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HomeMy WebLinkAbout0023 LARCH LANE - Health Larch Lane r Centerville F/R A = 189 006006 ,I f+ 0 YJU-t4.-tom E ILA Ytc. + F ti a 4 4 t; t t1: sf { i �kf �C v pA)o 6 �24t�j rr �Ja J.,k wen U�d y� �c� cW wr,'C AIf 7� %d %n)a SP�O�c.Ct=� SOO,- ,o0 19-6 tom' J:D 0 OO Oo 4 xa• § s � B 4 ig 1Y-a' b o b �•t t ta•4* zaP-ir O Existing First Floor Plan La Porchia & Peterson Philamar Date: 1/9/2003 Home Cape Improvement Specialists of G e God Inc. p p 23 Larch Lane Page '� 25 lyanough Rd. Ph 508-775-2815 l Centerville, Ma. 02632 Hyannis, Ma. 02601 Fax 508-115-2887 1-'� Ai New Dormer Add double uAW1 for plumbing BATH6 computer Create cavItU over linen closet Bath ai"We .r Master Bedroom belau to run FHA heat and Alcove plumbing to basement — — — — — — — — — — Umn Existing 9'Bedroom \\// ------- - — — — — — — — — — — — — — — — — - - Half Y'wl SW up -- --- - - - - - - - - - - - - - - - - - - - - - - - _---Existing Stairs t OPEN BELOW STORAC#E Proposed Second floor Plan with Dormer La Porchia & Peterson Philamar Date: 1 M/2003 Home Improvement Specialists of Cape Cod Inc- 23 Larch Lane Page 2 251yanough Rd. Ph 508-115-2815 Centerville, Ma. 02632 Hyannis, Ma. 02601 Fax 505-715-2657 No./ �� 1 FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, &1;-;, �'ARLE MA. APPLICATION FOP, DISPOSAL SYSTEM[ CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgradep< Abandon( ) - ❑Complete System XIndividual Components Q 1 Location R�> LpipcA Lfl r m TE - Owner's Name Map/Parcel# A a Address oZ E Lot# Telephone# Installer's Name A 2� _ �' Designer's Name t .� ,7 Address S -0 Address Telephone# -+r+k-ri4le, Telephone# 50 -&Aa-D Type of Building Lot Size "'���MQ sq.ft. Dwelling-No.of Bedrooms -T 1rtiXPA Garbage grinder QYA Other-Type of Building No a E No.of persons 3 Showers (Cafeteria (L)/ GAther Fixtures l...P►Qyrrus<Y eA SjK*-T ymz?,Y Design Flow (min.required) ,A gpd Calculated design flow 440 Design flow provided 4(.00 gpd -man: Date 1 1 +1 ,C Number of sheets � , ' Revision Date Title yb�c� 5- `G) Description of Soil(s) �e Qac A-o (2,A* C+'s.C`�F26 Soil Evaluator Form No._`� \ L_Name of Soil Evaluator RQt4Gl,� S4AY Date of Evaluation IL DESCRIPTION OF REPAIRS OR ALTERATIONS AnCV The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agreesL td not to plac system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed ✓ Date t7 a Inspections No. I//1� / i/ / ! FEE Board of Health, MA. APPLICATION FOP, DISPOSAL SYSTEM[ CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) UpgradeX Abandon( - ❑Complete System Individual Components �{} Location �� Owners Name Map/Parcel# h _ Address Lot# Telephone# Installer's Name C !�� Designer's Name L -M JC s. Address s sb - , H Address fl a Telephone# aq _ Telephone# Type of Building en�� Lot Size �1 �sq.ft. Dwelling-No.of Bedrooms `T1n V20- 9-4,-T. Garbage grinder tYA Other-Type of Building No.of persons Showers (Cafeteria ( Other Fixtures LA\lATtsy-*_Y -rCH F►t Z*esign Flow. (min.required) 4 4D gpd Calculated design flow 440 Deesign,flow provided !'(n0 gpd flan: Date_ p ` Number of sheets C 1 ,Revision Date Title Description of Soil(s) car- �� �` *C � �� Soil Evaluator Form No. `a Name of Soil Evaluator ('AR_MC►J SHAY Date of Evaluation o DESCRIPTION OF REPAIRS ORALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. * Signed �/ 7Z ! � Date X � Inspections 7/) /_ Q i No. M . SOT �\ FEE s/ C®MMONWEAlLT14 ®F MASSAC14US ETTS j � .Board of Health, CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the ewage Disposal Syste onstructed� ),Repaired ( ),Upgraded ( ),Abandoned ( ) by. A S /11�' -r a at --- , has been installed in accordance with the pr visi ns of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 2OO�J"n 56, dated 'l V7 IDS Approved Design Flow (gpd) r Installer j Designer: v Inspector: Date: S DA The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE COMMONWLA 114 OF MASSACHUSETTS - Board of Health, DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby ranted to; Construct( ) Repair( ) U grade. Abandon( ) an individual sewage disposal system hl at ` r as described in the application for Disposal System Construction Permit No. " ; ed Provided: Construction shall be completed thin three years of the date of this er it, c 1 co i ' ns must be met. Form 1255 Rev,5/96 A.M.Sulkin Co.Boston,MA Date ,/ Board of Health "'4 - / TOWN OF BARNSTABLE LOCATION f 1 � SEWAGE # VILLAGE �� ,� ,C. ASSESSOR'S MAP &LOT �� � INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /6-0 0 LEACHING FACILITY: (type) h790 &Af-- ,Z,.