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HomeMy WebLinkAbout0035 LOOMIS LANE - Health 35 Loomis Lane Centerville A= 230— 101 —001 UPC 12534 � No.2-153LOR HASTINGS, MN r L-b.efe.efum 4:08F"1 BARNSTABLE BOARD Of FEALTH NO.769 P.1i1 Town of Barnstable Regulatory Services Thomas F.C,eiler,Director Public Health Division Y Thomas McKean,Director 200 Main street, Hyannis,MA, 0201 Office: 508-96246" Fax: 508-7W6304 Date: C , Z 1 - o q� Sewage Permit# 66(, 124' Aueesor°s Map/Pareel '3a t u faller&Designer Certification Form Designer: J&y161 �,7h vli yr PC PAS Installer; Address: Address: Va f i_ f a(„,,,,,,,I4 R 9 MA .� 2sf�7 ��t�a�� L.(F --(h A 62 ss 2_ -2 t-o E was issued a permit to install a ( e} infer) septic s at _ 5 1-�,b M US k,i i C EWf-P-a L.;i I I P MAbased on a design drawn by (address) �� C dated 2 design} certify that the septic syf3U=referenced above was installed substantially according to the design, which may include=nor approved changes such, as lateral relocation of the distribution box and/or septic tank. Stripou as inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major ch anges hanger (i.e. greater thau 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 wbuilt by designer to follow. Stripout(if required ►�aa inspected and the soils were found satisfactoryDAIPID . r ` C to THULIN 'n er s S, e} 3 NO.29975^�i� ' 9 ' iM esigner's Signature) ( D tp Ham) PSE RETURN TO B ABLE UBLIC ALTH D S C1N CER ATE OF CO LIANG WII, OT BE ISS D BOTHIS FORM An A BUILT_CARD An RECEIVED Y THE BARNSTABO L P HEAI.T1<I D ION. 1 U. q:bf to fb m W(Wiffi► &3ffam f�amdoc Y Y E Q U A Q U E To 40 0 20. 40 80 160 LAKE 0,6 �r _ . , ( IN FEET ) w cp: 1 inch. 40 ft. /o vo s r0 .Z c0 •w A B DESCRIPTION ELEV b 27.3 28.0 ST INV IN CL TANK 49.11' Q 23.0 37.8 ST INV OUT 48.89 S , , 119.00, �C 19.9 40.9 DBOX INV OUT 46.36 9 O S 38.4 53.6 INSPECTION PORT 1 18 F O G J W CT O O a m LOT 5 B A D BOX - O 1500 GAL. TANK ' 9 20 E �x. . Z N un 45.00' YLn 1 , � s 0. 11'2 _ � • w N `S8• >> 2 o INSPECTION PORT c� COCOO 0s' 7 8 ADS BIODIFFUSSER,•1100B0 gt INV.,IN 46..16 6' .a DAVI. C) C �� O THULIN in cD OD. 1� o No:29976 ou 70�53�32 2 91 CIVIL �O ;, p : 4�. N r�1 SIT�P. � o 'T .', 123.12' '• SAS AS—BUILT PLAN 4019 Z CB_DH .:+oNo, N 74-48 2a .E-.; N w zo 35 LOOMIS LANE LO 0 CENTERVILLE MASSACHUSETTS Op W . , . p: . SCALE: 1" _ 40' DATE: 2-21708 � TBM TOP CB." 'C Cl � ELEV= 51.81 a. „„x ,. NGVD �; � DAVID C. THULIN, .PE, PLS N 80'58 35' E 211 MILL ROAD - 60.00' EAST SANDWICH, MASSACHUSETTS 02537 PH I N N E YS LANE (508) 688-2345 FAX (508) SM-7259 .v PREP. FOR: ASSURANCE DRAWN BY: PST I CHKD BY: DCT JOB No: 07-021 REV. L'7-Z 9 SHEET 1 -\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY & ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 °Q, s DEVAL L.PATRICK IAN A.BOWLES Governor Secretary TIMOTHY P.MURRAY ARLEEN O'DONNELL Lieutenant Governor Commissioner MODIFIED CERTIFICATION FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Advanced Drainage Systems, Inc, 4640 Trueman Boulevard Hilliard, OH 43026 Trade name of technology and model: Biodiffuser; 14 inch and 16 inch High Capacity, 11 inch Standard and Bio 2 and Bio 3 Biodiffusers, ARC 36, and ARC 36HC (hereinafter the "System"). Schematic drawings of each model are attached. Transmittal Number: W036726 Date of Issuance: October 3, 2003, Revised December 17, 2003, Revised June 14, 2006 Modified July 19, 2007 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Advanced Drainage Systems, Inc., 4640 Trueman Boulevard, Hilliard, OH 43026 (hereinafter "the Company"), for General Use of the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. July 19 2007 Glenn Haas, Acting Assistant Commissioner Date Bureau of Resource Protection Department of Environmental Protection This information is available in alternate format.Call Donald M.Gomes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. MassDEP on the World Wide Web: http://www.mass.gov/dep 0 Printed on Recycled Paper Advanced Drainage Systems Modified Certification for General Use Page 2 of 7 I. Purpose 1. The purpose of this Certification is to allow use of the System in Massachusetts, on a General Use basis. 