Loading...
HomeMy WebLinkAbout0137 HORSESHOE LANE - Health 137 Horseshoe Lane Centerville A= 207 - 125 SMEAD No.2-153LOR UPC 125u emead m • Meft In USA Imtmumlmom OIN wrir�oaw�ooa f 1� Town of Barnstable Barnstable yP °� Regulatory Services Department fr;caC hy BARN1MIMS:LE,� public Health Division m MASS rfD MAt A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7006 0810 0000 3524 5072 March 30, 2012 Leslie W. Gay 122 School Street J Stoughton, MA 02072 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5. • The septic system.located 137 Horseshoe Lane, Centerville,MA,was last inspected on 3/6/2012 by Sean M. Jones, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails"under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Single cesspools automatically fail in the Town of Barnstable i You are ordered to repair or replace the septic system within'two (2) years from the date you receive this notification. PER ORDER OF TIC BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health Document3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '~ 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for every Centerville Ma 02632 3/6/2012 page. Cityrrown State Zip Code Date of Inspection Inspection results.must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information . fillingng out forms on the computer, ` use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones e the return Name of Inspector ,— t 8 key. Capewide Enterpriseszzle Company Name &3 153 Commercial St. Company Address b Mashpee Ma. 02649 , City/Town State ;Zip Code r t 508-477-8877 SI 4522 i'ry i Telephone Number License Number i-n B. Certification 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 3/6/2012 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspection Form:SubsWavmge posal System•Page 1 of 17 ): Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is Centerville Ma 02632 required for 3/6/2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts L v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments QM 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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, safety and 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ®. The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ 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 If rw you have an "y seed yes to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR.15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): Number,of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: vacant Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �^M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 �M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑'fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments cw 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 2 Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts = W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): System consists of 2 very small SINGLE cesspools resulting in a failed septic inspection per Town of Barnstable regulations. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 l Commonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for every Centerville Ma 02632 3/6/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately � J71 A-/ Z 13-Z 3rb" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was not established Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 137 Horseshoe Lane Property Address Leslie Gay Owner Owner's Name information is required for Centerville Ma 02632 3/6/2012 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 10 ti