�� (size) f� X NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: t—P a— 7 _COMPLIANCE DATE: Separation Distance Between the: Feet ` Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site of within 200 feet of leaching facility) exist Edge of Wetland and Leaching Facility (If any Feet within 300 feet of leaching facility) Furnished by TOWN OF BARNSTABLE L0CAT ON �6-(� �✓!7 ��� SEWAGE # `'Ji.LLAG � L�Ui� �ui� -� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. DA 106A SEPTIC TANK CAPACITY Jam® GOZ— LEACHING FACILITY: (type) h�0 C'o�f— ,Z ,�, (size) ,Z:? NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: I—17- 03 COMPLIANCE DATE: 3-S 03 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 3 �- Sep - 20-01 13 : 52 ` BARNSTABLE HEALTH DEPT 5087906304 P . 02 .: i .NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. _ _ — i PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM l Cr►1�� � � hereby certify that the engineered pian signed by me Cle;ec _ 63 concerning the property located at a`� _LAeCLI LcA,•�t , �E+� �111� meets all of the lot'o,v;ng cnterla. • This failed system is connected to a residential dwelling only. There :ire no .ommerzia! or business uses associated with the dwelling. • The soil is ciassc;:ed as CLASS l and the percolation race is less than or equai to n:nue:s per +nth. The applicant may use histoneal data to conclude this fsc: or may _onduc:t cre!imi:.ar- tests ac the site without a health agent present. • There :s no increase in flow and/or change in use proposed • There are no vanances requested or needed. ' • The bottom of the proposed leachin7 facility will not be located less than fourteen l�j lee; aonve the maximum adjusted groundwater cable elevation. (Adjust the -ound•vater cable using the Fhmp(or method when applicable) Please complete the following: op of Ground Surface E!evacion (using GIS information) _ ^_ B t cD W Elr vac.or, �J + a rn d;uscen( for high G.W. _ R,ENCF EETWEEN A and B S.G)fED — DATE: NOTICE 3asec a�r�n tre above information, a ceoair permit wil! be issued for Bedrooms dd,ti,.-MM bedrooms are authorized in c�e future without engineered :epi!_ sy.t plans. _ --- — r Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: oZ3 LAP_c%-y tr3s C�aJTEPl�tt.t E Lot No. CQ Owner: LgPr,zoA,p CWryt iprby Address: ,M LE A Contractor: CXLAyA'C%0 ddress: -S, W i I I nL.,A N-4 W- y+ ki'Al9t�iW Notes: STEP 1 Measure depth to water table to nearest 1/1Oft. .............................................................................. Date _ month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate M1W site and determine: OAppropriate index well.................................................... ©Water-level range zone..................................................... STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth to water level for index well ........................... O month year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A),current depth to water level for index well (STEP 3). and water level zone(STEP 2B) 3 determine water-level adjustment .......................................................................................... ` STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water lg levelat site(STEP 1) ............................................................................................................. Cape Cod Commission: USGS Well Data- December 2002 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties, the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey (USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001 to predict high groundwater levels. For your convenience, we've also provided links to USGS national and state data. See the last column in the table and the footnotes below. For further information, please contact Hydrologist Gabrielle Belfit at the Commission offices (508-362- 3828). December 2002 t.1SGS Site Departure from Numl)er*''** Location Well No. Water Record