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HomeMy WebLinkAbout0020 CONNERS ROAD - Health 20 Conners Road Centerville A= 251-066 i S M EA® No.2463LOR UPC 12534 smead.com • Made in USA �J��cvct� i 3 FBERUSmNrAs LNEPRODIKT SFI OFTHEMPRVAW REnUQtFNIFMS SCE AEG VWVW.SfiD20�� No. t y r U l r Y - Fee /d d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Misposal *pstrm Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System 21ndividual Components Location Address or Lot No. , C®�fil�/'S Owner's Name,Address,and Tel.No. Assessor's p/Parcel e4l f/e '7494,1 1' -eweety Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 9 Lot Size l 6Z sq.ft. Garbage Grinder( �Q Other Type of Building J`/ L' G� No.of Persons Showers( ) Cafeteria( ) Other Fixtures 2`, Design Flow(min.required) J gpd Design flow provided J`7/ , 3 gpd Plan Date ///iF& umber of sheets /�� 4151 evision Date /Z Q Title yr , �� ® e:746v /1 Size of Septic Tank /oo � , 1'<5 Type of S.A.S. �" ✓��i�o � �� �s Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H lth. 17 V Si Date / Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 2 U 10 —D d2 Date Issued p .........� ...,..,. .. ..,.its_.,r:s•...r-+..+.r•+wv*+..,.:.Y�+•�"e,aanh�'avdfroivwt^'.""'-"+v^-�.......`-+rnw,^-� s..�,+.r:.•vt,r`M,n+h..o'e%s':i�:rw.,i`�':'�.a's^�f..'._'r�} � No. U � U - UI � Ff ' 7 Fee /0(j d Wit' t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS F, Yes application for his oe al 6pstent Construction J)ertait Application for a Permit to Construct( ) Repair Upgrade(�,j Abandon( ) ❑Complete System 21ndividual Components Location Address or Lot No. � Q C We'4 S rep , Owner's Name,Address,and Teel.No. Assessor's6ap/Parcel GGI�j '/ (// Ile -;Wfl 11�"Al-f/y Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �rtola�fi' CH>�` 77/, Type of Building: Dwelling No.of Bedrooms 3 Lot Size A/�� sq.ft. Garbage Grinder(�/Q Other Type of Building No.No.of Persons Showers( ) Cafeteria( ) Other Fixtures l 1 Design Flow(min.required) 33Q gpd Design flow provided 3�' `7/ A 3 gpd Plan Date r�/��/Q 9 (Number of sheets Revision Date Title Size of Septic Tank P �AM/f�1Q'/ . ,�/r/5_� Type of S.A.S. 41"' 3e,-7-5-0 Description of Soil �~.r if.215:1 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. �/ f Sigtre 6` "�-'� Date Application Approved b I 7 PP PP Y {� D r �!� .,�•�-F' �� ate Application Disapproved by Date for the following reasons Permit No. ^�U u -U j Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(1� Upgraded( ) Abandoned( ) at z� C0AY&1-6Y 3 �"G� (��� `�' has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No..)Q/u-/1 J dated Installer Designer #bedrooms Approved design flov </ end- The issuance oft is permit shall not be construed as a guarantee that the system will nctiltF designed. Date ( Inspector 11AJ 11 . No. _?Ulo - 1.7 Fee /0V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction J)ermit Permission is hereby granted to Construct( ) Repair(V�' Upgrade( ) Abandon( ) System located at Z•a ©oyelo ' a y�%/' Gee en l,'�� and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permiDO Date / /U Approved b .); , � � S d - r TRA1*4S. NO.: APPLICANT: ADDRESS: DESIGN IEL® gpd REVIEWED BY: DATE: N/A OK N0 e4 Legal boundaries denoted [310 CMR 15.220(4)(a)] 110/6 Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(f)] daily flow septic tank capacity(required and provided) soil absorption system (required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] i Location and log of deep observation holes (existing grade el. on / each test) [310 CMR 15.220(4)(h)] •/ Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(1)] Percolation test results match loading rate? [310 CMR 15.242] Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address Sheet 1 of 7 N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case / of surface water supplies and gravel packed public water supply ✓ within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CNIR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] - Water lines and other subsurface utilities located [310 CMR / 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) V Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor (required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as ✓/ approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] E; Test Holes adequate to confurn adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.000] System components not> 36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] Address Sheet 2 of 7 p�3lid/A OK NO .7 JL'�li.