Loading...
HomeMy WebLinkAbout0022 FULLER ROAD - Health PF 22 Fuller Road Centerville A= 188 -�032 SMEADO No.H163OR UPC 10259 smead.com 9 Made in USA s No. I�l , Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pphLation for Ne-po8al *pstrm Construction 3permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. o�a FU LLB RD Owner's Name Address,and Tel.No. Assessor's Ma /Parcel t���, p $� � 4337 S 3 Si A2Lt0GFT?DYJ VA Installer's Name,Address,and Tel.No. �jd$- �7-$�`2°� Designer's Name,Address,and Tel.No. 5b 2-305 -03-1-1 sr- r14*4544 Q-C ?,S 54 C ZA�� 14wY -6 V-;4PCNAM Type of Building: 2 Dwelling No.of Bedrooms J Lot Size 0 O 00 sq.ft. Garbage Grinder( ) Other Type of Building R CS[neTJ-r(Ar .. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 30 gpd Design flow provided 3 qq, gpd Plan Date 1 o- D.4- ad 14 Number of sheets Revision Date Title a j. 1=U LLE P- Q 64b Size of Septic Tank ( So© Type of S.A.S. (A) 500 C,'� GkritL(BE25� Description of Soil M eb, Tlp 5g4&�D Q_ 6b Ft�1 SC-E 'P4,44 Nature of Repairs or Alterations(Answer when applicable) 30!5-0q� n/E(x) 15O C'jcjt O Q 14-1 s c�T lc. -lw-).J V-- �:Q t JEW D-6OX -Tj,,�, dal .500 6g4-C,L0ly 4-1- 10 usAcgi vG-4 C-A*.4,,AG9,-s uji-ri+ 4 Fej�Z dF Act CSA-Te�, SuP-'ou*Jbt✓Gr Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 10 -as—.20 1. Application Approved by Date TG L — Application Disapproved by Date for the following reasons Permit No. 4 01 G Date Issued S�- r t, No. 6fo Fee THE COMMONWEALTH OF MAS�ACP4USETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Misposal*pstrm ConstructlO�II erttt[t Application for a Permit to Construct( ) Repair(Xj Upgrade("Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. as 1=v U—CaL R:D Owner's Name,Address,and Tel.No. C w eo_r (c c.. Z-OH W K(RK Assessor's Map/Parcel $$ 3a � 7 S 31; k S-T ARL(N(&71_1rJ V4 Installer's Name,Address,and Tel.No. 56%—�-77—9 2177 Designer's Name,Address,and Tel.No. 50$--2-71 3 —03-1.7 ! A C,9"4tA id A-t._ 5`r A4AS41 P QC aS 5q gE.A>nL= 1.4WY E, bvAiklEINAM Type of Building: Dwelling No.of Bedrooms 3 Lot Size 0,O 00 sq.ft. Garbage Grinder( ) Other Type of Building R C--S t CsXr o'4 L No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �J 30 gpd Design flow provided 3 qj,4- gpd Plan Date O— A4 odd 1 4 Number of sheets Revision Date ..;, Title ;Q, FULL&7IZ R OAb i -Aj _�yl LLLB ki Size of Septic Tank 1,500 Type of S.A.S. 'A 5 0Q QTA _ C147+04BEP-' Description of Soil M CD, TD C OAA SiG� 5A4A Q1._1(o�/SG E P44n1 i -" Nature of Repairs or Alterations(Answer when applicable) =1V5T)4-C,L ME;UJ 115L r 5a?T1C -14wIL 'h7 NEJ D-BOX -ran- (a) Soo eg- - Orj Lj- 1O lg�qjc . WETH L4 FED` 6E AC�G&A-M Su��0u1.l�[1JGr E Date last inspected: ik Agreement: t 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 Lned Date Application Approved by -- _ Date i Application Disapproved by Date for the following reasons r � Permit No. c9 01 L Date IssuedI i THE COMMONWEALTH OF MASSACHUSETTS I BARNSTABLE,MASSACHUSETTS ti Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by d 4 rcu)(D at a Q rU LLEZ R D a C-trjELV/tLr has'Ueen constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.o?01 y-L16& dated 16—1?"(f f Installer dAPGwtaE E Q6� 4A-C . Designer G C (--- ►AGL tJC #bedrooms 3 Approved design4lb C> gpd The issuance o chi drmit shfI no•be co strued as a guarantee that the system will / ctio e'igned. !