HomeMy WebLinkAbout0022 CENTER LANE - Health 1
22 CENTER LANE
Centerville 'p
A'= 251 - 128 ;
No. 42101/3 ORA
ESSELTE
100/0
a 0 0 a
'7/2��,�
No. o "' v( Fee
IL THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0(ppliCation for Disposal *pstrm CO1TetCULtion permit
Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) ❑Complete System [M Individual Components
Location Address or Lot No. aa, eG&)7" (,40 6� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel Gi `sw Rp RpccK.(A 1V 6 NA
Installer's Name,Address,and Tel.No. SOI -14 n 99071 Designer's Name,Address,and Tel.No.
Ge<P6;vt 0G e A3sr (,Lc M/A
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
— erA a ov
n
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of HeAffN
Sign Date
Application Approved by Date
f'23-/Y
Application Disapproved by Date
for the following reasons
Permit No. L Date Issued "a�' L/
fT _
i
y
aU -
No. �' � Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN„OF BARNSTABLE, MASSACHUSETTS
ftplicatlon for Misposal *pstrm Construction permit
Application for a Permit to Construct( ) Repair(x) Upgrade( ) Abandon( ) ❑Complete System [M Individual Components
LocationAddress or Lot No. a-"\ LAO 6� Owner's Name,Address,and Tel.No.
G'W_Q32,U1 Lt L>A V( O ¢osc c�K 4�D
Assessor's Map/Parcel P- CI V I sw r-Z y_u 1V6 (KA
Installer's Name,Address,and Tel.No..50Ts -Lf-n 9$71 Designer's Name,Address,and Tel.No.
(tAP6Zvt 0G e ltssK LAa_- /
ti/A
Type of Building:
n
Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ;
Lf/
I
Date last inspected: -
Agreement:
'? The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
- Compliance has been issued by this Board of He
Y -9 3�aol�Sign d Date
Application Approved by , Date GI — 2-?'
Application Disapproved by Date
• for the following reasons
4- Permit No ,G/ ' 35-11 Date Issued
_j
f
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
�„ S � �� �� ���••��� ,CerttRate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned( )by CA pc`wl bE (.L_r_
at as GC�UT�_ L&u15' 4aAX rLL. _' has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a c�(y'3f 1 dated
Installer CAP&k)Cb6 �7GOQL I; C1.0 Designer N
#bedrooms A)I/� Approved de ' flow � gp -
The issuance of t s p rmit hall not be construed as a guarantee that the system ti r a es' ed
Date Inspector O ��
i
- --- -/ - - - - -------------------- --------------------- --------
No. �_U �l 33 I� Fee ,Uy�
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
30isposar *pstrm Construction permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System located at � d.�'�
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
i
Provided:Construction mustC/be completed within three years of the date of this permi,I ��
Date 3 r Approved by v�`'
Bk 27563 Ps318 �W429 1
07-23-2013 d 01 = tea-1 a
DEED RESTRICTION
ku` WHEREAS, David A. Rosengard of 2 City View Road,Brookline, Massachusetts 02446 is the owner of 22
3 Center Lane,Centerville, Massachusetts (hereinafter referred to as 22 Center Lane,Centerville,
Massachusetts and being shown on a deed, duly recorded in Barnstable County Registry of Deeds in P4ao-
�t Book 27403 Page 300.
WHEREAS, David A. Rosengard as the owner of said lot has agreed with the Town of Barnstable Board of
Health to a restriction as to the number of bedrooms which can be included in any home built on said
lot as a precondition to obtaining a disposal works construction permit in compliance with 310 CMR
15.000 State Environmental Code,Title V, Minimum Requirements for the Subsurface Disposal of
Sanitary Sewage;
W WHEREAS,the Town of Barnstable Board of Health,as a pre-condition to granting a disposal works
Wconstruction permit for a septic system in compliance with 310 CMR 15.200,State Environmental Code,
V Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,and authorizing the
issuance of a building permit for the construction of a single family home on this property,is requiring
that the agreement for the restriction on the number of bedrooms in any house constructed on the lot
N be put on record with the Barnstable County Registry of deeds by recording this document.
NOW,THEREFORE, David A. Rosengard does hereby place the following restriction on his above-
referenced land in accordance with his agreement with the Town of Barnstable Board of Health which
restriction shall run with the land and be binding upon all successors in title:
1. 22 Center Lane,Centerville, Massachusetts may have constructed upon the Iota house
containing no more than three (3)bedrooms. David A. Rosengard agrees that this shall be
permanent deed restriction affecting 22 Center Lane Centerville, Massachusetts,and being
shown on the deed at Book 27403,Paged 300.
C,
The foregoing restriction shall remain in force only so long as the property is serviced by a private septic
system,and said restriction shall terminate and be of no force and effect upon connection of the
property to a public sewer system.
Executed as a sealed instrument&day ofluly,2013.
David A.Rosengard
i
Bk 27563 Pg319 #42901
COMMONWEALTH OF MASSACHUSETTS
���'iAeC� ,ss: f1*1-V ,2013
On this of d��'�' ,2013, before me,the undersigned notary public, personally appeared David
A.Rosengard, provided to me through satisfactory evidence of identification,which was MA Drivers
License to be the person whose name is signed on the preceding or attached document,and
acknowledged to me that he/she signed it voluntarily for its stated purpose.