No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIpplication for WgpoaY *pztem COn5truction 30Crmit Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 131 N ORS65b106 LN eaT> Owner's Name,Address,and Tel.No. mac 51-1 C CGaAy Assessor's Map/Parcel A6,7 tio-r 1;L 0 a;L S GHOvt. S I"C Installer's Name,Address,and Tel.No. 50 E_471 � -`t 1 Designer's Name,Address and Tel.No. 509-X7 3 —®3 Z 7 CAtDWQ)6) GU-1155W (Ae, 7C ca&r_—t0ecawC-Z—sntjt 1te,- P ek5 a,54 cami 6%K.4 Lim E .uAyawt Type of Building: Dwelling No.of Bedrooms 3 Lot Size 11,(4' (O sq. ft. Garbage Grinder ( ) Other Type of Building REES, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33o gpd Design flow provided L���o a gpd Plan Date q-i R-atol:;L, Number of sheets ! I Revision Date Title 1371 kJOCKESHOF (,N 6EA17Z�)f_VjL(,6 Size of Septic Tank (500 /50 260KR I Type of S.A.S. t�O 4AQ-3(��(��� Description of Soil 7 P C,t¢��i juf 51✓c 5 & Nature of Repairs or Alterations(Answer when applicable) 00 r5urul_ -mWk . Tn u5g_Zr)- ax �12o4Q 3 h 010plFFJ1t@k iN C'- 06%&L c42A Wcrri- P"V - POUP q&o"u &.0 2of6cL. Camp 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 4—ao —i J., Application Approved by Date C) Application Disapproved by: Date for the following reasons Permit No. Date Issued �� 0 _r No. y i Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 PUBLIC HEALTH DIVISION - TOWN OF`BARNSTABLE, MASSACHUSETTS Yes ZIpplication for Conaruction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. ' +1 1-4 a r,H�(,N tI M. Owner's Name,Address,and Tel.No. ? lam.5WC- Cry Assessor's Map/Parcel yN ab Lo-r I ), ► �Z. ScNoQ4, S'f 5-toLx-,.1+TDtQ, (M Installer's Name,Address,and Tel.No. 5 pS—C4r(- b`a 01'7 Designer's Name,Address and Tel.No. 50 8—o173 031 7 Ce4OWQ)E s ud, zc c+•rw 0WM2cU(T-rrk)t, Type of Building: - Dwelling No.of Bedrooms Lott Size (114QQ ± sq. ft. Garbage Grinder 01 ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow(min.required) 330 gpd Design flow provided 3 C;57-A gpd Plan Date (4-1 Cf-;tof;t. Number of sheets ! Revision Date Title 137 RURSESHCS LN 6(aJ7iXvlLi,6 Size of Septic Tank 1 5oo f 5a a c wgP4& Type of S.A.S. aU dt+t 3 G CJ/(0 j)l���{__� Description of Soil P�-� pt T `� kj6j)k"3 6 CAJb k Nature of Repairs or Alterations(Answer when applicable) N(5W (QUO 5co QA, ;) d4wo e, 5MO-:7n�k- M NIJ J l)-j34 X T71 0 Age- 3(©�O to Di i ocox 1u 067 Pry W[rrf uu� - �tu� �u dsc.D 2.�V E� ct� �A A-g&J Date last inspected: V ` ( Agreement: The undersigned agrees to ensure the construction and maintenahce oaf the-afore described on-site sewage disposal system in .� accordance with the provisions of Title 5 of the EnvironmentaF.Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health.." � ,l Signed t �' Date -I-J.. } Application Approved by t - h Date Application Disapproved by: Date for the following reasons i Permit No. ,, ; Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of �ornfiarrce��, y THIS IS TO CERTIFY,that the On-site Sewage Disposal System/ Constructed ( ) Repaired (x) Upgraded ( ) , Abandoned( )by l TIn A P61A D- 1,� - at 1,31 Hniz�("S 4 L'AW6 � tZE has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �o 'o (f) dated L�.r jC) r J Installer 6W(D _ d 11(Q1� M. Designer TG F}�C-s(1�J�'21Q�L.��• #bedrooms j r Approved design flow gpd The issuance of this permit shall of be construed as a guarantee that`the system will fune as de i ned. Date Inspector ——=————————————---——.