HomeMy WebLinkAbout0096 HAWSER BEND - Health (2) 96 MAWSER REND DR. , CENTERVil
A =193.064 L28
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UPC 12534
No. 2� 153LOR
HASTINGS. UN
No. 20o l Fee $5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpplication for 3iopooal Opotem Conotructfon 30ermtt
Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
96a�jse� Bend, Centerville Steven Farrow
Assessor's ap arce Q
Installer's Name,Address,and Tel.No. / (p Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service C R Short
P O Box 1089, Centerville P O Box 1044, S Dennis
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building R P G; d en t; a 1 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 gallons per day. Calculated daily flow gallons.
Plan Date 1 g 2 n, Number of sheets Revision Date
Title
Size of Septic Tank 1000 r` Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) T i le 5 l e a e h s y s t effi to the —
plans of C R Short,. dated 1 0-2Fi-01 F ##1 -897
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 vironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been is ued b o of Health.
�-®-
Signed r Date
Application Approved by 1 V- Date 1 JS O
Application Disapproved for the following reasons
Permit No. .2)0 1- -71 Date Issued 0
TOWN OF BARNSTABLE
I;OCATION D RQiAt7 SEWAGE # ®Q 1— tl
VILLAGE_ ASSESSOR'S MAP & LOT �1 Old
INSTALLER'S NAME&PHONE NO. & Ur,SW uy Sera 4l 7-25® 77
SEPTIC TANK CAPACITY l Cad 0
LEACHING FACILITY: (type) 3 Q W(fJCc((S (size)
NO. OF BEDROOMS in yvG j 1 t
BUILDER OR OWNER
PERMITDATE:�/ ( COMPLIANCE DATE: I/ G
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
4a,
m
% ! � d
1 '. t Fee
)oa)
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes /
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2ppitcation for Mtgo.5al 6potem Congtructton Permit
Application-for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
96 arser Bend, Centerville Steven Farrow
Assessor's ap arcel Q t/
I
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service C R Short
P O Box 1089, Centerville P O Box 1044, H Dennis
'Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Ren i dPnf-i a 1 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 gallons per day. Calculated daily flow gallons.
Plan Date 0=3 ro_n 1 Number of sheets , Revision Date
Title
Size of Septic Tank 1000 Type of S.A.S. 1 3IX
i
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) m_i i _S �,. 4-9
plans of Gt Short, dated 10-26-01 , #1-897
Date last inspected: \�
Agreement:
The undersigned d'grees to ensure the construction and maintenance of the afore described on-site sewage disposal system
~' in accordance with the prrisions of Title 5 of the nvironmental Code and not to place the system in operation until a Certifi-
Cate of Compliance has Ceen is ued b i o of tiealth.
-61
Sig�d i Date
U
Application Approved b w �- Date � ,S
Application Disapproved for the following reasons
Permit No. 200 1— 71 t Date Issued /S (l
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Farrow Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( X)Upgraded( )
Aba d6one 1( )b Wm. E. Robinson Septic �ervice
awsexy end, entervi e
at has been consttruc ed • accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 001`71/ dated
Wm. E. Robinson Sr. _
Installer Design- C R Short
The issuance If thi permit shall not be construed as a guarantee that the system will function as d si ned.
Date I I r �Gi1) Inspector a ' 1.,) 47
----------------------------------------
No. n U A ` 71 Fee $5 0
THE COMMONWEALTH OF MASSACHUSETTS
Farrow PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS
1"tg;po!6a1 *pgtem Con.5truction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 96 Hawser Bend, Centerville
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date: ( G/ Approved by t/LP �i' =At
r
44, i ?Tye a e t9a � k ' t r
AM
SEWAGE
r -
VELAGE_CCi1'�Cf2Vl 1 ASSESSORS MAP &SLOT x f•
s. INSTALLERS NAME&PHONE NO. d2—*QroUn Wh%J 56Q C 7.75—Z 7--
x t SEPTIC.,TANK:.CAPACITY 1 106 d
7
LEACHING FACILITY: (type) 3 02e! JCe( (size)
NO OF BEDROOMS
BUILDER OR OWNER
PERMITDATE
COMPLIANCE DATE // G
7.51�.A a<-�:� '��L4('�..''7 w.b 7 �r .Ft '.�rtt.•#-A'. '�c;a� � r�..r.� -t.. - ::. ...:; - � .Y t ,.. .. a* r �I�.,+ :dj;.
Separation ►stance Between the:
k •.. Maximum Adjusted Groundwater Table.to the Bottom of Leaching Facility f= Felt
Private Water Supply Well and LeachingjFaciLty ;($any wells east
.;on site or,
r within.200 feet of leaching.facihty),;:. Beef
Edge of Wetland and42fing'Facility(If any>ve't}ands ez�st
:.� 2. •; 1.
i*i ti 300
tu :feetofg facility) F.eet.:
411
yr ;. Ftirntshed by
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: ✓ ` ` I $ t i I F rr J1 t ( Z ,—.'_- x. g
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0 _
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Graci
DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector
ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119
TeaTicket,Ma.