Notary Public
MICHAEL .3CHULZ My Commission Expires: g1j.3100/3
11 kowy PUNC /
Cea1000 MG MA"ichism
Mir C0mmieeWrrVXP"8
$epl mb*r 13,2013
BARNSTABLE REGISTRY OF DEEDS
wj
No. a 007 s� / y Fee V
s
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es
ZIpplication for Wgponl i§pgtem Cuttgtruction VCrmit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete SystenvK Individual Components
Location Address or Lot No. Z Z Vq— LN, Owner's Name,Address,and Tel.No.
Ce0Ak %\\e I M(' `—
Assessor's Map/Parcel 24 i 2 e
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Co K>e.Z%c�E 6- i, LLC eK .1, S�vCS,
Type of Building:
Dwelling No.of Bedrooms &> Lot Size M sq. ft. Garbage Grinder (4A
Other Type of Building No.of Persons -A Showers( ✓' Cafeteria(�)
Other Fixtures _L C2LC� �C�t1 St(1 1 r�c7C1��
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title soli_'sS CQ
Size of Septic Tank I.r Type of S.A.S. ac&b Q F 1 L)I fAvIs —
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Ac,-3
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mainteriance 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 oLHeal
Signed Date 3r
Application.Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. go v7— o"7 Date Issued 3 — s—o 7
No. a 001_a� `
Fee
Aro
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '1
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
apphration for �Bigogat 9Pp.5tem Cott.5trurtton permit t
'yl , Application for a Permit to Construct O RepairX Upgrade O Abandon O ❑ Complete System Individual Components,. 1
F y Location Address or Lot No. Z Z C,,c)�p LN, Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
t .
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
CcaC�E��t>E. EY 7, C.LC. sN)V , S "C g
s 42�-go2�3J�t'-19G(1-
Type of Building: 11.
Dwelling No.of Bedrooms �> Lot Size 49, U00 sq. ft. Garbage Grinder (Aft,
Other Type of Building c ,Y CcK- No.of Persons Showers( ✓) Cafeteria(1)
Other Fixtures r! GQG,\-Xcv� IY C�n .�ilil c f .�AtXIC�
Design Flow(min.required) _ gpd Design flow provided gpd
Plan Date Z 1 Number of sheets � Revision Date `
» Title ° - tZ��� C� S�, a`,� C,C C3 c;eC_Q
Size of Septic Tank j C' \�� Type of S.A.S. C�P I-T6�,S 7 t?Z13CN
r--J
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement: `
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued,by this Board-of-Health.
Signed Date 3,5_,,1oo"7
r
Application Approved by - ` Date
Application Disapproved by: i / / , Date
for the following reasons -or
Permit Permit No. U U 1 Lj Date Issued 3 5-o
- - - - - :. -
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERT(I�FY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded X,)
Abandoned( )by 'l' 4--
2 2 Ce +��� L
at ,4r'`-2 has been constructed in accordance
with the provisions
Qo'f.�Title 5 and-the for Disposal System Construct:---Permit No. 2 d 07- O 7L/ dated
Installer C" �"" ,+g.c C--t- a,L1,>. UL_ Designer �- ^�.'• ��� y
#bedrooms '� Approved design flow 3 6 gpd
The issuance of this permit shall not be construed as a guarantee that the system will fiunctior��,d'}signed.
Date -3.! 4/- Inspector
—_--y----- —_-- ---= --- - ---- —=—
No.)U 0-7 07 L( Fee f
THE COMMONWEALTH OF MASSACHUSETTS`
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
A wi.5poot is' p$tem Con5tructton Permit
Permission is hereby granted to Construct ( ) Repair ( ) jUpgrade (t,/ Abandon ( )
System located at 2- 2- C- L,4.� ce"t- ;
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
$ ... to comply with Title S and the following local provisions or special conditions.
Provided:-Coon�struc�t(i�on i�st be c/om,,8 leted within three years of the date of this permit.
Date y_ Al\ �t Approved by
06/02/201"1 03t24 FAX 0 VV 'j"VI
Town of Barnstable
Regulatory Services
. z Thomas F. Geiler,Director. i
S s,+tcv�rnat.�, ►
U Public Health Division
++ ` Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
i
Office: 508-8624644 Fax: 508-790-6304
I
Installer & Designer Certification Form
Date: 3/06/07
Designer: Shgy Environmental Services,Inc. Installer: Caoewide Eatterarises
Address: P.O. Box f27 East Falmouth Address: P.O. Box 763
MA 02536 i Marstons Mills,MA 02632_
i
On 3/05/07 Cavewide Enterprises was issued a permit to install a
(date) (installer)
septic system at #22 Center Lane, Centerville. MA based on a design drawn by
(address)
Shay Environmental Serviced.Inc. dated 2/06107
(designer)
XX_ I certify that the septic ;system referenced above was installed substantiallX according to
the design, which may include minor approved changes such as Iateral relocation of the
distribution box and/or septic tank.
1 certify that the septic system referenced above was installed with major changes (i.e,
greater than 10' lateral reelocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow_
.a N OF AM w;
v,
��± _ F., c�,1
(Ins aller's Signature) SI,:+Y ��1
No. 1ial
G157E��4
SgIVITAR���
(Designer's Signature) (Aftix De p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CE TIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
TITANIC YOU.
0:HeaWSeotic/Desie►er Certification Form - _
cfib
,'tc"WOM : wn cape engineer ng_,inc FAX NO. : 15083629800 Feb. 28 2007 03:29PM P2
.
DOWN CAPE ENGINEERING INC.
