HomeMy WebLinkAbout0044 COTTONWOOD LANE - Health 44 Cottonwood Lane, Centerville
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UPC 12534
No.2 LOR
NASTINGS•MN
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11/09/2011 07:24 5084775313 ENGINEERING WORKS PAGE 01
Town of Barnstable
Regulatory SeMets
Thomas F.Geller,Director
# Public Health Division
` Thomas McKean,Director
200 Main Street, Hysnnb,MA 02601
Mce: 509-9624644 Fax; 508-790-6304
Date: 0 1 1 Sewage Permit# Assessor's MapAPsncel 'ZSZ — t fog
Inaftgm&Desim"C919ftft F
Deaignew , iN.Ar%45, IncInstaller: F-*11S
Addrm: Lz W. Cm s s jai 'td. Address: V1 &40 /2cd ()r?, l
On was issued a permit to install a
(installer)
septic system at CQ.v\.-, based on a design drawn by
s
dated t U L
(designer)
certify that the septic system referenced above was installed substandially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Stripout (if required) was inspected and the soils
were found satisfactory.
x certify that the septic system referenced above was installed with major changes (i.e.
greater Ow 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. Stripout(if required) Wak d and the soils
were fa .d satisfactory.
PMR T.
On er's Signature) C a1LF€
NO'16109
(Ns gner's Signature) (Affix Design )
TURN TO BARN P .
CE BE ISSUED IL FORM
AND AS-
BUMT CEIVED BY In BARNSTABLE PUBLI N.
THAiiIK YOU.
q:lo8fae 5ormaldesi �cativa iorm.da�
r
No. 3 /per.� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZIppYitation for bisposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. ., Gs?al 44 a Owner's Name,Address,and Tel.No.
Assessor's Map/ParcelS�"'
Installer's Name,Address,and Tel.No. j Designer's Name,A dress,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size /-9, 4/d4 sq.ft. Garbage Grinder( )
Other Type of Building dC e'5r d04 1_ 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 ��� woV, IZ e
Nature of Repairs or Alterations(Answer when applicable) ki
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 Environmen 1 Code and not to place ystem in operation until a Certificate of
Compliance has been issued by this Board 9f.HVh. //// /J
Date !!' "!/
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. ")Jew �a Date Issued 1
/0& 1
No. 69011 ..� }, Fee f
i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
�r
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppiication for Misposal 6pstem Construction Permit i
Application for Permit to Construct( ) Repair(- ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. �rWO, �� e Owner's
Name,Address,and Tel.No.
Assessor'sNla&arcel �S�,r 144151 L1J awM 4
Installer's Name,Address,and Tel.No. 4*"17 Designer's Name,A dress,and Tel.No.
io 5 %He-Pri
Type of Building:
I
-� / d�_Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Reo�5i CY104 F No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
i
Size of Septic Tank Type 1of S.A.S.
Description of Soil
i
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Nature of Repairs or Alterations(Answer when applicable) L�� Pla N
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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 Environme 1 Code and not to place t , ystem in operation until a Certificate of j
Compliance has been issued by this Board th.
�//tgne Date
Application Approved by Date
1
Application Disapproved by Date
I
for the following reasons
Permit No. d G�/ "-3� Date Issued 1-71 1
------- ------------------------- --_----------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposalstem Constructed( ) Repaired( ) Upgraded( ) {
Abandoned( ),bbyy /0,90
at�7 �O//G/1 (it/C'.v"L� hI has been constructed in accordance -7)
with the provisions oof)STitle 5 and the for Disposal System Construction Permit No�/" 3 dated l 1
Installer Y'•g Designer W\C.�,7 kQ -e--
#bedrooms Approved design flow 33 O gpd
The issuance of this permit shall lnnloj '�construed as a guarantee that the system�il �osgned.
Date / ! / Inspector
----------r----- /--------------¢--- ----------------------- -
No. y ''!/ ✓ �O Fee ®
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
33isposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System located at `77 4(/6cvl /7
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
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Provided:Construction must ,e completed within three years of the date of this Permit.
Date t +� Approved by
4'
1
l TOWN OF BARNSTABLE
LOCATION SEWAGE#
VILLAGE CeAtCA e, ASSESSOR'S MAP&PARCEL a S-d-lb
INSTALLER'S NAME&PHONE NO. ROh S � Ca Ur�-I-1 v�G hC
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) A D� rC- 3�WC, (size) yYG, 5 F
NO.OF BEDROOMS-3
OWNER L1 P�Q.s� L,v a. 6Le V\
PERMIT DATE: 1 l I/ COMPLIANCE DATE: I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility Feet
FURNISHED BY
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Town of Barnstable P
Department•of Regulatory
:Services
,utNa
Public Health Division bate F IZ- �(
Ma Street,Hyannis MA 02601
Date Scheduled Time Fee Pd.