�e,�d. .La�1�Y�.t tYi}i�°,• 1 �... Y .a 2 �0.yWSt-.'ui^1;stRr) Size OK? [310~CMR 15.223(1)] Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)]. Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228(1)] Separation between inlet and outlet tees (no less than liquid / depth) [310 CMR 15.227(2)] �/ Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] " < Access to within 6 of grade - one port for systems 1000gpd, two for systems >1000 gpd [310 CUR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] "Fed .(xyyTsM'7n+Ta aE'mXis'7fs btlWt;7Y; .A` f�iyt�i'a d,� t id'�:G Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address Sheet 3 of 7 N/A OK NO MUM 1�;II�R PYY'Y11�T�Y� yU `:, ' Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[11) Cleanouts required/provided? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/ (leachfield below pump chamber) r ps or vent manifold specified? nd orientation of discharge holes specified? (not smaller/8" not larger than 5/8") [310 CMR 15.251(8) and 310 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) DSTI2I��7I O SIC BOX Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] fit Capacity(emergency storage above working--design flow)? [310 CMR 231(2)] Proper setbacks [310 CMR.15.211 (same as septic tanks)] Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] Service components accessible (not too deep with piping, disconnects accessible) Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating m lead-lag mode. [310 CMR 15.231(6) and(e)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)] Address Sheet 4 of 7 N/A OK NO 1L �BSORPITI�l ° 5'STEl '( G +s1AT '"r Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] . Inspection parts specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] LES;tIT3 �S�1V� # 253 !t; �a', Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate P minimum- 4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum. [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] Ir >FI. 3 r0 C1tS_5 d , Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater (3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMRp15.252(2)(a)] Maximum separation between lines 6' [310 CM RI5.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds I U minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address Sheet 5 of 7 N/A ®K NO Pressure Dosed System..,.. Provided pump and piping calculations as required [310 CMR 15.220(4)(1)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless sys tem-make sure et is dire cted.as not to scour soil interface [Guidance Document] Inspections once per year (systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(01 �Gra11F7 e' �s�'e.na ( 4 Pr , Na ;e tees, Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface l i�dtiyFT ic s`lepri /Cl/ 'nTy 'ovcalLe Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance Are the variances listed on the plan? [310 CMR 15.220 (4)(q)] RLS Stamp necessary on plan if a component is within five / feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address Sheet 6 of 7 • v N/A OK NO Is the system in a Designated Nitrogen Sensitive Area ,..., y gn g Area (Zone II for / a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and v/ 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? 1310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] yypp Id�zsLellcctae®ics . i P tX i 3 F'a, Pumping to septic tank? [ 310 CMR 15.229] Shared System [310 CMR 15.2901 Address Sheet 7 of 7 Town of lRanistable ®FEE R' ,ulatory Services x Thomas F. Geiler, Director BARNSFABLE, •', MASS. Publk Health Division Thomas McKean, Director 200 Main Street,Hyannis,II A 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certificotion Form Date: Sewage Permit# Q010 /O� Assessor's Map\Parcel Designer- �Oon e /no,49 VY, JUSta lere e0 -�/0 U� c q (t Address: l�/ Ma I � y AAddress: �0. dd x a,►-►�o to Po r-f- /w b On / y(<� ��� ly � ��5�, was issued a permit to install a (date) (installer) septic system at a0 Cp/1 v�J a, based on a design drawn by /� (address)c.n f / � 1 /O dated // /3/�% ��y 1. l// 9' (des'gner)' i 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 to follow. OF DANIELA. o OJALA (Ins er s Signature) CIVIL �No.46502Q 0� �SS/ONAL CD (Designer's Signature (Affix Designer's Stannp:Iere) v, 1•� PLEASE RETURN TO BARNSTABLIE PUBLIC HEALTH IDIVIS10N. CERTIFICATE-- OF CCaIW1r-LW-4CF VUI L- NOT BE ISSUED tTN'1'iL BOTH THIS FORM AND AS-B IL-T CARD_-ARE=7f' RECEIVED BY TIIE BARNSTABLE PUBLIC MALTII gDMSION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc `f TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE ,e;41w, ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. ,��d�i�i �yST•ct� e✓ �- mf ,6 SEPTIC TANK CAPACITY aaa LEACHING FACILITY:(type) o!