SOIL ANALYSIS '
DATE: c a� o
_....-.----.-.--..._.------ -.--.-.-.---
SAMPLE DRY:
WT RET % RET % PASS
3/4"
1/2"
3/8" 13
#4
#10 .3
#20
o
#80
#200 02��. q�'. l . — 0 a.,
BOTTOM 30''-.J 10 Q
310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION a
t, 1 243- Types of Soil Textural Classes
(1) The following soil textural classes apply to soil types of which they are composed:
is CLASS I Sands,Loamy Sands
CLASS II Sandy Loams,Loams .
CLASS III Silty Loams
I CLASS IV Clays, Silty Clay Loams
`I' (2) Textural Classifications are made based on the relative proportion of sand, silt and clay in
. the soils and in accordance with the following textural triangle:
;
SOIL TEXTURAL TRIANGLE �. .
100
90
a. O
70 F
I lay :A
m� 60 ,
CO
00 50
K X1
/\/)W\
sa A 40
co
cl Nity
30
san cla o
d O
20
san 10 I ad
VI
l�10
� ,K
10T
f
silt O
san As ,O
j00 `00 CO D 60, t7`O 00 r0 Z
percent sand
B0
Z p v s 1e;9� - O
o ' e"
12/1%95 (Effective 1.1/3/95)-corrected 310 CMR-526 "
�� ao13 03 73d
e
I 371 Loafs i 4tj
Fe"e e! A tL to V,e a LA�t�6
. n
0
,a
- t
2_ ��i H km-q
c.
--- .��..,.�.�� �_ ate_��9 �,���. o�,�►�
6AIFiRm�H
n
0
0
r
TOWN OF BARNSTABLE
LOCATION /h SEWAGE#200-1-0 1 y
VILLAGE G�� ,,,i/1 ASSESSOR'S MAP&PARCEL ,)S- /
INSTALLERS NAME&PHONE NO. vlLL( �� Srap YaaB
SEPTIC TANK CAPACITY /SwX.j
LEACHING FACILITY:(type) (,�_1 a)s—o (size) i Z 1C .2S
NO.OF BEDROOMS ,3
OWNER , J!�Qrj-? r
PERMIT DATE: `3-S- Zo o-1 COMPLIANCE DATE: 3-1-1oo-1
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ✓i'0 3 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 G n4er pro`s," L(,
At 2,-7
na
6a ai � l
i33 -o-s �
�3y (-QU.o
C3 yy.v
c4 ss.8
C�
.�
Towiq of Barnstable P#
Department of.Regulatory Services .
�,, Public Health Division Date
K"SS• 200 Main Street,Hyannis MA 02601
Time — Fee Pd.
Date Scheduled ���
80' Suitability Assessment for Sawa ee D osal
.
Performed By:
7(r r 1 AA Witnessed By:
LOCATION &GENERAL INFORMATION
'_ `�_ i Owner's Name
Location Address a -can�`'`( ` Lj
Address
- t s. S`�vc5
I Engineer's Name � 7r7r C.(l
Assessor's Map/Parcel: '1 Jr a` -- l!
NEW CONM, nON
REPAIR i Telephone# S 3S— Q
pp Surface Stones /U o20
Land Use S�a ^ 'Q`\ Slopes M 1
1A ft Possible Wet Area —ft Drinking Water Well /" ft -
Distances from: Open Water Body r
prainage Way ft Property line a�--ft OWer
ft
SKETCH:(gtreet name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes)
h
s
�E>>%
C) F
n t7
Cen^)'e-C J w M
' t
'( 'I�S
1 Depth to Bedrock
Parent material(gedlOgic) I
W eeping ftom Pit Pace
Depth to Groundwa'ler. Standing Water in Hole:
•N(\�
Estimated Seasonal high Groundwater
�`�r�• .1� r�-�S1JtY���
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: In, Depth tO s011 mettles: fr
Depth dbgerved standing in obs.hole: groundwater Adjustatent
Depth tosweeping from side of obs.hole A ,1aCt0Y_, Adj.®tcundwflter level
htdex Well# Reading Date: Index Well level
i
PERCOLATION TESL' Date Tj`"t _
Observation 1 Time at 4" —�-
Hole# --�_ J
Time at G'
Depth ofPere 1es2 �(1G�vJS�S
-.---
Start Pre-soak Time.0 --
End Pre-soak
Rate MinAnch
Site Failed. Additional Testing Needed(YIN)
Site Suitability Assessment: Site Passed ;
Original: Public He$ith Division Observation Hole Data To Be Completed on Back ---'
to be conducted within 100' of wetland,'you must first notify the /
***If percol0ion test is week prior to beginning-
Barnstable C44servation Division at least one(1)
DEEP OBSERVATION HOLE LOG Hole#_ !
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
to rav
� r
co-3 C_5 I b e(L
3�^8 C meekW) w)s►+ ,a�o
(.cc5e
NwA ScrXi 2,5 Y -/mot � F too'
DEEP OBSERVATION HOLE LOG. Hole# a
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) i (Munsell) Mottling (Structure,Stones,Boulders.
nsisten y,%Gravel)
�0Yk 3),q r'IA �Ctc.
I z r'IZ S .e zah
tti ez� SC c.w
Lode
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders.