2. With the necessary permits and approvals required by 310 CMR 15.000, this Certification authorizes the use of the System in Massachusetts. 3. The System may be installed on all facilities where a system in compliance with 310 CMR 15.000 exists on site or could be built and for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the local approving authority, or by DEP if DEP approval is required by 310 CMR 15.000. II. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1. Chamber Dimensions Dimensions Invert Model W x L x H Height Inches Inches I I" Standard Biodiffuser 34 x 76 x 11 6.5 ARC36 34.5x60x13 7.13 14"High Capacity Biodiffuser 34 x 76 x 14 9 16"High Capacity Biodiffuser 34 x 75 x 16 11.3 ARC 36HC 34.5 x 60 x 16 10.75 Bio 2 Biodiffuser 15 x 87 x 12 6.87 Bio 3 Biodiffuser 22 x 87 x 12 6.87 2. The System is an open-bottom leaching unit molded from high density, high molecular weight polyethylene (HDPE) Type III, Class A or B, Category 1 or 3 or Polypropylene Group 03, Class 3, Grade 0. It can be installed without aggregate or distribution pipe as an absorption trench in accordance with the requirements in 310 CMR 15.251 or as a bed or field in accordance with the requirements in 310 CMR 15.252. 3. The use of aggregate as specified in 310 CMR 15.247 is not necessary with the System when installed as a trench, bed or field. When designed with aggregate in accordance with 310 CMR 15.253, the System shall be designed in accordance with Section II item 10. I Advanced Drainage Systems Modified Certification for General Use Page 3 of 7 4. The minimum separation between any two trenches shall be as specified in 310 CMR 15.251. 5. The requirement that the Chamber installed in trench configuration as specified in 310 CMR 15.253(6) be provided with inlets at intervals not to exceed 20 feet is not applicable to the System. In accordance with 310 CMR 15.240 (13) a minimum of one inspection inlet shall be installed per system. The inlet shall be capped with a screw type cap and accessible to within three inches of finish grade. 6. For new construction, the applicant can size the System in a trench configuration without a ggregate, a sing t he e ffective 1 caching a reas presented in Table 2. No System shall be designed and constructed with a soil absorption system area of less than 400 square feet of effective area. Table 2. Effective Leaching Area for New Construction And Remedial Sites Effective Model Leaching' Area SF/LF 11" Standard Biodiffuser 6.5 ARC 36 6.8 14" High Capacity Biodiffuser 7.2 16"High Capacity Biodiffuser 7.9 ARC 36HC 7.8 Bio 2 Biodiffuser 4.0 Bio 3 Biodiffuser 5.0 1. Effective leaching area is equal to 1.67 (bottom width+(2x invert height)) 7. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Table 2. above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 8. In accordance with 310 CMR 15.240 (6) absorption trenches should be used whenever possible. When the System is installed for new construction without aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the System shall be designed using the effective leaching area for the bottom width presented in Table 3. Chambers shall be spaced a minimum of six inches apart i Advanced Drainage Systems Modified Certification for General Use Page 4 of 7 (edge-to-edge) when used in a bed configuration. No system shall be designed and constructed with a leaching area of less than 400 square feet of effective area. Table 3 Effective Leaching Area for Bed or Field Configuration Effective Model Leaching' Area SF/LF 11" Standard Biodiffuser 4.7 ARC 36 4.8 14"High Capacity