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HomeMy WebLinkAbout0055 EBEN SMITH ROAD - Health 55 Eben Smith r A = 171 =.199 �'', s < r ' oi�ri Centerville41 a �" I I IN UPC 12534 No.2-1153LOR YAiiIYQi.YY 3 L�5 ( e No.r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION — TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicatiou for Dizpozal *pftem Con5tructiort permit Application for a Permit to Construct( ) Repair(( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lqt No.SY 15�W SA1.e)t h Ro Owner's Name,Address,and Tel.No. C eVww t))-e Assessor's Map/Parcel 1 — LJ Installer's Name,Addrea&and Tel.No. Designer's Name,Address and Tel.No. Type of Building: p� °� ' Yp g� �a..Q,X�j�y V rM�. �(1—fvS� Dwelling No.of Bedrooms 3 / Y Lot Size / sq. ft. Garbage Grinder ( ) Other Type of Building &d!5�e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re uired) gpd Design flow provided 3y0�J gpd Plan Date /0 / Number of sheets Revision Date Title Size of Septic Tank /&W, �-ry/,!� ,(AV Type of S.A.S. Description of Soil C,pja_ ip Nature of Repairs or Alterations(Answer when applicable) 01-r.. Alec l �jer�• :5 Date last inspected: Agreement: it 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 Upard of Health. Signed Q Date Application Approved by + p Date Application Disapproved by: Date for the following reasons Permit No. Date Issued 10 +D .. � r ' k, w v.� ,.- +p s No. r .. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes -,Z(pplication for. 3igpo5al 6p5tem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components i f Location Address or Lot No.SSOA.J SM•I$-h R0 -) Owner's Name,Address,and Tel.No. out Assessor's Map/Parcel / /C1 Installer's Name,Address and Tel No. Designer's Name,Address and Tel.No. L , lU Type of Building: Dwelling No.of Bedrooms 3 Lot Size �f2::� sq. ft. Garbage Grinder ( ) Other Type of Building h0✓!5!e_ No.of Persons ; Showers( ) Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided 3y6•'3 gpd Plan' Date Number of sheets Revision Date � 4 Title _ Size of Septic Tank /qeo CW5hj Type of S.A.S. Description of Soil /rA^-/ - Nature of Repairs or Alterations(Answer when applicable)/ �(/pr,.! S ,5 Date last inspected: + , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in f accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date m Application Approved by f� Date /O Application Disapproved'by: . /? Date for the following reasons, /�� "' E PermifNo. OC Date Issued to�� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( v) Upgraded ( ) Abandoned( )by 9 G t X /OWE y�r at 5-f E hp� 4}-� � ����i t 1 ,�, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a 6b9—3 Lf S dated Installer-6,20G3 A 7ry,.x),y Tnj-e Designer .vii,v,- Y,•,V s #bedrooms _� Approved design flow ��,--j, gpd The issuance of this permit sh 11 not be c nstrued as a guarantee that the syst fit ction ride gned. Date �(/ /' Inspector ram_ No. q Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS. I=i!5pogal 6p,5tem Construction_ Permit Permission is hereby granted to Construct ( ) Re air ( 11�upgrade ( _ ) Abandon ( ) System located at �� �{,� L�,,,t,` /(v.✓/�ddc 11f and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditionsf. Provided: Construction must be completed within three years of the date of this e Date E� - � Approved by �.s v. TRANS. NO.: CITY/TOWN: (2? fie Lk APPLICANT: 7.. A 63 ADDRESS: S DESIGN FLOW: gpd REVIEWED BY: _ %'� c,' N�Q- �- DATE: to N/A O.K NO_ Le al boundaries denoted 3r10 CMR 15.220(4)(a ] ✓ 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 31.0 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 andprovided) soil absorption system(required andprovided) whether system designed for garbage grinder North arrow 310 CMR 15,220(4)(g)] Existing and ro osed contours 310 CMR 15.220 4 ✓ 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)(i)] 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 9 r t5 r�.� _ P " N/A OK NO Location of every water supply, public and private, [310 CUR 15.220.4 k within 400'feet of the proposed system location in the case of surface water supplies and gravel packed public water. 