�y (size) y .04 NO.OF BEDROOMS 3 OWNER /K7 PERMIT DATE: I-IV-10 COMPLIANCE DATE: ;t :�ct Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �� Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) ` Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY .- a Town of Barnstabk Department of Regulatory Services BA BAH Public Health Division bate la t6� 200 Main Street,Hyanais MA 02601 9 ry l' Date Scheduled Time Fee Pd. Foil Suitability Asses,srizent for Sewage is°po, al Pcrfonned By: Witnessed By: 1/ ` LOCATION & � a NE RAL l[NFORNfATION Location Address QC) O � � Owner's Name Ke in ti `Z V11 Address 6 .t Assessor's Map/Parcel. � / Engineer's Na I,e NEW CONSTRUCTION REPAIR Telephone#1 6:0, • �fod l Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Linc Ft 011ter ft SYMI'TCH: (Street name,dimensions of lot,exact locations of test holes&pert tests,locale wetlands�111 proxindly to holes) /Q GA 2 5� c �°o 5&(_ Parent material(geologic) CST It- Depth Lp Bec Depth to Groundwater: Standing Water in Hole: 3SS Weeping n-am Pit Fftee lz% -&5 Estimated Seasonal High Groundwater DETERAU VATION FOR SEASONAL HIGH WATER rJG'.AB Method Used: " + Q Depth Observed standing in obs.hole: In, Depth to 59113101 Depth to weeping from side of obs.hole: 1!1, Grouadwuter,Adju91ment Index Well#P Reading Dale: Index Well level '_. A01,faetor' , .T A41.Ormllit u[er Level_ 1 C> A ERCOLA11I.OA'V .tl.ETS A L,Da1 'Q�111�L Observation Time.at 9" Halt# 6 %� Time at 6" Depth of Perc m 3 kJ M c}'J ,,,,,A � 1a car, . Start Pre-soak Time @ � Time(9"•6') /rV End Pre-soak U Rate Min./Inch / Site Suitability Assessment: Site Passed Silti-Failed: Additional Testing Needed(YIN) Original: Public Heald,Division Observation Hole Data To Be Completed on Back----------- ***If percolation testis to be conducted Within 100' of Weiland, you niuSt RilirSlt UGUFy axle. R Barnstable Conservation DIvisioll at least One (I) Week prior to beginning. Q:\S EPTfC\PERC FORM.DOC .DEEP-OBS ,RVATION HOL + L®G Depth from Soil Horizon Soil Texture Hole# Surface(in.) Sdil Color , Soil Other (USDA): (Munsell) Mottlin g (Structure,Stones,Boulders. Co istenc %' ravel lgy2b y - t ------------ D.REP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture ®Ie# Surface(in.) Soil Color Soil (USDA) (Munsell) Mottlin Other ! (Structure,Stones,Boulders - $ Consi POCY,%Oravel 41f C DEEP®BS]'RVAT ION HOLE LOG Depth from Soil Horizon ��®]�# Surface(in.) Soil Texture Soil Color (USDA) (M SoilOther (Munsell) Mottling (Structure,Stones,Boulders. Co sistc c O ve ' Sr ]I ]EIERD GBSER2VATiON g�GL� �,®G _ Depth from Soil Horizon Soil Texture Hole# Surface(in.) Soil Color Soil Other (USDA} (Munsell) Mottling (Structure,Stones,,Boulders, Consi ten c a I f•Wd Insurance Date IVpi$ Above 500 year flood boundary No Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No yes Depth®� i l��tturallp ®ecurrine)E'eiryious 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? If not; what is the depth of t:att:rally occurring pervious rnattwlid _ Certification I certify that on fy. (date)I have passed the soil evaluator examination approved Department of Environmental.Protection and that t PP t ved by the he above anaiyeis•was performed by me consistent with the required training, expertise and experience described in.CIO CMR 15.017. Signature Date Q:\SCPTICU'ERCFORM.DOC l n leo l 1 U; C;o i 1 � b w1 -I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS FEB 9 1999 DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON ILA 02108 (617) 292-5500 TRUDY CORE Secretary DAVID B. STRUHS ARGEO PAUL CELLUCCI Commissioner Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 20 Caywers �• cenferVi•& Name of Owner' �r Address of owner: z�p D�`�✓� Date of Inspection:SA3l99 iv r Name of Inspector:(Ptease Print) Rr��lrd 4 to Section 15.340 of Tide 5(310 CMR 15.000) I am a DEP approved system inspector pu Cornparty Name: I n'T Marring Address: D.