——— No Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,,MASSACHUSETTS Di'5pont *paem Cougtruction'permit Permission is hereby granted to Construct ( ) Repair Upgrade ( ) 'Aliandori ( ) System located at 137 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�errnJJ /it-, pl 2 Date ` O f)^ Approved by dd ((r- r 5/02/2012 04 :40 5082730367 V 089 P. 001/001 Y Town of Barnstable > Regulatory Services Thomas F.Geiler,Director : MASS. r Public Health Division i6sq. •`� Thomas McKean,Director �pD fM� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: J"2" �— Sewage Permit# 2®i 2 ' t i Assessor's Map/Parcel 20 7/ i 2 Installer&Desinner Certification Form Designer: SC EfI4tnee.<<rn -roC. Installer: Ca(�cw;de ���Eer,fciszs Address: .48-`i C fan,occr� 4!§nLU!4 Address: 'PO 3OX 7 So 3 t-pst �uar6nom� .11A 02539 014 a2632 sob-z73-a3 77 - On LA C4,9eL,0' _ U' -e_ref13@.5 was issued a permit to install a (date) (installer) septic system at 1-31 f Ocse"svjo e;_ LQra e., based on a design drawn by (a dress) _. IC En�t���ccr►5 ,Zhc_ dated ftec'l %9 , 2-0� Z (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (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) ected and the soils were found satisfactory. OP t URCHI \ OHN L. CHURCHILL JR. (Ins Viers SignatuW nnL 4100) esigner s Signature (Affix Deg Here PLC RETURN TO ARNSTABLE PUBLIC HEAL, DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY-THE BARNSTABL,E PUBLIC HEALTH DIVISION. THANK YOU gAofFce foms`dcaigncrcertification form.doc ' Submit byEmail , HIGH GROUND-WATER LEVEL COMPUTATION Date: April 7, 2012 Site Location: 137 Horseshoe Lane, Centerville, MA Permit: Owner: Leslie W. Gay Phone: Contractor: Capewide Enterprises Phone: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. (depth is in feet below land surface) Date: 4/06/12 8.33 mm yy teet below Is STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well MIW-29 B) Water-level range zone B STEP 3 Using monthly "Current Water Resources Conditions" determine current depth.to water level for index well. 03/28/12 1_8,16 mm/yy STEP 4 Using Table of Potential Water Level Rise for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 213) determine water-level adjustment. 2.5 STEP 5 Estimate depth to high water by subtracting the water-level adjustment (STEP 4) from 5.83 measured depth to water level at site (STEP 1). NOTE* Tables 1-9 "Potential Water-Level.Rise" are attached as worksheets to this file. monthly index well data: www.capecodcommission.org/welIs.htmI 1 TOWN OF BARNSTABLE LOCATION 7 Lq,he- SEWAGE# Z012k— 101 4VIfLAGE(fev)'f'e,✓,V P`r- ASSESSOR'S MAP&PARCELgsg, GZ 1075, INSTALLER'S NAME&PHONE NO.(fapCLQi ,- ko )-1PCZ L-C- SO477-?177 SEPTIC TANK CAPACITY /560 A c,( + ,M 6,,( &M,* Ghrn ni(ree LEACHING FACILITY.(type)c?0 A KC 36 I'd h,'1!S ksize) Q( X //, NO.OF BEDROOMS 3 ./ OWNER I— f _ U!/. ��OL\r PERMIT DATE: ;4- z o l 2 COMPLIANCE DATE: S5—2 1A Separation Distance Between the: op Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 15,-1 0 q 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) ,a _ /✓. Feet FURNISHED BY C A,00,,i j� oy7W p,,3�_5 L.L c- r � a� o op 07 kip-,24 A A®7= 6,a' J3-7=36 , 6 �n 13 R Poach D ARNSTABLE LOCATION 137 Horseshoe Lane SEWAGE# VILLAGE Centerville ASSESSOR'S MAP&PARCEL d07 "INSTALLER'S NAME&PHONE N( Sean M._hones Capewide Enterprisess SEPTIC TANK CAPACITY_ _v : 3/612_ 012 LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER, Leslie Gay__._ PERMIT DATE: COMPLI�AN�P=D�AT,B��� Separation Distance Between the: i��\l Maximum Adjusted Groundwater Table to the Botttm�f Leaching Facility Feet Private Water Supply Well and Leaching kill ,Of any wells exist on w� site or within 200 feet of le cHinj,)NaPity) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY hand-sketch in the area below --- ❑ drawing attached separetely I � , 0 Z 4-7 66, N.00R SYSTEM p - LSTSE/3' BlO Y •BOTrom 10311EO Mr R0.yW -E/ETLOBM GEAWRTNB:EATtEb •PAW 7075T TO 10 BEAM OONNECTLRa �. -R2OI lE0EEf i EJQSTDW HOUSE u/ •Rb02RTMO EBp g S -W 9RfiA0RQ4SUwFO ANDNaDED ��U99 � M 0 OLErl S ar � .