Soil Suitability Assessment for Se Disposal
Performed 13y: ��-�J_ Witnessed By: V`
LOCATION& GENERAL IFORMATION
Location Address 1 L I l Co it TTd_, A�,A / h Owner's Name
i vet n C/O j CIA S e
�� \�'e✓1/��� fT: Address
tiq
Assessor's Map/Parcel: 'z _L — E, ro Engineer's Name
NEW CONSTRUCTION REPAIR Telephone# -`tea —73-—4_7 b 6
Land Use Y2e3`Jelti4"c e'` Slopes(%) Surface Stones <�
Distances from: Open Water Body 3cr� ft 'Possible WeGArea'] ft Drinking Water Wel�� ft
Drainage Way ft Property Line eft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
69
a`~,
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UJ00
Parent material(geologic) C J '�G`� Depth to Bedrocit
Depth to Groundwater. Standing Water in Hole: �� Weeping from Pit Face
r�
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL`HIGH WATER TA$1i.,E+
Method Used:
Depth Observed standing in obs.hole: ___in. Depth to soil mottles:
Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft.
index Vs/e!!# Reading Date:_� Index Well level � Adj,factor Adj.Omwidwater'Leval,,e
PERCOLATION TEST Dgte , Time,
Observation l
Hole# -+4 2-VK a Al1K C11 Time at 9"
Depth of Perc Time at 61'
Start Pre-soak Time @ [�„ ,j.f 1-q tit�/ 'rime(9"-611) ,.
End Pre-soak
Rate MinJlnch, c1��el k�' tr4 ky
Site Suitability Assessment: Site Passed�4 — Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conservation Division at least one (1)week prior to beginning.
Q:\SEPTIMERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#_L_
Depth from Soil Horizon Soil Texture, Soil Color Soil Other
Surface(in.) (USDA), (Munsell) Mottling (Structure,Stones;Boulders.
Consistency, Gravel)
d to
a ct 'cS 10 y,iL5 -,al brow-d
ro-,,e-I
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency:3c v
ld ye'L 16 84 C C5 lCJ`�` � Z� °�^`►e1
DEEP'OBSERVATION HOLE LOG Hole
Depth from, Soil Horizon -Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling —(Structure,Stones,Boulders.
Consistengy. O ve
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) _. (USDA) (Munsell) Mottling- (Structure,Stones,Boulders.
Consistency,
Flood InguranceRate Map:
Above 500`year flood boundary No— ' Yes _
'Within"500 year boundary No 0( Yes
Within 100 year flood boundary No L Yes
Depth of Naturally Occurrine Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout.the
area proposed for the soil absorption system?
If not,what is the"depth of naturally occurring pervious material?
Certification ,(�
I certify.that on ��" (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me con ststent:with; .
the required tra ,expertise and experience described in 310 CMR 15.017.
Signature Date-- ,
Qi1$BPTICtPBRCFORM.DOC
I - S
,ems
�\ COMMONWEALTH OF MaSSACHt'SETTS
..',{4 yJ}- >.r.'..:. .• ,..
EXi L'TIVE OFFICE OF E?'VIRON\1ENTAL AFFAIRS
DEPARTMENT OF EN-VIRONNIE\TAL PROTE �6 �
ONE WINTER STREET. BOSTON. NIA 02105 hl'-=S=•.'S0( � r
OD NOV
W ILLIAM F WILD - 4 199r$L'D)i�,CO\1
Govemc r0WA10f 11ff A Secret
NBC HAO a:�
V. P7r�D:4�'1D
AAGEO PALL CELLL&I
Lt.Governor ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �m issionc:
PART A 49
CERTIFICATION S
Property Address: %,,Address of Owner:
Date of Inspection: 1612 t� - . Of difierentl
Name of Inspector: 1l�o
I am a DEP appproved system inspector pursuant to Section 13.340 of Title 5 (310 CMR 15.000)
Company Name:1}/Lg ti-Ai'tr Ei9 eL ce-j h #c p.x 4!-L-/
Mailing Address: R 40 Acpx e_37?!4 H ASN4eQ H 46- v e-C4.C/
Telephone Number. CSG2t) Lrc Z�
CERTIFICATION STATEMENT
I cenii tna: I have personally inspected the selvage disposal system at this address and tha: the information reported below is true, accurate
and cornolete as o;the time of inspecoo-.. The inspection was penormed basec on m% training and experience in the proper iunctior, and
maintenance of on•s-te sewage disposa systems The system
Passes
_ Conc-t,ona i% Passes
Neec- Furtne- Eya'ua:ion 9\ the Local Approving Author^
_ Fa.-
Inspector's Signatu Date:
The Skse- Inspecto• sha'' subma a cop, of this inspec116n report to the Approving Authorrtv within thirty (30i days of completing this
lnspec-or. h the sNstern is a shared system o, ha= a design flow of 10.000 god or greater, the inspector and the system owner shall submit
the repo^: tc the appropriate reg,or.al office of the Department of Environmental Protectior The orig:nal should be sent'mthe system owner
and copes sen: to the buve•. if applicable, and the approving authorm
INSPECTION SUMMARY: Check A, B, C, or D.
Al SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criljria,as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below. .
COMMENITS.
BI 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 NDi. 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 (anachedi indicating that the tank was installed within twenty (20; years prior to the date of the inspection; or
the septic tank. whether or not meta!, is cracked, structira!ly unscun:;, shows wbs:artial 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.
