION ( REPAIR ✓ Telephone# Soff 41-9- )c(33 Land Use Fawn ty I P e$i Ae_*A ,,( Slopes % i" P ( ) Surface Stones Distances from: Open Water Body 7 111 ft Possible Wet Area 7 1 ao L1 ft Drinking Water Well A ft Drainage Way ft Property Line 7 ►o ft Other 1 ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Z:7 :rs t-- Parent material(geologic) 06r"*em Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face 13i"3C>S Estimated Seasonal High Groundwater 13Z' gCaS DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: —Dw*rr Q85t c1oN Depth Observed standing in obs.hole: in, Depth to soil mottles:? ) "BGs jn Depth to weeping from side of obs.hole: 'I3L-Jt;5 in. Groundwater Adjustment N k ft. Index Well# NIP Reading Date: N1A Index Well level dfg,,,v_„ Adj,fhctor A draundwater 1 evel MA PERCOLATION TEST bate'111.11 Time td:!5 tw1 Observation t Hole# Time at 9" - Depth of Pero 3i' Time at 6" Start Pre-soak Time @ was AM Time(91-6") End Pre-soak AM Rate MinlInch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) IV Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. v Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# t Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell Mottling (Structure,Stones;Boulders. itenGravel) 0-3l Flu. "Sotum SANS z.SY tcoSE DEEP OBSERVATION HOLE LOG Hole# -x Depth from Soil Horizon Soil Texture Soil Color Soil IOther Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 32-%32- C ME040M & cost: DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistengy.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from . Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell Mottling (Structure,Stones,Boulders. Consistency.,% Flood Insurance Rate Map: Above 56b year flood boundary No_ Yes Within 500 year boundary No '� Yes Within 100 year flood boundary No �! Yes 0 , Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? YM `- If not,what is the depth of naturally occurring pervious material? Certification d I certify that on /o'27-.9 9 (date)I have passed the soil evaluator examination approved by the Q Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 310 CMR 15.017. g G�i/ a Si nature Date C� QASEPT10PERCFORM.DOC No. D/. Fee 3 0 .0 0 THE COMMONWEALTH OF MASSACHUSETTS "' J PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migpoga1 *pgtem Congtruction Verna � Application is hereby made for a Permit to Construct( )or Repair(x )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 25 Capt Lumberts Way M. Lesinski Centerville MA Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Service P.O. Box 1089 Centerville Type of Building: Dwelling No. of Bedrooms 3 Garbage Grinder(nq Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) additional precast overflow in the reserve area as blueprint shows. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this of Health. q Signed A O o Date I <�� Application Approved by Application Disapproved for the following reaso6L lqlPermit No. Date Issued h` No. Al 7.... / l;�Y Fee •30 00 ' D f fi .' n THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS } ' rication for Dig o.5a1 item �tCon�truction Permit A� � Q� Application is hereby'made for a Permit to Construct( )or Repair(x )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 25 Capt Lumberts Way M. Lesinski Centerville MA M. Installer's Name,Address„and Tel.No. Designer's Name,Address and Tel.No. W.E. Robinson Septic Service P.O. Box 1689 Centerville Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(no) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons.— Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) additional precast overflow j in the reserve area as blueprint shows. it Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this �Aqf lth. Q q c Signed e fi O' 2 o Date! %/ Application Approved by Application Disapproved for the following reaso Permit No. Iq Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certif irate of (Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(X )on by W.E. Robinson Septic for25 Capt Lumberts Way xx M. Lesinski has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: R No. Fee 3 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1wigw5al *pgtem Construction Permit Permission is hereby granted to W.E. Robinnon Septic Service to construct( )repair( x)an On-site Sewage System located at 2525 Capt Lumberts Centerville and as described in the above Application for Disposal System Construction Permit. The applicant reco nizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All cons ti n mus rpleted within two years of the date below. " � FDate: Approved by j p TOWN OF BARNSTABLE L T?J.'4 CeWiLLUME SEWAGE # SS-0 31 t�7 01/ as 2, .,41LLAGE a5 C pi- L(K&9fS QPP, / ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. !.%)C gcn6til Soul SEPTIC TANK CAPACITY 1�O®U 9!fi I S-� LEACHING FACILITY: (type) G aG q A 1 (size) O 0 C' NO.OF BEDROOMS 3 Bk3§0ER OR OWNER tr As //V$`fit PER ff DATE:�� q S COMPLIANCE DATE: L,20I 9 S Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ' within 300 feet of leaching facility) Feet Furnished by % .� �. ` � � � �ah� R �� �� . � d � � � i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL NVORKS CONSTItUGHON I'EItMI"I' (WFF110U'F DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated 9'l�— g , concerning the property located at (f A W CA11,V meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are nb private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED:z/1V I DATE: ` LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. J, v f.. TOWN OF BARNSTABLE LOCATION C�WGIJ 1 SEWAGE#. 9 S`l 7 3 I 1, 7 ell '00 2, JII.LAGE Af3 j- �i,�h�uA(� i,J��/ ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. UIC RC26 Sow � 'C 7 i SEPTIC TANK CAPACITY l ado LEACHG FACILITY: (type) l C�^ (Jc aV a,� (size) IN f NO.OF BEDROOMS 3 B13R OR OWNER PERIvIITDATE: y I S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjust ed Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by '�j) GA2GF ^fiC2ajv"�' b� t1UJ$�c C> o �a hti i r , i tYra / SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO" Address of property cA Owner's name Date of Inspection � _ Xa 17 �� � ff -7` PART A = CHECKLIST Che-Ir if the. following have been done: 7Pumping information was requested of the owner, occupant, and Board of _ Health. P� None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. L/ The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. . G/ All system components, excluding the SAS, have been located on the / site. l� 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. !1/ The size and location of the SAS on the site has been determined based /on existing information or approximated. by non-intrusive methods. l� The facility .owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. .J OCT 51995 to 1 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential q number of bedrooms 9 number of current residents 1✓ garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: Last date of occupancy GENERAL INFORMATION Pumping records and source of nformation: o �b8 .o.