(508)564-6813
TRUDY COXE
Secretary
1
ARGEO PAUL CELLUCCI DAVID B.STRUHS
Governor Commissioner
UBSU WAG ;11OSAL SYSTEM INSPECTION FORM
RT A
TI CATION �,� 1 �8�
Property Ad ress:1 96 HAWSER BEND �. CENTERVILLE L Z3 Q,
Name of Own STEVEN FARROW
Address of Own r SAME ti
Date of Inspection, `-'--411/99 A p
Name of Inspector:(Please PrRfiV401*$eftACI 7 1999
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) € \
Company Name: n/a �
Mailing Address: n/a
Telephone Number:. n/a
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate
and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems.The system:
Passes The inpection is based on criteria defined in Title V
_ Conditionally Passes code 310 CMR 15.303.My findings are of how the system Is
Needs Further Evalu tion By the Local Approving Authority performing at the time of the Inspection.My inspection does
X Fails not imply any warranty or guarantee of the longgevity of the
septic system and any of its components useful life.
Inspector's Signature: Date:4/20/99
The System Inspector shilsuibmita copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of
completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner
shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
THE SYSTEM FAILS TITLE V INSPECTION.THERE IS NO EFFECTIVE LEACHING LEFT IN THE PIT.THE LIQUID LEVEL WAS OVER THE PIPE AT
THE TIME OF THE INSPECTION.
revised 9/2/98 Page 1 of 11
4 a
• • t
a • 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
INSPECTION SUMMARY: Check A, B, C, or D:
- A. SYSTEM PASSES:
_ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated
are indicated below.
COMMENTS:
n/a
B. SYSTEM CONDITIONALLY PASSES:
Wa One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the
ass.
replacement or repair,as approved by the Board of Health,will p
Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not.
nLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or
the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank
failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as
approved by the Board of Health.
nta Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
broken pipe(s)are replaced
obstruction is removed
distribution box is levelled or replaced
Wa The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass
inspection if(with approval of the Board of Health):
_ broken pipe(s)are replaced
_ obstruction is removed
revised 9/2/98 Page 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety
and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS
NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
_ Cesspool or privy is within 50 feet of surface water
_ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS
FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a
surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
_ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well,
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the
well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less
than 5 ppm,Method used to determine distance n/a. (approximation not valid).
3) OTHER
nfa
1
revised 9/2/98 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
X I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped n(a.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality
analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure.
E. LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and
safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public
water supply well)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2/98 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
Yes No
X Pumping information was provided by the owner,occupant,or Board of Health.
X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles
or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption
System on the site has been determined based on:
X Existing information,For example,Plan at B4O,H,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
(1 5.302(3)(b))
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
Subsurface Disposal Systems.
revised 9/2/98 Page 5 of 11
v
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4113/99
FLOW CONDITIONS
RESIDENTIAL:
Design flow:-=g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual):.1
Total DESIGN flow: IQ
Number of current residents:4
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): NQ If yes,separate inspection required
Laundry system inspected(yes or no):JIQ
Seasonal use(yes or no):DLO
Water meter readings,if available(last two year's usage(gpd): Wa
Sump Pump(yes or no): NQ
Last date of occupancy: nta
COMMERCIAL/INDUSTRIAL
Type of establishment: pia
Design flow: pia gpd(Based on 15.203)
Basis of design flow: nta
Grease trap present:(yes or no):M
Industrial Waste Holding Tank present:(yes or no): NQ
Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ
Water meter readings.if available:pia
Last date of occupancy: nta
OTHER: (Describe)
pia
Last date of occupancy: pia
GENERAL INFORMATION
PUMPING RECORDS and source of information:
pLa
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped nLa_ gallons
Reason for pumping: n&
TYPE OF SYSTEM
X Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
I/A Technology etc.Attach copy of up to date operation and maintenance contract
Tight Tank Copy of DEP Approval
Other: n&
APPROXIMATE AGE of all components,date installed(if known)and source of information:
SYSTEM IS 18 YEARS OLD
Sewage odors detected when arriving at the site:(yes or no) NO
revised 9/2/98 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
BUILDING SEWER:
(Locate on site plan)
Depth below grade: 1
Material of construction:_ cast iron X 40 PVC _ other(explain)
Distance from private water supply well or suction line: TOWN
Diameter: n/A
Comments:, (condition of joints,venting,evidence of leakage,etc.)
nLa
SEPTIC TANK: X
(locate on site plan)
Depth below grade: f!
Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain)
n&
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ
Wit
Dimensions: L 8'_6"H 5'7"W 4'10"
Sludge depth: ti_
Distance from top of sludge to bottom of outlet tee or baffle: 2E
Scum thickness:l
Distance from top of scum to top of outlet tee or baffle: OVER
Distance from bottom of scum to bottom of outlet tee or baffle: n1a
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM NOW AND THEN MAINTAINED
EVERY TWO YEARS,
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain)
n&
Dimensions: n&
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle:_nLa
Distance from bottom of scum to bottom of outlet tee or baffle nLa
Date of last pumping: n&
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
nLa
revised 9/2/98 Page 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nLa
Material of,construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain)
n
Dimensions: nLa
Capacity: nta gallons
Design flow: WA gallons/day
Alarm present: NO
Alarm level:jila- Alarm in working order:Yes_No_ MO
Date of previous pumping: WA
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
nLa
DISTRIBUTION BOX: _
(locate on site plan)
Depth of liquid level above outlet invert:nLa
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
nLa
PUMP CHAMBER: NO
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): NO
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
nLa
revised 9/2/98 Page 8 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION('continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
nLa
Type:
leaching pits,number: ORE
leaching chambers,number: j3La
leaching galleries,number: j2La
leaching trenches,number,length: nLa
leaching fields,number,dimensions: nLa
overflow cesspool,number: n&
Alternative system: Wa
Name of Technology: _n(a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
SYSTEM IS IN HYDRAULIC FAILURE THE LIQUID LEVEL IS OVER ALL PIPES THERE IS NO LEACHING FT
CESSPOOLS: _
(locate on site plan)
Number and configuration: nLa
Depth-top of liquid to inlet invert: Wit
Depth of solids layer: nLa
Depth of scum layer. nLa
Dimensions of cesspool: nLa
Materials of construction: nla
Indication of groundwater: n& inflow(cesspool must be pumped as part of inspection)nta
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nLa
PRIVY: _
(locate on site plan)
Materials of construction:n& Dimensions:Wa
Depth of solids: Wa
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nLa
revised 9/2/98 Page 9 of 11
V
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
n/a
6
d
LlA )3
�A �l
36,
3�
revised 9/2/98 Page 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 96 HAWSER BEND RD.CENTERVILLE
Owner: STEVEN FARROW
Date of Inspection:4/13/99
NRCS Report name: Wa
Soil Type: nta
Typical depth to groundwater: nLa
USGS Date website visited: nta
Observation Wells checked: NQ
Groundwater depth:Shallow _ Moderate _ Deep _
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
_ Shallow wells
Estimated Depth to Groundwater 12 Feet
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
XObserved Site(Abutting property,observation hole,basement sump etc.)
Determined from local conditions
Checked with local Board of health
_ Checked FEMA Maps
_ Checked pumping records
_ Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS AND VISUAL-12+FEET
I �
revised 9/2/98 Page 11 of 11
TOWN OF BARNSSTAiBLE
LOCATION q�Q Cs.S V� SEWAGE #
VILLAG ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. ��\\//11
SEPTIC TANK CAPACITY 600
LEACHING FACILITY: (type) _ ( (size)
NO.OF BEDROOMS
BUILDER OR OWNER c �S
PERMITDATE: COMPLIANCE DATE:
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) _r Feet
Furnished by
4 � C
lJ
Ap 6
Ac 36
ec
rr pr - yr6
LOCATION SEWAGE PERMIT NO. '
VILLAGE
INST�A-4ER NAME i ADDRESS
I U I LSD E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
k �
i
No. ..:s'..'.�._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOW .......OF.... BaJrr):ST& 1J..---•---•--------------------
Appliration for Biipnsal Works Tnnstrnrtion Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (4--ran Individual Sewage Disposal
System at
...CI _... :ist� ........................ - -............
- ------------------
Lo- Address
c Yiesz-Add r Lot No.
� --------------
�� caner Address
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures -----------------------------------------••••-
w Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity.........._.gallons Length................ Width................ Diameter__:_____________ Depth................
x Disposal Trench—No_......._............ Width.................... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
'-, Percolation Test Results Performed by......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-._________________-_-_.
a •••••-••-•-•------ - ------•. ••• ------ ----••••..... -
0. Description of Soil------•-----•-•••••-----••••.� - Im"Cl---------------••-•.-- -=--••••• ---•--•---•---•-••••-•----•-•-
x
W ----------
-----••----
x Nature of Repairs or Alterations—Answer when a licable_____________
- ------...........
P PP __
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 be9f issued by th boar of health.
>gned . ..•••. • 5.�.f
ate ,
Application Approve B . ._.. ....----••••....................•-•--....•-• ............-
..................
ate--•• --------
Application Disapproved r e following reasons---------------------------------------------------------------------------------------------•-•--•--•-•••------
••-••••-•-•••-••••--•--.....-•••-----•...................•-•••-•-••--••-••------••-...-----••-•-----•••--I-•-•----••---•••-•--•-•-••._._._.._..---••••--•-•-••--•-••-----••----•-----------•••-...-•-•---
Date
PermitNo......................................................... Issued------•--------------------•--•-----•--•---------------
,� = Date
�+s
N��j��f �S . FE$.
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEAL-TH
. i
AVV tratton for Disposal Works Tontrurtton Prrutit,
Application is hereby made for a Permit to Construct ( ) or Repair (-ran Individual Sewage Disposal
System at:
r -
..... .................... ._............_..._.....
_ Location.-Address for Lot No.
..
r Address
Owner ! w
r' . » i t �I f Y , i I "
................................. ......... .___._. -_...:.._ i........____.....___......_..-_____._._................--
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms................................._----------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ..............: No. of persons___.___.__.__________.___:__ Showers Cafeteria
dOther fixtures -------•------------A•••--•---•--------•-----••----••.......•-------•••-
W Design Flow............................................gallons per person per day. Total daily flow______________________......................gallons.