1 ✓ 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 . wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 507 ft. 310 CMR 15.220 4 Water lines and other subsurface utilities located [310 CMR 15.220 4 m -water-line cross see 310 CNIR 15.211 1 1 Profile of system showing invert elevations of all system com onents and the bottom of the.SAS. 310_CMR15.220.4 0 Stamp of desi 'er 310 CMR 1 5.220 1 and 310 CMR 15.220 2 Stamp of Registered Land Surveyor (required if construction activities-within 5 ft. of lot line 310 CMR 1.5.220 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 CNIR 15.405 1 k Test-hole-adequate to demonstrate four feet of suitable material? 310 CMR 15.123 4 Test Holes adegOate to confirm adequate groundwater separation? . 310 CMR 15.103(3)1 Benchmark within 50-75' of system 310 CNIR 15.220 4 Materials specifications noted?jvarious sections of 310 CMR 15 000. System compongnts not>36" deep (unless Local Upgrade Approval or LUA requested) 310 CMR`l 5.405 1 e Address Sheet.2 of 9 N/A OK NO 01 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 � �� T' 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 descriped 31-0 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k Minimum cover . (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 Three access covers (inlet and outlet must be 20" or greater) - �- middle access at least 8" 7/07 310 CMR 15.228 2 Access to within`6 of grade - one port for systems<I 000gpd, two for system,s,,>1000 gpd. 310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from buil hn 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 1310 CMR 15.211 Required when other than single-family dwelling or flow>1000 d 310 CMR 15.223 1 First compartment 200% daily flow; Second compartment 100% daily flow 310 CMR.1.5..224 2 and .3 fluff pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] Address Sheet 3 of 9 r x N/A OK NO Located at least ten feet.from any water line? [310 CMR ✓ 15.222 2 Disposal piping it least 18" below water line(when water and sewer cross, see 310 CMR 15.211 1 1 Cleanouts required/provided ? 310 CMR 15.222(8)] Thrust blocks s ' ed in force mains?310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 3.10 CMR 1.5.222.6 Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CN4R 15.252 2 c Siphonproblem/ eachfield below pump chamber Endca s or vent manifoldspecified? Size and orientation of discharge.holes specified?.(not smaller than 3/8" not larger than 5/8") [310 CMR, 15.251(8) and 310 CMR 15.252 2 Materials specified (310 CMR 15.251(5) specifies various pipe types allowed 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)] Riserif deeper than 9".1310 CMR 15.232 3 Inside minimum dimension 12" 3.10 CMR 15.232 2 Minimum 310 CMR15.232 3 e Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232 3 d 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 pumpsspecified? Exceeds two units must have two pumps operating in lead-lag mode. 310 CMR 15.231(6) and 8 Stable Compacted Base 310 CMR.15.221(2)] . Address Sheet 4 of 9 !� Q 1 j. N/A OK NO Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation togroundwater? 310 CMR 15.212 Aggregate specified as double washed 310 CMR 15.247 2 System Venting required/provided? (system under driveway or >36" d 310 CMR 15.241 Inspection ports 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 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 tograde) 310 CUR 15.253 2 Aggregate 1'minimum- 4'maximum: 310 CMR 15.253 1 2' sidewall credit maximum 310 CMR 15.253 1 a In bed confi ration, inlet every 40 N. ft. 310 CMR 15.253 6 ffiffmom 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 egntours 310 CMR 15.251 2 Breakout OK? [310 CMR 15.211 1 A41 and Guidance Document minimum 2 distribution lines 310 CMR 15.252(2)(a)) Maximum separation between lines 6' 310 CM R15.252 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 Se aration between beds 10' mirAmum. 