Consistency, Gravel)
J` •
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
consistenc gravel)
Flood Insuranhe Rate Map: /
Above 500 year flood boundary No_ _ Yes
within 100 year boundary No Yes„
Within 100 year flood boundary No—V— Yes '
Depth of Natu"lly Oecurrin Pervious Material
Does at least foor feet of naturally occurring pervi us material exist in all areas observed throughout the
area P�
ro sed for the soil absorption system? 9`�
P
If not,what is the depth of naturally occurring pervious material? IJ f
Certification
I certify that on• \ (date)I have passed the soil evaluator examination approved by the
Department of f nv nmental Protection and that the above analysis was performed by Me consistent with
the required trai "expertise and exp e e ''bed in 310 CMR 15.017.
Signature Date
z- 1 5-O
Q:S.EPTIC%PERC1.ORMMOC
1
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
LOCATION ,oA4a-C ^)Cer IN SEWAGE#2001-0'1 y
VILLAGE Can�,�,vi l�_ ASSESSOR'S MAP&PARCEL /
INSTALLERS NAME&PRONE
.NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) � ��� c1 (size)' Q- Y Ay-
NO.OF BEDROOMS
OWNER 3Ar'czft.ctift, 140"A.e r
i
PERMIT DATE: 3_5- Zo 0`1 COMPLIANCE-DATE: _3-'f-10a"1
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility vo 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 _G+4Pkz.J;t�e �� D�i`S�� LC•C.
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A( -27
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63
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http://issgl2/intranet/propdata/prebuilt.aspx?mappar=251128&seq=1 12/13/2011
No.
/Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplication for Di5polal Opgtem Con0ruction Permit
Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Owners Name,Address and Tel.No.
Z ceAv-�e� 1.4�ve L,ot- �5�- "Dt-41V e S c.vi fa
ll-e
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
'j--P /PL4 R t A)
7S S-tk- -
Type of Building:
Dwelling No. of Bedrooms Garbage Grinder( )
Other Type of Building &S t4cdAt -1 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
Naltugre of R pairs or Alterations(Answer when Applicable C-0
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 offitle 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss d b thi oard of�jalth.
Signed - sue' Date.3-2.0` p�
Application Approved by
Application Disapproved for the Yllowinog reasons
Permit No. �� tJ� Date Issued
. ..._., �,..r.....-M.,:.�.�,,�..-..-.. --.r- ...Z,-•�.,..-isw,�--�--+.y�.r.'.�V+°sr� y.,"»,,� r �., _...ter•::: .."�= ..-.�:Nt�;...�;.s-.-k-. r,.r#=<°: { �w„u+,ti�'v�„.+a -.�.
Y ( .....`..=! � �
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a � .
:J,Y,,s�� fie.� _ ,�a'`. ��`,:'�.�-. `i;'.1
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6
1 \ � ��
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No. X.� 7JJ Fee <
{ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
0[ppYtcation for Mt!5pogaL&p_0tetu C_n0t .uction-Ptrmit
'4 Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
- Ge2J-,Le4 ->A,-U - Sc(, 4-cs
G-eiu4_PA /iIle
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
JpN1az ``�
Type of Building: c
Dwelling No.of Bedrooms Garbage Grinder( )
4 Other Type of Building s ia1_-AAr 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
r.
4
Nature of Repairs or Alterations(Ans explicable) v
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 Title 5 of the Environmental Code and not to place the system in operation untilia Certifi-
cate of Compliance has been issued by this oard of He)lth.
Signed G--� Dated ` 96
Application Approved by
Application Disapproved for the Rlowinog reasons
Permit No. / �� Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC-HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired eplaced( fin
by 7` /i?o for �� �c ervv�2- S
as has been constructed in accordance
. with the provisions of Title 5 and the for Disposal System Construction Permit No. 9l- 95— dated
Use of this system is conditioned on compliance with the provisions set forth below:
No. v - Fee
THE COMMONWEALTH OF MASSACHUSETTS -
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
1=igpo0ar *p! tem Construction Permit
Permission is hereby granted to
to construct( )repair( C-)"an On-site Sewage System located at py
04�e 2 LA eve Gin/ C/.
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.
All construction must be completed within two years of the date below. j
Date: Approved by ' -
a
3
I
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
_3
I, hereby certify that the application for disposal works
construction permit signed by me dated 1,Cconcerning the
property located at meets all of the
following-criteria: {
• There are,rio wetlands within 300 feet of. a p'ioposed septic system
• There-are-no_private wells within 150 feet of the proposed septic system
� 1
J r r �
� f
• The observed groundwater table'
1 i�14 fieet(�Ijgreater below the bottom of the leaching facility
• There is no increase in flow and%or change nu I se proposed
• There are no variances requested of needed.
r 1
SIGNED : DATE:
LICENSED SEPTI 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].
No `(s
I
\. I
L•G.f ��� TOWN
/OF�B�A,RNSTABLE Q/ �
LOCATION ��- /�"" `e SEWAGE #
VILLAGE / �� ` �� ASSESSOR'S MAP^& LOT�►�J/'L� s�!'
INSTALLER'S NAME&PHONE
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (s.
NO.OF BEDROOMS
BUILDER OR OWNER 5C.c> �r
PERMITDATE: Z-�' COMPLIANCE DATE:�`,:70
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Feet
',Private Water Supply Well and Leaching Facility (If any wells exist
A 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
� o
o 5 A 1 �o C Y T;4-iu K
I i 'D '2-1If
C
`�a � r _...__.._.._.• ..,.:.;ter-., _ --
ASSIMIRS MAP ft
PARCELNO: . . .. "
Commonwealth of Massachusetts
Executive Office of Environmental Affairs RECEN ED
Department of FEB 2 9 1995
Environmental Protection HEALTH Dram.