Biodiffuser 4.7 16"High Capacity Biodiffuser 4.7 ARC 36HC 4.8 Bio 2 Biodiffuser 2.1 Bio 3 Biodiffuser 3.1 1. Effective Leaching area is equal to 1.67 times bottom width only. 9. The System, when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in Table 3 above or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 10. The System, when installed as specified in 310 CMR 15.253: Pits, Galleries, or Chambers, shall have an aggregate base and/or be surrounded by aggregate and shall be sized as specified in 310 CMR 15.253 (1) (a) and (b), effective leaching area is equal to 1.0 times a conventional aggregate system. Effective depth can be increased to two feet with the corresponding addition of up to 17.5 inches of base aggregate for the 11 inch Standard BioDiffuser to up to 12.7 inches for the 16 inch High Capacity BioDiffuser. Bottom width can be increased by two to eight SF/LF with the corresponding addition of one to four feet of aggregate per side. 11. When the System is installed as specified in 310 CMR 15.255: Construction in Fill, the finished 15 foot horizontal separation distance, item (2), shall be measured from the from the top of the chamber. III. General Conditions 1. The provisions of 310 CMR 15.000 are applicable to the use of the System, except those that specifically have been varied by the terms of this Certification. f Advanced Drainage Systems Modified Certification for General Use Page 5 of 7 2. The facility served by the System, and the System itself, shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 3. In accordance with applicable law, the Department and the local approving authority in ay r equire t he S ystem o wrier to cease use of the System and/or to take any other action as it deems necessary to protect public health, safety, welfare or the environment. 4. The Department has not determined that the performance of the System will provide a level of protection to the environment that is at least equivalent to that of a s ewer. Accordingly, no new S ystem shall be constructed, and no System shall be upgraded or expanded, if it is feasible to connect the facility to a sanitary sewer, unless allowed pursuant to 310 CMR 15.004. 5. Design, installation and use of the System shall be in strict conformance with the Company's DEP approved plans and specifications and 310 CMR 15.000, subject to this Certification. IV. Conditions Applicable to the System Owner 1. The System is approved for the treatment and disposal of sanitary sewage only. Any wastes that are non-sanitary sewage generated or used at the facility served by the System shall not be introduced into the on-site sewage disposal system and shall be lawfully disposed of 2. For new construction, the owner initially shall size a soil absorption system in accordance with 310 CMR 15.242 to demonstrate that a conventional Title 5 soil adsorption system using aggregate, including a reserve area, can be installed on the site. The owner may than size the soil absorption system for the System. The total area required for the aggregate system, which may include the area designated for the System, and a reserve area shall be preserved and the owner shall ensure that no permanent structures or other structures are constructed on that area and that the area is not disturbed in any manner that will render it unusable for future installation of a conventional Title 5 soil absorption system. 3. The System owner shall at all times properly operate and maintain the on-site sewage disposal system. 4. The System owner shall furnish the Department any information that the Department requests regarding the operation and performance of the System, within 21 days of the date of receipt of that request. 