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HomeMy WebLinkAbout0009 CHAPPAQUIDDICK ROAD - Health 9 Chappaquiddick Road Centerville Y A 170 023 Flo i I� f� A a u aftn&NeYr 0 A ipsefte VIM I, 1521/3 ORA 10/o P2 No. C;cn 7 1$4 0 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,t MASSACHUSETTS ZIpplitation for Migpogar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 7 7,1 —6 3 6 2 2ssesso'salpfa�ce�iddick Rd Centerville David & Beth DeCosta 170/23 9 Chappaquiddick Rd Centervil-b Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO BOx 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder PO) 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 Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install new Title 5 leach system to plans of Eco—Tech, #ETt_—T770. 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 Bo rd o ealth. Sign d Date f Application Approved by Date 6 G Application Disapproved for the following reasons Permit No. —5 7 25 Date Issued D t © _L_ o Z ✓ fi xis _ Fle1 0 0.0 Q uc�•1t� ?.,> THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes �PUB1.I6-HEALTH DIVISION -'TOWN OF BARNSTABLE., MASSACHUSETTS Rpplication for Miquar *pgtem Congtruction Permit `Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 9 Chappaquiddick Rd Centerviller David & Beth DeCosta Assessor's Map/Parcel 170/23 9 Chappaquiddick Rd Centervilb Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO BOx 1089 Centerville 43 Triangle `Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder('�o) 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 Size of Septic Tank Type of S.A.S. Description of Soil Natur o Re ai s or Alterations Answer lvenra ph a e) Install new Title 5 leach s7stf errs' . o pAlans o k;CO Cr>i; `# 1 - - . Date last inspected: I 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 B d ealth. 1 Sign d Date /Q a �� '0 Application Approved by - Date Application Disapproved for the following reasons Permit No. :9w eq — 3 Date Issued /o �O 0 t t DeCosta THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Di s osal Systen; Constructed( )Repaired ( X ) Upgraded( ) Aba do ed( b .Wm E Robinson Sr Septic Service 'napp qy �a' Road, Centerville at has been constructed i� accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. UU tl-S7 3 dated /°/)61"L I Installer Designer r\ The issuance of this permit shall not be construed as a guarantee that the ystem will function as designed. Date 11, ; C1 1 H Inspector l.., W _ ----�5- — ------------------------ — - -- aaoq No. Fee10 0.0 0 DeCosta THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'igpogal *pgtem Congtruction Permit Permission is hereby granted o Construct( )Repair( X)U grade( )Abandon( ) System located at 9 Cttiappaquiddiek toadp, Centerville 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 cone�d--ii-t�ns. Provided: Co stru•tion mfust be completed within three years of therdate of this pe t. Date:_ �� �` Approved by '_ Town of Barnstable CF 1HE T Regulatory Services BARNSTABLE Thomas F. Geiler, Director 9� MASS. � Public Health Division p'E0'A0�A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: `1—`6, C Designer: Eco Tech Installer: W.E. Robinson Septic P.O. Box 1089 Address: 43 Triangle Circle Address: Sandwich MA Centerville MA On W.E. Robinson Sept icWas issued a permit to install a (date) (installer) septic system at 9 Chappaquiddick Rd based on a design drawn by (address) Eca`r'ech dated �����"C� —f— (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer toefgllow. , j DAVio (Insta er's Signature) V y 3 (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certificaiion Form TOWN OF BA�RN/STABLE LOCATION I C �u� � ��` SEW AGE VII.LAGE e— cf,4a 1�� " ASSESSOR'S MAP &LOT / 7®• fU INSTALLER'S NAME&PHONE NO. 'iiy+�►+^ e• ���►� Pi Vic` ��� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -:3e 4720' p� �:,.cl�l (size) 33°�aC la�X a NO.OF BEDROOMS g BUILDER OR OWNER ��& PERMITDATE: —COMPLIANCE DATE: D 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 oP USA �a 44 3 ' Gj TOWN OF BARNSTABLE LOCATION / � Qyr��rtL� SEWAGE # �� VILLAGE e-eA 4cr,0'Ile ASSESSOR'S MAP & LOT STALLER'S NAME&PHONE NO. Wet, C-�4 611,11a, Silo),c- .S'cr✓ece Sze, SEPTIC TANK CAPACITY ],EACHING FACILITY: (type) 3,9 SWO P-rd►i -c1/1 (size) x o NO.OF BEDROOMS �I S r o pe ETJII..DER OR OWNER � to 71-4 q PERMTTDATE: 1 U/.p&/O V COMPLIANCE DATE: , g v 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 or-, pr qa, Oco" �� TOWN OF BARNSTABLE LOCATION 44AMO&d ilt-k 2J SEWAGE # 5 73 VILLAGE Cm4uur II L ASSESSOR'S MAP & LOT/7023 INSTALLER'S NAME&PHONE NO.W fA-L 6PD6 n S U .