310 CMR 15.252 2 Bottom area used in calculations only 310 CMR 15.252(2)(i)] Address Sheet 6 of 9 Y s jBiloyahcy calculations needed ?Provided? L310 CM R 15.221(8)] Address Sheet 5 of 9 r - do Y N/A OK 140 Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r)] Pressure dosing Tequired on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use ovals If used in gravelless system -make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd) or quarterly >2000 dgood 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 3 10'CMR 15.255 3 ? Impervious barrier and/or retaining wall ? Guidance Document Impervious barrier installation must be supervised by designer 310CMR15.2552 b Retaining wall must be designed by Registered Professional Engineer 310 CDLR 15.25 5 2 a Side slope not exceed 3:1 ? 310 CMR 15.25 5 2 Breakout reiluirements met? [310 CMR 15.252(2) and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 f3. recommended) [2 10 CMR 15.255 2 e Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface 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 rote on the plan regarding the requirement for perpetual maintenanceagreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has gecant submitted a MX of a maintenance agreement? Are the variances listed on the plan? [310 CMR 15.220 4 RLS Stamp-necessary on plan if a component is within five feet of property[ine 310 CMR 15.412 4 Address Sheet 7 of 9 New constriction or.increased flow proposed - [Refer to 310 CMR°-15.414 Address Sheet 8 of 9 I Pr .4 e }r N/A OK NO Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.21§ - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? 310 CMR 15.214 2 Are the nitrogen loads proposed in compliance? [310 CMR 15.21 1 �� w Pumping to septic tank ? 310 CMR 15.229 Shared System 5 1-0 CMR 15.290 l ,y i Address Sheet-9.of 9 10/28/2009 09:05 5084775313 ENGINEERING WORKS PAGE 01 Y Town of Barnstable Regulatory Services Thomas F.Geller,Director Public Health Division Thomas McKean,Director 290 Main Street, Hyannis,MA 02601 Office; 508-8624644 Fax: 508-790-6304 Date: I 0 ZrJ 0 Sewage Permit# Assessor's Map/Parcel 17 ) — ) Ins ler&Deaiener CerV#-CAQR Form Designer: v�o,;�nT 4t r"'�S�^?�y,'w �� Installer: Q. • �cA W(1 ht • Address: Tz- W Cr-e 41- ,k cA tZA Address: P ' &A--ervf Ile z6I*Z. On ��A ,g�,�n Inc was issued a permit to install a ( ate) (installer) ` // a m /-h � septic syste at S� � ^ S'W•. �.__based on a design drawn by (address) I M C—&r-c-A i", E dated 10 (designer) I certify that the septic system referenced above was installed substantially according to the desir, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stnpout (if required) was inspected and the soils were found satisfactory. 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. Stripout(if required)was inspected and the soils were found satisfactory. tH OF M,qS PETER T. r` Hats er's Signature) McENTEE CIVIL •o ,9 No,35109� 9 Fps R� (Designer's ignature) PLE40 LRLE BMW 9ULTR wovywc. - CE OF COMPLL4LNCEJ'JULL T BE, IMM&MN. BYMBARNSTABLEP C 111ANK YOU, q;Wft f0=\dit*MC 0W ifiCaon fonm.dw of Town of Barnstable P'# 2 �� Departiment of Regulatory Services Public Health Division Hate Q a39.a�� 200 Main Street,Hyannis MA 02601 Date Scheduled U a Time Fee Pd. la06 - Soil Suitability Assessment for Sewage sposal Performed By: �P`�-e ! Mom"�"�� -�'fL v(� Y Witnessed By: �� �(/_ '� A?� LOCATION& GENERAL INFORMATION Location Address ss— C6,2h Owner's Name W �°e.��-e i:r:I� Address '� �wr�e.rw i Ile. wtA Assessoes.map/Parcel: f—7 f j G�J Engineer's Name Pe(—Cr f'ic NEW CONSTRUCTION REPAIR nC Telephone# 15�Z8'—7 37--9 7(o. Land Use S k'A ( t' Slopes(9'0) t Surface Stones w Distances from: Open Water Body U ft Possible Wet Areaft Drinking Water Well 2 S y ft Drainage Way N H ft Property Line 2sv w ft .Other ft SKETCH:(street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)- LAI— L Z t-Tt 1 I p Parent material(geologic) �l L < Depth to Bedrock � � , , Depth to Groundwater. Standing Water in Hole: /�' �- Weeping from Pit Face {A Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in, Depth to soil mottles: itt. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well:#, Reading Date: Index Well level— Adj,factor,,,,,4q,.!_ Adj.Grouttdwater Leval,,,,: - PERCOLATION TEST bete Thne,.__.� Observation 1 Hole# Time at 9" Depth of Pere % `��� �i �O,n, lme at 6" 5 . Start Pre-soak Time® . I S �r Time(91'•6"). End Pre-soak Rate MinJlnch` Site Suitability Assessment: Site Passed 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:\SEPTlC-kPERCFORM.DOC DEEP.OBSERVATION BOLE LOG Hole Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders: Cons—tenci, Gravel) Sim 10 . 12 (-3 � 6l r� DEEP OBSERVATION BOLE LOG Hole# `2— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. . Consistency,% 6—3(o to YrL -V� 2c , c �-c G/ti�l 2-�7 5 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones;Boulders. Cons Flood Insurance=Rate Man: Above 500 year flood boundary No— Yes (�,., Within 500 year boundary No Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least t four feet.of naturally occurring pervious material exist in all areas.observed throughout-the � area proposed for the soil.absorption system? S If not,.what is the depth of naturally occurring pervious material? Certification . I certify that on ( 1 6_�date)I have passed the-soil.evaluator examination approved by.the.. Departinent-of Environmental Protection and that the above analysis was performed by me consistent with the_required tr g,expertise-and experience described in 3 10 CMR 15.017: _ Signature Date W Q.\S.EI nC1 PBRCFORM.DOC 1`- TOWN OF BARNSTABLE rL�OCATION S�F \ ��-� 12�J SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) Arc, M Mc (size) d S 4c, ' i}S 30 or NO.OF BEDROOMS 2 OWNER PERMIT DATE: / COMPLIANCE DATE: C,; a - d 9l 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 �.�4q -30 y-G3.S art � C liOCATION � SEWAGE PERMIT NO. t / VILLAGE v ■ IN'STA LLER'S NAME i ADDRESS e U I L 0 E R OR OWNER DA TE PERMIT ISSUED •-/,1 /7 O DAT E COMPLIANCE ISSUED / X-2S-/fo t' - i �n� �'� �/ ` \ � U , ,. ,°l1 i No... U.�..�.��...� Fps...- ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH -x. oF....... . ......... ....................... Appliration for Dispog al Works Tonstrnrtiun ramit 11 Application is hereby made for a Permit to Construct ( ) or Repair ( ) Individual Sewage Disposal Sys at ............... ....... - . ... •--- ........ Locat' Address or Lot No. ' Owner Address ............. .... ......... ....... ..-..................... .........................._L__.r.. • ............_._.__._._........._........... � Installer Address r d Type of Building Size Lot..., . f._171"..Sq. feet U Dwelling—No. of Bedrooms............--.?.......-_._ .Expansion Attic (/U10 Garbage Grinder (I'V O `4 Other—T e of Building No. of persons............................ Showers — Cafeteria 44 Otboer fi�x+ture w Design Flow......... ............. allons per person per day. Total daily flow______-...3..0...................gallons. WSeptic Tank—Liquid capacity j. .....gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ __ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----/.. .. Diameter...........4..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY.......................................................................... Date.................................:...... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ix ••--••••-•-•-•---•-•--------••-•-•-•................•--•---•-•-•--•---..............._..._......•---......................................................... 0 Description of Soil........................................................................................................................................................................ x c, •••••-------•--•-•-•-•-........•••-•••-------•-•----•-•-----------•---•------•---•--.........••----•----...----•--•••••-••-••--••-•--•••--------•-•••••------•.................