� ® Y �J q u> r•rl � ® n1 � „ f EMIT.FOU BARON 9 E t $ mT811/ET h*mm 20 i FMSTDECCUM61 6 /roBaNrosm o/ DECKS G Ht s TOBEAuw 1 Z EMIT. o. i �aa.u,r� �3 EMST. NEWM.SATN ur Qp W j DGOC SYSTEM EOUAATiON SYSTEM p O T -RL00$OZSTS e16roe -MEEIERSOBEDEOOM AODTION < H O ' r MOSET yr -Yvrmo MOWEO Bm'O"r Tffs wsrutt�IBlauNAATIM6E rya C T OEAOIIOSST'WM"CION S', MSTMNTI5EL4 N R < 506E am -RLO011DE616EMSTO HOUSEM -OMPArS60EOt ADMON [Y a Yb6B SOISTNANMEAS6 EACHMM END INSTALLEOPER NUEATWHIS z v IAl11LRY a aa,r s ra - -R2A0RW BBABIP FND INSTRUCTIONS BC MU.' BObO rQ -OEACQBETBOBYOWNEM m 0 iaur NEW MASTER BEAM ABOVE NALL BEDROOM v,o, TOREP _ Ica@e: 1/41-1'0' DDBHC a• '•.Ur AW91 F-I �oasT , bate: 12-23-19 j Revisions: � r.ur 6066 EMIT EMSL EMIT. — , EMSTOER wREIN roROl000E O NEW OEOI - 1vrr Page: 2 OF 3 � g AD'b&HEA00STVP.*ALLNEEM •LbO NFAD913 m.e ALL NEw waoows-edO&AFT uaonEWsma ° V ALLMTEe•UT ATTAO®TO - WAU.KATE LVLRIOTE6 -zn-vew°Ln RIDiE EEVM dtAr cCUAR TFse- WALATMONNee OP lbroOeO.OIGO EAVES FEWEN R2.ILOCQKA«JMYS INFROM6AALE � Qe67 °4FO"f G� -14 SIRAFFFOEO WOW _I/r SNFATIOE - g K b ab bs � E .B b YONOIRWFVL$CLE SYS,EM �.� •ZWOHEAOER SEAM ATTACHED TO 9AmYi Gp FT.A M T C dSWPSNNIOSTGVs %pyNEi/SGIEBJPANELS •tmS4ElU�i JOISTS*M'OC •b0 RAFTERS TA'OC ATTACfO TO Z -WOIGOGEBOA IbITIES •W RIDGEe916D AzouAn TIER N o uaeamEOTa&L reEeamAAR b�uam+E r« ee05D1FROMSAFLE -Z IDLTL{ATIOM SIOF ipq.LVGO EAVES < 1y J pO( \ -1/T OIEAl1OIE W 6A f C1 le AUTw p � � —�"Basr" ROOF FRAME $_ \� WALL SYSTEM E CTEIdOY FDOSFES m m 8 6 —T -zaA•re lb'DC.SieLLE WTIOM -HEWNCSWPIRESTOMATM CUSMIS ODLASES,TM AM ❑� � SEATOHS DOTAIIED OVER HOUSE WWWSEANLS TAM FROMMOTWMOFRAMUPTOTOF FATOYRB{AM AS NEEDED 09 fln'' ai 701 WAUMTEd MO1DY0 -AU NEW TRIM TO RE AMTOMATCH a�T "WOOD mas o"RE ENO E124TWGDETAaS �{Aue: 1/4'-1'O� fLJJJI •:@IG AtDztAa(sNpS m. -ASFHM TROOP"TO CMTIH EKISTINO pp�� oeAwND EOFrEW%MMOWAnw FATOAIMAM AS NEEDED Ono LW D&e: 12-23-19 - q FELT dIGQN WATER AFL AWM ORV I� EDGE O EAVES TAevisi : •INTALL All RAS/mE Pei MMaRACTURMS RKOMM@WTIONS TM.MMSUATDON -NEW OECKMTRDWCWTEC - FUBAAss DLRAATTONO NEW WA"drTN.ao DEasrsTEM -.MMas0O NEW FLOOR9ON -XWO O ROPFE GMT •gMyFOAMIIIMAATDONOlEW -tAR zri00RON®GIRT d1eDA TZEs A"SYSTEM IVBR RAFFLESO O EAw7O6T TO GERM GONFECMON UCERME OF SHEATH" -FT edQ MGM OD STIW NOOSE. JOISTew6m0 EACHJOWTEND -FTDOORW f GAS E eo cww -bECIDETGD eY OWTER CROSS SS 1 ON MOOR SYSTEM •FT ede JOJSTS O IS'OC.L KOCWd FOUNMATOW SYSTEM O FOTTOM To sulfo lir ITFLYWOOD -OMFEMS 6 BEDROWI ADOTION •lATtdS HONED i]RT ANIe.sA TIES DWALED 161 N MANUFATM9U 1 O EACH JOIST TO REMOOECTIW �. DISTIUMTMONS -FTbOe LEDEEAOE%IST?ENONSEd -NFSO►IBt5O pECTCADDTION tOL4TIMN661SOLEEND STEND ZNSTA{IEb PER MANLFATUERS -&W SU W O MpE HL DMUTRUC MOMS E t -Tµ'SUIFi00R 43ED AND NAM.® PO�e: 3 OF 3 Town of Barnstable Pit [S 5 of Department of Regulatory Services BAMSTABLE,p r Publie Realth Division Date " 2(. I Z 200 Main Street,Hyannis MA 02601 7 rfD tM�� Date Scheduled y� Z Time Fee Pd. ��D Soil Suitability Assessment for Sewage Disposal Performed By: �tGvt ` `"M�� t ElT s E Witnessed By: Z�&1a(d LOCATION& GENERAL INFORMATION Location Address Owners Name LeS1te (To 1'�7 (lcJt5e5��Lcn� )/ CcnkrV lle- Pr a 21e3 2 Address Sauvre, Assessor's Map/Parcel: 20 7 17,57 Engineer's Name SC_ &vj5t 1Lg-ciJ1S, TVIC. NEW CONSTRUCTION REPAIR l/ Telephone# 5U8-273-637 7 Land Use ` [LI Iic °ma Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line I ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) See CtAAc&*A (Cal Parent material(geologic) d uk Wa 5Li Depth to Bedrock : l 2 b 4 b5.5 4 Depth to Groundwater: Standing Water in Hole: 00 �45 5 Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: CMe, Cvotvvu�tuvt !tZ�icc{ Depth Observed standing in obs.hole: :_ [o 6 in. Depth to soil mottles: _ in. Depth to weeping from side of obs.hole: — in. Groundwater Adjustment Index Well# Htu)11 Reading Date: 3.18-tz- Index Well level f3.i(o Adj.factor 2.5 Adj.Groundwater Level 7�4�f PERCOLATION TEST bate Y 12 Time 114 '(Y', Observation Hole# Z Time at 9" ` Depth of Perc >�D 7 y — Time at 6" ' Start Pre-soak Time c@ JaW AN Time(9"-6") End Pre-soak /6:57. A Rate Min./Inch 2 Site Suitability Assessment: Site Passed Site Failed: — Additional Testing Needed(Y/N) 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:\SEPTIC\PERCFORM.DOC ;fir. .-DEER.OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 0-3iA C-( Si I-CAm i 0 i t 4-6 36-7 - -7 C-7 Cs 2- 1-4 DEEP'OBSERVATION HOLE LOG Hole'# 2. Depth from Soil Horizon Soil Texture Soil Cc1or Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel L5 /OYr 3h- 36 . 6 LS jolt s`6 56 -1 2(o C- }-1 CS 2.5 r 1 6 DEEP OBSERVATION.HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION.HOLE LOG Hole# . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 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 pervious material exist in all areas observed throughout the area proposed for the soil absorption system? fe-5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on 1b-27-q j1 (date)1 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 and experience described in 310 CMR 15.017. Signature Date `�-�6 2, Q:\SEPTIC\PERCFORM.DOC I ' J* _.... ... ._ E '. I--.i. _.. _ .. .-... 1 _... _.. __ ................... i .. - E ... ._..E ... :... .. F. ��� 1 I 1 F 1 1 L t i 0 New Deck New Dock Q �—VERIFY LOCATION IN FIELD. II PROPOSED REAR ELEVATION ; ; ; ; PROPOSED LEFT ELEVATION z \ 3 } Zm W 4 F N O p po tl 10-II BATH °t 'A' m bed mCIE lu DD BGL�A�NSA LmT _ = I r v r f1g ` 5-8 Y RiOH ii, T�IGAL AR SH NGLE&DING WA L. 0 V To WEATHER i V4 PLYWOOD BNEATNING ---- �� Ln4 BTIIDB•16•o.c. 4.Q. _ Fasten ledger to existing box v m ATt I v�T 4'-6" O w/3-5"timberlock screw yr oRYwAu TAPED AND MISS D.— _ 1'-4" fV TAPED t BANDED CIO CIO. 2'-0" Pon a Pwt o every oc. 4 le" ` rw"amlo" rw°eeuo° 0 LU LU - r --- ------- -----"----- ----------------------------- -- a - dOW11 Exmu.g _---- 3-2 FLUSH 13/4"x 11 1/8 LVL _- ul6210 2x10 frame typ. stub wall O BEAM ABOVE V 0 slab`.... NTS. m• p bed kitch a WO 6 16"oc,w/3/4 advantec subloor. Uj bath o NEUI MASTER match existing floor heights.R-30 fg [maul. {-- z In Floor bays.frame stub wall from slab with: 2x6 pt,double layers of 2°Rigid Foam Insul. New kitchen I fasten pt.plate to slab w/I/2"thread rod and door II'-1I" Epoxy system,every 32"oc.C516 strap from plate to existing gable every 4'oc. O R FRAME PLAN/NOTES PROPOSED..FLOORPLAN new 6'slider 2-2° ecALE,VW-ro• i NEW 12'x15'DECK m w/2xl0 PT box and Joietes B 16"cc,typ.Utilizing Simpson LUS210 Joist hangers.5/4"x6"pt.decking. 4x4 pt.poets,ABU44 post base. Wx4'sonotubes w/bigfoot bases. i � I TOP OF FOUNDATION = 13.6'± PROVIDE H.D.P.E. PROV'D H.D.P.E.RISER w/REMOVABLE, FINISH GRADE OVER D-BOX= 13.6'± 4"SCHEDULE 40 PVC MIN. SLOPE 1 % FINISHED GRADE OVER BIODIFFUSERS= 13,24' - 13.34' GENERAL NOTES RISER w/COVER TO SECURED,WATER-TIGHT COVER TO FINISHED GRADE F.G. OVER F.G. (TYP OF 2) REMOVABLE WATERTIGHT RISER SLOPE @ 2% MIN. 1 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION @ FOUNDATION = 12.8'± WITHIN 6"OF F.G. TANK EL.