5. No System owner shall authorize or allow the installation of the System other than by a person trained by the Company to install the System. V. Conditions Applicable to the Company 1. By January 3 1 st of each year, the Company shall submit to the Department a report, signed by a corporate officer, general partner, or Company owner that contains information on the System for the previous calendar year. The report Advanced Drainage Systems Modified Certification for General Use Page 6 of 7 shall state known failures, malfunctions, and corrective actions taken for the System as well as the date and address of each event. 2. The Company shall notify the Department's Director of Watershed Permitting at least 30 days in advance of any proposed transfer of ownership of the technology for which this Certification is issued. Said notification shall include the name and a ddress o f t he p roposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them. All provisions of this Certification applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 3. The Company shall furnish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. 4. Prior to any sale of the System, the Company shall provide the purchaser with a copy of this Certification. In any contract for distribution or sale of the System, the Company shall require the distributor or seller to provide the purchaser of the System, prior to any sale of the System, with a copy of this Certification. 5. The Company shall prepare and provide the Department an installation manual specifically detailing procedures for installation of its System. T he Company shall institute and maintain a training program in the proper installation of its System in accordance with the manual and provide a training course at least annually for prospective installers. The Company shall certify that installers have passed the Company's training qualifications, maintain a list of certified installers, submit a copy to the Department, and update the list annually. Updated lists shall be forwarded to the Department. 6. The Company shall not sell the System to installers unless they are trained to install these Systems by the Company. VI. Conditions Applicable to Installers of the System 1. Each Installer shall install the System in accordance with Company training on the installation of the System and the conditions of this Certification. 2. No Installer shall install the System unless the Installer has been trained by the Company on installation of the System. VII. Reporting I. All submittals of notices and documents to the Department required by this Certification shall be submitted to: Director Wastewater Permitting Program Department of Environmental Protection One Winter Street - 5th floor i Advanced Drainage Systems Modified Certification for General Use Page 7 of 7 Boston, Massachusetts 02108 VIII. Rights of the Department 1. The Department may suspend, modify or revoke this Certification for cause, including, but not limited to, non-compliance with the terms of this Certification, non-payment of an annual compliance assurance fee, for obtaining the Certification by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Certification, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Certification, the System, the owner, or operator of the System and the Company. 4 1 ff rr- �z rM��ce OP�h'Cl pl '�`jj,r ct e v A CC,� 1 are i�� .11tdr �w,�c C AGa GOD WINNATER WORKS 508-862-0166 508-862-1666-FAX DATE; z COMPANY:�� ATTN: FAX : FROM: C �( PAGES (INCLUDING COVER SHEET'): SUBJECT: l d tl0 'ON flivMNIM 003 3dvD 80H '9�1 '8= d IF',;6--:26-08 06 a 21A PVA ' Inc. A mnhsiili,iry of 4640 T uon nn Fllvd. Hilliuril, OH 41 020 PH; 8(X)-921-W10 Rix: 614,AS8.0204 Advanced Uruii:jF�Sy �cma. Inc, MWIL111MAUM-14 01'Hi0l)if1 .SVVTM LOAC11111$ CIRRI UIN February 25, 2005 Mr. Bob Sousa Cape Cod Winwater Works 174 Airport Road Hyannis, MA RE: SioDiffuser Standard Model (1100BD) Chamber Installation Town of Barnstable Dear Bob; It Is our understanding that D & P Paving has