�dx y d r ns MA OZ6,S3 -v/78 Telephone Number: 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 _ Fails Date: Inspector's Signature: The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty (30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of-Environmental Protection. The original should be sent to V-M copies sent to the buyer, if applicable, and the approving authority. system owner and NOTES AND COMMENTS revised 9 '2/98 i Pagel of11 %j Primed o�Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 C 7nne" Owner: /-. µII&- Date of ku;peetion: V-77/9y INSPECTION SUMMARY: Check A, B, C. or A A. SYSTEM PASSES: 1� I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined",explain why not. _ The septic tank is metal,unless the owner•or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ - The system required pumping-more than four-times a year-due to broken or obstructed pipe(s). Thesyatem will r— inspection if(with approval of the Board of Health): - broken pipe(s)are replaced obstruction is removed revised 9;2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 CrA H tf P Owner: j„ f}Igqcr- Date of Inspecti3n: VZ y j I C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: KA— Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the 7 public health,safety and therenvironment. 1) SYSTEM..WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICKYALLPROJECT THE PUBLIC HEALTH.AND SAFETY AND THE ENWHONMENT: _ Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: - _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS,is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9,12/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: ZO COMner'.S R.�. Owner: Date of Inspecti 11 23%yy D. SYSTEM FAILS: You roust indicate either"Yes" or"No" to each of the following: 1 have determined that one or more of the following failure conditions exist as described in 310 CM R 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No _ Backup of sewage intofeciiity-ef-wf*tem componentdoetto an overloaded orcleggedSAS-or cesspool. - Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in,the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is-within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for »coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to pcbli• health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is-witWn 200 feetofa#ice+tear teaaurfaoelltira{cir+g water supply - --- - - _ _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone It of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4ofIt SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST' Property Address: 28 456:IACrl Owner: L. A 1 q er Date of Inspection: V Z319 9 Check if the following have been done:You must indicate either"Yes" or"No" as to each of the following: Yes No _No Pumping information was provided by the owner,occupant,or Board of Health. None of the system compoaents haw,boen puarped4or-atJeast two weeks and tbe"system hasAmwa=c6i0i094"WMW flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. NA As built plans have been obtained and examined. Note if.they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _k-_. _ All system components,excluding the Soil Absorption System,have been located on the site. �i _ The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge, depth of scum.. The size and location of the Soil Absorption System art the site has been determined based on:- OVA _ Existing information. For example, Plan at B.O.H. _ NIA- _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)] The facility owner(and-occupantJf different from-owner)wcere prnuided.wi2h iof^*�*+a*ioann t T mai^*a^ "^'f Subsurface Disposal Systems. revised 9/2/98 Page 5ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: ZO C "AerS . Owner: J.. &'q9er Date of Inspectio0i: VZ3/yy FLOW CONDITIONS RESIDENTIAL: Design flow: L O g.p.d./bedroom. Number of bedrooms(design):3 Number of bedrooms(actual): 3 Total DESIGN flow ,?� O Number of current residents:Z Garbage grinder(yes or no):_(d Laundry(separate system) (yes or no):j&: If yes, separate.inspection,required - Laundry system inspected (yes or no) Seasonal use(yes or no):4. Water meter readings,if available(last two year's usage(gpd): Sump Pump(yes or no): 10 Last date of occupancy: 14au: COMMERCIALIINDUSTRIAL:_I l� Type of establishment: / .Design flow: aD ( Based on 15.203) Basis of design flow Grease trap present:(yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system:(yes or no)_ Water meter readings,if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information:' Js ulfP System pumped as part of inspection:(yes or no)-NQ If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components,date instafled{if known)-end source 4a44nformation: Sewage odors detected when arriving at the site:(yes or no)to revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) - Property address: Zo eor+.,crr RJ. Owner: G, 141yer Date of Inspection: I/t-3/9 y BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction:_cast iron f-46 PVC_other(explain) Distance from piivate water supply well or suction line Diameter 4" Comments:(condition of joints,venting,evidence of feakage,-eta) dnnd -- SEPTIC TANK- a� (locate on site plan) Depth below grade: cover 2" Material of construction:✓concrete_metal_Fiberglass _Polyethylene_other(explain) -If tank is metal,list age_ Js_age.confirmed by Certificate of Compliance_(Yes/No) Dimensions: /O[�t3 r!�!'• Sludge depth: tiro Distance from top of sludge to bottom of outlet tee or baffle: -3 1 Scum thickness:11`�u 4 Distance from top of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baffle: t z How dimensions were determined: wn.wxurr Comments: (recommendation for pumping,condition of inlet and outlet tees or-baffles,depth of liquid level in relation to outlet invert, structures integrity, evidence of leakage,etc.) �iti�ia 1' a SB /911 f 1►, �/r `►M`�earldltrtsi•1 —Ze✓r'1 -/16 APA-S- GREASE TRAP: (locate on site pl n) Depth below grade:, Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:.2.0 Corner$ AA Owner: J,•. A(g er Date of hspection: I�L 3 42 9 TIGHT OR HOLDING TANK:4Tank must be pumped prior to, or at time of,inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX:1�� (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.) - -- N��'.atr-T oLc2 k PUMP CHAMBER: 41A (locate on site plan) Pumps in working order:(Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Lo Ccr»n ars Rd Owner: 4. Alge-r, Date of Inspecsorf I�L3�9y SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Type: leaching pits, number: 6 X4 leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields, number,dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure,level of ponding, damp soil,condition of vegetation, etc.) ilt 4Pc+ nv o"r!locv ra 6" s� rn Trion a cdc>}- CESSPOOLS: (locate on site an) 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) - o Comments: (note condition of soil, signs of hydraulic failure,level of pending,condition of,vegetation, 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, etc.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Zd 61J) ICP,s Ail Owner: L. i9/5cr Date of Inspection: ,,23/99 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) � a B 1-- Z 4-' Zoe Bz a 9' A3 - 2e 63~ 36 A4.- z' 84- — 4-�' Canners' Rg. - - e revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYS fEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:26 C"oAners Ad- Owner: j,� Al er Date of Inspection: ��2 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _. SITE EXAM Slope .3 Surface water Norio Check Cellar I.— Shallow wells Estimated Depth to Ground watert—al Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed.Site(Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers i,,,-' �sed USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) �;nisi grade �' Elegy. 6a water �It;r. 3v — Ae.?rdy like at J4 revised 9/2/98 Page 11of11 Fxa.... 1Q%(�..�J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTI-4 f Appliration for Movoottl Worko Tunotrnr#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair (1-3--,Xn Individual Sewage Disposal System at: �� 1.. .... .... ................. ......... ----- ---..... ..... ...... ...... Locati Address r t No. .. fit.�i'1 S ---- '....b... . YU.a.l .......................... ................... Owner dr ss ........ _ ... C r_�� � s C . . . ............................................... Installer Address dType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, 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....................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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.--.................---. 04 .---•----•-- ........ O Description of Soil---------------���--f �. ............................................ ._.._.. ----------...........--- x x .-------- ------------ U Nature of Repairs or Alterations—Answer when applicable.........1:-,�.�u,(1... .. .»_�.. ........................ ...............................................................-................................................ t�-&T.. _)."r................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hhE y the bo of health. Signe /.l...•• ell Date Application Approved By............................ PL.�.L Z'��. ----•------ Date Application Disapproved for the following reasons------------------•----•--------•----•-----------•------.......------------------------------..._.............-- -----•---------------------------------------------------------------------------•---••.........----•-•.....................•-•••••--••••-------•-------•-----•----------••-----•-.•----•----.......-•--- Date PermitNo......................................................... Issued....................................................... Date ------------------- ----------� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, ..awn.........0 F... ea w-....dam`-J-0,k ........................ Appliration for Diapoiitt1 Workii Ton rurtivit Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (L-)'an Individual Sewage Disposal System. at --� Locati Address r Lot No. ---_..... r � .. c. � ...................... rf _ " �.1. -_--------_ .........------ ....... W r �� -�. . be - -� ���� Installer Address d Type of Building Size Lot............................Sq. feet v Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ---------------------------- No. of persons............................ Showers { ) — Cafeteria ( ) a' 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....................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. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ GL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wafer........................ - - �-- - - f•------------...---•--=--------....------._.._...---------.....---•----•--------•----•-•-- O Description of Soil----------- -•-- x _ .._._... lam -••-----•----•---•------•-••-•-•-•••----•--- ........................................... x --------------------------•-----.-...--••-••-•••-•--------------= .................................. ........................... 0 Nature of Repairs or Alterations—Answer when applicable._.-----.J- -/-+ .. ---_-_--_-____:_____________ Agreement: . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo r of health. �i .411,11 Signed f =-- D ��._._. . f pp Date Application Approved By---------------_--------_ .....x••- L�.•= L .��_ Date Application Disapproved for the following reasons:.................................................................................................................. -•-•----•-•-------------------------------•------------------...---------•---------.....----•-------•----•--•-•--•-----•-•-•---------•------•-•-•--••••-------------------••••-••----------••-----...--- Date PermitNo.......................................................... Issued......................................................... Date THE COMMONWEALTH. OF MASSACHUSETTS — BOARD OF HEALTH ........ ............................OF... .js' .-) !.16!............................ Trr#if iratr of Toutpliatur THUS I,$.,TO CERTIFY That the Individual S wage Disposal System constructed ( ) or Repairedby ( '-} 1' .... !' -------- at... ........ _ s-----•--• I P fl ..---•--••-------------•----•-----........------- Can. t.. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........0-.3_-"dvl�.-.__._.... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACT RY. DATE............................................................ L_ Inspector............................ ........................... THE COMMONWEALTH OF MASSACHUSETTS , BOARD m—Q HEALTH OU ............. , )l...........OF......... . . ...................................... FEE.�V.� Repo t or u Touptrudion ramit Permission is hereby granted ranted_.--•--� '- -.-_ - - -- - -- -- -------- � to Const t ( ).Cr-_Repair,(C .) .an._I d-v_i _..-. ! .D al S ytemi i at No.._, .... ?? ---•--....--•---..--- �(•�"!�'1.§tre �j ,i 51' ..,...... et as shown on the application for Disposal.Works Construction 'No..................... Dated................................... `___ Board of Health DATE................ FORM 1255 A. M. SULKIN, INC., BOSTON LOCATION SEWAGE PERMIT NO. D (2G�twos VILLAGE A4) T -2,J d INSTkj-L"'S NAME i ADDRESS e U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED l I /0 I \ t f {j� i( Y � � { 9� .� �; '°� $ B°` °�� �,fJ �-° 1 .�� � f si � � r� � .��; _ ,_f ..,�. �-' �: � � � `_ _. � .