� X,6 /- t A/ System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Typ 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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: 9 10 s �/ Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) depth below grade: !L material of construction: /concrete metal FRP other(explain) dimensions: sludge depth distance from top of sludge to bottom of outlet tee or baffle 3 ' 'scum thickness 1,,' distance from top of scum to top of outlet tee or baffle LL'distance from bottom of scum to bottom of outlet tee or baffle 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, recommendations for repairs etc. ) � ,` w �� 1"�t? :�-� �sr s�- ��• Cam_. e a DISTRIBUTION BOX: [/ (locate on site plan) 0 depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) I�� D PUMP CHAMBER: (locate on sit plan) pump in working order, yes or no Comments: (note con tion of pump chamber, condition of pumps and appurtenances, recommend tions for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and number leaching chambers and number a' T �/ — /lo z 44-1 -- -ce ,C— leaching galleries and number V r leaching trenches, number, length l leaching fields, number, dimensions ' overflow cesspool, - number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, r commendations for maintenance or repairs,etc. ) CESSPOOLS (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, recommendations for maintenance or repairs,etc. ) PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil, signs of hydraulic .failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' l , i C, L,1 M Ld b' ' l a �0 lC DEPTH TO GROUNDWATER depth to groundwater method of det;R, ination or. approximation: 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? V Required pumping 4 times or more in the last year? number of times pumped V Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? [/' below Is any portion of the SAS, cesspool or privy: the high groundwater elevation? V within 50 feet of a surface water? ►` within 100 feet of a surface water supply or tributary to a surface water supply? -Zwithin a Zone I of a public well? y within 50 feet of a bordering vegetated wetland. or salt marsh (cesspools and privies only, not the SAS) ? within 50 feet of a private water supply well? 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 analysi for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. TOWN OF ry7SlhAG14--- BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION _TYPE OR PRINT CLEARLY- PROPERTY INSPECTED � / ,� STREET ADDRESS o2 6 /�?i`22t C/,LrY/UC S 2D ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME PART D - CERTIFICATION NAME OF INSPECTOR W.E. Robinson Sr COMPANY NAME W.E. Robisnon Septic Service COMPANY ADDRESS P.O. Box 1089 Centerville MA 02632 Street Town or City State ZIP COMPANY TELEPHONE ( 508 ) 775-8776 FAX ( ) CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system a this address and that the information reported is true, accurate, and complete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Che one: System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails tc protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. PSignature Inspector Date One copy of this certification must be provided to the OWNER, the. BUYER (where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.do 13': - lip ,C ,A T ION E W A C E PERMIT N0. VILLAGE 1 T �AlER'S NAt4I ADDRESS BUILDER OR OW EA DATE PERMIT. ISSUED DAT E COMPLIANCE ISSUED � / �- �! "1 � l �j .�� �� � �� � � �� ��-� � ............... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF ALTH . �.;r✓. ..�.. . .................................:............. ....�- -- M............. OF. ' Appliration for Bitivaou1 Work nntrnr#inn 1rrmi# Application is hereby made for a Permit to Construct (, ) or Repair ( ) an Individual Sewage Disposal System at f „ t ... 