•----•----•-••-•••••-••-- w V Nature of Repairs or Alterations—Answer when applicable...._........................................................................................... ----•-----------------------------------------------•--•------------•----------.........-------•--------•------------------------------------------•---------•--•--•------------...............•--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewa e Disposal System in accordance with the provisions of LITLL 5 of the State Sanitary Code— The undersigned the agrees not to Ae the system in operation until a Certificate of Compliance has been ixM by the b 21,6 of ealth. ............. ..� 's Application Approved / ? -------------- -��l��� b............. Date Application Disapproved for the following reasons:................................................................................................................ ----------•---------------•--•----................-•---------•---•---•-•--------------......_..--•-•----- Date PermitNo..................................................._.... Issued--------•-•------------•-----------•--•---•-••-•-•••--. Date tom. '� ♦r. V.e� No...ROL!n.65.4 Fps...:? !............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . - :._ f..... ....:? ...............OF........'.......�' . .:1.r._....C., ts�._ Appliration for Bispos al Works Tonstrnrtiun rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposals; System at: .....(......"Cr..».J.......::r....'�� ! '.pC' .�..:........................... .............................. l Location Address •, P or Lot No. owner + .••. ddress A .r.., r MM-1 Installer ' Address - U Type of Building Size : .._Z. "'"� Sq. feet Dwelling—No. of Bedrooms_____________ .........................Expansion Attic (;, ,;;r Garbage Grinder (,��)/4.1 Other—T e of Building a Other—Type g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures.:::.............. .•--•--------- • ----.....--.•----••---•--••----•---•-----..._..-••-•---•---._....•---------....--•......-------'--..._..___. ................................................................................... .: W Design Flow___...__:"...:_ ._'.................... allons per person per day. Total daily flow......_r`_._;,'':_:..:?........... ........gallons. WSeptic Tank—Liquid capacity.___'_:_:gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No L. '. �....._ Diameter...........?+..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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........................ .-••---•--•---------•-••-•-•---••••-••--------------••••---...•-••--..._..__.............._--_-----------•-•-------.........-----'•-----. ---••------------ 0 Description of Soil....................................................................................................................................................---.................... x x ••-•-------• -- •••-•-----•-------- -----• ----------------------------------------------------------------------......................................................... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ae Application Approved By............ ..... .a...... ------------ Date Application Disapproved for the following reasons---------------------•----------•----•--•---------------•------•----------------•-------••-•-••••-...------_..._ ......................................••--------•----------...-----------.....-------•--.._._...----...---------•...•-•-•--•--•-....----•••-••----••---•••---- Date PermitNo.................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r ........../. ""...........OF..... -- . .- .........'`........................ ................ r C9rrtif iratr of Toutplittnrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed (Vor Repaired ( ) bY-•-•----_---• ---____ +,.................................................. ....................._......................................................... Installer at 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._d©__._-(�SA�_____________ dated--.............................................. THE ISSUANCE OF THIS,CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. •----•---•--_. Inspector. ...