Record Average" (links to IJS( S Level* High* Low* Monthly Overall national water-level database) Barnstable 230 24.9 20.5 26.6 -0.7 -1.2 413956070164301 Barnstable 24w 26.9 20.5 28.6 -1.8 -2.4 414154070165001 Brewster BMW 21 13.2*** 6.9 13.6 -2.6 -3.0 414518070020301 Chatham CGW138 24.7 20.9 26.6 -0.3 -0.8 414100070011101 Mashpee MIW 29 8.2 5.6 10.0 0.7 0.3 413525070291904 Sandwich SD 2 47.6 45.9 48.2 -0.1 -0.3 414418070241601 Sandwich SDW 54.2 45.8 55.1 -3.6 -4.0 414124070265901 Truro TSW 89 11.9 10.2 13.0 0.2 0.2 420206070045901 Wellfleet W�W 11.7 7.3 12.8 -0.7 -1.3 415353069585401 http://www.capecodcommission.org/wells.htm 1/13/2003 r FORM 11 - SOIL EVALUATOR FORN Page 1 of No.: ®ate: 1/6/03 COMMONWEALTH OF MASSACHUSETTS Barnstable , Massachusetts Performed By: Carmen E. Shay Date: 4115/02 Witnessed By: Waiver- Per Barnstable BOH Location Address or #23 Larch Lane, Owners Name: Laporchia Cannady Centerville,MA Address: 940 W.Main St„Centerville Lot# Map 189 Lot 006/006 MA 02632 New Construction • Repair • X Telephone Number: 508-771-7410 OFFICE REVIEW: Published Soil Survey Available: No ❑ Yes ❑ Year Published: Publication Scale: Soil Map Unit: Drainage Class: Soil Limitations: Surficial Geologic Report Available: No❑ Yes❑ Year Published: Publication Scale: Geologic Material: (Map Unit): Landform: Glacial Outwash Flood Insurance Rate Map: Above 500 Year Flood Boundary: No ❑ Yes 5_1 Within 500 Year Flood Boundary: No 5_1 Yes ❑ Within 100 Year Flood Boundary: No Fx1 Yes ❑ Wetland Area: None Observed National Wetland Inventory Map (map Unit): Wetlands Consercancy Program Map (map unit): Current Water Resource Conditions (USGS): Month Range: Above Normal ❑ Normal FX I Below Normal ❑ Other References Reviewed: USGS Topographic Map I DEP APPROVED FORM 12/7/95 FORM 11 — SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.: #23 Larch Lane, Centerville, MA On -Site Review Deep Hole Number: #1 Date: 1/6/03 Time: 10:00 PM Weather: Sunny, Cold, 35OF Location (identify on site plan): Refer to Sketch Landform: Outwash Plane Position on Landscape (sketch on back): Refer to Sketch Distances From: Open Water Body N/A feet Drainage Way N/A feet Possible Wet Area N/A feet Property Line 25' feet Drinking Water Well N/A feet Other N/A feet DEEP OBSERVATION HOLE LOG Depth From Soil Soil Soil Soil Other Surface Horizon Texture Color Mottling Structure, Stones, (inches) (USDA) (Munsel) Boulders, Consistency, % Gravel 0" — 6" A Sandy 10 YR 3/2 None Friable Loam 6" — 36" BW Sandy 10 YR 5/6 None Friable Loam 15% Gravel 36" — 144" C1 Sand 2.5 Y 7/4 None Medium Sand, 5% gravel/cobbles,Loose Parent Material (Geologic): Glacial Outwash Depth to Bedrock: N/A Depth to Groundwater: Standing Water in the Hole: None Weeping From Face: N/A Estimated Seasonal High Water Table 144"Assumed DEP APPROVED FORM 12/7/95 I • FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.: #23 Larch Lane, Centerville, MA Method Used: Determination of Seasonal High Water Table ❑ Depth observed standing in Observation Hole: inches ❑ Depth weeping from side of Observation Hole: 144" inches (assumed) ❑ Depth to Soil Mottles: inches ❑ Groundwater Adjustment: None feet Index Well Number: Reading Date: Index Well Level: Adjustment Factor: Adjusted Groundwater Level: N/A DEPTH OF NATURALLY OCCURING 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: Yes CERTIFICATION: I Certify That on September 17, 2000, (date), I have passed the soil evaluators 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: 'I f�) DEP APPROVED FORM 12 7 95 FORM 12 - PERCOLATION TEST Location Address or Lot No.: #23 Larch Lane COMMONWEALTH OF MASSACHUSETTS Centerville , Massachusetts Percolation Test Date: 1/6/03 Time: 10:53 AM Observation Hole #: #1 #1 Depth of Perc 42" Start Pre-soak 10:53 End Pre-soak 10:00 Time at 12" Will Not Hold 24 Gallon Presoak Same Time at 9 Time at 6" Time (9-6") Rate Min./inch < 2MP1 Assumed @ 42 " Same i * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Performed By: Carmen E. Shay Witnessed By: Waiver per BOH Comments: Would Not Hold 24 Gallon Presoak - <2 MPI Assumed Al 42" Site Passed X Site Failed DEP APPROVED FORM 12/7/95 TOWN OF BARNSTABLE L- L CATION Z 3 Gdre-t4 LAJ SEWAGE # 7-0 1-oy r- ,vII,LAGI✓ ��►J'r�'lZl✓t t�L ASSESSOR'S MAP & LOT 1ff-7 _G INSTALLER'S NAME&PHONE NO. �l�'+� f 64Zt57 ... -/2 0 SEPTIC TANK CAPACITY (6971-5 1Afr LEACHING FACILITY: (type) (size) a X S-0 o 6 4-4- NO. OF BEDROOMS BUILDER OR OWNERiSLtl��-- PERMITDATE: C —Z�=o l COMPLIANCE DATE: J/-O 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 e� f q/ �- I No.' G� d .' f� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Migonl *pWm Construction permit Application for a Permit to Construct( )Repair(✓4u pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3 (, C(4 1. k-0457 Owner's Name,Address and Tel.N Assessor's Map/Parcel M PAS Installer's Name,Address,and Tel.No. q-2-0 e d Z�� Designer's Name,Address and Tel.No. ` u 70 - M h"-ro&i s lk I t.c.S Type of Building: Dwelling No.of Bedrooms -3 Lot Size 60d sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 gallons per day. Calculated daily flow :3 40,, gallons. Plan Date 01 • Zs. b 0 Number of sheets 1 Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 'QgrL-k,:1;a7 Le A FI EZ-i> 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 Certifi- cate of Compliance has been issue by this Board of 41th. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued" a,J,�J- ! f✓� TOWN OF BARNSTABLE w LOCATION 3. GAS 1 L-1.f r SEWAGE # / _G�/ VILLAGEf�"'r��l/i LLE ASSESSOR'S MAP &r LOT INSTALLER'S NAME&PHONE N0. J! / / i. SEPTIC TANK.CAPACITY /c®� (c EXf�TinlC 1 LEACHING FACII:ITY: (type) i-fA-r'Y► �� (size) NO. OF BEDROOMS ..rrrr r�r^n /�n nll/.TCD 5 k� PERIvIIT.DATE> l: -" l: COMPLIANCE DATE:-. >' 3/—.O/ i Separation Distance Between the: I Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water SuppiyWetl and Leaching Facility (If any wells exist on site or withim'200 feet of leaching facility.) Feet Edge-of Wetland and Leaching Facility (If any wetlands exist eet within 300 feet of leaching facility) Furnished by '.'.. i " •. ...,^ .f....:: . �• ,".s. r 41.._#Kf } * =G , . r5 Z- F 3 33 �o - 1 Z � �- . �7 - 3 of _6 No. 10 ` % Fee' 'v c THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Migoml 6pgtem Construction Permit Application for a Permit to Construct( )Repair( VI/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Z Z (,,kP e-(.{ (,pr)JAC-7 Owner's Name,Address and Tel.No Assessor's Map/Parcel CeNTelt-v I ut EF M 189 PprR OL-ro Installer's Name,Address and Tel.No. �� Z�� Designer's:Name,Address and)Tel.No. i J I M t(1t,o,L1.GL j I►" 4V L[Z-7_ Bb 70'L, M k2STc nl S N I L I-S Type of Building: Dwelling No.of Bedrooms Lot Size 60d' sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures j Design Flow 3 3 gallons per day. Calculated daily flow 3 4D gallons. Plan Date 01 + ZS+ 61 Number of sheets Revision Date IIJ A Title Size of Septic Tank Type-of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) BEFLAC-'C LZ7W-d Fi E2-Tj 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 Certifi- cate of Compliance has been issued y this Board of W,��lth. Signed Date 01, 2-S , 61 Application Approved by Date/,-E� i4�, 4:lw Application Disapproved for the following reasons Permit No. Date Issued Jd' � Gs 6 f ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certiffcate of Comptiahre THIS IS TO CERTIFY,that the On-si Sewage Disposal System Constructed( )Repaired ( �raded( ) Abandoned( )by IFl,,n CS tto L-J V=7g_ at 2.3 LA-R-0-k LA)JC— , ('0j r MV t",45, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No O .t(C ated :..'�,ZOFF+` Installer Designer The issuance of this �;t s�4all not be construed as a guarantee that the syste 1 funpt�ian s designe . Date l Inspector JV ---------------------------------------- No. /i�6 �� 4:1 0:4 Fee 5b ` THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwfopooaf *pttem Con!6tructfon Permit Permission is hereby granted to Construct( )RFpair( ✓)Upgrade( )Abandon( ) System located at 23 WZaA LAWE CiZE LV I Y-6 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�ompleted within three years of the date of t t. Date: .� dz� I Approved 116/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL V WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated d( • 2S, D , concerning the property located at 0,3 IA42l bojE &0JT-e772_01U-9_ meets all of the following criteria: t� This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. ✓• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. t/• There are no wetlands within 100 feet of the proposed septic system ✓• There are no private wells within 150 feet of the proposed septic system ✓• There is no increase in flow and/or change in use proposed • There are no variances requested or needed. �• The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation..[Adjust the groundwater table using the Frimptor method when applicable] If the S.A.S.will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS information) t i B) G.W. Elevation +the MAX. High G.W. Adjustment .3.7 = 2- DIFFERENCE BETWEEN A and B , SIGNED : DATE: Uh ZS�• O/ [Please Sketch pTiposed plan of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert • .� - -_ � -._-J_.._ �. _ '_ _-_- .- , - --+----------- -- ---+- ' I----------- --_ -+--- - -(�-ram- - -- - - - 175 r of ulan> Iaq- -big MAI Iry 1 ) SSESSORS MAP NO: .—.4, C A T 10 N PARCEL NO.: I W' A G E P.F R 91 N Q. VILLAGE i �IHST A LLER;S NAME A ADDRESS iM 8 U t L D E R OR D IN Em DA 1 EE .P RWiI "T` 15SD £ 0 2,, DAT E C 0 M P L I A N C E ISSUED_�� 23��a l S Fps.............. ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � �� 2 Z o ............ .._....... ........---................... , ppliration for Bhymal Works Tonstrnrtiun Fautit Application is hereby made for a Permit to Construct (k-1-or Repair ( ) an Individual Sewage Disposal System at: t15 e, a 3 .... 1.............•--•- Location-Address ................... .... ....._._ or Lot No. - - ----• Owner Address W � Installer Address d Type of Building Size Lot...___ __________........Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ,(ter' Garbage Grinder pa, Other—Type of Building _____________•_-__________-- No. of persons........... Showers. ( ) — Cafeteria•{—�- a' Other fixtures .._--• --------------- W Design Flow...........................� ......gallons per person per day. Total daily flow........ .._. _ ._ ...............gallons. WSeptic Tank—Liquid capacityl!?! "gallons Length..9__.��`. Width.. .' .Q! Diameter-__ --- --- Depth...`f_f.._.. x Disposal Trench—No. .................... Width.................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.._.....L2..... Depth below inlet...3_-_:�`�..... Total leaching area....0.4 sq. ft. Z Other Distribution box ( / ) Dosing tank _ Percolation Test Results Performed by...... �. �..�-..._._...���.... Date._..__`_.Z �. -�. Test Pit No. 1.... ..�-_minutes per inch Depth of Test Pit-__� `_. Depth to ground water....../_� ____/9Z-1+1111-W. (i Test Pit No. 2...�...�.minutes per inch. Depth of Test Pit....l ®_��_ Depth to ground water......_�.��...._ I' a+ -----•-----•-•-•••---••••-•...................•--•--•••--------•....---------....... _._..-.-.--- i/ / ✓ Description of Soil...........K ....- JP......... .............. .... - ................................. W ------------------------------------------•-----------------------------------------------------------------------•-----------....------------------------------------------------------....._.._----•- V 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 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 s ed b t boar f health. Signed- .... _`... Application Approved By--------- ........ a I ate Application Disapproved for the f o11rasons---------------------•----•-----------------------------------------------------------......-•-•-....---•-••••--- ..------•-•---•...................•••----...-•-•---•-•••--.....-•---•----....-•-------....._•--•---•....••--------------._.....--••-----••--••----•---------••--•----••-•••--••-----••-•••-----••------- Date PermitNo....................................................... Issued_..'................................................... Date r R No................-- ----- 4 Fxs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ]`.Q ✓l/.sue.....O F....L.�'...;74:>.....— .Appliration for Disposal Works Cfontrur#ion throb# Application is hereby made for a Permit to Construct (1.-�or Repair ( ) an Individual Sewage Disposal System at: ...... .............. ..........................................-•--.................................................... / -Location.-Address or t _ • ` f ' .�.—,1.—�.'..C1 L. O ._r_..d�.f .r J....:�.Qt` Y� , •� / l�� l� /G✓% / ��' ✓T�i11.