1 ................ Location-Address or Lot No. ..................... ..................•.................-__-__............_..---•--........... .....-_-_.-,-----...........--.................._................................................. .. ner .-•---•-•----------.Address _----- Installer Address rr U Type of Building Size Lot....k._�__ _�-......Sq. feet a e Dwelling—No. of Bedrooms.-•-----•--••_----------•------_----•_----- Ex Expansion Attic ( ) Garb g Grinder ( / J P4 Other—Type of Building ____________________________ No. of persons_._.40.................. Showers Cafeteria ( ) A4 Other fixture 7 W Design Flow................ __-___-..._._._..gallons per person per day. Total daily flow......... _-_?l_�__.......................gallons. WSeptic Tank—Liquid capacity�w'2?_._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". ft. Z Other Distribution box ( ) Dosing to ( ) 22 O a Percolation Test Results Performed by..... .......:.... . a�''` ? !!!�!t...�� _____ Date...... a Test Pit No. I................minutes per inch Depth of Test Pit____ 'i_f Depth to ground water.. ...... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �j _._________ _ _ _ Description of Soil----------��, / �l��. r - ��® = x _•---------------- �- - _----------------------------- , U ---•-•-•--•-----------------•-----•-------._._..__-----------....--------•------•---------•---------------•---•---------..._..-•---------------•--------------•---___-----------------------------__•--• 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 TI I T,1Z 5 of the State Sanitary Code— The un ersigned further agrees not to place the system in operation until a Certificate of Compliance has been i ed b � e b and of health. gne -L°d D e Application Approved BY - -_----= - --- ' ................................................................... �!< . Date Application Disapproved r th ollowing reasons--------------------------------•----------------------•-----------------------•-----•-----------------.-------- -----•--------------------------------------------•-------•-----•------•-------------------_------•----'--------•--•---------------•------............................................................ Date PermitNo......................................................... Issued_....................................................... Date a Fnic ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH .....�.4t .............OF.....V .r`. ;.. .................................................. , pptirFation for Uhivvii al BlorkAjamitxurtion 11rrntit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at• I , ................_ _.._.............._..--_t...l - - - •----••--•----Location-Address ---•-••------•or•Lot No. ................ ....----...........•-•-•- ^--•-------_.. ....... --y t � ner Address a ...._.......•••- ..........F"11-=- ----- -- -------------------•-- ----------••-•---------- .-__---_ -_------------_--_-_-----•---1_----_____-__------- Installer Address U Type of Building Size Lot------!--------------------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (P)'2 Other—Type of Building No. of persons.....&.................. Showers — Cafeteria QI Other fixtures W Design Flow..............._,` ��..____.....__-_•_gallons per person per day. Total daily flow........................................... WSeptic Tank—Liquid capacityt'glZL.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 ( f) 3 /� a Percolation Test 'Results Performed by..._�tG�t ._. "� !a?. � ..... Date_______ _______V_ . m u s r inch De th of�TestPit....