•---•--•----------- l DATE.---•--•--...... .......... =x ----------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OFEALTH No... ' '4e;Sd ..............OF......-._... ., !QG- ................................ .t� FEE..., d Disposal Vorks T,antrnrtinn rrntit Permission is h eby granted........�r � '�..... ............ to Construct ( or Repair ( ) an Individual Sewage Disposal System J at No..---• -- - ..........f ----• 1-�- •--------•--------------...----•--...-----•-•--•-------•-------•----.....----...... Street as shown on the application for Disposal Works Construction it No..................... Dated.......................................... DATE............���---�--5�•�'-�................................... oard o alth FORM 1255 HOBBS & WARREN. INC., PUBLISHERS - S!t`l��L� irL1,MIL� - 3 �S=DtzpO�K '� l.•10 C-�At"L'E:Af 1✓• �Tf�l�.fGFlZ, ,\ ID O •�J a,� r�a��� �t�ow � !tb �c 3 = 33c� G.pb 1r••- {� �. �; �E>'t-tc 'r��r = 330,. ISo 's • 4.s�56.t?v. h - f ` f JZ I A,T t o 1,4 TOTAL lZ>eSA6Kt - d25 -roTA L TD,at L.-( DEf�GOLQT101.l F'l�TF (����J 2tittll�orz Ls%. • � . Per �, �4.enrt ��":z I� MAN t',S } .'� �... � \�.: gyp\.�--•_., �, - �.•. a 173 I t i T1 'E�T -/dSo TOY FNozwo.0 Ham- �r/I i479 tuv T l n Hof" 4rri0S aKr iw. 80X (� SePnc INV. Tvr1K 4 SAID 1000 R&'a V. to/.. �. Y G,�1.. a�,Z q4 � • •A PlT S Wirt °' i STuNE. 90.0 CoezSE �O c.•�• � - C.GZTIF1C.D PLOT" P2v�`1 try — — +-� LofAT1W J (fF—I1TM,/ II, —E 1'J IS C_ctzTll=%4 -14AT TI-1r-- F0v Dxll0N 5N6'MiQ pl-A.Q RG1:7 GVLI.IGa N1Z-.1,1_n1-1 GC Ar PLI-(S W 1'T A TWG: l•C7T' Ie G Auu TN( ' t 7wAll-i or `�Ag+ rT �t_� CENTS-Urt.l$ k+16�11.A.rJC r)I C- !o zn O • RCGtSrcr�:� '�.ANa 5vev�Yu�s CA-4 AN 3 �.J;r.7�:�t,w; ,u�_•i�_�� Y���: car- =•: T'•: ,�Icwln APPL-Ic:A.t`.!-[' l�r C;t_ c�� rc, c��:..�(-:�:M�►fit LOT (_ WC:-5 � AL.AQ C rt o L(.,. rJ�, tP LEGEND ti °% " P� Z -- 98 -- EXISTING CONTOUR �`� a�a S 62*16 46„ E W ao 1OL13 _ _ _ 100. 0 _ - 100,40 x 100.98 EXISTING SPOT GRADE t° CB/DH/FND stockade fence 100,25X �� U UNDERGROUND WIRES Pcym� o°�� ova 00 5'7�a? �, W EXISTING WATER SERVICE x 100,48 N 10 . N� TEST PIT �a TP-2 $ BENCHMARK Gcag �D LOT 166 �IP100.18 100.23 APN 171 -199 w' I H xy y I i 100,2 Benchmark Set 15,000 s.F.f I 100,8 x n I I PROPOSED S.A.S. Outside cor. conc. pad u 100.18 q 2 TRENCHES EL.=101.37 (Assumed) SHED + I ( PORTIDE ON IEACHCTION TRENCH �a _ 101.01 x' x , x 100.39 100.83 '•. S LOCUS EXISTING LEACH PIT TO BE PUMPED, FILLED W/ x 140,78� , .1OL21 -- :L4 LOCUS MAP SAND & ABANDONED I �-'� O SCALE . . . X O I �a9� x f lawn Grill X' 100,38 100.85 Pad table GENERAL NOTES: EXISTING SEPTIC TANK �� X 101,37 -I' 0 8 100.87 1• BOARD ALL HOFG HEAES LTH TA D THE DESIGN HIS PLAN MUST BENGIINE APPROVED BY THE LOCAL (TO REMAIN) f 1 1,26 TOP OF TANK, EL.=100.19 I O 101.69 Ln v 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 1NV.(OUT)=98.86t(VERIFY) 101,86 O P' ' LOCAL RULES AND REGULATIONS. Z 100.41 - o T 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR . ► TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE Ln G DESIGN ENGINEER. O 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING L''1 10 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN � 0 101,15 ENGINEER BEFORE CONSTRUCTION CONTINUES. a EXISTING 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. m HOUSE (#55) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF I T.O.F.=101.86f THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF o GARAGE HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 100.81 ENT. 101.58 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. I I 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. I lOLO X 101.68 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS X 01,05 WALK AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE y DIRECTED BY THE APPROVING AUTHORITIES. 