installed an onsite wastewater disposal systaum for the Town of Barnstable. We understand as well that the system was designed by David Tuelin, and called for use of our BioDiffuser Standard Model (110013D)chambers In an H-20 load bearing application. Please be informed by way of this letter that ADS/Rancor will fully warranty the performance of the Sio®iffuser Standard Model (11001313) chambers in this H-20 load bearing application. If you or others have any questions or concerns about this application, please refer them to our area onsite market specialist, Steve Minor, at 207-240-5967, Sincerely, Dick Bachelder ADS, Inc./PSA, Inc. CC: Mr. )im Talarico,ADS/Rancor Mr, Steve Minor, ADS/Hancor Z 'd ti10 'ON f31dMNIM COD 3db'D W E :0l 80H '9Z '8: j � �nl '� WGS i D.Etu i d. Thu 1 i r PE PLS FAX NO. 508 8887259 Feb. 25 2008 12:28PM 'P1 7 s' ® ' r , � E N%f 1 N BEE R I rN" 'Ug" & RESEARCOH 4 SERVICES ' FINAL REPORT Witness Testing: H-20 Load Testing of the Slo®t-ffuser'rm 16" High Capacity(1600 BID) Leaching Chamber to lAPMQ Standard PS 63-2005 by - Amy Harrison, Project Manager Engineering & Research Services NSF International Test Facility: Gerken Residence V-133 State Route 106 Napoleon, OH 43546-9766 Sponsor. ADS, Inc. 4640 Trueman Blvd. Hilliard, OH 43026 April 25, 2007 tde,p,art Number 07l 1 ADS,Inc. Copyright®NSF International ApAl 25,2007 PA 4 900SO5 1 of 6 Thin$report may not be distributed without the"tten permission of NsF Intemational David Thu 1 i n PE PLS FAX N0. 508 8887259 Feb. 25 2008 12:29PM F'3 NSF representative observed at the open.end. The chambers were then uncovered and exposed for visual Inspection. Testing Results- Each evaluated section of the chamber returned to its original geometry despite experiencing some deflection during each pass at each test load. There was no sign of damage or deformation to the joints or center of the assembly upon Inspection. This complies with the requirements of section 6.1.1 of the IAPM0 Standard. Annex A Product Specifications BioDifftaerO At Grade System Detail 18" High. Capacity Chamber ru�Tnnt Tr�1J68.L +(� OR APMVn FILL 1. 6CCAiVA7E TPFIA,MOC TO PwPER zenw Al:, REAL=3 BY CUM AMD LIICAL CO=. 2, CMOTH MaZE611LAMUG III THE EXCAVATUX a LEVU; FLAT CLfl =32 MMRCU i 4-�WRL C 210WARSR LAACLIINS ERMMM AND .1 WN MAL RNOPLATC2 7M.-tER IN IRENMEWL A, INSTALL LkWt!:9L 09 COO No tc LM Rd PLrAEL:VISE/BACLFW.. L RaM n1T Pipe HCLC aPLx an as r.4 CjC 1L9� FU=Olt lir"CL.WC C0W&W.11LET PIPES ra FILL LIY11EWAL L AREA YO TOP CHAB®EG MLTM WIVE MML CURZ$A1®Ce FIDE UMVEL NOT MZU 1C L SM- 0 Hb%Vr CLAY.JILT,qR=Q13 MALL SE IN:WUM 7. WALK I111 FILL TO Lbmaacr =L AL@G smrs nF 7t• MUDWi•USM, THII I3 VMT IHIPMANT To ACHIEVE LOAD RATM 8. OIiv6R ZI=IFn=ft U=KrNo WAVE= TIC A 1¢mmil OF LB• COVE® Wom LARGE RUCHM OR ?ERRd$ LN'CIV2R ItlATE�lL VMTH AMLUMS R'CF SIDE%MLL=MI mLi. MHz r } l7 11w a � Report Number 07/21 ADS.Inc. Copyright 0 NSF International April 25,2007 PA 4 9005035 4 of 6 This report may hot he distributed writhaut the written permission of NSF international I =RET-1 Da u i d Thu 1 i n PE PLS FAX NO. 508 8887259 Feb. 25 2008 12:29PM P2 NSI!Yha e;rnahansl Q6 Tiesting Organl2atioan: NSF International Phone: 734-769-8010 789 N. Dixboro Road Ann Arbor, MI 48105 Test Date: April 18,2007 Report Issuance Date: April 25, 2007 Deport Revision Date: N.A. client: ADS, Inc. Phone: 614.658-0284 4640 Trueman Blvd. HIIIIard,OH 43026 Product ription: BiOMuseff"16"High Capacity(1600 BD) Leaching Chamber +C ancHuding Summary: All portions of the test performed were under continuous and direct supervision of a representative of NSF International. This product complies with the requirements Section 6.1 of IAPMO Standard PS 63-2005. Testing Witnessed By: NSF Representative: Date: Te0hnical Manager: Date: �2� ®7 P of IV,I CNjr�!'�:. 