= 12.5'± TO WITHIN 6"OF FINISHED GRADE INSPECTION PORT WITH METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE 5" DIA. OUTLET(S) ACCESS BOX TO WITHIN 3"OF ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 20"MIN.ACCESS 9"MIN. F.G. (ONE PER OUTER ROW) ` 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD EL.11.7' COVER(TYP.OF 3) 36"MAX. _ - t � OF HEALTH AND THE DESIGN ENGINEER. EXISTING 4" i 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL SEWER PIP 2" PVC FORCE MAIN 36 MAX. 9" MIN. BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 2" DROP MIN. _ TO DISTRIBUTION BOX 9"MIN. 36"MAX. TOP OF SAS/B.O. - ' MIN.SLOPE(t�1% 6" -- 3" DROP MAX. 3" 9" - 12.49 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN PROPOSED 4" - - - - - - - ELEVATION = 12.49' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS SCHEDULE 40 PVC ® b " A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10.25PVC EX. INV. 14 2"PVC TEE TO SASOUT THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. #_10 7'± 'U 4 1 0$' T 13" 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 0.59, (TMP') 7.13"(TYP) j 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" DIMENSION AS PER - + 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO 10.50' WIGGIN PRECAST CORP. 12"MIN. 6" 12.00' �- 11 .41' laid flat 2.875'(34.5")�I STONELESS SYSTEM) BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR POCASSET, MA 12.27' 12.10' (�,P ) ( INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING (800)564-6774 5.0' APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. 10.7 1500 GAL. �°r� 6 CRUSHED STONE I (TYP ) 11.5' 8. ELEVATIONS BASED ON AN APPROX. M.S.L. DATUM OF 12.15' ESTABLISHED ON A STAKE AND OVER MECHANICALLY j 5 MIN. COMPACTED BASE 25 0' TACK AS SHOWN ON PLAN. 22"ZABEL FILTER 6" CRUSHED STONE �j 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EL.6.0' OVER MECHANICALLY OUTLET DISTRIBUTION BOX ; THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE MODEL#A1801-4x22 COMPACTED BASE TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= 6.37' AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY (GAS BAFFLE ON BOTTOM) BASE. FIRST TWO FEET OF OUTLET DISCREPANCIES TO THE DESIGN ENGINEER. PROPOSED 1500 / 500 GALLON TWO-COMPARTMENT SEPTIC TANK PIPES To BE LAID LEVEL. BIODIFFUSERS PROFILE BIODIFFUSER END VIEW i10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE LENGTH 12'-2" WIDTH 6-8" DEPTH 5'-8" CROSS SECTION VIEW STRUCTURES SHALL BE MADE WATERTIGHT. SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL 13" HIGH ARC 36 (#3613BD) BIODIFFUSERS 11. NO ZONING INLATIONASBEENMADEAS NTISTOOBTAI WUHDEEDEDOR NOT TO SCALE ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH NOT TO SCALE - NOT TO SCALE DETERMINATION FROM APPROPRIATE AUTHORITY. „ NOTE: PUMP MUST BE EQUIPPED WITH A HIGH - :" . TEST PIT DATA 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS CONSTRUCTION NOTES: INSTALL 1-1/4 PVC TO HOUSE. JOINTS TO BE MADE 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. LEVEL ALARM LOCATED IN THE BUILDING ' + ; + I' LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE WATERTIGHT.WIRE PUMP AND FLOATS TO SIMPLEX + 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED LEACHING SYSTEM TO SERVED WHICH IS POWERED BY A CIRCUIT + . • PERC NO. 13598 CONTROL PANEL No. 1-CC2 NEMA-1 MFG. HOOVER SEPARATE FROM THE CIRCUIT TO THE PUMP. . Q '" ���• r + THEY SHALL WITHSTAND H-20 LOADING. ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD INSTRUMENTS +r d• . INSPECTOR: Donald Desmarais, R.S. 