�5 W Owner Address --•.......................•-•----•----.......--•---.......-•-•-----...............--•---...... -•-•-----........---.................--------............---.--7 .. -• ...'-•O----..--•--.. Installer Address Type of BuildingSize Lot........:.................. S feet Dwelling—No. of Bedrooms.................3.....................Expansion Attic (.--fir - Garbage Grinder -t—r_ Other—T e of Building g ____________________________ No. of persons........... '._....._.____ Showers ( ) — Cafeteria t-T- Otherfixtures -----------------------•--------------••------•....--.---••--------------••--•------•-•---•••----•----....---------•------- W Design Flow............................._`a.C2......gallons per person per day. Total daily flow_._........_.-�....�...�._............gallons. 04 W Septic Tank—Liquid'capacity__l_'�H?s'gallons Length...�'�.__ _ Width...._l_�.._!_`-Diameter-_____:_....._. Depth_._......._L__. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........1.--------- Diameter.........I.. `- Depth below inlet.... �..._. Total leaching area..._0:!f`�sq. ft. Z Other Distribution box ( /) Dosing tank.,.F—')''" Percolation Test Results Performed by._....�..�...j.�-�--�_—--_:--1�G.._- Date......_�_��f Test Pit No. 1....:5__�_-minutes per inch Depth of Test Pit---- {�_'.. Depth to ground water....... ,. ?�- P�( Test Pit No. 2......:.__%_._minutes per inch Depth of Test Pit..... Depth to ground water--------- ..`......_... ....................................... ........................................ -- ----••••----------------- x Description of Soil Y? `. .......................-....................... ------•-----------.� . U --•-•••--••••.....................•....--•••-•----...---------•...--------.....--•---•••-•...•-•----••-----•••--------•----••-•------••----•-....--••-•-•----•...--------...----••......•---------••---- W 110 ------------------------------•••--------•-•-----•••--•......-------•...------••...------•••-•-------•-•-•----•------------•-••----....--•--•-•--•••-----------•-•••-•----•-•-•-•----•-••-•---•...--•- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -------------••------•-----...------•---••-----•---•-----•-••----•--•----•-•••....-•-••••--•--.....------------•----•----•-------••------••-----...---------•••••------------•--•---•••...._..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation u�n-tiilia Certificate of Compliance has been issued by the board of health. Signed..A.............................................................................. Application Approved By.......I., Cing, v W. Ate'_... a__. __. ✓l.......................... .......a{ f iate Application Disapproved for the f oll reasons-------------------•--•-----•----------------•----------•------•----------------••--------------------••---••••-- ................................••-------...............--•-----•-•------••••.--••-••----------••----•---•-•---...-------•------•--------------•......-••-•---•-------•.-•--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7—In �'_� _r — � I �---> a,,, ..........................................OF..................................................................................... (Irr#ifiratr of Tontplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( P'T'or Repaired ( ) by..............................................................•..................................................................................................................................... Installer at...1T•Co � ZG L-�'��✓ c: �=r✓ )-=.�Z✓s L �1y -------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as destcribed in the application for Disposal Works Construction Permit No...... 7?.-6__1— �......... dated--------- ;-_jj1_ x' ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL UN TION SATISFACTORY. DATE....--..---- Inspector j+!t -------------••----•--•...----........--•--•-•••-••--••-••----•------•----•--------------------•-•----•------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..773... '`1.1......OF......� ' ==:'>1?1J f�-� 3 -2 ' y . No...- FEE...... . ...... Disposal Works Tonstrudion Errant Permission is hereby granted........:-_�_'2�4-/-1 !-4 Q• ..................._s (" �f Z •- --- to Construct ( or Repair ( } an Individual Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No..5 -(�:p .)