WSeptic Tank—Liquid capacity------------gallons Length................ Width................. Diameter................ Depth................
Disposal Trench—No_____________________ Width.................... Total Length.................... Total,leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
.................�.................................. -----•---------------------•------ --- --
D Description of Soil----------------- ..:... ! .a a r
4
V ..............................................----------------••------------••••...------•------
W
U Nature of Repairs or Alterations—Answer when applicable............... �__. ,'r .r._.__ ....4._ _________________
,.
-•-•--•-----.---•----------------------------------------------------------
--------------
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 beeg issued by the board of health
ned
.Y-- - ate
Application Approve Y - � ----------------------------------------- �-------
a
- -_. -...._ �_ _
a -•�, te
Application Disapproved f t e following reasons:..........
............................ ..... ..... ............•.._..------------------------•--------•-....._._._._..._._....----•--------••-•••-•---............------............____Date
PermitNo......................................................... ,- Issued_:• - -
t
' ?q:,,„. Date
2*»'. THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT,K
t
OFd: ......}.� .i.Yw+.y ....... .....,�a,a j..a+....,.... .y....... J. .:'w.............................
Trrfiftratr of TompliFaurr
THIS IS—TO CERTIFY That toe Individual Sewage Disposal System constructed ( ) or Repaired
x
Installer�X
4g
at......................... t`ate" - ---.P_ �..�.•. '• .. sr �r f j Ef
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cd
e ribedin the
application for Disposal Works Construction Permit No._g14/ _{f_ .________________ dated_.- ..........................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........................................... � ........... --•••---•--- Inspector.------......y _ ...........................................................
fi
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF . HEALTH
NO._ :... ..........OF..... �,� b J
........__ FEE......................-_
DisposalWgrkp Tomtr tun .eynttt .
\�-�,,
Permission is hereby granted......... �...f�_._Y l .f_._ _ __ __. _.._r`�,e _.; '. 7(.-._ ___
to Constr 9rjRepair �i I vldual S -wa Dis o al ystem "
IL
at No.......... _ ,..
Street
as shown on the application for Disposal Works Construction Permit.,No ............... Dated..........................................
...•••. ...... -- --- .•--•-------- .....................................................
/ Board of Health `
DATE---i-- I..'V_...-•-------------------------------------------
FORM 1255 A. M. SULKIN, INC., BOSTON ,
LOCATION SEWAGE PERMIT NO.
a i 2k i-IAUU & er< Qcf09 77 - �-YZ,
�.1LLAGE
V-
I NSTA LLER'S NAME & ADDRESS
go b��1 Cam(Z
wtc.r1
B U 1,L D E R OR OWNER
C Kt
DATE PERMIT IS UED 7
DATE COMPLIANCE ISSUED
DC
y
$oX
V o
�A.M1L - TStED2OONC
►�� ��arrr�.a�� Uri��
Tab t L`! F Low a I 10 c 3 t SS C> G•P b. r /C 5'0 f
�S3O,, I150 % - 4_95 6.P.o. CS
USA IOOp 6.4L.. r. ICI(v .57F
�PO4At__ F'tT . uSa loco G4.L._• Q �1
e,U;6jA/A><L.L AV-G-A - t so S.P.
Icy SF ,c 2z s = :�;7S G.P.D.
8dr'T'o vl a2 EA r o SI=. ' N
.o
TOTAL T�ESIGtJ = d25 G.P.D. Z
TOTAL mat L�f 1-�� = 33D 6.Pv. �
IP
t rlr-OLaTtot.1 I??47-E: : "its ZMiW' O2 L1=6S. 3g
�III� - ,0
' f D Z#
•ko
TAT TOT F'14 c Ibcx.o
9g o,
T Z
oAn� �1"P.o� Iuv. a�
loco iuv
S�SSOIt. 4 9&.1
3 INV. 'fox cz d Sepric
T'ahtK
1OOO ';8 t,Nv
GAL. gb•P qL.2
MEDIUM PIT
wlrr_t
l 1a14 �,�2 •;
WASWEV
STowJE ,g
CF tZTI�I1vD P L.bT �L /.>l..l
Ptz.v�-1 erg -
LOCA.TIOtJ
nv un��""' PQO�vSt�
I C_t tZZtt=ter l"t-tAT T11G btv LL+►J` SNo�cll.l P'!__A" ?Ir-_P F-F- c_C
t-tC.t;t_r5i_1 �ca���t_\(S W t'C't•� Tt-i`: 51 tam t_t►-ate
Aug �,�-Y-tZ�n�l� t:�cq�1��M;=uTs of TNT Lo-r `!8
-ro w t-1 off' E A(Z. 5T*,&B LG
�IJaTT�I V I LL�1L�-�.
EEL
BA)(TEu. �-L, WYC ttJG_
• REGIS�[�tZcD I`A1.1G 5tJ2v'C..Yot�-�
Tt-�l5 C7l_At-! 11, WOT A,W OS'fE2�/1�LC o
it.1�t'�?J;✓�C_W /,cJ�:\/l=�' ;� ''C�{t� opt:--, (��i it1GWLD l�PPLIC_/S.!-�iT f *�
t 'r>t" CSE'- U•>C_��` i�-, ter l'i_c,M�►Jl= lrD'Y" L_tt•1��.� - � �AP�E W(TU� L.)t�1.I
No.............�....... Flms ZJr-...............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® F HEAL
...._... '.... G�.......OF... .................. ...... . ........ ...............................