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. ' • • EVALUATOR: Michael Pimentel, E.I.T. 3.) ALL PROPOSED WORK IS LOCATED OUTSIDE THE LIMITS OF ANY AQUIFER PROTECTION AREAS OR NEMA 4 JUNCTION BOX CORROSION RESISTANT& HOISTING CABLE 7 x 19 STAINLESS STEEL . + :'% ■ • 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 1/8" DIA./ 1,760 LB. STRENGTH ' ,� ♦ 'C) • C.S.E. APPROVAL DATE: Oct. 1999 ESTUARINE WATERSHEDS. • L� ,/ + UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF CONNECTORS SUPPORTED BY 1-1/4"PVC CONDUIT, • DATE: April 6, 2012 I LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN JOINTS TO BE MADE WATERTIGHT 2"BALL VALVE w/UNIONS SCH. 80 PVC • , • 11 + ' ! COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN GEORGE FISHER CO. MODEL NO. 560 • + , . �� TEST PIT#: 1 III _ ACCORDANCE WITH 310 CMR 15.255(3). MAP 207 ;. 3" 2"SCH.40 TO D-BOX ; 0� • (r .. ELEV TOP = 12.20' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN LOT 123 \ "SCH. 40 TEE w/CLEAN-OUT CAP + r �s lam. " ELEV WATER= *6.37' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. ALARM ON * LOCUS , PERC RATE _ 16. PROPOSED PROJECT IS LOCATED WITHIN: 1/4"WEEP HOLE IN DISCHARGE PIPE ! ASSESSORS MAP 207 LOT 125 1 UMP ON M 4 y * ` DEPTH OF PERC = PROP. 40 MIL. IMPERVIOUS , OWNER OF RECORD: LESLIE W. GAY ` PUMP `- 2" BALL CHECK VALVE SCH. 80 PVC 100 O - 11 • r GEOMEMBRANE LINER; O P.S.I. FLOWMATIC MODEL No. 208S �Q TEXTURAL CLASS: 1 / o�5�0 TOP EL.=12.49 ` �" � ADDRESS: 122 SCHOOL STREET BOTo o + 1 STOUGHTON MA 02072 12x4' (2)WIDE ANGLE CONTROL FLOATS M o • � � " �12 (BARNES 073618) 0 2"SCH. 40 PVC DISCHARGE PIPES �� 0 • 0 • • .,, r 12.20' `� � FEMA FLOOD ZONE C I 1 / PROP. TOTAL 20 ARC 36 12x4' 1: PUMP ON/OFF 120 ACTIVATION 12x4' (#3613BD BIODIFFUSERS IN A 1?_x2.' / X- BARNES SE411 PUMP 0.4 H.P., . Fill ' � �; �"� � ,� �" c ; AS SHOWN ON COMMUNITY PANEL# 250001 0008 D / ) 2: ALARM ACTIVATION ; FIELD CONFIGURATION---, <, 4 ` 115 V, 2" DISCHARGE PASSING ( !17. PLAN REFERENCE: P.B. 140, PG. 33 -� 1-1/2"SOLIDS OR EQUAL + '`~ cy, `' "" PROPOSED INSPECTION �`L� PROP. + 36 9.20 18. DEED REFERENCE: DEED BOOK 1442, PAGE 467 PORT WITH ACCESS BOX DBOx 1500 / 500 GALLON SEPTIC TANK DETAIL. ° � u � :' •;••••. � ,,� �- .. , All TO GRADE TYP OF 2 2x0 ' �" '� +` + "'�'• + •a ii + ( ) NOT TO SCALE - 19. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY FOR I . -' ..._- ' „r .• Sandy Loam 12x6 } C 1 NOT ASSUME ANY LIABILITY FOR USES OF f � _. 10Yr 5/6 PURPOSE. THIS LA OTHER SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL 'XIST. LEACHING PIT TO BE 12x1' BUOYANCY CALCULATIONS PLANTHAN ITS INTENDED POS •+ ---- -- 2x ' •+ ,rt ." + r1ki Q `ESHGVV @ 70' 0 6.3T`; PUMPED AND FILLED WITH IR � I " \ PROPOSED 1,500/500 GAL. 2-COMPARTMENT SEPTIC TANK ` CLEAN SAND (TYP OF 2) ,� f * � ` s'`- e � , .. \ HIGH GROUNDWATER EL.=6.37 �. ' (5 TOP OF SEPTIC TANK EL. = 11.7' ublic 4y�' 78 5.70 LP 12x4' 1 3) N,6 BOTTOM OF SEPTIC TANK EL. =,6.0' , Landing �, � � � /3 � Coarse Sand .� 12xT WATER DISPLACED=(6.37 -6.0)x 12.17 x 6.67 =30 C.F. C-2 2.5Y 6/6 TP 2 �= Zyo WEIGHT OF DISPLACED WATER=30 C.F. x 62.4 LB/C.F. = 1,872 LBS (loose) WEIGHT OF 1,500/500 GAL. 2-COMPARTMENT TANK=22,000 LBS n \ 12 , 12x1' jo SOIL COVER= (12.5'- 11.7')x 12.17'x 6.67' =65 C.F. LOCUS PLAN ,00„ _Standing 12x2' 13 c, �� WEIGHT OF SOIL ABOVE TANK=65 C.F. x 110 LB/C.F. = 7,150 LBS j REMOVE ALL UNSUITABLE MATERIAL DOWN O mm 6' 1 22,000+7 150=29,150 LBS> 1 872 LBS; THEREFORE ACCEPTABLE �m 12x5' TO"C"SOIL (EL. 5'±)& REPLACE WITH CLEAN 2) r2 a0. ' SCALE: 1"= 1000' 126 1.70' COARSE SAND PER 310 CMR 15.255(3) (6 DESIGN DATA 