(rev:v*d 0412519" Page 1 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
I ,? PART A
CERTIFICATION (continued)
r
flail
Property Address: F `
Owner:
Date of Inspection:
BJ SYSTEM CONDITIONALLY P SES (continj&d
_ Sewage backup or reakout or high static water level observed in the distribution box is due to broken or obstructed
r pipeii) or due to a oken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health):`D cribe observations-
bro en pipe(s)are replaced
obstr ction is removed
diistrib ion box is levelled or replaced
:�-•� • ,
The system required pump; g more than four times a year due to broken or obstructed pipers). The system will pass
inspection if(with approval f the Board of Health) -
`broken pi !ss are replaces
obstructior. s removed.. �*
C) FURTHER EVALUATION IS REQUIRED BY THE ARD OF HEALTH:
Conditions exist which'rec'u)re- funhe,evaluan by the Board of Health in order to determine if the system is failing to protect the
public health• saie:y and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALT DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH A I SAFETY AND THE ENVIRONMENT.
Cesspool or prn% is within 50 fee, of a su 'ace water
Cesspool or privy is w ithin 50 ieet of a bor 'e%ng vegetated wetland or a salt marsh.
21 SYSTEM "'ILL FAIL UNLESS THE BOARD OF HEALT (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THA PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank and soil absorptio system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply
The sysiem has a septic tank and soil absorption ystem and the SAS is within a Zone I of a public water sup-)Iv well.
The system has a septic tank and soil absorption ystem and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption s stem and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, uniess a we!] water ana. •sis for coliform bacteria and volatile organic compounds indicates that
the well is free from pollution from that facility an the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. Method used to determine distan a (approximation not valid).
3) OTHER
kj
(re-,see 04':5'9'1 Pea* 1 of IC
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
., PART A
CERTIFICATION (continued)
Propert% Address:
Owner:
Date of Inspection:
D) SYSTEM FAILS:
You must indicate either "Yes- or to as to each of the following
I have determined that th system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The casts
for this determination is id tified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure
Yes No
Backyp of selvage into acility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of luent to the surface of the ground or surface waters due to an overloaded or clogged SAS of
cesspool.
Static licu,d le%-e! in the dis:ri tion box above outlet invert due to an overloaded or clogged Sk5 or cesspool.
Liculd depth it cesspool is less t n 6" below invert or available volume is less than 112 day ilov.
Recu-reds pumping more than, 4 tim in the last year NOT due to clogged or obstructed pipe s
Numper o`times pumped
Any pon-on o-*the Soa! Aoso-ption Svste. . cesspool or privy is billow the high groundwaee• e+e%-atio-.
An% por::on o:a cesspool or pri\j- is ithir. 00 fee: of a surface water supple or tributa'\ to a surface %ater supply.
And po-:jon c:a cess000: or pri\)' is N ithin a ne I of a public well.
Arn pc-�:c- c:a cesspoo' o• pr:\;• is within 50 f of a private water suppl% well
An\ po-:,or. o:a cesspool or prwy is less than 100 f : but greater than SO feet from a private eater supply well with no
acceptable \ate• qualm\ analvs!s If the well has bee analyzed to be acceptable. arach cop% of well water analyse for
cohiorm bacteria vo!atile organic compounds, ammoni nitrogen and nitrate nitrogen.
E) LARGE SYSTEM FAILS:
You must indicate e.the• 'Yes' o, "No- as to each of the following,
The fo!ioN:cg c•,te•,a aop;% to large systems in addition to the criteria oye.
The system serves a facilir\ with a design flow of 10,000 gpd or greater ( arge System: and the system is a significant threat to
public health and safety and the environment because one or more of the ollowing conditions exist
Yes No
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 upply
the system is located in a nitrogen sensitive area (Interim Wellhead Prot ion Area •IWPA) or a mapped Zone 11 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.
trev%zed 04 •zs-s" o... .
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
.CHECKLIST
Prope t• Address:
Owner: (l
Date of inspection: '
_. ._ ._ '• _.
Check if the following have been done You must indicate either 'Yes'or "No"as to each of the following.
Yes No _
Pumping information was provided by the owner,occupant, or Board of Health.
m for at least two weeks and the system has been receiving normal
_ hone of the system components have been pumped
flow rates during that period. Large volumes of water have not been introduced into the system recent[% or
as part of this inspection ifthey, r not available with N:A
examined. Note r are As burl. plans have been oo:a:ned and e a
The iactlm or d%%elhng %%as inspected for signs o*.sewage back-up 4
x _ The system does not receive non-sanitary or industrial waste flow
The site %%as inspected for signs !)i breakout. .�
_ A!l s\sterr co^iponehu. excludine the So,: Aosorpaon System, have been located on the site. 4
•. _ The sep:.c tarsi, rnanho;es were uncovered. opened. and the interior of the septic tank was inspected for conditior: of
banes or tees. mater:a• o' cons:ruction, dimensions. depth of liquid,depth of sludge. depth of scum.
The sue and loca:io-, o"the Sol Absorption System on the site has been determined based on "
_ The iac-ia,, om.ne• ,ane occupants. if difteren: trorr owneri were provided with information on the proper maintenance of
Sub-Suriace Disposal Systerr.
4 Existing iniorrnation Ex Pian at B O H
_ Determined in the field zc am of the failure criteria related to Part C is at issue, approximation of distance is
unaccexah-e 115.302 3;b?