�e UV Ice SOk 773 716 SEPTIC TANK CAPACITY / 35C$� Gal Qrv�—c1/! (Size)33�Sx l,2.Fya LEACHING FACILITY (type) ) ilO.OF BEDROOMS BUILDER OR� bt CyS�c. ft PERMITDATE: _i0bj&L COMPLIANCE DATE: 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 Furnshed;by 5 o A 3 jy r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .7 v^--r— OF Appliration for Disposal Works Tonstrurtiun Vvrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ............. . .....................0—?............ •- G�` :. Location-Address or Lot No. .........`..... .._.._...........................•-•---------............•.................. -•--.................--•-----....----................................... ...............---- Owner Address� /-- ? ..... ..............................................%� d- Installer Address T Size Lot............................Sq. feet Dwelling—No. of Bedrooms...................................•._____..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----------------------------------------------•----•- W Design Flow............................................gallons.per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity......_.....gallons Length................ Width................ Diameter................ Depth..........._.... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area..................... ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ `� ODescription of Soil....___-h"�-----------------------------------------------------------------•-----...-------------------•--•------------•-----------------------------------._......-------- x U Nature of Repairs or Alterations—Answer when applicaLA�x �..�.rj.�..A.�a �-�� --------------------------------•-------------------------•--------•---------------.....----------- ------- ....... ............................................ Agreement: � The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.�:, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issiq by the board of health. J �p Signed -- .......... _ _ ..................... / . �------...._.... Application Approved BY. ' ....:.......... . . .............................. ..I ....... --•--- Date Application Disapproved for the following reasons:-----•------------------------------•---------------------------------------•-----------•--•---•--...----------- -•----•------•--•---•---•--...--••...---•-------•---•---•-•-------•---••...•-•---.....--••-----------•--.--•--•----•-._...-•-••-••---•---•-•-•-•--•-•-•-••---•------------•------------•••-------------- Date PermitNo...................................................... Issued....................................................... Date No......................... °.�.......... THE COMMONWEALTH OF MASSACHUSETTS .�---- BOAR® OF HEALTH ................OF.......................................................................................... Appliration for Dtopooa1 Works Toni ruction Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System t: ........�."�.._ .. .. c. -. .........-` ................... ............... - - Location-Address or Lot No. - .,...........r» �•' Owned Address --. ------------------- Installer , Address Type of Builds g Size Lot...........................Sq. feet Dwelling—No. of Bedrooms-__... ................................Expansion Attic ( ) Garbage Grinder ( ) pP-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil �_M - - --- - - ._........_._ x U -•--•-•----•------••--••-•--•--••-•-••---•-•- ....-•--•---------------•------.....---•----------------- . --------------••------------------...----•---•--•--•--•••--......._ ---•---------------------------------------•------------------------------------------------------------------------------------------------.......•-•--•-•------...-------••-••..... zv U Nature of Repairs or Alterations—Answer when applicable_ _ ,,._efln_... . ..�_:.a .. -------------------------------------------------•----------------------------------.........._......-•-. Agreement: '"" xt• f The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TiTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss Wd by the board of health �""'.�� iE'` �.:+ !/ '> �_ •z-----•----' fix! ....- A/' �� ---•- V Date ApplicationApproved By........................................................ ................_...._.......---•-------..__...------- _.._-........