WIIIIam F.Weld7M OF BARNSTABLE
Goamor
Trudy Coxe
8eeretary,EOEA .
David B.Struhs
Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: J" G jtv Address of Owner.
_Date of Inspection: (if different)
Name of Inspector: P rno/Z/Yv
Company Name, Adores and Telephone Number:
3 C evkc1 -2+Nn SL,0411 gS
� s- S K�l_ �C C c.�,�r►� 4..
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes
conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
ails
Inspector's Signature: !� , Date:
The System Inspector shal submit a copy of4this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B, C, or D:
AJ SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
Bj SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not)
The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health.
(revised 8/I5/95)
One Winter Street • Boston,Massachusetts 02108 • FAX(617)SW1049 • Telephone(617)292-5500
Printed on Recycled Papa
1%
s 1
<N
F �r �U�rC�{ SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM
'+bar cJ !N PART A
CERTIFICATION (continued)
jj
Property Address: `
Owner: Ua lfrla4
r. rr
Dateof'Inspection:n}lrr
B) SYSTEM CONDITIONALLY PASSES (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
The ha, a septic tank and soil absorption system and is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water
supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is
free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5
ppm.
Dl 7 EM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to Correct
the ailure.
Backup of sewage into faq'lity or system component due to an overloaded or clogged SAS or cesspool.
Discharge or pondi4tg of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
(revised 8/15/95) 2
}
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: �,)L- iru
Owner.
Date of Inspection:
D) SYSTEM FAILS(continued):
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the welkhas been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds,`ammonia nitrogen and nitrate nitrogen.
El LARGE SYSTEM FAILS:
The following criteria_apply to large systems in addition to the criteria above:
The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety
and the environment because one or more of the following conditions exist.
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 8/IS/95) ' 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: C
Owner: � � S
Date of Inspection:
2.- fZ -�L
Check if the following have been done:
vPumping information was requested of the owner, occupant, and Board of Health.
_ 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.
%If tAs built plans have been obtained and examined. Note if they are not available with N/A.
The-facility or dwelling was inspected for signs of sewage back-up.
L-*The system does not receive non-sanitary or industrial waste flow
-"The site was inspected for signs of breakout.
/ All system components, excluding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
/j�The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
L"rhe facility ov.ner (and occupants, if different from o%%ner; were provided with information on the proper maintenance of Sub-
Surface Disposal System.
(revised 8/15/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: ,Xo
Owner: �c
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 136gallons
Number of bedrooms:
Number of current residents:-3
Garbage grinder (yes or no):
Laundry connected to system (yes or no):4
Seasonal use (yes or no):ljL
Water meter readings, if available:
Last date of occupancy: O�
COMMERCIAUINDUSTRIAL•
Type of establishment:
Design flow:_gallons/day
Grease trap present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non-sanitary waste discharged to the Title 5 system: (yes or no)_
Water meter readings, if available:
Last date of occupancy:
OTHER: (Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
System pumped as part of inspection: (yes or no) QO
If yes, volume pumped /n J d gallons
Reason for pumping: d7t'�' cla �
TYPE OF SYSTEM
Septic tank/distribution box/soil absorption system
Single cesspool
L/G+verflow 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) and source of information:
Sewage odors detected when arriving at the site: (yes or no)v
I '
(revised 8/15/95) 5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
SEPTIC TANK:_
(locate on site plan)
Depth below grade:
Material of construction: concrete _metal _FRP_other(explain).?:
Dimensions:
Sludge depth:,__
Distance from top of sludge to bottom of outlet tee.of baffle:
Scum thickness:
Distance from top of scum to top of outlet;tee or baffle:
Distance from bottom of scum to bottom'of outlet tee or baffle:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
GREASE TRAP:_
(locate on site plan)
Depth below grade:
Material of construction: _concrete _rnetal _FRP_other(explain)
Dimensions:
Scum thickness:
Distance from top of scup, to top of outlet tee or baffle:
Distance from bottom t- hottom 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. etc.)
6
(revised 8/15/95)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner: Z?-A� S ,p
Date of Inspection: ,`1
TIGHT OR HOLDING TANK:_
(locate on site plan)
Depth,below grade:
Material of construction: concrete_metal _FRP—other(explain)
Dimensions:
Capacity: Qallons
Design flow: gallons/day
Alarm level:
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX41L
(locate on site plan)
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, etc.)
PUMP CHAMBER:_
(locate on site plan)
Pumps in working order:(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 8/15/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 22 GQz,� Q,- �
Owner:
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):_
approximated by non-intrusive methods)
(locate on site plan, if possible; excavation not required, but may be
If not determined to be present, explain:
Type:
leaching pits, number:_
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:�_
leaching fields,number, dimensions:
overflow cesspool, number:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.)
CESSPOOLS:
(locate on site plan)
Number and configuration:
3 ( �S
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer: !U
Dimensions of cesspool:_
Materials of construction 11
Indication of groundwater. &)
inflow (cesspool must be pumped as part of inspection)
Commentrr'C�ote condition of soil, signs of hydraulic fa re, level of pondir)g, condition of v e ion, a c.)
PRIVY:
(locate on sit an) `
Materials of construction: - Dimensions:
Depth of solids:_------'
Comments__(note6ndition of soil, signs of hydraulic failure, levefof ponding,,condition of vegetation, etc.)
B.