1) `BASED ON THE CAPE COD COMMISSION METHOD \ EXIST. CESSPOOL (approx. location)TO BE PUMPED INDEX WELL: MIW-29 X & REMOVED IN ACCORDANCE WITH TITLE 5 NUMBER OF BEDROOMS(DESIGN) 3 WATER-LEVEL RANGE ZONE: B \ 1 12x ' MAP 207 DESIGN FLOW 110 GAUDAY/BEDROOM WATER DEPTH READING: 8.16' WATER DEPTH READING DATE: 3-28-12 p 70 � � TP 1 PROPOSED 1500/ 500 GALLON LOT 124 TOTAL DESIGN FLOW 330 GAUDAY WATER-LEVEL ADJUSTEMENT: 2.50' G) / P -r X TWO-COMPARTMENT SEPTIC TANK B.H. ---- DESIGN FLOW X 200 /o GAUDAY LEGEND 1�� 12x8' x 66U TEST PIT DATA O N o �; o °' X S HCA USE PROPOSED 1500/500 GALLON TWO-COMPARTMENT SEPTIC TANK - - -- 50 - - - EXISTING CONTOUR gym\ x GAS GAS GAS - --- GAS PERC NO. °� 13598 \- R.S. 50 PROPOSED SPOT GRADES INV.=10.7'± INSTALL 20 - 13" HIGH ARC 36 (#3613BD) BIODIFFUSERS INSPECTOR: Donald Desmarais, 12x HC-2 EVALUATOR: Michael Pimentel, E.I.T. i 0 PROPOSED CONTOUR ' - Oct. 1999 GP 12x8' X'X--X SCREENED SYSTEM CAPACITY C.S.E.APPROVAL DATE. EXISTING GAS LINE VP' PORCH #137 M TOTAL L.F.OF BIODIFFUSERS&COUPLINGS (4.8 SF/LF 0 74 GPD/SQ.FT. - GPD DATE: April 6, 2012 g, 1 EXISTING ( ) )( ) W W - EXISTING WATER LINE 3-BEDROOM 0 (100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING/DAY TEST PIT# 2 Benchmark DWELLING a : ❑/H/W -- EXISTING OVERHEAD UTILITIES \ / Stake and Tack TOF=13.6'± o ELEV TOP �¢s Elev. = 12.15' r = 12.20' Approx. M.S.L a TOTALS: ELEV WATER= "6.37' TEST PIT LOCATION TOTAL NUMBER OF BIODIFFUSERS: 20 o r TOTAL NUMBER OF COUPLINGS: 0 PERC RATE _ <2 min./inch O O O PROPOSED 1500/500 GALLON SEPTIC TANK TOTAL LEACHING AREA: 480.0 SQ.FT. DEPTH OF PERC= 56"- 74" m m \ �7 �/� TOTAL LEACHING CAPACITY: 355.2 GAL./DAY O PROPOSED DISTRIBUTION BOX \ / TEXTURAL CLASS: 1 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE Oc N/W y� 0/N NOTE: PROP. 2"SOLID SCHEDULE 40 PVC FORCE MAIN 13 p MAP 207 EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE PROPOSED 13" HIGH ARC 36(#3613BD)BIODIFFUSER DEPARTMENT m I / N/W y RT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER 0" 12.20' 1 - 13 I LOT 125 "MODIFIED APPROVAL FOR GENERAL USE" ISSUED TO INFILTRATOR N p 11,490 S.F.± SYSTEMS, INC., DATE OF ISSUANCE OCTOBER 3, 2003(LAST MODIFIED Fill MARCH 14, 2012). TRANSMITTAL NUMBER=X235253. 24 10.20 REV._ DATE BY APP'D. DESCRIPTION A Loamy d PROPOSED SEPTIC SYSTEM UPGRADE 10Yr 3/2 4L 36" 9.20' PREPARED FOR: DOSING & STORAGE REQUIREMENTS B Loamy Sand I� �. ��P�;cKUF���sS9�-<.� CAPEWIDE ENTERPRISES DESIGN FLOW: 330 GPD 10Yr 5/6 1 / JOHN L. + ' CHU HILL JR. \ 771 I Z ro 31' DOSING REQUIRED: 4 CYCLE/DAY Perc ESHGW (a), 70" ` IQ I8�7 LOCATED AT 9 y3 l Pl 330 GPD/4 -82.5 GAUCYCLE 74" 6.03' �„ �,, �T � 137 HORSESHOE LANE N88°1740"W i /M� DISTANCE REQUIRED BETWEEN PUMP P`I CENTERVILLE 02632 OF P SWING TIES ON AND PUMP OFF FLOATS: 35.46' C Medium -Coarse Sand 1 12- - r DESCRIPTION HCA HC-2 82.5 GAUCYCLE = 125 GAUFT = 0.66 FT/CYCLE 2.5Y 6/6 �� (USE 0.70'TO PROVIDE FOR BACKFLOW) SCALE: 1 INCH = 10 FT. DATE: APRIL 19, 2012 ,\��/W - SEPTIC COVER IN (1) 27.6' 22.7' (loose) 0 5 10 20 40 FEET \ www��\ STORAGE REQUIRED ABOVE WORKING LEVEL: 330 GAL. E STORAGE PROVIDED ABOVE WORKING LEVEL: 337.5 GAL. - -- H�i✓ LAN SEPTIC COVER OUT(2) 23.9 28.9 Standing @ 100" _ . PREPARED BY: - SHOE _ _ 100" --- 3.�7' HORSE oELWOUT) BIODIFFUSER CORNER(3) 33.3' 38.3' RESERVED FOR BOARD OF HEALTH USE JC ENGINEERING, INC. �40 W, BIODIFFUSER CORNER(4) 44.7' 46.7' 126" 1 1.70' 2854 CRANBERRY HIGHWAY EAST WAREHAM, MA 02538 SITE PLAN BIODIFFUSER CORNER(5) 53.5' 37.1' 508.273.0377 SCALE: 1"= 10' BIODIFFUSER CORNER(6) 44.4' 25.7' Drawn By: MCP g y: y:Designed B MCP Checked B JLC JOB No.2184