_ Date Application Disapproved for the following reasons:-----•----------------•-----•---------------------------------•-----------•-----------------------••-........--- -•------------------•---.....--------....-•------------------------------..•........-•--------------...--••-•--•-•-•-----•--------•-------------•-------------•--••-•----•-......----•--•-•---•---•----- Date PermitNo.......................................................... Issued-.................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rt'" .....................OF .�' .�'� '' ""�w..................................................... Trr#ifiratr of f�otn �i nrr TI S I O CERTIFY, T at the f.Individ ewage Disposal System constructed ( ) or Repaired ( ) by... -• -� .. ......... 1-"I' "-----------------;......................................................................•.... j a ..................:"".�--- •-- .......................` I.....Lv.�-- "ofTh"e �'���� G`•......` has been installed in accordance with the provisions of T i L, State Sanitary Code as described in the application for Disposal Works Construction Permit No----------------------------------------- dated----._.___.-..----_---._-__---__._-_------__---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................. =G��� ..................... Inspector........ ' °f f----------•---------•-------•----•-•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ''i No......................... FEE........................ �iopoo I r Conoiion motif Permission is hereby granted._.: ...................�.� .. • ----------- -------•-----------------------•---•--.......--------...................... to Co�tstruct ( ).. ore it �a Indivldual'Sewa e Disposal System as shown on the application for Disposal Works Cons rtic IoA�Vreim%­'.._._ .... ated.......................................... ...... ----------------------- -----------..... -------- f� Board of Health DATE- 4L=',-•- ...U FORM 1255 HOBBS & WARREN. INC., PUBLISHERS LOCATION SEWAGE PPERMIT AO- VILLACE 7-1 I N S T A L L E R'S NAME i A D D R E SjS CRAIG MEDEV"f.�4 T=dking CZ 142 COrpwa t i St " IBUILDEIt OR OWNER mylowlt s-W-s8 DATE PERMIT I S S U E D DATE COMPLIANCE ISSUED r l t�. -A►v OLD xz, I\j j � IV16 .�d No. -1�a. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Grp/!r...........OF....... ..� .. - ?FJ-..1.3- �..--------------- Appliration for Uhipos al Works C omitrur#inn Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at- r �>��.0` /� Location-Address or o. .......... ..w` ---- �-C-O-S'/ .9----•-•................................... . .................. w7' ? ......................................... Owner Address ............................................................... . _.....--•---......•-------.....••--- ••-•--------•-•-•••-•-•...........--•-•-... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............... No. of persons.....................--...-- Showers — Cafeteria G4 Other fixtures ...................................................... Design Flow............................................gallons per person per day. Total daily flow...........:..__.___......____._.___........gallons. WSeptic Tank—Liquid capacity/ gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No------------------- Diameter.A�A.!...... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1­4 Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit---................. Depth to ground water.....................--. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R�+ •--••-•••----•----......-•-----•-••••••--•..........-•••••••-•••-•........................•----..---......................................................... ODescription of Soil.........................................................-............................................................................................................... x V -••••••-•-•-•••••••-•--••-•••••-••--•••--•----•-••--•••-•--•-••-••......-•---•-••--•----•••------••-.....•-•-•-•..............••-•-•••-----•--•-••-•••............••••••••-•-•-•--••......••..........•- W ----------------------------------------•--------------•----. ------------•---------- --------------------------------------------------------••-•.• • -- ..... UNature of Repairs or Alteration —Answer when applicable S (/---- /s:�? _...�.. <�s-r..__y�(l�L %'/0 d c� Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI LE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f h-a Orr / ----- .......... s .