(revised 8/15/95)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
/� n SYSTEM INFORMATION (continued)
Property Address: Z� Ln"-Z,
Owner:
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
DEPTH TO GROUNDWATER
Depth to groundwater:_feet
method of determination or approximation:
_ S
(revised 8/15/95) 9
• 'MNVCi�lll�k�iil eY. '\.. 't' -, Y"sM1' K'RY :£ , ,r +•' "
SECTION A -A 3-24•DIAM. ACCESS MANHOLES � ; _ �� ;,:
VENT PIPE (O Least 24 inches toll) IV -e. ors _ _ , ` y:: r •`> �,r
*NOTE: ALL PIPES ARE TO BE 41" SCHEDULE 40 P.V.C. Schedule 40,,PVC w/Charcoal Odor Filter ���.����
�hou3e
10' min. from PROFILE VIEW OF LEACHINC SYSTEM .A .' , ,- y Existin Foundation to septic tank � �5����� �9D-90X cover mutt DeL�"�`.. '' k' ,_^_k.t:�s. i. ". ^"
At
TOP OF FOUNDATION w ELEV. 100.00 (Assumed) Septic tank coven must W within to GRADE w/Steal Oowr f�'
I�pr. is�k x
within 6 in. of flnhlxed prods
Not to Stole �' _
bode over SepHe Tank- 92.00 _ bode over D-sax - 99.00 over SAS - 99.00 w w w v� ^ ^ b } 'o � }� i#s,_
3 HOLE H 10 fn mk >-
8 of 118 1/2 hashed Peastone / / / ` . + ;wig
` `
DIST. BOX INLET 1 1w alpF4 7 +^
8 f" to 1 1 2 " hashed CIrushsd Stone ` cU �s n,. r r3z t r
_ 1
INLET .: ` ''i ` .e �',u', a3' <` ,.�'t
s 0.02 �.>
k ..
THE ACCESS COVERS FOR THE SEPTIC TANK, `�- �»:� '�„r�-, , • ,, .� -.... f :� �
Top OF System- Elev. �9575 DISTRIBUTION BOX AND LEACHING COMPONENT '" '� : ' / i
12 EXIST. s�o.01 or Greater 4 PVC (CAPPED) INSPECTIO PORT TO BE .. ,
i�l#tne �a Q
N 1 500 L. S< e
�.
rrrsT. PtnE
71F
INSTALLED AND TO BE WITHIN 6 OF GRADE
SHALL BE RAISED TO WITHIN 8' OF
, .Ty ���r4,;�^T,''j''7,�^+',�^-r;•�..�. �„ .� fe-••;:�-,. tt ...,}I` � �'
FROM EXIST, FOUNDATION � m SEPTIC TANK � � � FINISHED GRADE.
rn
ao / STEEL REINFORCED PRECAST CONCRETEINSTALL TUF-TITE GAS BAFFLES OR EQUALS II °.t.,t, o ON ALL OUTLET TEE ENDSCONCRETE FULL FOUNDATro nH-10 11 Ui ui2' EFF DEPTH „•ry, PLAN VIEW 6 In.of 3/4•_11/2. Z d ig 3-24'11E]10VASLE COVERS d SYSTEM PROFILE aompact.d eon. , o 3. a' 24 Effective1ar d� �wNot to Scale - c • 10' 11 i ., f. :, 4' , :. 3
Sidewall , mh.ekora,« 7 GENERAL NOTES
e _ _
t
C f9fctivf Vktth
c > r c i
` u 3 Units C 7 21 INLET s m�Lmin. Inlet to outlet s.Tti. .<
a in.of 3/4'-1 1/2' a $ 1, I,, r min L vel�* 01J T �' 1. Contractor is responsible for Digsafe notification, Verification of Utilities
compacted stone o s -T * - I ,'s -r and protection of all underground utilities and pipes.
" T
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE
e OD Ef f ective Length +' � `. 4'-O'min, 2. The septic of distri¢t{tion box shall be set
tZ.J Bottom of Test Hole 2 Elev.- 88.00 , w tMr '• Liquid depth level on 6 of 3 4 -1 1 2 stone.
5 3. Backfill should be clean sand or gravel with no
------'--' ' stones over 3" in size.
Groundwater Observed - NONE OBSERVED
w, •. .t.. " 1 4. This system is subject to inspection during installation
SOIL ABSORPTION SYSTEM (SAS) "10'-0• s -s• by Carmen E. Shay - Environmental Services, Inc.
(OR EQUIVALENT) CROSS SECTION AND-SECTION 5. The contractor shall install this system in accordance
with Title V of the Massachusetts state code, the approved plan
Note: Remove sod down to mod sand layer & replace with Note: Certification of Fill Material Required. NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30" /EFFECTIVE HEIGHT IS 24" and Local Regulations.
(elev. 92.00) do replace with clean coarse sand w/pert. Before and After Placement by Solve Analyses TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK 6. If, during installation the contractor encounters any
rate less than or equal to 2 min./In. before & after placement NOT TO SCALE soil conditions or site conditions that are different
from those shown on the soil log or in our design
f, installation must halt & immediate notification be
made to Carmen E. Shay - Environmental Services, Inc.
7. No vehicle or heavy machinery shall drive over the
P E R C O LAT I O N' TEST P 1 162 4 Septic System unless noted as H-20 Septic components.
Date of Percolation Test: '2/15/07 8. Install Tuf-Tate gas baffles or equals on all outlet tee ends.