10 100.81� 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING la PAVED C CONSTRUCTION. DRIVEWAY o° 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS I o • Ic�o x 101,16 LAMP ��� �F MAss9 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND m 100.98 y��Q �yG REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). I I i o PETER T. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE I McENTEE INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 18. 100.00' i__________ v CIVIL 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND I No. 35109 , „ O IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 100,35 N 62*16 46 W I X00.37 A� sEcl j ���`` PROPOSED SEPTIC SYSTEM UPGRADE PLAN r 55 EBEN SMITH ROAD, CENTERVILLE. MA - edge of pavement 100,30 100.31 99'71 4�k0 prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 99,95 EN SMI TH ROAD Engineering by: SCALE DRAWN . N0. EBEN1 OWNER OF RECORD Engineering Works, Inca 1"=20' P.T.M.. 200-09. (7 I RICHARD WARD - g 9 55 EBEN SMITH ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. CENTERVILLE, MA 02632 (508) 477-5313 10/13/09 P.T.M. 1 of 2 'T rs NOTE: TO PREVENT BREAKOUT, THE PROPOSED BACK OF HOU� FINISH GRADE SHALL NOT BE < EL.97.3 zzzz FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D—BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT OVER END UNIT T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE 'I9 F.G. EL: 100.3(MAX.) EXISTING F.G. EL.=101.3t F.G. EL: 100.4f C moo' h MAINTAIN 2% GRADE (MIN.) OVER S.A.S. g a oo' INSPECTION p L = 52' L = 6'(MAX) PORT 11 I T S=1% (MIN.) ® S=1% (MIN.) I I I I 4"SCH40 PVC 4"SCH40 PVC I I 6" 10.38" TO I I I I 1a° ' INVERT I 1 EXISTING 48" LIQUID LEVEL INV.=96.87 G ADAS D E INV.=97.17 PROPOSED7.,.=97.00 2 ROWS OF 6 UNITS AT 5.0'/UNIT)= 30' I u INV.=98.86 D—aO� SOIL ABSORPTION SYSTEM (PROFILES —Im �I— S•A•S•LAYOUT EXISTING 5.7 EXISTING SEPTIC TANK ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS 15 5" (3) 5" DIA.OUTLETS 16* 2, NOTES: 1) D—BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED TOP ELEV.=97.33 12" STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). INV. ELEV.=96.87 115.5- e 2) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM ELEV.=96.00 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 2.83' 2.83' • Top View Section 2" AS MANUFACTURED BY TUF—TITE, ZABEL OR EQUAL. 5' MIN. ABOVE BOTTOM OF H-10 LOADING 5 4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE T.P. EXCAVATION OR G.W. D—BOX INVERTS PRIOR TO CONSTRUCTION. EXISTING SUITABLE NO G.W., EL=89.2 = MATERIAL USE 2 ROWS OF 6—ADS Arc 36HC UNITS SEPTIC SYSTEM PROFILE IN TRENCH CONFIGURATION WITH NO STONE 63.25" TYPICAL SECTION N.T.S. y�� DESIGN CRITERIA SOIL LOG w6. 34.5" DATE: OCTOBER 1, 2009 (REF#12,716) NUMBER OF BEDROOMS: 2 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R.S. HEALTH AGENT DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH TOP VIEW DAILY FLOW: 220 G.P.D. 60" 100.2 A 0 100.2 A 011 END CAP END CAP DESIGN FLOW: 330 G.P.D. SANDY LOAM SANDY LOAM FRONT VIEW SIDE VIEW GARBAGE GRINDER: NO 99.7 B 10YR 4/2 6 99.7 B 10YR 4/2 6„ END CAP REAR/TOP VIEW hk LEACHING AREA REQUIRED: (330) = 445.9 S.F. SANDY LOAM SANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW 74 97 2 10YR 5/ 36" 97.2 10YR 5/ To 36" DIFFER FROM ACTUAL CHANGE SLIGHTLY WITHOUT PRODUCT PRODUCT APPEARANCE. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY C 42" C 4640 TRUEMAN BLVD PROPOSED D—BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED 54RC gffzw.HILLIARD, OHIO 43026 Are 36HC DETAIL ADVANCED oIRAINAGE MTEM5. NC. USE 2 ROWS OF 6—ADS Arc 36HC UNITS IN M—C SAND M—C SAND PROPOSED SEPTIC SYSTEM UPGRADE PL AN 2.5Y 6/4 TRENCH CONFIGURATION WITH NO STONE 2.5Y 6/4 I 55 EBEN SMITH ROAD, CENTERVILLE. MA (GENERAL USE APPROVAL FOR 7.80 SF/LF IN TRENCH CONFIGUATION) Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 2 x 30' TRENCHES = 60'60' x 7.80 SF/LF 468 SF 89.2 132" 89.2 132" Engineering by: SCALE DRAWN JOB. NO. = DESIGN FLOW PROVIDED: 0.74(468.0 S.F.) = 346.3 G.P.D. PERC RATE <2 'MIN/IN. ("C" HORIZON) Engineering Works, Inc. NTS P.T.M. 200-09 NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 10/13/09 P.T.M. 2 Of 2