> Dated.......__�4.F.!!!.`'w___•_•-•_-- ' "' ., ------------------------ / ..................................... Board of ealth DATE........ I f-. .`_��.C' .................................... h FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS rer mi 1 Number:---- _UaI C.: Completed by HIGH GROUND-WATER LEVEL COMPUTAI1014 Site Location: W LrZ.0 tl 1 %"> '��- Lot No. Owner: Address: ) 3 r o Contractor: Address: � Notes: STEP 1 Measure depth to water table. / 1 10 ft. . . . . . . . . to nearest / _ date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: / VV A) Appropriate index well . . . . . . . . . . . . B) Water-level range zone . . : :s �!'( 4f. La STEP 3 Using monthly report"Current Water Resources Conditions"L determine current depth to <i1 •�� water level for index well mo yr STEP 4 Using Table of Water-level Adjustments for index well STEP 2A , current dLpth. to . water level for index well (STEP 3) , and water-level zone (STEP 213) determine �J water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP S Estinate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water level at site (STEP ) ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l /=L �F V. J vV�=),F-!e 2Z-2- I -- ­- - , I -- - I -- -­ --- ­ ----.-,-.--- -­-­­­­--­- - ------ --- ­ - -- - ­- -- � -, , , I. T�r -,,-v --pr , - �� 7­��, T 17-1 �1�7 ------�-. -7,­-- I � , -7 -­------W-tT� - "I .,�� , 1'� . - -, -- �l --- , zi, 1..`��77­,F.f , � .� 4 - v �,- ­ �-', � , .1�� 1��Y 'I I�.�!'��,� - ., b , " � I , ." I " , ­�11'."-` , ` , 17777" �� " , , - 11 , .�J, ,.��,.,�J,I - .I I " 371*--F`��- , - - , I " �,,,,,,� I ,,�, ­.11 I, - K � �­ " e If� .',,c , ,��- ; 7. , !"Z, - -�Z-,.� I", , � , o, � - ': � ". -1 '­ � ­ ­. ; . - ,,, , 'T � , , - - ,, � - -,,:, 11 I , . -. - "I �. I I.- - , ­�-- ,,,, " - , �.i I � � " " , , ,, ,,,,�," ­ � . - ,--.I-- 1­ , Q, . . 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" SECTIW�N A -A ALL fx,ME7 PPEs FKIM THE �� 1" _ 2000' +!-_ 10' min. from •NOTE: ALL PIPES ARE TO BE 4 SCHEDULE 40 P.V.C. house to septic tank _ PROFILE VIEW OF LEACHING SYSTEM SET'�" FOR AT LEAS`T°z FT. u• CONCRETE COVER �,r Existing Foundation ton* cowry must be septic r9 within 6 in. of finished geode .-.•,:,•y,+� 2• CF ' Groae ow Septic ton* - 99.00 �fiode over o-Box - g6.00 i--trod*ore.SAS - g9.00 3' of 1/8" - 1/4" wosned Peostone ,,• K�so MET f/ UTs 3/4" to 1 1/2 washed Crushed Stone 1S.S•a;•^ OUTLET •, ,"� 12• tAti s 0.02 3 HOLE H-10 ! s n Bur TOP OF SAS - 96.00 chill DIST. BOX J' Mox,nt„m Cover �• �- '^ k,d >r r EXIST s-0.01 or Greoter ... .�r., ' 2 WAY ILA 10 uT 1.000 GAL. s- o of root ".'ss AMEN.;EXIST. PIPE 4" - SCH. 4o T 1.rs' �+ d F1?dt EXIST. FDl1NDATIDN j SEPTIC TAB 20 r` 20 /-r'"""""''"" CROSS-SECTION 9 �orGr A��� Roo n H-10 1 In o 0 o PLAN SECTION N o 0 00 0 o C3 S I 2 CONCRETE FULL rOUNW c p ,rj o+ • C3 o C] Ct O F = t o +' 6 4'„ 3 units a 8.5• a 25.5' 3 HOLE H-10 DISTRIBUTION BOX SYSTEM PROFILE 6 in.or 3/4--t 1/2- " ,�� 25.5' c compacted hone 5 u 'v 11 a +� �L NOT TO SCALE Not to Scale - e . o Effective vkftn t 4 4 LOCUS l"I A F c Effective slength - 6 in.of 3/4'-1 1/2' GENERAL NOTES compocted stone o$ SOIL ABSORPTION SYSTEM (SAS) 1. Contractor is responsible for Digsofe notification Bottom---of---Test- ---- Hole t Elev.-=87.00 500 - C (H-10) LEACHING UNITS / WIGGINS PRECAST and protection of all underground utilities and pipes. -------- --- ----- --- -- Elevations'Aooroximate Based on Existing Information and Field Conditions_ 2. The septic tank and distribution box shall be set Not to Scale Trench Extension to be Constructed at Some Elevation as Ezistinqen Trch. level on 6" Of 3/4"-1 1/2" stone. 3. Bockfill should be clean sond or grovel with no stones over 3" in size. 4. This system is subject to inspection during installation by Cormen E. Shay - Environmental Services, Inc. PERCOLATION TEST II! 5. The contractor shall install this system in accordance with Title V of the Massachusetts state code, the approved plan and Local Regulations. Date of Percolation Test: JANUARY 6, 2002 - 6. If, during installation the contractor encounters any Test Performed By. CARMEN E. SHAY, R.S., C.S.E. a0 soil conditions or site conditions that are different Results Witnessed By. WAIVER ( per Barnstable B.O.H.) O O O from those shown on the soil log or in our des,gn Excavator: Roberts Septic Services I 1 , installation must halt & immediate notification ba Percolation Rate: Less Than 2 MPI 1 + ++ I 1 I t mode to Carmen E. Shay - Environmental Services, Inc. N 20d f6 30 W Inr , I 1 .9 AJ + r 7. No vehicle 'or heavy machinery shalt drive over the 1 170.00 1 i septic system unless noted as H-20 septic components. 