Test Performed By. CARMEN E. SHAY, R.S.•. C.S.E. 9. All Distribution Lines shall be 4" diameter Sch. 40 NSF PVC pipes.
Results Witnessed By. Dorald Desmarais/
10. All solid piping, tees & fittings shall be 4" diameter
EXCAVATOR: Shay Envlroninental��Services, Inc. Schedule 40 NSF PVC pipes with water tight joints.
Percolation Rate: <2 MPI 072 11. MUNICIPAL WATER IS AVAILABLE TO THE SITE and Surrounding
Test Hole Test Hole Properties.
No. 1 No. 2
DEPTH SOILS REV. DEPTH SOILS ELEV.
Note: Remove soil down to el. 92.00 & replace with
•. t o 99,00 o 99.00 ��
clean coarse sand w/perc. rate less than or t THE PROPERTY LINES ARE APPROXIMATE AND
Loamy Sand Loamy Sand COMPILED FROM THE PLAN BY BEARSE & LAW, RLS
or equal to 2 min./in. before & after placement 1�. 10 YR 3/2 10 YR 3/2 ENTITLED " SUBDIVISION PLAN OF WEQUAQUET HEIGHTS, CENT. MA"
(5 FOOT STRIPOUT ALL AROUND AS SHOWN)
o"- 6" A, 99.50 0"- 6' At 99.50 PLAN BOOK 134. PAGE 113
AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
CIDLoamy Loamy IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
`\ t1 Sand Sand
THE SEPTIC SYSTEM INSTALLATION.
\\ , y 10 YR 5/e 10 YR 6/6
250.33 _ I� 6"- 36" 8, 96.00 6"- 36' B° 96.00
Medi. Sand Medl. Sand
` Sdt Pocket NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
------ - - - -- - - - - - - , 1 Silt Pocket
I / --- - r- -- - -' I 2.5 Y 8/6 2.8 Y 8/6 FROM THE EXISTING SAS TO BE DISPOSED
i W2'
, - - - - - - -- - - - '-\\\ I I t, 36'- 84 CL 36'- 84 C, OF AS PER BOARD OF HEALTH SPECIFICATIONS.
t �-- - - ------ - - - - - - - I) ; i i, Medium Medium
r -- Sand Sand EXISTING SAS TO BE PUMPED DRY dt2 S Y 7/4 25 Y 7/4REMOVED TO FACILITATE NEW SAS INSTALLATION
4'- 132 8,4'- 132' Ct E. 0 I ItTEST HOLE #1it i I w ELEV.= 99.00 it I \ _. III
I - ASSESSORS MAP - 251 PACEL '128
s IN-GROUND I� \ '
3 i b+;,+' ! z SWIMMING POOL o I -`* ZONING - RESIDENTIAL
• I t, :,., .':;i d Perc #1 " -
1 o Depth to Perc: 72
Perc Rate= 2 MPI - Per SEIVE ANALYSIS
8, ,` TEST HOLE #2 I zn Groundwater Observed - NONE OBSERVED m 132"
_ _ t.LL. i 26' I ELEV.-' 99.00 - _I_ _ t O No Observed ESHWT
WETLANDS ARE NOT LOCATED WITHIN A 200' RADIUS
ID Box I ==_=g=====_=_��.,_.� 1 .-t --
SING � I OF THE PROPERTY AS.SHOWN .. .._. �. _..... .
EXIT ---=--- PAVED i
---- I \
GARAGE _ TENNIS COURTS t
I ---_ jT'1ALL--___ II � I •{� v 1 gSTRI9aUTON SOX>�Al sE
PROJECT BENCH MARK t O 1500 al. ----_- -- II
TOP OF FOUNDATION l I Septicank I I sET LEva FaR AT LEAST 2 Fr. 12' CONCRETE covER LEGEND
1 , CONCRETE 1\\ II I \ t1 7 � / KND r ODU v .,.•. .�.., 2
/ } D V
1r INLET - V/�0
ELEV. = 100.00 (Assumed) PATIO
DENOTES PROPOSED
FJ
e' SPOT GRADE
�'OfOKV
I `\ li I ,ss• DENOTES EXISTING
4' - SCH. 4o To ,.>1s• X 104.46
SPOT GRADE
\ I I I \ PLAN SECTION CROSS-SECTION
a Q EXISTING \� I I ' PL PROPERTY LINE
cARacE I; I ; 3 HOLE H-10 DISTRIBUTION BOX
a- -EXISTING
I a_ ; 1 �' I I i I i \ \ PROPOSED CONTOUR
3 BEDROOM
HOUSE 97- - -- -- -97 EXISTING CONTOUR
\\ \ � Design Calculations _
_ 9 N
22 i I t`\ - - J \\ `\\ 111 = ® DEEP TEST HOLE &
L�-� - _- - - - - - - \\ �� PERCOLATION TEST LOCATION
-
1 ---------------- \ \ , Garbage Grinder. No
Number of Bedrooms: 3 Bedroom EXISTING
i I \ FENCE
Leaching Capacity Required. 330 Gal./Day (MIN. PER TiTLE �- �
t
\ Septic Tank : 2 x 330 Gal./Day 660 USE EXIST. 1,500 GAL. Septic Tank.