-__.Test Pit No. 1...... ._ m to pe p Depth to ground water_ _ . ..._ f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a' /t �, -----•---•--•----z'r -..... O Description of Soil �-� ..! 'g' S = 2�..--`----------------------------------------- ----- --------------------------------- x ----••••-••--••--•.._.--•--•------------- ' Jsw. 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 TIT1Z 5 of the State Sanitary Code—The un_(-rsigned further agrees not to place the system in operation until a Certificate of Compliance has been iss-ed be dard of health. f, igned r.,x --------X--------•- - -- e Application Approved By--•••••.---•� �•••••••-••----...••--•...•-•-••--...------•.................••--• Date Application Disapproved f r th following reasons:............................................................................................................... •....................•-----...•--•----••-••--•--......_......_..••-••--•------•-_._...........•---•-•-••-•--•••-•-•••----•--•-•-•-•--•----•-•-----••----•--•-----•--•••---•......•-•-•-......••--------- Date PermitNo....................................=................... Issued_.........-............................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOAR F HE � `~.....................oF......:.. :. .. ..... .......::...............................-•----. %trrtifiratr of Tnntph anrr THIS IS T,,O—CERTIFY, That the Individual Sewage Disposal System constructed (Xorpaired ( ) ................. - -- --_____-1-t------- .......�!.. .......... has been installed in accordance with the provisions of TI�TTE 5 of The State Sanitary Codxt/ es fibed in the application for Disposal Works Construction Permit No.... __'�...... _ l______________ dated_.../._ d"P THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE A GUARANTEE THAT THE SYSTEM WILL • N ION SATISFACTORY. DATE......... "" ".. 9...--•..................•------------...-----.. Inspector........- .....---------------------------•................................... THE COMMONWEALTH OF MASSACHUSETTS BQARD HE T�,�+ ............O F...... .... .. ..�1✓. ... N.:............................ r No..... ................. FEE__ 60............... ]BiIVogaa o ko Tons tr ; itrrntit Permission is r8tiy granted . ---•-•-- +7_.f.......... to Construct r Repair ( ) an Individual Sewage Disposal System atNo..........................................................................••---••-•----••----------------------------------------------------------•-------•--•----•--•-•- Street --�� i i as shown on the application for Disposal Works Construction Permit NJo�._..�'`�r� :__._ ISated/f''`___��_ �� / 1f6ard of Health DATE....................-..........-•- -----.. .................................. j FORM 1255 HOBBS & WARREN. INC., PUBLISHERS L o-r v N (u/F62if LyT .2 q4- '\I 7, 6-7 Sr' S,Frl r 'p 50 T atq 1: 6N1 F�E�W0�r1-�l 3 � \' 4' N 14 N �1�^ N . c IARI joN 74 * 7✓ rd,.+ / MAN, �� SU�� CA A 16 qg1 �� .��,..�: 15• moo s s= PIZ F�oNr � � 10 IC> GA .a { ca ra,.w END Cor.'R r l_ ,ED PLOT PLAN . . EXISTING SPOT ELEVATION xO \n OF EXISTING CONTOUR --- 0 � ' CAP 7• LUM 'E'I T` GAkE E t//FINISHED SPOT ELEVATI Gz/V T L1 ' FINISHED CONTOUR 0 �' y o RSE I N APPROVED BOARD OF HEALTH No.ios51 Q S10.NA\ R DATE AGENT SCALES / =40 DATE , r t3eAyS'I,U.E'�. LDREDGE ENGINEERING C4. IN CLIENT. i CERTIFY THAT THE PROPOSED 8/Z—---3 BUILDING SHOWN ON THIS PLAN LEGISTERE REGISTERED JOB NO. . — CIVIL LAND {; CONF�RIyIS TO THE ZONING LAWS GINEER URVEY R DR.BY .. l OF BARNSTAB E , ASS. N STREET E E T C H. BY l .1.1 .E. 7i2 MA S. 12 08 8 _ H YA N N I S, MASS. SHEET` OF 3 A E R G. LAND SURVEYOR IV Ore /F EITNF�4 FP / TA K OR 20 PT. MIN. �Bi4CN/wG P/T ARE MORE THA:"J /2"BELOfv !t7 PT. lilt/N 1RA OEM A4 ?4"V 1 A 14 E TER C'ONCR"E T� COMER SWALL BE BROUGHT TO GRAO.E.64,v EXTRA CONCRC A/TC TE 414 �PY P/Pd �XieAVy C^ST /RON CO{/ER Sh�AL L DE USED N /F/N L>R/VI=WA Y FLE✓• 1.100,,9 COYERS �B PFR FT 2 MAN. CONCRL�TE CO VE.4 CL EAN .SAND _ 8AC1CF'/LL LIQUID Level- ' 4 _ 2 LAYER "" /RCN f•/PE /a v D � � ' o I b MIN.P/TG!