SUBSURFACE SEWAGE DISPOSAL SYSTEM I%SPECTION FOR.m
:. .ra'PART C
SYSTEIN-Ik}F+ORMATIO%
W� �S�l{SxRA�( ��jfYlY
Prope Address: f( CA��
Owner: &rill
Date of Inspection:
( FLOW CONDITIONS
RESIDENTIAL:
Design t7ov, p.d.,1bedroom for S.,k.S
Number of bedrooms 0 7
Number o current residents 7
Garbage g•.:der (yes or not V7
Laundry co-•^ected to system (yes or no!
Seasonal use tyes or no-.
%Vater meter readings. if available (last two :2 yea: usage tgpdj: - PCB
Sump Pump (yes or not
Las; dare o:occupancy tuex�S �t27c�¢ �a �rQs�e}�Q rJ
COMMERC140%DUSTRIAL:
Type of evablishmen:
Design fio%% _�a!ions.oa\
Grease trap present ►ves or no
Industrial %%aste Holding Tank present wes or no
%on-sanita-� Mzste d-scna•gec to the T:;fe S syster" i%e> or no
%%ater meter readings tf a•allabie
Las:Fate o: o
OTHER. De-cribe
Last date of occacanc.
GENERAL INFOILMATION
PUMPI%C RECORDS and source oi t rrra*Io^ "
System pumpec as par, of tnspecion. tves or no
If yes, volume pumped _ ¢allons -•. -- . _.....
Reason for punpmE _.
TYPE OF SYSTEM
_ N Septic tankrdistnbution boxrsoil absorption system- .-
Sinl;4 cesspool
Ovenlow cesspool
Pn.).
Shared system (yes or no) (if yes, attach previous inspection records; if any) - _•-
VA Technologv etc. Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information:
""-Sewage odors detected when arriving at the site. iyes or not ICU Wr' �' - �- -•
I
SLBSURFACE S E DISPOSAL SYSTEM INSPECTIO% FORM
= + °APARTC
SYSTE I FORMAT110% (continued)
4
ti •�
Propert. Address: I{ C6 fi4�'Jwao
Crwner��NNu c
Date of Inspection: t U L
BUILDING SEWER: `"'
(bate on site plan)
Depth below grade .
Material of construction. _cast iron _40 PVC_other (explain!
Distance from private water supply well or suction li-e
Diameter
Comments: (condition of joints, veriting, evidence of leakage etc► =
SEPTIC TANK:_
(locate on site plan
Depth below grade O
mater.a► or construction 1concre:e —me-.a _Fiwg!as! _Polyethylene _othenexplrn
li tank is me-a:. Iis: age _ Is age col..:.rmec o� Ce^•tica:e o: Compirance f1es.-No
Sludge depth 6Cl
Distance from top o: s!ucee to bonzorn o*ouae: tee o• bi=e_gzL`r
Scum thickness
Distance from top o'scum to top o`outle: tee or ba-ie i t'
f�
Distance from bottom o-sco-n to bone- o;outle: tee r ba�.e _ _
ho.w dimensions Mere dete•mmec oA! no
Comments
trecommendanon icr pumping ronda,on o; inie: and oitlei tees r bafi)es. depth of liquid le.e! in reiatioenntto. o tlet inve structural
integric�, evidence of leakage. e:c a WJ W t 1 ibaerk�j; CIA
�c -1-
GREASE TRAP:,
(locate on site plan.:
Depth below grade
Material of construction. _concrete _metal Fiberglass Polyethylene _other(explain)
Dimensions: r
Scum thickness:
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bonom-of outlet tee or baffle"
Date of last pumping
Comments:
(recommendation for pumping• condition of inlet and outlet tees o baffles, depth of liquid level in relation to outlet invert, structural
integrity. evidence of leakage. etc —�
_. . ..
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Prope Address: �� Clb �woo O�
Owner:
Date of Inspection. ��ZS
SOIL ABSORPTION SYSTEM (SAS): S
(locate on site.plan, if possible, exca,. .on not required. but may be approximated by non-Intrusive methods,
If not determined to be present, explain.
Type
leaching pets. number
leaching chambers. number._
leaching galleries, number.
leaching trenches, number.length
leaching fteids, numbe,, d.^riens+o^s
ove:4ioN cesspool, numbe-
Alternative systerr,
►.ame of Tecnr,oiog,,
Comments
inole C CIOU^ 0' SO:i. `IF'Sv0' h%d-ailic fa!l,,re. leve' o' pond:n OndU: n of vegi tation.
PS
1
CESSPOOLS:
(locate on site plan
Numbe, and cc-:,g.:.a.,cn
Depth-top of hgj,d to inlet Inver,
Depth of solids lave-
Depth of scum lave,
Dimensions of cesspoo:
Materials of construaio^ _
Indication of g,ound%ate•
inflow tcesspooi must De pumpeC as par, of inspection.
Comments.
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY:
(locate on site plans
Materials of construction:
Dimensions.
Depth of solids: _
Comments
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
_,.:;SYSTEM INFORMATIO% (continued)
Propem Address: qL j(uG ffaN l
0%ner: 16 is�5
Date of Inspection. tU(ZSI��
TIGHT OR HOLDI%G TASK: �JO 7ank must be pumped prior to. or at time; of inspection:
(locate on site plan,
Depth below.grade
Mater:a! of construction _concrete _metal _Fiberglass _Polyethylene _other(explain)
Dimensions.