PRIVATE DRINKING WATER- WELL
SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch _
►\ ,�' �\ �\ \\ t Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. - 222.00 gallons
Sidewall Area: 0.74 gal./sq. ft. x ` 148 sq. ft. = 109.50 gallons REVISIONS
DRIVEWAY - \\ 11 ( Providing: = 331.50 gallons
LOT #71A \
I _ \ tl Use: (3) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH-
ASPHALT
DATE: DEFINITION
ASPHALT �•� 1 49,600 Square Feet +/ t
\ (4' W x 7' L) TO BE USED WITH 4 OF WASHED STONE ON THE SIDES AND Jl1 3/5/07 Changed to 3 BR System
\ \ I �L'
DRIVEWAY I
10, : ,� \ ► �, ; 2.0' OF WASHED STONE ON THE ENDS.
1 . 1 � ��,���/. -• _ a �\\ �\ t 1 1 i t 4
311.58� % PROPOSED
`� ------------J' --------------------- PREPARED FOR -
---------------------------'' `----------�---------------- ----------- _______-------
----- --------- SUBSURFACE SEWAGE DISPOSAL SYSTEM
CENTER LANE of
(14 FOOT RIGHT OF WAY) MR. JONATHAN ANTER '_..,; 22 CENTER LANE
;mot #
�`961 CENTERVILLE, MA
22 CENTER LANE 7
CENTERVILLE, Mq 02632 PREPARED BY:
NOF RffEY E. ,SHA Y
0 20 40 50 ENVIRONMENTAL SERVICES, INC.
_ �
P.O. BOX 627
EAST FALMOUTH, MA 02536 :
v"gSgIV I TA Q vPN
SCALE: 1"=20'
TEL/FAX 508-539-7966
SCALE: 1 "=20' DRAWN BY: CES DATE: FEB. 19, 2007
PROJECT#SD-1017 ILENAME: SD1017PP.DWG SHEET 1 OF 1
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BULKHEAD
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MUSIC ROOM >x
LAUNDRY AREA T-111 I f 7"211
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BATH 13' 7:
24'-3"
D30
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,-fr.
y, 4" LOLLY CLMN FURNACE
8t_'7,t_241-511 It
rl'«` try ^L' aL~(_i'' •xI 'ti�A:. L
3 11 ��
,pr; °SA $'-4" 15°-9t, o SA 2'-10"
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.. ART ROOM
MEDIA ROOM
:+L 2-11 I '-11'"-r oSA 10'-7"
PLAY ROOMT-4114
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D30 f __N
ELEC. & GAS — 16'-8"
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o SA
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t 12,,1„ GYM
4T-1" oSA 10'-7" D3s
5
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AREA: 1811 SQFT � ..".
WINDOW WELL
BASEMENT----FLOOR FLAN
22 CENTER LANE, CENTERVILLE, MA 02632
Designed By: AD
Date: 7 / 4 / 2013
Checked By: ROPOS, ED RENOVA IONS
Project No. 1 - Revision 2
Scale: NOT TO SCALE 22 CENTER LANE
CENTERVILLE, MA 02632 Drawing: 1 of 3
58'-8"
24'-2" .
36 x 36 SKYLIGHT
' D32
0 20'-6"
o 0
7'-6" CL
BREAKFAST NOOK 11
�/ \ DW 2110„
L 14'-8"
El
23-2 13'-7" � ( HUTCH
SAp r
22'-7" KITCHEN 0 8'-11" CL
" I DEN 14'-3"
SA �.
GARAGE AREA BATH I�D3
15o _3
UP �i 1-5,1 °SA �i----- ------� ry�
_
CL�1 BEDROOM 3 3' UP D30 _ •�: OSA_ D30 5, ~:
SAO 3'-10"
20' ors ' D30
-�— - 13'-3"
CL 3'4" SA CL ` 11� SHELVES
-0 21"9 7'"0't `
4 �.
o3z _ r FIRE ;-9 ' I 1 39`-3"
-2 ,
PLACE 2 OSA 5
11
3-37_3,� 12-6" DINING 15
10'-0" C18 2,�9„ LIBRARY 4 LIVING ROOM
2,I7" 3'I7 UP 0 SA D3`3,�2„ 123'-3" FIRE
CL PLACE 1
71
20'-0" 15'-7"
191-211
UP 9'-1001
AREA: 2885 SQFT
FIRST FLOOR PLAN -
22 CENTER LANE, CENTERVILLE, MA 02632
J y:
' Designed B AD
Date: 7 / 412013
Checked By: PRO. OS' ED RENOVA IONS
Project No. 1 Revision 2
Scale: NOT TO SCALE 22 CENTER LAND
-CENTE RVILLE, MA 02632 Drawing: 1 of 3
i
- - 76'-1'1
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28'-7"
D30 BATH "� BATH i
MASTER BEDROOM 8'-6„ 8'-11" CL =
D24
13-0' ' -�
SAS ��-- CL _ ' i O CL ,-� „ BEDROOM 2
1-3 CL D24 2-6
CL o SA
_ - - 2 �5 /-4- D30 31I711 2'-1p D30
PLUMBING WALL � �.
14' CL 31011
-
. 71-a7
11
zz/ 20,.p11 i
15'-711 ,
- 024 D24
CRAWL SPACE / CRAWL SPACE r
-51t
-18'-511
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46'-311 J
AREA: 1576 SQET
SECOND
22 CENTER LANE, CENTERVILLE, MA 02632
Designed By: AD
Date: 7 / 4 / 2013
Checked By: RO OSED RENOVA ,10 N
S�
Project No. 1 - Revision 2
Scale: NOT T4 SCALE 22 CENTER LANE
CENTERVILLE, MA 02632 Drawing: 1 of 3