/ GAL. • 1 • . . • • • • • n •4 RYA SHFO STONE , SLEPT/C rA)VX DJST. • a 1 • • • . • • • e all { Bay o • 1 B • • • • • o .•e • 7t: • ��• 1 1-OFT/VG f • •• 314 • • • . oEPrfl • • 1 • ► o . WAsiYFO STDNE 2, 3-7 7 . • • o p ' PRECAST SEEPAGE /lax 1.0 _ /J3 • a. • • • • • �• • p ••p a ►■ • .1 • • • • • • o P/7 OR EQUJV. p�T CAP4.0 y =4%FD �fi3 y • a CL. 9 3 IMMERT..AT Q[!!tD/IVG o • Fr . ltyLET .SEPT/C TANK 9 .2 FT. L 2_ FT. D/AM. v C SEE Ts�BI/L.4TION> r. 1C=H. OUTLET SEPT/C.TANM. 9 OFT. P.ruu S- MAY, GROuNO W,47ER 7AALE EL = 89.4 � /HEFT OJSTR/BI/T/DN BOX � co�Pg 9 7. SECTION O F srl 3-F 3 -3 '7 OdTll`TD T'/JSTR/BIlON BOX 5'' A P7 S�eyyAGE OISfAS�4 L SY.ST.EM. //VL.ET LFACMING /,IT fT, 7AJ411-ATIDH LEACHING P/T D/MENS/O N 2� FT. SCALE DESI6IV CR/TERIA 0J�1�xs/ow $ FT- NUMQER OF BEDROOMS 3 DJMENSICN C' 4 FT. M I N G,4R46A4GED1SPo5AL UNIT JfdNE SO/L LOG SDIL TEST TOTAL ESTIM�IT'EG FLOW 3 3 O G.44.1DA'r -SO 1 L TEST */ $O/L 7ES7702 . NUMBER QF 40ACMING P/TS f`ELFY. g�3 (—ArLFY, PATE OF' SOIL TEST -3 S/OE LCACHJ/VG PER PIT RESULTS iVJT/VESSED BY �R,F 41fl v2/17 907To/yPLEAcH/NGPERPI7 �.3 W. A o'-i i rnvsctL PFRCOLATYOIv RATE,*/ Lc s S MIAIIINCH 7-07.44 LEACHING AREA SQ. FT. F1C�t'COL.47"/ON RATE>*2 .aESERVE LEAG'fI/N6 AREA SQ. FT. z'- 1' sZD 2, 0 f{ H 0 M- ht�N OF' o � � HiGN q� P� �� LaT21 - C•RpT.. LuMF3E'ZT LA-r.lE7 51� 1Je co u F5 LW EL= 8G-S OEf- -P—\JI LLL= o vi � ,� ORSE ry o N0.10951,�O EL01gEDCsEENG/NEAR/NG CO,/NC. A FGISTE�9T 7/2 MA/ ST. //YRNNrs. MASS.O a � N ' Np Su N`� FSS�0 AI- / Q NO GROUNv yV,4TER ENCoUN74F,��EZ> P��/S�pE D7E A : 12/02/ 82 yvATE'R' A-- ELEL! .IOB NO_• 8 I"L23 SHEET 'L OF 3 Permit Number: Date: Completed by HIGH GROUND-WATER LEVEL COMPUTATION Site Location: GA-P-r. LuAAPL =P.T LN . �+-� Q��L-�� Lot" .No. " 2-�- Owner: BA-(SIDE P_>_JlLbl► 6 Co Address: C>=ti.�' viLLE: Contractor: p� �.Ay� Address: /4+_L<=tuf=- ° Notes: So i L _TeEsT E=1 L = 9 89 4 P C- Donn p5 1 l STEP 1 Measure depth to water " table S to nearest 1/10 ft.' . . . . . , ... . .. . . ... . . . . . . 719 /82 date 1 STEP 2 Using Water-Level Range Zone and Index We) ) Map - locate F site and• determine: ,QLW 2 30 ) A) Appropriate index well B). Water-level range zone x STEP 3 Using monthly report"Current Water Resources Conditions" degrmi.ne current depth to water level for index well . . . . 5/81 mo yr i STEP 4 Using Table of Water-level Adjustments for index well FS f—E F 2AT,—current depth to water level for index well (STEP 3) , and water-level { zone (STEP 2B) determine V, 2 water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . f STEP 5 Estinate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water •`1 level at site (STEP 1) . . . . ... . . - • • • • • - - • • • - • • - - • • • • • • - E i TOP OF FOUND. ELEV. = 37.7 ± PROVIDE EXTENSION RISER WITH GENERAL NOTE S COVER TO WITHIN 6 OF FINISH 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION GRADE OVER INLET&OUTLET FINISH GRADE OVER D-BOX= 36.5 FINISH GRADE OVER CHAMBERS = 37.2� - 36.2' METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE REMOVABLE CONCRETE COVER ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. TO WITHIN 6"OF FINISHED GRADE SLOPE @ 2% MIN. OVER SYSTEM FINISH GRADE @ FND. EL.