�� f)r,� � �_ �� � � j � '-= �� i �` : � � � ��• � J -�- �= � j .. � s � �� � � � `� �� � '� { M }�; �. � � i F�p ' � �� �. �-� l' /� {{i . ,� � � � � ci 9 iR � :� i r � i i e S � f9 p i �/ [[[ ` .R«f+n<mi�naa�earxtxsaa�a�v�zrv� i y� S i 9 i { { i 1 -_---�- ..-- 1 i . + 1" ! rA 4-1 -W -7 M_v --------- r - - i t C C G J- - _ --z�- --- ��1.. GC_7 -'" SCALE:/ � ( �� e/ APPROVED BY: DRAWN BY { DATE': /0` 0 HYdY11115,MA DRAWING NUMBER 1 BARRYJONES=HENRY ARTIST/DESIGNER - i i - - _ --------------- ff t71 _.._. ._- 7, 10 ! { - 1 -- 4 E Mgr . �.,,s.�...._-.:....:.:._...m....:.._-...—..._....__..._.............�.a.�.�.�_._. ... �....._._.....-:_,,._.. a<,..,�r ^�� t I O_H_JAL.. U E: t-i q- Z..o J 1 APPROVED BY: - SCALE:� Q DRAWN BY DATE: 3-2.., ^�l7fa de's i n Hyannis,MA DRAWING NUMBER BARRY.JONES=HENRY DESIGNER - d F 19 ' , it _ 14 a .... .. .,., .._......... _ ..-.aW ..._.. _..._tee �.. _. .._.,w. .... ...._. -. .d_._. ,Y # t f z 2 0 SCALE:YWt '— (� APPROVED BY: DRAWN BY .. - DATE: Hyannis,MA - DRAWING NUMBER BAI{RY:JONES HENRY DESIGNER C F 19 4 ----------- . .......... ....... _..._...__ �- i' i 1 EE ......... • ha_: SCALE: �+ ' APPROVED BY: DRAWN BY /q = I o DATE:'3-Z' deQS1 n Hyannis,MA DRAWING NUMBER BARRYJONES-HENRY -DESIGNER �-- OF 19 ! ! -- — —"—--- 10 O a >J r' (J 1 If d . HDNo � { tlAI I !� Is f o;a i a —j-- _.: I L i F .. SCALE: I APPROVED BY: �' _ DRAWN BY r ' - DATE: 3--2- (��o Hyannis,MA DRAWING NUMBER BARRYJONES-HENRY DESIGNER 4 dF �— 4 T— I I 9 { I as `0- t I Lae-P1=IV44.y 4 !N r G -.. C. i. 7 .4. GC cm L._t_ I�C�1�11_c.�/ 4 ,r.5...� ;l> (::7 /--t e d�fUosvy Lwj cp� 7 SCALE: 'I , APPROVED BY: - 5)V���7 _ �� � � DRAWN BY DATE: .-Z -0& ju e8l9n Hyannis,MA DRAWING NUMBER BARRY.JONES=HENRY DESIGNER 457 - C F — 5 i I � 1 ---------------\ git 2UL_L_ -00 t R �~ -1---•-- --.,._._._,.���l - �, r,�= .���rt�a� ram. �pm _ � )2-1 --� � _ � � f v iv �".,�"„ ! �' Rey a w�• _ �}- .� i I € ; wn Utl n, � Llrit • 'C nItz . } - _ A �� UYU, ricv�� _ _ � s nQvj:. �, _-r ... J � 9� �� >�,_�, �t•^1�.F_'�AT"GN- i r> N a ..-. � L G hFJ �s- - i t vL � I . - - fIV I-(�IZv Gt�x � '� ' ��o G - _N ✓/a-� , a4310 \� I wl I ' L I '. MATC1A t�w_> " { j `!_BvrrvM,�ti F f a I _el Inc.is 2XG4�r1 IA J- 1 J, of r-t9VFiunT'1vq'-- i 0 • .Zo , APPROVED BY: i SCALE: - Q DRAWN BYa; _ " DATE: 3 de8ln _ Hyannis, DRAWING NUMBER Y BARRY,JONES=HENRY DESIGNER. O �— i lift.o�F- i . r , _ <F .'i-r iLt�t! ed 4afALA :tom t 4s I :52S eAL-Ly z ; p , � 2xgPT,-{fib.@1�E. .••_-.� �'o i � M'�A ) • f_U S.I f to E.i, { 1 4N C1 4 1`!_J _.5::'f Li) -/�--1 C- co N ti . Zo G:or'j N vrz S R'Lo)A +?, SCAIE:14)1�� 1 '- 0 APPROVED BY: DRAWN BY ;=�i j r de8l Hyannis,MA DRAWING NUMBER BARRY,JONES-HENRY DESIGNER -- a F E�t G 6�t G32�CT2 OC41. V'/A 0 G__ .. C-0NC- I—ulC' rlPlCl � I � �.14L.44G ^ s UU 3 _ 1.E 0 6 ! I ,, L 1.�6�1Ts—�.s S T s�1.G � - 1./_a i-�.G�" I �F-k t'�J ' � `t 6 �/ter • i< �`�j �f{jy i • ! %2 _S�.zr_ 41,tcrt�Z-_,3c� �y ��t,._�•5h �'•-,..�4 .s 5, U----- .—l-• s , w. -- t 6e-r J_ V E 6-V TG,+ = Yrt Itzc-- IrZA 7 t ).i F ojj:� {i {{ 30—_ + t { _.� 7?�-ic.J�-.-_�F�r�_r—_rr_�G�.,r_G©1.I-��=_T�_F�..acs�• `04 i ' I J S F i /3r_nGKT(9P �121VG kJs6 ' ((�� g„ � _ ._,-- .:_.: � � - .� .. �.O N ICI..:�- -�'�_t �..- L I���ly:N ��� rt.r�..S 1 .►� �1—.t_e. _.l,—��`t�y o- -- �• q. f--„i'•-���1�►.GI_..:1��!U-hID,�.�or-I � .. �� H jGK 2�N F9 ;� S t;A C� >s - . . I/d .� i, APPROVED BY: L� 8 3a � H E: q = LAG SCAL K A ' �. DRAWN BY z -B.�u"ifi� .Ci1-1�<v -.T9L--. _ = DATE: ':• ..F.l��..'��.�.�•_w�!�-T►c.ar• :J..�P��:Q__%2"�.:t3.���.� s-rt���, �. 9 , de QS 1, n —� Q_7- ._t� T .. [] 1 .Hyannis,MA DRAWING NUMBER i 6 V 1`{ �I 4�7' l ►�L _( t- �` DESIGNER BARRYJONES-HENRY —r aF j t MA . 40 VEL.VX Ob AA w o v. . ` _ C fZ 1_SJ,Lq .._._.....—_ I: 9 a I I W �` d APPROVED BY: Y SCALE. DRAWNB C`r.. I DATE: ' - 10- CD6= IZSV`1510jk-1 ' - - Hyannis,MA DRAWING NUMBER BARRYJONES=HENRY ARTIST/DESIGNER f � - e YL M -- o OW I , f`ve Wx s �\9 L. s.MD.ram.a—- 3v�8 � L116t . 1 -';T , Q Vzwt r- I , f r G C G F p. 0, µLz A ci v , z I d APPRCS\V�ED BY: DRAWN BY I -- SCALE:��` I DATE' ' _ I D- �6 . 12--tA5/0M; 2- /S.