Appliration for Dispoti al Works Tnnstrnrtinn nuat
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
Sys 01
•--- �� �� ................-
..
� F
.Loca' pAAddd,rre�ess / or Lot No.
y� ............................"-__ _. . .................................
W caner s W Address
a ... _...
Installer Address
Type of Building Size ......Sq. feet
,., Dwelling—No. of Bedrooms......3.................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type e of Building ............... No. of ersons....._...................... Showers — Cafeteria
f� YP g ------------- P ( ) ( )
Q' Other fixtures -- - --•-•.............................. • f
W Design Flow.......110............................gallons per person per day. Total daily flow------------e,'A.Q B....................gallons.
WSeptic Tank—Liquid'capacit}_1 allons Length................ Width................ Diameter................ Depth................ <.
x Disposal Trench—No.....................Y.idth....._.._...._ _...Total Length........- _....... Total leaching area....................sq. ft.
Seepage Pit No... `-: r.............
belo _ .Total leaching area._�t.®k...sq. ft.
s�� __
Z Other Distribution box ( Dosing tank ) (��o /0
'-' Percolation Test Results Performed by-- ..--.�
6 ....
Test Pit No. 1... %L-_...minutes per inch Depth of Test Pit.................... Depth to ground water.........................
LX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
xa ........ -• `
--•-- •----- •...
_O Description of.Soil.---"" 0 .
.................
W ......-----•-------•••------....••••---------••--••••--••-•••--••---••--•----------------•----•"••---••------•••------------------•"-•••••-•--••-•••-•••---•"--"--•-------...0.0.-----..............
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 TITI U 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.
Si 4�e :.0ned . Date
Application Approved BY Jl�-- •/i%�'111 -----------
--- .._.._.
Date
Application Disapproved for the following reasons:............ -------•--------•------------------------•---
....................•---......---••-•---......_....-----•---•----•••-"......--•-""""•••--•-.-"""
Datc
PermitNo......................................................... Issued_.......................................................
Date
No. -............. Fps/ ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE T
......... .......oF.... - -, - ...
Appliration for Disposal Works Tonstrnr#inn ramit
Application is hereby made for a Permit to Construct (t+'� Repair ( ) an Individual Sewage Disposal
Systems ,�xz..
J oca -Address or Lot No. /
• .....:
W �� Owner �t -'�%i,{�
........... /f,.r'`• Address `
•........ --......._.....••... ..................•------•------........_.._.......---------------.--......---
Installer
Pq
Address
Type of Building Size Lot....:e5-/9'.6.......Sq. feet
Dwelling—No. of Bedrooms....... ...................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons....................... Showers
a YP g P ( ) — Cafeteria ( )
Otherfixtures --- ....' ................................................................
W Design Flow....... ............................gallons per person per day. Total daily flow-----------„s_ _ ....................gallons.
WSeptic Tank—Liquid capacit/,d_ allons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width_.. . .... Total Length _,� Total leaching area....................sq. ft.
3 Seepage Pit No.... ':..r �er............. . belo.%43 .. . ......•Total leaching area.. .�k:..sq. ft.
Z Other Distribution box ( o} Dosing tank
Percolation Test Result Performed by. f....� ............... Date__.� -----------
Test Pit No. 1.. 2,.......minutes per inch epth of Test Pit .................. Depth to ground water..............._--------
fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
...........
. ....r.s.... ..... ................
O Description of Soil.... 440C�F.fj t — J 'y*- ------•-----------•----------•----
x
W
UNature of Repairs or Alterations—Answer when applicable............................................................................................:..
F
Agreement: x
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIE 5 of the State Sanitary Code-The undersigned-further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the bo rd of health
SignedG ---. ......'?13 er
Date
Application Approved B ..` ::...............:.:..
PP Y �=
rDate �.......
Application Disapproved for the following reasons---------------••--6--/.'.......................................................................................
--•.............•---.......------------------------------•--•-------------....•-------------•-------•--•----........--•-•-----•---------------------•------------•------••-------------•-------••---•---
Date
PermitNo.......................................................... Issued.........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
: -:......oF.... - .......... ....: . '. .......................
Tnrtifiratr of Tomplittnrr
THIS,J4 TO CERTIFY, at th mdividual ewage Disposal System constructed 41� or Repaired ( )
-----by .....................................
Install
has been installed in accordance with the provisions of , TLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit 1 X_T__. ' ,' ......_--_-_---_-.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE... '"' ..7.... .................•......------...--••---- Inspector.............RIC-10#10
*e-------------------------------------------
THE:COMMONWEALTH OF MASSACHUSETTS
BQARD F HE
,/
?T ......I......., "�� ...-OF....G! . .......-
...........................
0......................... FEE........................