= VARIES FINISH GRADE OVER TANK EL.= 37.0'± 4"SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2"DOUBLE WASHED STONE TO CROWN OF PIPE 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD 5" DIA. OUTLET(S)20" MIN. ACCESS COVER ACCESS BOX WITH COVER TO GRADE 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE OF HEALTH AND THE DESIGN ENGINEER. � - - (TYPICAL FOR 3) 9"MIN. -- - _ ------- - "--- - - 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 36"MAX. PLACE RISERS ON ALL BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. - " TOP OF SAS = 34.73 CHAMBERS WITH INLET EXIST. SEWER PROP. 4" 36 MAX. 1 9"MIN. PIPES TO 6" OF FINISHED 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN PIPE I SCH. 40 PVC 33.90 36"MAX. BREAKOUT EL = 34.40� GRADE ELEVATION =34.40' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS 2" DROP MIN 6"I 3" 3" DROP MAX. 3" 9" � PROVIDE WATERTIGHT SEE NOTE#22 A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 1 1%MIN.SLOPE THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. JOINTS (TYP.) I� „ * 4" PVC IN FROM > 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. T 14 35.1 } SEPTIC TANK 4" PVC OUT TO O 0 0 0 O o T LEACHING FACILITY IC>. 0 0 06. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. OUTLET TEE 12" = = 00 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN i 48" CONTRACTOR SHALL 22"ZABEL FILTER 34.27' MIN. \_ 34.101 2' o ❑ o 0 C>CDC> = = = = = ono SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO CONTRACTOR SHALL VERIFY CONDITION OF MODEL#A1801 4x22 6" CRUSHED STONE °° o 0 0o BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. VERIFY SIZE AND EXISTING TEES M�3 OVER MECHANICALLY oo 0 0 0 0 0 0 0 0 CONDITION OF EXISTING AND REPLACE AS COMPACTED BASE - 8. ELEVATIONS BASED ON APPROXIMATE USGS DATUM OF 36.00' SEPTIC TANK NECESSARY 5 8.5' OBTAINED FROM A NAIL SET IN U.P. #2 AS SHOWN ON PLAN. OUTLET DISTRIBUTION BOX 4'0' 3.7' 4.9' 3.7' TO BE INSTALLED ON A LEVEL STABLE VARIES (SEE DETAIL BELOW (NP,) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1000 GALLON CONCRETE SEPTIC TANK BASE. FIRST TWO FEET OF OUTLET , GROUND WATER ELEV= 26.1 12.3' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE LENGTH 8'-6" WIDTH 4'-10' DEPTH 5.-7,� PIPES TO BE LAID LEVEL. 31 .90 AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY 2 - 500 GAL. CHAMBERS 5'MIN. Z DISCREPANCIES TO THE DESIGN ENGINEER. *CONTRACTOR TO VERIFY AND SEPTIC TANK PROFILE CROSS SECTION VIEW CHAMBER END VIEW 10• ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE NOTIFY ENGINEER, IF DIFFERENT NOT TO SCALE DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE STRUCTURES SHALL BE MADE WATERTIGHT. NOT TO SCALE CHAMBER DETAILS 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH TEST PIT DATA DETERMINATION FROM APPROPRIATE AUTHORITY. rr n fr � INSPECTOR: Donna Mirandi 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS EVALUATOR: Michael Pimentel, EIT, CSE LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE ') DATE: April 9, 2008 THEY SHALL WITHSTAND H-20 LOADING. I � TEST PIT#: 1 (Pere# 12161) 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND - ELEV TOP = 37.2' FINES. I • <<- P �� 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND r ELEV WATER= < 26.2' UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN -- _ PERC RATE _ <2 Min/In COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN DEPTH OF PERC 32„-50" ACCORDANCE WITH 310 CMR 15.255(3). = 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN i Mil TEXTURAL CLASS: 1 