�/... . e Application Approved BY F ------ ate Application Disapproved for the following reasons:.............................................................................................................. --..•....-•---------•.........................................•...-------------------------•-------------...........-----------------------------...-----------------------------••••- �� Date PermitNo.......... ..__...----- -. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Jam=' / Appliration for Eli-spasal Works Cron.5trurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ....:...........««._.: ...��.._..---._.........•-••--•.................._.....-•••_. .......••••...••-•--------••--••-•--•....._.....-••--.._.._......__........._......----.......•... r� Location-Address _ or Lgt No. - - - - Owner Address ......... ............•'°='••-•-••-•••••--•...........................---•-•-•-•---•••-.... . .....---•-------•-----........••-•-...........--••-•..........•-•...... Installer ................ � Address UType of Building Size Lot............................Sq. feet �.. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`LI Other—T e of Building ............... No. of persons............................ Showers YP g -------------------•-•-------•--._._......P_.._ ( ) — Cafeteria ( ) 04 Other fixtures ---------------•-- ....-•--•---------.....---•---------------•-------•--•----....._.....-•-•-•---•-•-•-•--•••_... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacityL.:S.`c:gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No......!....:........ Diameter.G_ _ ...... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ ----•-•-•---•-------••••••......................••------•----••-....-•----------...-•-•---•..........-•-•••••••.......•••-•-...............-•••-........••--- 0 Description of Soil........................................................................................................................................................................ W V ......••--------------------------•-•--•••-•--------...••-------•---•-•---•••-.....---•--•••-•-•----....•-•----------••-•-........---------•--•----•----...........---••-••-•-----•-•••-•.._....-•-••-... W U Nature of Repairs or Alteration —Answer when applicable.r :'_.?-.-)_.: .........................................................` �r' y- y-< 5 G ..7; � _ ................ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,in accordance with the provisions of TITIS 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board ofheaI:. Application Approved BY ....._..... 7np...-.. r �t ate Application Disapproved for the following reasons:..........................................................................................................««« ...............................•-----•------•------•--•-----....................-----..•....--------•---.---••--•-•-•••---•---....-•------------......---•-----•--•-••....--•-------••-----••-•••-•...« G Date PermitNo.......... ......f I-------------« Issued..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ?..:.. ::':'✓.....................OF....... ..'7...:`,: ............................................... Tntif irate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired j_ )` by................. 1.. _ r .. ..._.........•-••---••-•-•-•••---•--•..............•-•••--•......_.....-•-•-«_...« r at -.-• a ;t.L'. :....... � '/' Installers has been installed in accordance with the provisions of TITLE of The ate Sanitary Code as described in the application for Disposal Works Construction Permit No. K..._...��_ ... dated.......... - �. ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. = J. P�.............•-•...... Inspector..................... .. ............................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c qc� ........� ...OF......... L�r .�J ...�..1.. ! Fim..... ...... Disposal Works Tonotrurtion Pre it Permission is hereby granted.....1.......1--•-/,.,=..;:r�__ .L,.,�: 1.:� - ___../ .4::-........ ..... /_.................... to Constru ( ) or Repair ( ) an Individual Sewage Disposal System «««-. at No............. �,Ind{ _? c,c... -e-n f T ,.....--- 4................ ...---.... Street as shown on the application for Disposal Works Construction P� ated...... ...... L`. �- DATE------..... 7..-� Board of Health-•-•-••---•••......-•_--••-••S- FORM 1255 A. M. SULKIN, INC., BOSTON r TOWN OF BARNSTABLE " M, L®G TION _ q evo G��� />�SEWAGE VILLAGE ASSESSOR'S MAT G LOT®� INSTALLER'S NAME PHONE NO./� 1�2 rr i SEPTIC TANK CAPACITY / e� 57 titACHING FACILITY:(type) L•-Y ✓ / NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER/4: G�c BUILDER OR OWNER /9,,9 v ari''" / t DATE PERMIT ISSUED: DATE COZiPLIANCE ISSUED: VARIANCE GRANTED: Yes No . 