Capacm galions
Design floN gal,ons'da.
Alarm level ka•r, :n „ork:ng oade• _ Yes. _ ^o
Da!e of previous pump;ng
Corr,ments
(condition of role: tee cond.;:or, o• a!a-n-. and floa-. switches. etc.i
DISTRIBUT10% BOX:
Dec:, c,hcu,c le%e' aco.e outle: :nee'
Comrne-ts
tno:e ' leve' and ca :t_: or :s eaua ev,cence of sol:as carn•over, e%:dence o?leakage into or out of box, etc.)
_PUMP CHAMBER:-j _
(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.)
ti
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM I%FORMATIO.N (continuedi
Propert. Address:
OKner��Nt�\y 1
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within.100 (Locate where public water supply comes into house)
"At—
Gii
N - 3 s Cis
c�
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO% FORM
PART C
SYSTEM INFORMATION (continued)
Propem Address: L4(� �W
w r:-�
O ne `✓a�1e,���Date of Inspection:
I�IZS�
Depth to Ground%ate• 2QFeet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained irom Design Plans on record
Observation o-*Site (Abutting property. obser\atro., hole, basement sump etc.)
Determine it from local conditions
Cr+eclk %%ith Iota 5aard o• nea!tr
Cnecl, FE1 A macs
Check pumping recofds
Cnect• Iota' exca:a:o•s rr's:a'le•s
t.se t.ECS Da:a
r•
Descibe in \ou• c••-. %c_ esao:!s6,ec tyre r':E' Crownd\Axer Elevation. (Must be Completed
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Cq:�"fete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
IS Print your name and address on the reverse X ee
so that we can return the card to you. g, he-c/eive by Prin ry
■ Attach this card to the back of the mailpiece,
or on the front if space permits. $P T
1. Article Addressed to: D. IO t, ad`dressi3iffe rSt Item 1? es
f Ims,enter delivery addr��below: No
Marie Maddox /
PO Box 299
awlisport,MA 02675 3. Se Ty,
W.
14Y �ertifi • P- ress Mail I
❑Registered qca-etum Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number! i { S i - 4 -_�-- - r F; ; i 7v 1
(Transfer from service label)i � 7 0 ,5( 1'i16`0 t i�0 0 0 19 0 91 4 41 V
PS F6rm 3811' February 2004 ' i i Domestic Return Receipt 102595-02-M-1540 1
L . , . . 1 . „i !„ . ,. , it E t I . 1, , i ,
I _
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
Permit No.G-10
I
I
I • Sender: Please print your name, address, and ZIP+4 in this box •
I
I
I
(( l$ Town of Barnstable
Health Division
200 Main Street
Hyannis,MA 02601 '
1�11111t�l11�'121'1?is111f11f14M111111!)It'll I 1111:11it1111111
i
u y
i
I �
Health Master Detail Page 1 of 1
t>CgedI` As, ' . vW'Oc{Yne Health
Cj j Master Detail
.
Ap,p'ication Center Parcel Lookup Selection Items
ParcelSeptic I Peirc 1,Afell Fuel Tank
Parcel: .2 52-1 6 Location: 44 COTTONWOOD LANE, CENTERVILLE Owner: MADDOX, MARIE o
Business name: Business phone:
Rental property: Deed restricted: Number of bedrooms : O
Contaminant released: r Fuel storage tank permit: > W
I
;Save Parcel Ghange's ` g Return fo Lookup
�.
Parcel Info Parcel ID: 2.52-1.66 Developer lot: LOT 179
Location:44 COTTONWOOD LANE Primary frontage: 115
Secondary road: Secondary frontage:
Village:CENTERVILLE � Fire district:C O 14 M
Sewer acct: ` Road index:0358
Interactive map.
P (Groundwater Protection Overlay
District}
Town zone of contribution: State zone of contribution:IN
Owner Info Owner: MADDOX, MARIE 0 Co-Owner:C/O SWFENEY, SHAR
Streetl:PO BOX 288 Street2:
City:WEST HYANNISPORT State: A Zip: 02675 Cow
USA
Deed date: 11/5/1997 Deed reference:C146450
Land Info Acres: 0.28 Use: Single Fam MDL-01 Zoning: RD-1 Neighborhood: C
Topography:Above Street Road: Paved
Utilities:Public Water,Gas,Septic Location:
onstruction Infou'[;"in .QY'c _.,iitiW°f;; iv esJru3r'r z, Bathrooms
1 11984 11416 13 Bedrooms2 Full
Buildings value:$12-0,500.00 Extra features: $2,700,00 Land value: 1-7,167,600.00
http://issql/Intranet/healthMaster/HealthMasterDetail.aspx?ID=252166 7/8/2009
Town of Barnstable
F
the rp Regulatory Services Barn.stz`=I
o
Thomas F. Geiler, Director
Public Health Division
* swxxsrABLE. •*
9 inns. Thomas McKean, Director 07
�Ar 16..39. A`0 200 Main Street
fD mi
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
0 o �
p
July 8; 2009
Marie Maddox
PO Box 288
W. Hyannisport, MA 02675
As of October 1, 2006 a new rental registration ordinance was put into affect requiring
all property owners of rental units to register their rental units with the Town of Barnstable
Health Division. According to our records, you own the rental property at 44 Cottonwood
Lane, Centerville. Enclosed is an application. Please use a separate application for each
rental unit you own. Should you need more applications, they are available online at
Nvw-Nv.town.bartistable.ma.us. Go to the Health Division page by looking in the Department
Menu. There is a link to the Rental Registration information on the Health Division page. You
may print out as many as you need, and return them to the Health Division with the appropriate
2009 fees included. This must be completed within (14) fourteen days of your receipt of
this letter.