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. j 'ti e 0 37.20' 16. PROPOSED PROJECT IS LOCATED WITHIN: co co MAP 147 s ~� ASSESSORS MAP 147 LOT 11-02 Fill „ LOT 11-03 p 1 ` 4t-' 17. OWNER OF RECORD: MICHELLE R. BARBANO r , ...Y. II r n •r ADDRESS: 25 CAPTAIN LUMBERT LANE � MAP 147Al/ � 32" 34.53' CENTERVILLE, MA N LOT 11-03 O�O�� �. y1w !o Perc no F e 33.03' FEMA FLOOD ZONE C EXISTING 1000 ZONE 11 y y { 50 AS SHOWN ON COMMUNITY PANEL# 250001 0015 C GALLON SEPTIC TANK 18. PLAN REFERENCE: PROPOSED 1. LAND COURT PLAN 37432-F DISTRIBUTION BOX Medium Sand C 19. DEED REFERENCE: 2-500 GALLON y ' +Q5 (Loose) 1. CERTIFICATE# 169993 4" LEACHING CHAMBERS ( 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. r� V \ y MAP 147 Benchmark - "y _ - - 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY Ste' ` - Nail in U.P.#2 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY LOT 11-02 Elev. =36.0 TREELNE 35 / FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. � 0' 17,678 S.F. ± #25 3(3 �N�W \ /r Approx. M.S.L. 22. A 4" PERFORATED SCH. 40, PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A DECK EXISTING 238, �-- - LOCUS PLAN 132" 26.20' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A 3-BEDROOM O REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. DWELLING k's No Standing, Weeping, or 3� i LU SCALE: 1"= 1000' z Mottling Observed \ \ TOF = 37.7' LEGEND MAP 147 �' LP � co ' 0 3, r" co r- ^ DESIGN DATA TEST PIT DATA fi LOT 82 x v n I / ►- INSPECTOR: Donna Mirandi EXISTING SPOT GRADES Q a P rr x 50 GARAGE TP1 :" TP1� � m O EVALUATOR: Michael Pimentel, EIT, CSE - - 15 - - EXISTING CONTOURS S 37.2 zF w NUMBER OF BEDROOMS (ASSESSORS) 3 DATE: April 9, 2008 Jp NUMBER OF BEDROOMS (DESIGN) 3 TEST PIT#: 7 (Perc# 12161) 50 PROPOSED SPOT GRADES �SSo 2�� L✓ i z DESIGN FLOW 110 GAUDAY/BEDROOM 15 PROPOSED CONTOURS o ELEV TOP= 37.1' TOTAL DESIGN FLOW 330 GAUDAY DRIVEWAY ELEV WATER= <26.1' - f� a DESIGN FLOW X 200 % = 660 GAUDAY X-X EXISTING FENCE LINE MAP 147 Q PERC RATE = Min/In GAS EXISTING GAS SERVICE EXISTING D-BOX� U USE PROPOSED 1500-GALLON SEPTIC TANK LOT 83 \ \ DEPTH OF PERC N/A W - EXISTING WATER SERVICE \ � = EXISTING LEACHING PIT TO BE n PUMPED, CRUSHED AND REMOVED TEXTURAL CLASS: 1 ❑/H/W EXISTING OVERHEAD WIRES rn SWING TIES R, INSTALL 2 - 500 GAL. CHAMBERS 0 37.10' TEST PIT LOCATION m SCALE: 1" =20' ° " \' O \ O r S85 10'29 W C) -n SIDEWALL CAPACITY �Q 0 EXISTING 1000 GALLON SEPTIC TANK 03 DESCRIPTION GC HC _ 56.47' m �➢ Fill I m (PERIMETER)(2' HIGH) (.74 GPD/S.F.) = GAUDAY 32" 34.43' O PROPOSED 500 GALLON LEACHING CHAMBER CORNER LEACHING (1) 37.8' 32.5' i n (73.4') (2') (0.74 GPD/S.F.)= 108.6 GAL/DAY PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE CORNER LEACHING (2) 47.4' 42.3' o -+ CORNER LEACHING (3) 63.7' 36.2' BOTTOM CAPACITY ❑ PROPOSED DISTRIBUTION BOX CORNER LEACHING (4 61.5' 30.8' (AREA) (.74 GPD/S.F.) = GAUDAY Medium Sand (302.7 S.F.) (.74 GPD/S.F.) = 224.0 GAUDAY C 2.5Y 6/6 CORNER LEACHING (5) 58.0' 24.0' (Loose) TOTALS: REV. DATE BY APP'D. DESCRIPTION PROPOSED SEPTIC SYSTEM UPGRADE TOTAL NUMBER OF CHAMBERS: 2 PREPARED FOR: HC TOTAL LEACHING AREA: 449.5 SQ.FT. 132" 26.10' CAPEWIDE ENTERPRISES TOTAL LEACHING CAPACITY: 332.6 GALJDAY No Standing, Weeping, or - �� (5) Mottling Observed LOCATED AT ' (4) 25 CAPTAIN LUMBERT LANE RESERVED FOR _ CENTERVILLE, MA 02632 O (3) BOARD OF HEALTH USE O _` SCALE: 1 INCH = 20 FT. DATE: APRIL 13, 2008 0 10 20 40 80 FEET JOHN L. Ism PREPARED BY: CIX JC ENGINEERING INC. (2) N 8 2854 CRANBERRY HIGHWAY GC EAST WAREHAM, MA 02538 SITE PLAN 508-273-0377 SCALE: 1"=20' Drawn By: BSM Design By: MCP Checked By JLC Job No.: 1399