7 �r aP660 3 I � � VENT FLOW PROFILE PIPE RAISE COVERS TO WITHIN TOP OF'FOUMATION 6 in OF FINAL GRADE a -'1 EL � �42 30--+ ONE INSPECTION RISER FOR LEACHING GALLERY } + .+ 41.20 �_p�� 2" LAYER OF 1/8" /1G=L25C� 1/2- STONE 3' DROP I� FLOW LINE TEE ti, K 10- a 14- rrY r" I PRECAST GAS�� a, ;� r - ,'o'r' '': 48 sjr: DRYWELL �^ STONE BAFFLE rrta<`� cr wc�a, BOTTOM OF r' .a 6 in 38.21 +- SOIL ABSORPTION r ` ExlsnNc STONE 37 63 LEACHING SYSTEM BASE GALLERY EMST"(1 * ' 37.80 - EXISTING - 37.a5 5.00 ft '« Ex�TNo I500 GALLON (END VIEW) 35.45 SEPTIC TANK Ewsnrlo ' ' 28.9 .fr a) 5 Fr 12.5 Ft # "`.•� .y f =f= , ADJUSTED 30.45 SEASONAL HIGH GROUNDWATER 3 ' lJ1 �j n m rn _ k m m z r . Y S M1' i . r) a m v, y m Z n `can oo Z N A. 0 -J o /�oo T o m a D m m m Z m -70 9 G " y �'1 �X.c°< / A 9 w 77 "� X 3 Cf> Nay a-+ n fit? $j �(�. f r Z na (,, rT-1 r to —1 m c m--I d n S m 4 Iito 0� -o o 'o � --i 'op mm C) -n z to m � (� o�, _ m-r ..m O� � fTl,� �. < ZO m m n n4� � ,.` a= m cd ° > t z inz�n n 0 (n v v�<n 01 W�� .... 'CI'mI x Q C�.J ® ° 3 N D D SKUNKNET r T jr�i a " f- 1 7D 1 1 1 U� fll W � ;n RDAO r tV' cc > O rI pZ O m� m ,dT .r O > U> O, r n O rn 1. ,,— z, -Z o y O wag c� < y lk "1SGz� ss m C 41 �. 3 n ,, R 7C m 1 mv �z s ) i� Z, c, m . ice; ':tv trn --� 7ti r aL •-� rt z: 4t3 M f�"`�.,} i*,'"}.r•Y, , - 1 - ..w::lt, .., _..it.,««r.-_ +!«�.hir ui�:lH,:/�i t�d..t�`r�.'��.pr.�a�a,.�;..a._,,.. c_:o`M..`,.�..1=.. - � .. - .c...._ ... ,.. ai SOIL T Es T L_ o _ DE S I GN'-' .C,A L C U L- ATIONS. w f DATE OF TEST OCTOBER 6. 2004 SOIL EVALUATOR: DAVID D. COUGHANOWR, -RS WITNESS REOUIREMENT WAIVED - NO VARIANCES SOUGHT - DESIGN FLOW: 4 BEDROOMS X 110 GPD - 440 GPD.GROUNDWATER ENCOUNTERED 180 , TEST PIT I ' PARENT MATERIAL: PROGLACIALTOU WASH ES SEPTIC TANK: 440 GPD X 2 DAYS - 880 GALLONS ELEVATION - 41.15 PERC AT 90 in : 2 MIN/INCH IN C SOILS USE EXISTING 1500 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL -CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) _ DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) _:HORIZON TEXTURE (MUNSELL) MOTTLING DISTRIBUTION BOX: USE 3 OUTLET D-BOX. 0-38 FILL SOIL ABSORBTION SYSTEM: A 33.5 ft x 12.5 f t x 2 f t LEACHING GALLERY CAN LEACH 38-40 0 LOAM 10 YR 2/2 NONE FRIABLE A b o t - (33.5 x 12.5 ) - 418.75 s f 40-46 A LOAMY SAND 10 YR 4/6 NONE FRIABLE A s d w - ( 3 3.5 - 33.5 12.5 - 12.5 18 4.0 s f) x 2 - Atot - 602.75 sf 46-74 B LOAMY SAND 10 YR 5/6 NONE FRIABLE V t 0.74 x 6 0 2.7 5 - 446.03 =G P D 74-186 C MEDIUM SAND 10 YR 6/3 NONE LOOSE USE A 33.5 f t x 12.5 f t x 2.11.7t GALLERY. Vt - 446.03 GPD > 440 GPD REQUIRED GROUNDWATER ADJUSTMENT LEACHING GALLERY CONSTRUCTION DETAIL GINS. OBSERVED GW 26.15 GALLON PRECASTEDRYOWELL INDEX WELL SDW-252 \ EOV VAILENTNIT OR ZONE D sTONE READING DATE. SEPT 04 READING 47.6 2 ft EFF. DEPTH 33.5 f t ADJUSTMENT 4.3 ADJUSTED GW 30.45 ro to n O O O O O '^ NOTES " 1) GARBAGE GRINDER NOT :ALLOWED WITH THIS DESIGN 2) ALL LINES TO BE SCH 40 PVC^ AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 33.5 ft OF MASSACHUSE'TTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM, 5) EXISTING LEACH PITS TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE DOUBLE .WASHED AND FREE OF IRON. FINES AND DUST IN PLACE ♦ 1 ` 7) LINES EXITING 'D-BOX TO RUN LEVEL FOR 2 -O' BEFORE PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW--FLOW. FIXTUREs SEWAGE DISPOSAL SYSTEM.j=PL#ANk AND APP,LIANCES.Y=AND. BIANNUAL PUMPING OF-;THE 'SEPTIC. TANK...,.' - � _.. � - -'-TO-. SERVE.�EXISTING:;D,WEL-LING f "x 9) 'SYSTEM` IS"NOT7DESIGNED TO WITHSTAND• VEHICULAR LOADING. DO NOT p - PARK OR_ DRIVE VEHICLES OVER SEPTIC SYSTEM. - . - -- ., -'. « DAVID (h '-BE I DeC.OST`A� :. . 10) .INSTALLER.'TO 'OB_TAIN DISPOSAL -WORKS PERMIT BEFORE STARTING- WORK. - - .9 CHAPPAQUIDDICK_ ROAD�GENTERVILLE:,MA la O - - • I I) SEP.TIC-TANKSaSHALL BE. .INSTALLED:LEVEL AND =TRUE TO GRADE �ONF A LEVEL ,-- {.. :_!.'.__:;. s STABLE•-BASE THAT.-HAS- COMPACTED .AND, :ON'�TO ;WHICH - ., :. ..• .,.- ;.'„• "" fCRUSHED--:STONE P AC TO `MiNIMIZE<UNEVEN='SETTLING SIX-:INCHES {OF HAS BEEN L Eb •_. __r.'_> : v, - . -',CHECKED... 2) SEPT IC TANK-•TO 'BE,%�PUMPED. DRY_ AT TIME; OF. SYSTEM:�REPAIR AND, _ .; .. - k F ,.. `.."`,.. '> . ..:...__� - --r.-•:,c y;-.:.;s':r,,':.- .. 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