Eiapooal orkg � 11tr� ion rr ft
Permission is rfeby granted__..._.: ... ,__: _.__ ::.. %1., /!� �.
to Constr f ) or Repair ( Ind•. idual Se rage Disp_Qsa1,� �stem /
001
44: Street
as shown on the application for Disposal Works Construction P rmit o.......... ........ Dated.__�_�r_,�?�l.-. - '.__..._._....
r _ - -" z ---•---------------•---------------
I �rc� ea
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
i
,
.t I
5 '
laUle9 IV -Ifeaders Ut NOlrLaaAUearirtg Walls(conlinuerf,
eA
/ ----- � I I ,[>„„ . , ! lip I�t�N I l` ���E���{'�l`�►"�,
r�2"f�� eL�i�vd Uldl�ti l ,r d I
: - _.-- -- n;rl.va_15nn1zle`; ' It•....t•.•'. � �4� � Pk6q,*T�(1'� 5��7"Ih r:1.-.
rl •I,rt .. . . .. tr ��`\ I ---tn51nt>•„Id,,.,l -�'i, I I1w1311 'a��y=[I� �kn11'f pkdfltdtl. � � `�5t>� ��)FiiF; [@r!(} '[b {r., � t
-v.:•;,,.t I La,." t ,—/r. L nap t:rr_,r : .-_. ' s r 1 d If`t i:f1!>;4 flats�x r• "4,�I rF'Jk 7 e a
rI) P {.
Tt r x'liu• .. .. __.. r .. t f.,. vJ..,s7 ( ) t{r[' r`v' t,. ttb,d
}t t"
,u_V.i.•, I '' '`k'S b') �'"' "„�;i )Lx6 iflal) +�,'' 14f�.♦` I 11 f; r�{6d}'tt 9 i
.. I i ,, s., s,...l<. I 1 .. .,..,. -4�.� t3 /.��3 f7�.��x�r'1x�(flalJti4 Sr S,1IS 3_��t� t-• ���i
I ,i ca 6 t11.1 @xe(nall at ti
-3� �� �F�•C t p� ('fl_ t721b[ S i Y t .do7
la- _ .. t �rn.l U.l- @ .J •.V"0 �- - Sk t~ rc Jt r ado t t , :.�2f1
' of q 3lN1tl ;2���xe(fl9) i r'� L:B.m''
r.l.'.,U.�•:;S'A—,
a!.fiso t
Sy)I_II.if9LfAll_ Cc^= �kL12xk1(!(ta Aa d:taltrd rbJdrs.?��hr�e[-`2�� ;.!
- a
.1 t Jr0 t '36d r I
Fo ou.-Ioadlog be dig wags o:d Wadow sat plot t2 2r9 teal)can be subsnlul aylor t 2se alga -
--' i
_ cln
;lu )1('-I;i II (\7,":I.�>,� - I .. .. ._ 4.3 EXTF_A9pl Olfli NUAI_I_SIiIEAl-1-AlFAG
- - - _ - - let Exterior Wall Sheathing.Exterior Fall,shall be sheathed NOW u mininnnn of 7/IG°.loud su-It rat
. __.-__- ____-_._.__._..__ _ ' n c
�, p eel sheathing or 1/2°cellulosic fiberbon d she thing and mhch d pet'fat Ie 2(page 7)wheu shads me
.. ..._._ ._.______ ...._-.__..._ ___._-..__... __...___.. _.___--_-..___--__- spacedIG"oc o lee r ,s When studs are spaced greater thou IG"o c,I5/32'er greater wood stmcnu sl
- -_---- - - ---- ----� panel'l-siting shall be used'the mini-n requited percentage of full height sheathing in the wall lines
' - f is provided in Tables 10 and 11(pages 19 and 19)To meet the regni-nents for perceningt,full II gl i
J sh-Lifing,a full41,ight w.tI segment shall not be less than 27 t/2"in all 8'wall.i 1"in a o'wall, 34 n
' - 10 wall(aspect it.5 3_I/2.l)Exterior sheathing shall be eomindous fmm the lrouom plate to t1
a
_ u top ate,with nil anel edges over fain
i ll
2�IL'1'll r'F
�\. ._ -". __ - ---'-- -- Hold towns Bold dnwus wiW a cnlmnty iu acrnrdauce wiat lSble 10 of I1(page IR of 19)ore req uc[I m Ure
,/ fill height segment at each earl of a wall line When lull height se a cuts meet at a miner,a single held down
v2,.5utl.11"',,oN. __-. g g'
ILKt[i I'.nC1tfS n•�'1, q shah be to rutifled to be used to resist llle ov tuuting fotcec in boat d'uecuons when sired to resist be larger
I \ bad and the comer fmnhi in the d'nitdt valis is(asteued together to umrcicr the upti0land(See Figures
Js'r5..vi _ - g n J B
-30 ud'sv[. -- - \�. 18.and l8b) A coatiuuous load Pat[' be maintained to the foundation.where lhold,towns on
�� fluor nfgn wiW hold dowua an a lower Uoor,U,e comfiued capacity of rim t,vu hold duwus must 6e resisters by
13 Si0 rn Ic, w�\ anchorage to tre ConndnUon.
- _ - "— •�� - - `7- - - - - - - - 9t Exterior Wall Cladding.Exterior we0 claddin shall be rased for a 110 mph Gxpesm{g 9-second gas,
`
win d and be iuslell p t to manufacturer s instrucumu.
q- g
�a
r t
d speed l
UI ' PN£XROSU[tll[-B WIMIP,ZONE_ r
�C,1�) a11•I .I "' r 9
I 2.E).fO,SrS General Naflin Sc/raAole
1, �' irq•-(9 4Va F-Lc`"il\1 it
,1
..........