-'0-7 //rdc' 1 n H}78t]YI15,IV1A DRAWING NUMBER BARRYJONES H£NRY ARTIST/DESIGNER i I PROFILE SYSTEM i STEM f ROI ILE MARKED WTHCMAGNETIC TTAPE OR BE NOTES COMPARWBLE MEANS FOR FUTURE LOCATION. PROVIDE MIN. 20" WATERTIGHT (NOT TO SCALE) 1. DATUM IS ASSUMED ACCESS COVERS TO WITHIN 6" OF FIN. GRADE TOP FOUND. EL. 76.1' PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 2. MUNICIPAL WATER IS EXISTING MINIMUM .75' OF COVER OVER PRECAST 2% SLOP %REQUIRED OVER SYSTEM 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. a 4. DESIGN LOADING FOR ALL PROPOSED PRECAST PRECAST H-10 UNITS TO BE AASHO H-Q RISERS (TYP.) n/ S 2'0 PROP. TEE 4"OSCH40 PVC wequaq�[et PIPES LEVEL 1ST 2' 2" DOUBLET 1NASHED PEASTONE 5. PIPE JOINTS TO BE MADE WATERTIGHT. Lak \ OR GEOTEXrII�E FABRIC WITH 73.1' " EXISTING " I I 72 3 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 10 1000 GAL H-10 TEE ` (EXIST) TEE SEPTIC TANK \72.5±*9 •.. • 310 CMR 15.000 (TITLE V.) (RE-USE)** 0000 0 0 0 0 6" MIN. SUMP GAS BAFFLE.:' °9°0�°o0°g°o°o° 12" MIN TNT. DIM. 0 71lp 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 72 07' 71 9' 0 NOT 70 BE USED FOR LOT LINE STAKING OR ANY o00 69 $' OTHER PURPOSE. H-20 3050 INFILTRATORS 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. � i J�� Phinne� 6" CRUSHED STONE OR MECHANICAL 3 4" TO 1 1 2" DOU'3LE WASHED STONE 9. COMPONENTS NOT TO BE BACKFILL OR COMPACTION. (15.221 [21) / / w CONCEALED WITHOUT INSPECTION BY BOO ARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD MIN. MIN. OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30.4' X 10.25' OF HEALTH. ( 1 % SLOPE) ( 1 % SLOPE) 5.5' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LEACHING CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP 2p VERIFYING THE LOCATION OF ALL UNDERGROUND & FOUNDATION EXIST. SEPTIC TANK D BOX 3 FACILITY OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT WORK. UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. BOTTOM TH-1 64.3' 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 251 PARCEL 66 SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. LOCUS IS WITHIN GP DISTRICT VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED (NO CONSTRUCTION PROPOSED - UPGRADE ONLY) IMMEDIATELY INSPECTOR GRANTED BY THE BOARD OF HEALTH AGENT OR AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND SAND. 99- EXISTING CONTOUR PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED BY THE BOARD OF HEALTH REVISED DURING A PUBLIC X 99.1 EXIST. SPOT ELEV. HEARING HELD ON AUG. 4, 2009 7�P06 99 PROPOSED CONTOUR 2) FAILED SYSTEMS ONLY : SEPTIC SYSTEM COMPONENT TO 7 75.05 198•4] PROPOSED SPOT EL. FOUNDATION SETBACK, IF AN IMPERVIOUS LINER IS DESIGNED 4. SYSTEM DESIGN" AND INSTALLED (10 OR GREATER ALLOWED). :1 75.19 TH1 75 ,7 '�� \ LARGE WHITE PINES AND SPRUCES TEST HOLE TH2 GARBAGE DISPOSER IS NOT ALLOWED Q�$ 2 .05 SLOPE of GROUND 3' 5.87 DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD _ urluTY POLE 7 99 5.z 75 %� 80 USE A 330 GPD DESIGN FLOW 75.25 BENCH MARK - TOP OF BOTTOM PROVIDE PR F;40.MIL,LINER '`� W b�., STEP AT DECK ELEVATION = 76.3 _. . , _ FIRS, HYDRANT RO_DE .AP.APPROX. O Ya , _ _ -SEP 1Ic, Hivl 330 c: D (2) = U60 ..__. AT 5 OFF SAS IN AREA SHOWN. TOP AT L .52 NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING 5.08 30 .33 ELEV. 72.3, BOTTOM AT ELEV. 68.3' 8 o ' 5.32 0 **RE-USE EXISTING 1000 GAL. SEPTIC TANK 7 .46 5.21 LP JUNGLE c M LEACHING: TEST HOLE LOGS 75.28 � GARAGE /� AREA 7 51 SIDES: 2(30.4 +10.25) 1.85 (.74) = 111.3 GPD x 7 .67 / ,�$ �, 7 .94 SLAB BOTTOM 30.4 x 10.25 (.74) = 230 GPD {' ENGINEER: ARNE H. OJALA, PE, SEA / Q°y 75.64 / ( 9 TOTAL 461 S.F. 341.3 GPD WITNESS: DAVID W. STANTON, RS 75.8 DATE: NOVEMBER 5, 2009 a�G� USE (4) H-20 3050 INFILTRATORS, PERC. RATE _ < 2 MIN/INCH 7 75.82 WITH 1' STONE AT ENDS AND 3' AT SIDES APPROX. SEPTIC SYSTEM CLASS I SOILS P# 12746 PAVED DRIVE LOCATION (AS-BUILT UNCLEAR EXISTING / � DUE TO NEWER ADDITION) DWELLING / ELEV. ELEV. TOP FNDN. =76.1' 75.86 019 4 75.3' o,. `V 75.3' A A (x jJ4,211) �o SL SL MA 10YR 2/1 10YR 2/1 x�3.90 74\6 74.76 LOT 200 APPROVED DATE BOARD OF HEALTH 12" 12" 4.05 11,182t SF B B 74.5 TITLE 5 SITE PLAN LS LS 74.36 OF 10YR 4/4 10YR 4/4 \ °°o 20 CiONNERs ROAD 36 72.3 36 72.3 74.21 ' I �, CENTERVILLE o� \ I PREPARED FOR c c /� �" _A �74.40 •�� V" N/ PERC ,Q \ C � BORTOLOTTI CONSTRUCT O \ KENNEY CS Cs �� \ (X75.65 NOVEMBER 5, 2009 REV DECEMBER 1, 2009 (3 BR) 10YR 6 4 10YR 6 4 - a �r / / \ ` G Urlv�S�\. ��HQFM��S off 508-362-4541 �` 7 5.1 1 ;��' I.3AI�!EL. Lu, ��DANiEL,4. fox 508-362-9880 G� C? 1a1A a downcope.com [� CJf LPt 1 CIVIL. � • No.40 980 y No.4-6562 1 down cape eng/nee /ng, /nC. . '132" 64.3' 120 65.3' civil engineers NO GROUNDWATER ENCOUNTERED Scale: 1 = 20 ! 2.-t- � land Surveyors 939 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA,` P.E., P.L.S. YARMOUTHPORT MA 02675 0 9-255 09-255.DWG(SBO)