� 1 Date '> Inspector -------------------- ---------------------------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposai 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) Abandon( ) System located at r 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 permit. ✓"-' Date —1 Approved by / TOWN OF BARN_ STABLE LOCATIONQ Fir �—'.,,, Rc4 SEWAGE# VILLAGEC,e ,/,1' ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. Gg,(,�,W 4c�C i,�'u LLC. 5,O9-177,Wl7 SEPTIC TANK CAPACITY L5-00 C3 I LEACHING FACILITY:(type) �46W G,4 I rh4,rbz,3 (size) /a,Fl'X 25/ NO.OF BEDROOMS 3 OWNER�jOkn /V, Ar�lcmjj r 1641, /` -Fe�S PERMIT DATE: L 0 P X7" ZO I(f COMPLIANCE DATE: � � 4 Separation Distance Between the: 40,0 6 41 PV1t1Wft+VV_ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility m aT arFeet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) ✓V Feet Edge of Wetland and Leaching Facility(If any wetlands,exist within 300 feet of leaching facility) Feet FURNISHED BY C APiewt Dg e&)mg ei 5 LLC. A-lax, r Ada 40 , A-3--36. 3 A5-- i► A— = pia A ' - r 0-,�=38 6-345 . '��6 ,V Town of$arnstable �. Regulatory-Services Thomas.F.Geiler;Director BARNnABIX = Public Health Division i6}9.• Thomas McKean,Director Fo ram 200 Main Street, Hyannis,MA 02601 t Office: 98-862-4644 Fax: 508-790-6304 Date: I ' Sewage Permit# (0 Assessor's Map/Parcel / 3 L Installer&Designer Certification Form Designer: _SL Eg.,Ijoee;iInS. , T%)c, Installer: Ga(�` :�de C=nfer�tf5�5, LL(; Address: 2- ✓59 CtonNne;-ry Niihw�y Address: t 53 Cu,-nmerce.1 SE.ree.} fast woreharn F►-IA 02538 yas�►Qee_,. Nrt dZfc y q On to 10 Cge..:tde_ C-okereases was issued a permit to install a (date) (installer) septic system at 2-2— FtAtc k a d based on a design drawn by (address) �(- C���;rteecir�ct Tv�G, dated OC�D�Der Z`1, 20l`( (designer) _ I certitv 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. Stripout (if required) was inspected and the soils N ere hound satisfactory: I certify that the septic system referenced above was installed with major changes(i.e. greater than IA' 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 cerritied as-built by designer to follow. Stri.poui(if re nspected and the soils were Ibund satisfactory. V4OFA% , C,y d G JCHy L. p� ~! CHUkCN•I:L s V, JR. tfj. alte 1.r s Signa e — ct�.!L No .1.5,; a kAL esigner's Signatur (Affi) esig er's Wmp Here) PLEASE RETURNL BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT. BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD.ARE RECEIVED.BY THE BARNSTABLE PUBLIC HEALTHDIVISION. THANK YOU. } ui i r AFrms.hsi;nar ;utiruum timn.duc r FORM30 Caw HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE dffY/TOWN C W PARTMENT ADDRESS M SVBy`0 TELEPHONE n Address — Occupan Floor Apartment ND. No.of Occupants ,,,`_ No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units NQ. Name and address of ow�r Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof it IV Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 l q Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: S cc s, Flues,Vents,Safeties: Kitchen Facilities in S ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION R RT IS SIGNED AND CERTIFIED UNDER T E PAINS AND PENALTIEERJ Y " el- INSPECTOR TITLE ( (9/ A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply,of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300.. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. i 5� FORM 30 CH W HOBBs&WARREN' THE COMMONWEALTH OF MASSACHUSETTS B RD OF HEALTH T CI Y TOWN Eq ARTMENT AMITI&ESS /Q y� 0 TELEPHONE Addressr� FU/J kjf P- _ Op�&VilltcupZa� Floor Apartm o. No.of Occup is No. of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units No.Sto Name and add re s of o{w�ner 1 Y'1'1 l i Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: A ICNJat Drainage r Infestation Rats or other: .� STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ N Equip. Repair TYPE: A JL Stacks, Flues,Vents: PLUMBI G: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vents ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom -Pantry Den -Living Room Bedroom(1). Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, F es Ve ts,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CM�750 OF �,HE CODE ORd'TJU AUTHORIZED INSPECTOR.(See Over) (, J �� "THIS INSPE , REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENA I S tMT ." ,,11 INSPECT TITLE DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and wellbeing of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall'in no way be construed as a determination that other violations oi�conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature,'both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.60.1 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. � �� Town of Barn stable P# _A� ' Department of Regulatory services ,,,M Public Health Division Date D MAM rF1 h 200 Main Street,Hy is MA 02601 Date Scheduled Time Fee Pd. _J� Soil Suitability Assessment for Sewage Disposal Performed By: }{0nQe1 Ci/VletiW t 1 l 65 C Witnessed By: ( � LOCATION& GENERAL INFORMATION Location Address a FuL Owner'shame -fS411�0�A1LT�attS KtiZ1C Address 8Fs p 4331 3061 S o. AP-(-r��.1,v.4 �atDy, Assessor's Map/Parcel: 3+�-- Engineer's Name+�PE- tbty NEW CONSTRUCTION REPAIR Teleph'one# 6 jig (47 Z g!SZ-1. FG ni 1 Land Use 5 r tit ue,ll i Slopes(96) Z I Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well - ft Drainage Way ft Property Line �O ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) See_ CA-A�aJ1ec, elall y L:J Q, Parent material(geologic) U�wa3� Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_ Weeping from Pit Face Estimated Seasonal High Groundwater 7 12 6 •' DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: DUeCI se_(Ua1'tvA Depth Observed standing in obs.hole: 7 2 6. In, Depth to soil mottles: in. Depth to weeping from side of obs.hole: _ in. Groundwater Adjustment fr. Index Well# Reading Date: Index Well level Y, Adj.factor, m— Adj.Croundwuter Level, PERCOLATION TEST Date JO-23/Y Time Observation Hole# _ Time at 4" Depth of Perc 3�oi�- 5y r Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak 0'' 2 Ord Rate Min./Inch Z 2- Site Suitability Assessment: Site Passed Y e5 Site Failed: Additional Testing Needed(Y/N) Al 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:\SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# + z Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (MunselQ Mottling (Stnucture,Stones;Boulders. • onsistency.46 Oravell 19- 3 9 Ls jo.YrS/� 314-12(4 C, H-C S 2, 51 - 6 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi ten % DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%a t DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. s Flood Insurance Rate Map: 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 four feet of naturally occurring pervi gus material exist in all areas observed throughout the area proposed for the soil absorption system? l e s _— If not,what is the depth of naturally occurring pervious material? Certification I certify that on ib`27"�'9 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise an experie described in 3 10 CMR 15.017. Signature Date Q.WEV IC ERCFORM.DOC T.O.F. EL.= 32.4'± FINISH GRADE OVER D-BOX = 26.4 ± FINISH GRADE OVER CHAMBERS= 25.9' - 26.7' GENERAL NOTE S PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE 1• UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS BOX OUTLET TO WITHIN 6"OF F.G. 0 2"OF 1/8"TO 1/2"DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE 26,0'± 5 DIA. OUTLET(S) MIN SLOPE 1 /o TO F.G. (SEE GENERAL NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. STONE OR GEOTEXTILE FILTER FABRIC FI FOUNDATION = 27.8'± ---- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS COVER(3 TYP.) 36" MIAX. TOP OF SAS = 23.73' PLACE RISERS ON ALL DESIGN ENGINEER. 