1 i r 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. Test Hole 1 I f • , 1 NO. 1 1 I � 19.31 I 1 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. r I DEPTH sorts ELEv. 3 Q i I 1 10. All solid piping, tees & fittings shall be 4" dioreter 3 LOT 6 Schedule 40 NSF PVC pipes with water tight joi-its. 0 99.00 I t # j ( - 13__ 1 t Loom I.1 p I + 11. Municipal Water is Connected to The Residence and Abutting p f7,000 Square Feet +/- t I I I + Sand I 1 19.5'I I �- I Properties Within 150 Feet. - r �i r 20 ►- O 1 I 1 to YR 3/2 �. ! 1 1 I ! I + 0--6- A. 9aso �_ ;. ASPHALT r THE PROPERTY LINES ARE APPROXIMATE AND NEW D-BGx I t COMPILED-FROM THE SURVEY PLAN GENERATED BY i• DRIVEWAY t Loamy I q % %Sand + % GARAGE + 1 J. MONAHAN JR. & ASSOC., RLS OF S. DENNIS, MA to rR 5/6 O ` t1 33• I W,• • _^________L-___ __ I ENTITLED " PLAN OF LAND OF LOT, #6 LARCH LANE, IN CENTERVILLE, MA" 6"_ 36" B. 96.00 DATED APRIL 4, 1986, AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN Medium 0 O ���� + 1 ?;: • 1 11 C % = IT SHOULD BE USED FOR NO PURPOSE OTHER THAN Sand Exist. Leach' I � ��� hrenc i<;� i�'LI DECK t 25 C7/4 7� ��\\ (13' w x 2at`L) on �.r r It O ,\ THE SEPTIC SYSTEM INSTALLATION. 36"- 144 + EXISTING 1 + BEDROOM I ��___96 ~O EXISTING STONE ON END OF TRENCH LEACH PIT TO BE PUMPED/ REMOVED. , HOUSE o NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE #23 FROM THE EXISTING_ LEACH AREA TO BE DISPOSED EXIST.' 1000 gol i OF AS PER BOARD OF HEALTH SPECIFICATIONS. Septic%Tank t ,mot Perc # \�� i i l . thtinicipol Woter�i 1` ' LEGEND De th to Pe1rc: 36" to 54" Cl) ` I I + , �{ Perc Rate- Less Tho 2 MPI Groundwater Not Observed O % , `` , No Observed ESHWT DENOTES PROPOSED ADJUSTED H2O Elev. = None I , `, , 104X 1 co \\ 11 i tt ; � _ SPOT GRADE 1 170.00' 1 o X 104.46 DENOTES EXISTING \ - SPOT GRADE N 20d 16' 30" W 1 +� -• 11 cn Icfl a pO `, PL PROPERTY LINE 96P PROPOSED CONTOUR v� co - - - - - -97 EXISTING CONTOUR DEEP TEST HOLE & 2-18" DIAM AccEss MANHOLES ® PERCOLATION TEST LOCATION 8 6 FOOT STOCKADE FENCE \ a THE ACCESS COVERS FOR THE SEPTIC TANK, INLET / -- 1 ---- / DISTRIBUTION BOX AND LEACHING COMPONENT - - OUT ET SET DEEPER THAN 6 INCHES BELOW FINISHED • - GRADE SHALL BE RAISED TO WITHIN 6" OF PLOT LAN FINISHED GRADEn �T - INSTALL TUF-TITE GAS BAFFLES OR EOUALS 0 LO 40 50 - ; OF PROPOSED SEPTIC SYSTEM UPGRADE STEEL REINFORCED PRECAST CONCRETE NONE PLAN VIEW PREPARED FOR 3-24" REMOVABLE COVERS SCALE: 1"=20' M S . LAPO RC H IA CAN NAD� AT ,- - # 23 LARCH LANE 3" in. clearance 8" min. IT' INL[t'T INLET -_ --_T-_t�_ min- inlet to outlet 6,min -- _ OUTLET CENTERVILLE MA ,D•1„ TE;�u d level Design Calct�(ations tP s -r -- t--- s' -r __ ----- r' Number of Bedrooms: 4 Equivalent to 440 Gol./Doyt e GftWt. •• io�d devth Garbage Grinder: NoH 1q 9 PREPARED BY:. e' Leaching Capacity Required: 4� �o1./Day (MIN. PER TITLE V) o�� cyG f7 7� E. jJ� ?T Septic Tank - 2 x 440 Gal. Da = 880 USE EXIST. 1,000 GAL. Septic Tank. .L1 1�/ �I n 1" 'i SOIL ABSORPTION AREA: Using percolotion rote of <2 min./inch "'• A • g•_o-• • 4'.-10" Bottom Area: 0.74 gal/sq. ft. x 435.5 sq. ft. _ 322.5 gallons SH ENVIRONMENTAL SERVICES, INC.1 Sidewo0 Area- 0.74 gol./sq ft. x 186 sq. ft. = 137.5 gallons Providing: = 460 gallons •Q �O ' P.Q. BO CROSS SECTION END-SECTION X 627 orsTeR EAST FALMOUTH, MA 02536 SgN►TA R�P:',A' USE EXISTING 1000 GALLON H- 10 ' SEPTIC TANK Use: ADD (1) LEACHING CHAMBER OF MATCHING SIZE TO EXISTING 13' x 24' TRENCH. . ; TEL/FAX : 508-548-0796 UNITS TO HAVE A 2' EFFECTIVE DEPTH. TO BE USED WITH 4' OF WASHED STONE ON THE SIDES SCALE: 1 "=20' DRAWN BY: CES DATE: JAN. 9, 2003.� NOT TO SCALE' AND 4' OF WASHED STONE ON THE END OF tAS. - FINAL TRENCH DIMENSION TO BE 13 FEET WIDE BY 33.5 FEET LONG AND 2 FOOT EFFECTIVE DEPTH. PROJECT#SD380 FILENAME: SD38OPP.DWG SHEET 1 OF 1