Failure to comply with this ordinance will result in the issuance of a non-criminal ticket
citation in the amount of$100. Each day of non-compliance is considered a separate offense.
Should you have any questions, please feel free to call 508-862-4644. Thank you in
advance for your cooperation.
z7�
V
Timothy B. O'Connell, R.S.
Health Inspector
Health Division
Direct#508-862-4646
No........... _q-`••— Fss..... p..................
THE COMMONWEALTH OF MASSACHUSETTS a
BOAR® OF HEALTH
f
..................
.....-------------------
OF..........................................................
Appliratiou for Disposal Works Toustrurtiun' rrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sy`si.,.� at.
tem
1`5- nct
. ® ......................................
�.L.,00c`ation-�Address�� - Lot N �y��Q�
.. _ ... _� 6 T ....*-!-!----al.-------•--•-•---------• , --.......�� V►JL ........6,L tea............................
O ner A dre
�� h�► ` � thy`
Installe Address +
Type of Building \ Size Lot.... 21.VZ0--...Sq. feet
Dwelling—No. of Bedrooms___.(J _� ..........Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ............................ No.,of persons...._.......................
Showers ( ) — Cafeteria ( )
Ct, Other fixtures ... g �-� `•.S ?SR? --------------
W Design Flow...-V....j3_EDi CMLj......gallons per person per day. Total daily flow.._._...3W, -------- ---------- ----gallons.
WSeptic Tank—Liquid capacity.l .gallons Length....(r........ Width........ Diameter________________ Depth..... ......
x Disposal Trench—No. ....0.......... Width...&)............ Total Length.....!_......... Total leaching area------AJ........sq. ft.
Seepage Pit No.......I------------ Diameter...._ Depth below inlet.......!6.(........ Total leaching area....,593 __._sq. ft.
Z Other Distribution box ( ) Dosing tat* ( ) i
~' Percolation Test Results Performed by __fit-..-- :._._ 1�?_1_IJAI_..-n.-�- ••_••--- Date_.__z!;N.! ...............
a
Test Pit No. 1.---�.-------minutes per inch Depth of Test Pit.....t_�...._.__.. Depth to ground water.._. .'...............
�Test Pit No. 2.....' ..minutes per inch Depth of Test Pit--___43.___._.. Depth to ground water----
Y..............
R+ --------------------------•--•-•-•-•----------.. ------........--...-..................................................................................
ODescription of Soil....Ccu ...... ---.. .... --------------------------------------------------------------------------------------
x
U .......................-••-------••---.....-•••-•------•-•-----.......-----•-•••---•---•-•---•----------•--------------••--•------•••-----••------•-------------------•-•---•-•-------------------------
W .......................... --------•----•-•••-•----•----•-------------------------•----•--•--••---•---•-------••---------------------•------•-----•------------•-------------•--••-------------•-------
U Nature of Repairs or Alterations—Answer when applicable---------
-------------------------------------•--•-----------------------------------------................-•--.....----------•••-•------••-----•-------------•-----•---•------•--------•------------......---•
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of ilTlE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance haskwn issued by the board of health.
Signed...... -------- ... ....... ............ ...
Date
Application Approved By.................. ..... .
Date
Application Disapproved for the following reaso :--------•-----------------------------------------------------------------------•-----••---•----•--•--•---....._
--••----------------•------•-----------•-•---•--•------------......_........------------...........---------....----•------------------------•-----------------•--•----•---•-•----------•---••-•--------
Date
PermitNo......................................................... Issued.--------........--------..........-----------------....
Date
No............52 ..................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................. ........................0 F..........................................................................................
Appliration for Disposal Works Tonstrurtion "pumit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
Ac
............... .30A.-IO-VID......... ....................... .......M...................................................
Location Addres
Ir L,)t.N.............................. ........
------------------------------
0 ner ...... Pddr
e
----------------------------------------- ..... . . . ............................................
Install Address
+
Type of Building Size Lot...j_Z_r Mm...Sq. feet
Dwelling—No. of Bedrooms._.(- .Aiee..........Expansion Attic Garbage Grinder
aOther—Type of Building ............................ No. of persons..............._.._..__.____ Showers Cafeteria
Other fixtures .... ....$A�6........�j...lziow ....................................................................................
Design Flow...1A0...SOWOCLA-A......gallons per person per day. Total daily flow-------Z:W..........................gallons.
9 Septic Tank—Liquid capacityi6Z.-gallons Length___......_.. Width._.......__. Diameter................ Depth.....�4.......
Disposal Trench—No.....IQ........... Width--AJ............ Total Length....A).......... Total leaching area-----f%J---------sq. ft.