9 N. MIN. CHAMBERS WITH PROP. SCH.40 3 "MAX 9"MIN. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER PROP. SCH. 40 22.90 36"MAX. BREAKOUT EL= 23.40' INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. PVC SEWER FINISHED GRADE 2"DROP MIN. 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN.SLOPE @,% E10'. 3" 3" DROP MAX. 3" 9" L-16_ PROVIDE WATERTIGHT ELEVATION = 23.40' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE @ 1% o 4" PVC IN FROM JOINTS (TYP.) �wC 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF *25.6'"' 14" 23.75' SEPTIC TANK 4" PVC OUT TO 0 0 0 0 O 0 O THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. o °° LEACHING FACILITY pOp � � � � � � � � � °° � � p 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. Op 24.00' 23.30 MIN. 23.13 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" OUTLET TEE 12 2� op D O D O 0 °° 0 0 0 0 00 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK GAS BAFFLE 6"CRUSHED STONE 0 0 0 0 0 po 0 0 0 o o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS OVER MECHANICALLY po o o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 23.4'OFFSET TO FND COMPACTED BASE I I AND DESIGN ENGINEER. 4.0 8.5'(TYP) 4.0 4.0' 4.0' 5 OUTLET DISTRIBUTION BOX 4.83' 8. ELEVATIONS BASED ON APPROXIMATE U.S.G.S. DATUM. BENCHMARK ELEVATION OF 30.00, 6" CRUSHED STONE TO BE INSTALLED ON A LEVEL STABLE 25.0' (NP') ESTABLISHED ON THE TOP OF NAIL SET IN TREE AS SHOWN ON PLAN. OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 15.50' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE PIPES TO BE LAID LEVEL. 20.90 12.83' PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT Dimensions per Wiggin 2 - 500 GALLON CHAMBERS CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES *CONTRACTOR TO VERIFY EXIS-PING LENGTH 10'-6" WIDTH 5'-8�� DEPTH 5�-8�� precast Corp.,Pocasset,MA) CROSS SECTION VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. ELEVATION PRIOR TO ANY WORK& SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL CHAMBER DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE _ 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING ,J -kl a «ram • ++ • ! «'� - - TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM fir a r a• r r"' • *«a r • PERC NO. 14538 APPROPRIATE AUTHORITY. / # ` '• ` INSPECTOR: David W.Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS � EVALUATOR: Michael Pimentel, EIT CSE LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE ft �4 '+ • ` . THEY SHALL WITHSTAND H-20 LOADING. �-- • ,..IJ �! - ,. � - : + . C.S.E. APPROVAL DATE99 * � • `•+ ' • Oct.O Oct.ct. 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. CC BN f� . •. « ®ii DATE: October :/ (( •+• • TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE ff a II ,/ . +r BM 60 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. Hatt ry ` r ELEV TOP= 26.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, A•• Q +a • • ELEV WATER= < 15.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN I � ;,� +• . ' PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. " " 16. DEPTH OF PERC 36 -54 PROPOSED PROJECT IS LOCATED WITHIN: ch \ A • M r = \ MAP 188 rsn ' • « ` TEXTURAL CLASS: 1 ASSESSOR'S MAP 188 PARCEL 32 PARCEL 31 ,_ _.. a OWNER OF RECORD: JOHN N. &ARTEMIS G. KIRK, TRUSTEES KIRK FAMILY REALTY TRUST NQQ 00, - - M an erry r • « i 0" 26.00' ADDRESS: 4337 S 36TH STREET J \ OR/VFWq Y M Fill ARLINGTON,VA 22206 a Q 12" 25.00 U Q • ' Q A Loamy Sand FEMA FLOOD ZONE X L-P 2U �k�X * rr •s • ' „ 14" 24.83' COMMUNITY PANEL# 25001CO563J CO w � � � �X�FN �, r � «" • l C Loamy Sand 17. DEED REFERENCE: LAND COURT CERTIFICATE 177280 4w I GARAGE / C-2 \X�4- « B 1 oYr 5/6 18. PLAN REFERENCE: LAND COURT PLAN 24614-E (SHEET 3) cus 36" 23.00' J �w �. ' + Perc 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. \\mow x _ c� 54" 21.50' 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY / THE i I $ FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY Q ELINE x ' FOR USES OF THIS PLAN'OTHER THAN ITS INTENDED PURPOSE. r C Med. to Coarse Sand 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Y �. (Al CS 2.5Y 6/6 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A R�o O ' X MAP 188 REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. / �' #22 1 EXISTING I i PARCEL 36 MAP 188 LOCUS P LAN PARCEL 32 / 3-BEDROOM O � ) SCALE: 1" = 1000' 126" 15.50' / DWELLING 10,000 S.F. ± TOF = 32.4'± fNq` Q� ,26 ` BFE = 25.1'± � No Standing, Weeping or Mottling Observed 234, ( DESIGN DATA 'TEST PIT DATA LEGEND / 27x8' PERC NO. 14538 NUMBER OF BEDROOMS (DESIGN) 3 INSPECTOR: David W.Stanton, R.S. x O' EXISTING SPOT GRADE - - EVALUATOR: Michael Pimentel, EIT, CSE - 50 - - -- EXISTING CONTOUR O 0 �- DESIGN FLOW 110 GAUDAY/BEDROOM 441 / (2 24x8'- / C.S.E. APPROVAL DATE: Oct. 1999 PROPOSED CONTOUR TOTAL DESIGN FLOW 330 GAUDAY W � ?3>, EXISTING CESSPOOL TO BE PUMPED &/ DATE: October23, 2014 3) , REMOVED IN ACCORDANCE WITH TITLE 5 DESIGN FLOW x 200 % = 660 GAUDAY TEST PIT#: 2 50 PROPOSED SPOT GRADE T 1 1g USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP= 26.00' U/H/W EXISTING OVERHEAD UTILITIES 9 / PROPOSED 1,500 GALLON SEPTIC TANK ELEV WATER= � / I PROP. "D-BOX"- 25x < 15.50' W-----W-- EXISTING WATER LINE HC-1 13 01 / PERC RATE _ % TEST PIT LOCATION 4) o / ' o INSTALL 2 - 500 GAL. CHAMBERS W/ AGGREGATE DEPTH OF PERC= ^ MAP 188 O O O PROPOSED 1,500 GALLON SEPTIC TANK 26 PARCEL 35 � I SIDEWALL CAPACITY TEXTURAL CLASS: 1 (LENGTH + WIDTH) (2 SIDES) (2 HIGH) (0.74 GPD/S.F.) = GAUDAY CP` EXISTING CESSPOOL / ca0v h �o (25.0'+ 12.83')(2 ) (2' ) (0.74 GPD/S.F.) = 112.0 GAUDAY - / 0 N 1130 0" 26.00' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE i (6 �� Fin BOTTOM CAPACITY 12" 25.00 Sand � PROPOSED DISTRIBUTION BOX Loam ? T (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY A Y i \ s ` 26x7' / (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY 14„ 10Yr 3/1 24 83' PROPOSED 500 GALLON LEACHING CHAMBER H69 \ PROPOSED 2-500 GALLON LEACHING Loamy Sand / Q 10"W \ 1 5) / 25x7' CHAMBERS WITH AGGREGATE TOTALS: B 00 00, � \ / 10Yr 5/6 MAP 188 TOTAL NUMBER OF CHAMBERS 2 36" 23.00' REV• DATE BY I _APP'D. j DESCRIPTION PARCEL 33 l TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE Benchmark PROPOSED INSPECTION PORT TOTAL LEACHING CAPACITY 349.4 GAL./DAY Nail in Oak Tree PREPARED FOR: Elev. =30.00' /} \ Approx. U.S.G.S. / CAPEWIDE ENTERPRISES / C Med. to Coarse Sand 2.5Y 6/6 LOCATED AT SWING-TIES 22 FULLER ROAD CENTERVILLE, MA 02632 PLAN NOTES: L DESCRIPTION HC-1 HC-2 126" 15.50' SCALE: 1 INCH = 10 FT. DATE: OCTOBER 24, 2014 SEPTIC COVER IN (1) 39.3' 39.T �p�,, 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC No Standing, Weeping or Mottling Observed ���� " o s 10 20 ao FEET SYSTEM COMPONENT. SEPTIC COVER OUT(2) 36.3 47.3 - - - - - - --- --- r, J N L�;'" PREPARED BY: RESERVED FOR BOARD OF HEALTH USE CHu cHi��JR JC ENGINEERING INC. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED CORNER OF STONE(3) 27.7 50.1 �( Civic d' ' LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. 0 4180- 2854 CRANBERRY HIGHWAY REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH CORNER OF STONE(4) 39.3' 57.2' EAST WAREHAM, MA 02538 1 TEST PIT DATA. CORNER OF STONE(5) 38.3' 78.2' SITE PLAN Ty ,, 508.273.0377 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. SCALE: 1"- 10' CORNER OF STONE(6) 26.3' 73.1' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.2931