_
Id Rht910 pdi(A �d€ dlled r,'t�^ , ;M.,
)djlaff'� !; J .:i€�f tied i `v i 3isd E aaA d
rll d eon d t a uaia�hd tl ne � 9 F �7
qa
z^
1' `��f) ry I I 1p b tI ;
_._. l_ .. .,, I rt:'(IOI..-I ? •La„ � 6 (� i�t ,' fir,• a F �nli����
I
•. Jov�'dsol Y���,i�l.�{1girnir{'{�tlxl�sdl�J�fid�,,�f' �Udr�tF x�y d ioa< ref le Sr
__ . ... .._...__ _.._. _-... @tod..r ,each ehd
:elbck ng ld Jdi da I ^ `/'�'
____ _-__._- __._-._... .__.__..-.-.__-_-___._-___
. � - I. 7 3 ) a ' 7 .. p xd i6d , t3Aehl flr,ctt
t f Ledger Slrlp lo'13dAtl d�t�Ifder(KAcL4t511e�� 1 �r 3 36d' d IGd'(f ,� Lacs(oi-t
) �aolgl on Lddq�}Idlrl6ani(Y A nhll d!v"�;lti =t 3t fad R lad ! poi laid
W. ` 'good dol3t kl;:�,e131(Ftttf!)naht3dS1�!g,)*jdl?r ' I sr 3{aJ' d11Gd.'t 2 piloldt— -- - tb d � di( � l
r.r:. ,J.c, tom;' ^� :H• 5's ARM
�d$I 1 r Ids A W d. .1
. .rllr `Wo tt lAl bahm +, �r3 Gdf°
L {G
I 'FetterA dr lFU$s'A44J L]i`$rod�Ufl to'IB d d f,1 6d d {Uri 6'•edge/6 lllam
---'' �- .. _ t - raflAre.ar IILSS9 .9Ce da71d ed".':.�
- --- --II ? -[ d_° Eld 10d d"a19014"Geld
gabill ilndwdll rake bctAl2A,Irdit w/Mrrable b erhang rid to
, gd90/o'ram
( Urlural e[I 10d C'edgh I I,nald
nt[ak9 hus W/IooGouf blocks. ad 10d 47 Ldye!4 It.Id
- abrA endrtiph rnkL
q
1p
I i�'1-1u -.r m... �� .d ���
ea - �1� rd s U, U r r 5 rj $x told;:.
RE
1 �
I
rl = -=mil Ill _ u--- --" - l Wdod5lrud ralpflfal (�tii� ni(ra r r n r
I_J hJ 1_L,. ''arilBS�padkd ut{gb'.�d`:o(aTf r 1''d. t- S t - a I r:C; +".:-
c; I C t cq, 7 E+( t t 6c 1pd.t. 6 e 19d/19^IInId
r pr:,c=r.. ! �1) I - --- i I -� �) .1/2 and Ib€F d-{?enAl�
t
O _ - -_- _ 11 et t �d 3 eUge 16,(l91[I
_ {
. ,-d fl,; dot `. 9tl 0/to fie
- .. .... _11. :_It_.r �F,.,'; - -i� p
- 1 --_.__ - �__- -::,_-._ : _ _I_-_--- _-__—__--- _-_-__.- $bdbt�Fa!
1'ci t A rr x 9d Ipd a tlge/12^fl.1d
1 6r lbs9.7,}t }ti
' q Anleh IhrlB:l t:r«y'\ ___ _ loa_ trd G•Ldge 161 fold
• I-r)..911L�I It 1)I I l N J .. eormslu„restsm'hl+9 9 0o g nsend .aa nursed cn.ct<m..i i. .... ._.....
_ t tt a er nn n to gage smnM re pe, c oral I a I uls
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BMHUAM--- SOIL TEST
TOP OF FOUNDATION 20 FT, MINIMUM FROM CELLAR DATE OF SOIL TEST 10 1__,____
tRAI� R_ S�iQ�tT`PL
ELEV. _ �0-9-1-20_ SOIL TEST DONE BY
10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND WITNESSED BY _N/11
(ASSUMED) CONCRETE OBSERVATION HOLE 1 ELEV.=__� __
COVERS 4" SCHEDULE 40 PVC PIPE L04 AND SEED PERCOLATION RATE <_ 2 MIN./INCH AT __ 60=72 INCHES
MIN. PITCH 1/8" PER FT. 2" L'kYER OF
DEPTH HORIZ TEXTURE COLOR MOTT OTHER
1/8" To 1/2" LEGEND:
A WASHED STONE 8� FILL NO ROOTS
N/A 4" CAST IRON PIPE - " MAk 97.25 MAX. EXISTING SPOT ELEVATION 00 0
(OR EQUAL) MINIMUM ELEV. _ _96•3t _ - 95.25 QAtN. EXISTING CONTOUR ---.-00----
FINAL SPOT ELEVATION 11' A LOAMY SAND 10YR2/1 NO ROOTS
PITCH 1/4 PER FT, I \` X , FINAL CONTOUR �
�. SOIL TEST LOCATION 33" B LOAMY SAND 10YR5/6 i NO
FLOW LINE 94.25 °1 UTILITY POLE -O-
ELEV. _ -N1�-- -TM N.
❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ TOWN WATER —W—w 48" Cl LOAMY SAND ' 2.5Y7/3 NO
Z 0" �: � ; ° CATCH BASIN
ELEV. _ _94.60_ LEVEL ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° GAS LINE 132" C2 COARES SAND 2.5Y6/4 NO
ADD o
ELEV. _9 � BAFFLE ELEV. _ _ 94_Ofl_ 6" SUMP -ELEV. _ _93_�_ ° ° CLEAN OUT C.
° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ O ❑ 0 2' o O (TFIRNEESAND) it
EXISTING DISTRIBUTION CESSPOOL C P.
ELEV s ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° o °
LIQUID OUTLET BOX ° °o ° ° ° ° ELEV. _ _ 91_5 _
DEPIH TEE 4 FEET 14 INCHES (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED 3 500 CALLONODEYWE L IN WITH
5 FEET 19 INCHES IF MORE THAN ONE OUTLET NO WATER ENCOUNTERED AT __1L'___ rLL v = __t3&_-
6 FEET 24 INCHES 1000 GALLON
7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) 13' X 33.5' X 2' TRENCH FORMFTION i 6 5, WELL N A
8 FEET 34 INCHES SEPTIC TANK _ - -- --- _-------- - ZONE x
EXISTING DOUBLE WASHED STONE CLEAN SOIL ABSORPTION �; INDEX T�—
FREE OF FINES & SILT SYSTEM (SAS)_---- , DESIGN CALCULATIONS
-- - NUMBER OF BEDROOMS _ _4__
USGS PROBABLE WATER TAB.E ELEV. _ � GARBAGE DISPOSAL UNIT NO _
SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ __Y__ TOTAL ESTIMATED FLOW
vOT TO SCALE BOTTOM OF TEST HO-E FLEV. _ __$!,�__
( 110 GAL./BR./DAY X _ 4 _ BR.) _ 44Q__ GAL./DAY
REQUIRED SEPTIC TANK CAPACITY _._150 GAL.
ACTUAL SIZE OF SEPTIC TANK -1500L GAL.
SOIL CLASSIFICATION I
DESIGN PERCOLATION RATE _<-2_- MIN./IN.
X EFFLUENT LOADING RATE _.0,74_ GAL./DAY/S.F.
LEACHING AREA _621_5 SO. FT.
(13'X33.5)+(93X2)
x LEACHING CAPACITY (AREA X RATE) _ 45-2- GAL./DAY
621.5 X 0.74
Y, RESERVE LEACHING CAPACITY _NZA_ GAL./DAY
NOTES:
\ 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE
w\ DISPOSAL OF SEWAGE.
2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
/ WITHIN 6" OF FINISHED GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
' WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
® 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
(L USED UNDER OR WITHIN 10 FT. OF DRRIVES OR PARKING AREAS.
V 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL
BE MORTARED IN PLACE.
5. NO DEIERMINAi+GN H/A) uEEN MAUL A5 TO COMPLIANCE WITH
X
DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO
X x OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
DRIVEWAY 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR
IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS
x / PRIOR O 7. CONTRACTOR IS WORK
S F To VERIFY GRADES SITE.GRADESAND ELEVATIONS AS WELL AS
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION
IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
x x IMMEDIATELY.
8. PARCEL IS IN FLOOD ZONE c____.
9. LOT IS SHOWN ON ASSESSORS MAP -ALL- AS PARCEL
�0. 10, ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND
FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM,
AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3)
(I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT.
7q j ;,+C, e. 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND
CPA
sEiOt�4 Can+ 't�St `r OR REMOVED
NO GAS EXISTING „{ ti itAM
DWELLING I3 CIVIL � �� OX 1
x - DECK % .. A10. 27dt33 9134!_
,N � APPROVED: BOARD OF HEALTH
a o 71 #2228 AGEN'
SPRINKLERS
PRESENT PROPOSED SEPTIC DESIGN
STEVEN FARROW j
x 96 HAWSER BEND ROAD
i
------ ----- --- -------
CATCH 38 -� <o ' PARNSTABLE CENTERVILLE , MA
BASIN S F�
CA!AIG I� SHORT; P.17i.EXISTING\ / v � ,�
LEACH P11" �� 4.1 r� w 508- 235 GPREAOT B X TEOR44 ROAD
398-3922 SOUTH DENNIS, MASS. 0266C
x x SHED/ OV
HA W.S AMC I
II�r�rD 2v A R 1 SCALE 1 " = 20
L - I
x , REVISED � JOB N0 1—897
SITE PLAN 1 "= 20'
• EE
LOCATION MAP REVISED ' SHEET 1 OF 1
0 2001 CRAIG R. SHORT, P.E.