Seepage Pit No-------I............. Diameter....JbXJ(v.. Depth below inlet.......V........ Total leaching area...-SIT------sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
a Percolation Test Results Performed.by..Zwkk--- .....R.k* ...... Date...2.11-41$�4---------------
,--4 Test Pit No. I...Z--------minutes per inch Depth of Test Pit....1.1----------- Depth to ground water____ ___
0-4 ________
------
rX, Test Pit No. 2-----*&o_,'`"...minutes per inch Depth of Test Pit-----ta......... Depth to ground water....
................
P4 ............................................................................................................................................................
0 Description of Soil--- ime %------tp.....Q>Jg1 0.4.....jq .......................................................................................
---------------------------**-----------------------------------------------*--------------------------------------------------------------------------*--------------- ------
-
............... ........................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
.......................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT IE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha. ' en sued by the board of health.
Signed--... .... ..Wo ... `a.... ...............................
Date
Application Approved By... .. .. ........................................ .......................................
...............
Date
Application Disapproved for the following reaso ................................................................................................................
.............................................................................................................................................................................................I...........
Date
Permit No..............................
........................ Issued------...----------------------------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................................OF................................4......................;..............................
Tatifiratr of Tompliaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
by----0 ....A ..........................................................................................................................................
Installer
.......... - -------------------------------------------------------
_i ed in accordance provisions E, 5 of The State Sanitary Code as described in the
has Feen inst. ce with the pr ions of TITL
application for Disposal Works Construction Perlinit No:...................................... dated_...._.___..._._.........__..__.__._._._........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WIL F N SATISFACTORY.�
DATE..... 2............................21Z±'N I Inspector-------------------- ---- --- --------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................................OF.....................................................................................
No......................... FEE......................--
Disposal Works 0-yalustrurtion "Vrrmit
Permissionis hereby granted...............................................................................................................................................
to Construct or Repair an Individual Sewage Disposal System
atNo.. P ------ ---- ...............................................................
Str eet
as shown on the application for Disposal Works Construction Permit No..................... Dated........____.__....._......_._............
...................................................... ................................................
DATE_Z/ ............................................... Board of Health
FORM 1255 A. M. SULKIN, IN.::., BOSTON
LEGEND }� N
h
56 --EXISTING CONTOUR \\_
x 56.82 EXISTING SPOT GRADE
56 PROPOSED CONTOUR /� \ W'°'°""y°
W EXISTING WATER SERVICE
G EXISTING GAS SERVICE i` �l P�lnt kd LakenIda or n
103.98 U -
UNDERGROUND WIRES �`� _
�10�0 TEST PIT \��� C J� OCUS
IF ,
' � �0 BENCHMARK 9
�i+ 104.E
Q) .' �' x 10 9.10
- r
Lj 0 N + 1 3.1 IFQ
I,
/, T� �` Wequaquet LaIf ke J
V` r
O� e�e�`,�'�'�9 / / LOCUS MAP
96, �, ��pro,po/�___ , LQ7r 179 SR NOT TO SCALE
0.
0 0{ , �,�h�,' x 1�-53--- i 1,1,426fSF 110.8 �00 0\,'
GJ e6ge ��'/ / Pf/ 252- 166•... ��, CHMARK GENERAL NOTES:
BEN
x 110,24 OUTSIDE COR./BULKHEAD 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
PK R 0,00 + 13 ' �, G' 0o,'.. EL.= 110.84 (Assumed) BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
i , Vyip 45 �� 9�a OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS.
98.77 /.: 1(1,00 11 3�4 x 106.71
iIGHPOL i 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
x
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
9,7 DESIGN ENGINEER.
98.43 � 0,19. .. :�, i i i
+. 111.56 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
.78! FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
.'' 03.2 !;0L73.1 :,. 1 I EXISTING x 110,49 ENGINEER BEFORE CONSTRUCTION CONTINUES.
LE r � � 111.47
,. I i HOUSE(#44) , / 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
109,5 T.O.F.=111.7f 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
O�
,.
1 ` , THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS RI T DURING CONSTRUCTION.
' 106,59 EXISTING LEACH PIT
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
r.
� + 8. THERE ARE N W WITHIN 1 F T i /� TO BE PUMPED & FILLED E E E 0 ELLS W 50' 0 HE PROPOSED S.A.S.
S W AND AND ABANDONED
� 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
106.34.. ` i /'� AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
' DIRECTED BY THE APPROVING AUTHORITIES.
DECK x 110.
'• EXISTING SEPTIC TANK
1 5 �� 1 TO REMAIN 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
108.92 �• I )
`d / x TOP OF TANK, EL.=109.53 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
�p 2 �� �� INV.(OUT), EL.=108.20E CONSTRUCTION.
yz 00 `:.PAVED. 109,36 TP-1� ��4J . 1"p 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
O' 6' DRIVEWAY &' _ ______---�10-_. , / IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
TP-2 �/ REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
i .109.42 y��Gi INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
�O• 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
/e ETER T. 108,48 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
o\ P Gam, eo. � o
McENTEE 44 COTTONWOOD LANE, CENTERVILLE, MA
o CIVIL � "' ''•���
No. 35109 ? D8.84 Prepared for: Thereasa Wayburn, 33 Cottonwood Ln, Centerville, MA 02632
OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
Fsmh <N �� 1c/o'MADDSWEENEY, SHIEOARON Engineering Works, Inc. 1"=20' P.T.M. 223-11
'P. 0. BOX 288 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
WEST HYANNISPORT, MA 02672 (508) 477-5313 10/3/11 P.T.M. 1 Of 2
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL.107.3
SEPTIC TANK PROPOSED D-BOX FOR A DISTANCE OF 15' AROUND THE
INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT
PROPOSED S.A.S. PERIMETER OF THE S.A.S. EX/STING
OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE INSTALL INSPECTION PORT OVER END UNIT HOUSE(#44)
T.O.F.=111.7f
T.O.F.
EXISTING F.G. EL: 110.33(MAX.)
F.G. EL. � F.G. EL: 110.4t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. I DECK
"Bum mi
' INSPECTION �rO
L = 16 L = 7'(MAX) PORT �r�
® S=1% (MIN.)
6 4"SCH40 PVC 4"SCH40 PVC ^ �+
14" 10.75" TO T ' - -----
EXISITNG 48" LIQUID INVERT SA.
�, S
LEVEL GAS BAFFLE ` INV.=107.17 PROPOSED INV.=107.00 4 ROWS OF 5 UNITS AT 5.0'/UNIT = 25.0' L4 I SPIKE
INV.=108.20 D—BOX INV.=106.90 SOIL ABSORPTION SYSTEM (PROFILE) �-- --
(EXISITNG/VERIFY) �----25'--""
EXISTING SEPTIC TANK
ESTABLISH VEGETATIVE COVER S.A•S•LAYOUT
BACKFILL WITH CLEAN NATIVE OR
PERC SAND TO TOP OF CHAMBERS 21„ 6-4" POLYSEAL OUTLETS
NOTES: 2" 2" 1-4" POLYSEAL INLETS
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BREAKOUT=TOP
INVERTS, PRIOR TO INSTALLATION, TOP ELEV.=107.33
INV. ELEV.=106.90
2) D-BOX SHALL BE SET LEVEL AND TRUE TO N O O
GRADE ON A MECHANICALLY COMPACTED SIX BOTTOM ELEV.=106.00—'" LO
INCH CRUSHED STONE BASE, AS SPECIFIED IN 2.83' Gd
310 CMR 15.221(2). 5 MIN. ABOVE BOTTOM OF
3) INSTALL INLET & OUTLET TEES AS REQUIRED. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.3'
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE EXISTING SUITABLE iv Top View D—BOX Section
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W., EL=99.9 4 MATERIAL
USE 4 ROWS OF 5-ADS Arc 36HC UNITS WITH NO
SEPARATION BETWEEN EACH ROW & NO STONE —63.25"
SEPTIC SYSTEM PROFILE TYPICAL SECTION
dv�j
6"
N.T.S.
SOIL LOG
DESIGN CRITERIA DATE: OCTOBER 3, 2011 (REF. P#13,422)
SOIL EVALUATOR: PETER McENTEE PE, (SE#1542)
NUMBER OF BEDROOMS: 3 BEDROOMS WITNESS: DONALD DESMARAIS R.S. HEALTH AGENT TOP VIEW
SOIL TEXTURAL CLASS: CLASS I ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH 60
DESIGN PERCOLATION RATE: <2 MIN/IN 110.0 A 0" 109.9 A 011 END CAP END CAP
FRONT VIEW SIDE VIEW
DAILY FLOW: 330 G.P.D. SANDY LOAM SANDY LOAM END CAP
DESIGN FLOW: 330 G.P.D. 109.5 10YR 4/2 109 2 10YR 4/2 REAR/TOP VIEW
6' S" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW
GARBAGE GRINDER: NO e B TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
SANDY LOAM SANDY LOAM DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
LEACHING AREA REQUIRED: (330) = 445.9 S.F. 10YR 5/8 10YR 5/8 r
4640 TRUEMAN BLVD
74 107.5 C 1 30" 106.9 C 1 36" 11 HILLIARD, OHIO 43026 Are 36HC DETAIL a
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY COARSE SAND COARSE SAND ADVANCED DRAINAGE SYSTEMS. INC. UNITS MUST BE STAMPED H-20
PROPOSED D—BOX: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED 10YR 5/4 10YR 5/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 4 ROWS OF 5—ADS Arc 36HC UNITS WITH NO 10% GRAVEL 10% GRAVEL
SEPARATION BETWEEN EACH ROW & NO STONE 103.0 C2 84"+ 102.9 C2 84" 44 COTTONWOOD LANE, CENTERVILLE, MA
MED. SAND MED. SAND Prepared for: Thereasa Wayburn, 33 Cottonwood Ln, Centerville, MA 02632
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) Engineering b SCALE DRAWN JOB. No.
(Arc 36HC Units) 20 UNITS x 5.0 LF x 4.80 SF/LF = 480.0 SF 2.SY 6/6 2.5Y 6/6 En 9� 9 Y�
00.0 1 120" 99.9 120" g g
En ineerin Works, Inc. NTS P.T.M. 223-1 1
DESIGN FLOW PROVIDED: 0.74(480.0 S.F.) = 355.2 G.P.D. NO GROUNDWATER 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
PERC RATE: <2 MIN./IN. IN SAND (ON FILE) (508) 477-5313 10/3/11 P.T.M. 2 of 2
�"; ,
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