0 e Si'EVN c�J / c�? �•�CtifVtEx :l d Iii �aRh'QFESSti��q~� Repbft Numbw 07121 ADS,Inc. Copyright®NSF International April 25,2007 PA 0 9006035 2 of 6 This report may not be distributed vAthout the written permission of NSF Intematlonal TOWN OF BARNSTABLE 2 CATION j koo 0-v l5 SEWAGE# V LAGE C°-�rufaae)t Cle ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. AR/u'l)lfi'!VOO C/te-,riy .1A SEPTIC TANK CAPACITY A/ & I L- 0 :tQcW � r LEACHING FACILITY:(type) 117r (size �5"O r X y No +E NO.OF BEDROOMS _ OWNER PERMIT DATE: Z e4 COMPLIANCE DATE: Z Z /— O 9 Separation Distance Between he: i Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility > 7 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200,feet of leaching facility) NA Feet Edge of Wetland and-Leaching Facility(If any wetlands exist within 300 feet of leaching facility) N A Feet FURNISHED BY t919 MA V/Ci���'r` —TA boil erg 3 �•� Si' iA L). , 1.0 3-L t V No. THE COMMONWEALTH OF MASSACi4rUS`ETTS" FEE el-YBCSARD OF HEALTH ' g< OF ✓`n </ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - omp st/ lete System ❑In i idual Co onents I NO 17- �j v� ocation er's �, Map/P rcel# Address Lot# Telephone# Installer's Name Desk e' Nam fit.Rd asf��zL I Ili /4'l�'/G�va`�1� Address —� Address Telephone# Telep one# Type of Building: 6A 7 -P—C VIV 'i7 c".C� Lot Size 4C,. rtyv Sq.feet Dwelling—No.of Bedrooms Garbage Grinder (� Other—Type of Building •� No.of persons Showers.-(-4 Cafeteria .(_. Other fixtures Design Flow(min.req tired)-, ~('7 gpd Calculated design flow gpd Design flow provided gpd, Plan: Date Number of she is Revision Date Title Description of Soil(s) 0'" t,� Soil Evaluator Form No.K Name of Soil Evaluator Date f v luaioq I o ,20d t'% DESCRIPTION OF REPAIRS OR ALTERATIONS - e.(ci Ian The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TIoq� 3 -3vd TLE 5 and ther a rees not to I the system in operation until a Certi cote of Compliance has been issued by the Board of Health. igned C.�I Date e / G i n0 a P vt- l�e FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. 2OU(n-- 1 ?y THEn( COMMONWEALTH OF MASSACHUSETTS FEE 15V tR� rnS ��� BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( Repair/� ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at S L- /M 1-An.e T p� /� as described in the application for Disposal System Construction Permit No. . oo4 dated Provided: Construction shall be completed within three years of the date of this pert.AxlXocal conditl ns must be met. Date / 3( /) �O Board of Health / , FORM 2 - DSCP DEP APPROVED FORM 5/96 rd FORM 1255 (REV 5/96) H&W HOBBSE&WARREN TM PUBLISHERS- BOSTON t NO. E, OM'IVIONWEALTH OF MASSAC�rCU�S.ETTS FEE ` N r` .� -B QA'R"D O F H ESA LT I-[' t APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (-) Upgrad"e"e ( ) Abandon ( ) - ®}C mo plete System ❑Inoiit �A �iduual_Coi. mponents - tt I rr- Location Qwger',Nays F ' /�IurJ 2 �G L /y�• DTt! r o Ir � � �7 Map/Par el# v Address f Lot# - Telephone# ;AAmAA)W UtCr�v rv�; T�u/ire Installer's Name Des�gne s Nam e��rrxv, 1 1r. Address § Address Cn k _7 �7 - 7/y Z - 2ef.� Telephone# Telep one# Type of Building: �, '4es��i >"l-C Lot Size /t � � Sq.feet Dwelling—No.of Bedrooms Garbage Grinder (..4 Other—Type of Building No.of persons Showers Cafeteria (), Other fixtures Design Flow(min.required). gpd Calculated design,flow gpd Design flow provided gpd Plan: Date_ Number of sheets �' Revision Date — Title _ Aga S:zne Description of Soil(s) Soil Evaluator Form No hi Name of Soil Evaluator —rl,,/I("A Date ofvaluation I1 --µ-� DESCRIPTION OF REPAIRS OR ALTERATIONS ' *I The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and rther agrees not to place the system in/operation until a Certificate of Compliance has been issued by the Board of Health. p Signed VC l� w Date B° peeti _ CNN 31.y 0 d6i D11 F(� I �U S(h�P 1 = P �or vwtr 4, fd 'an rP� vi'M(f, � I , .-FORM' I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 — —————---.-- ---- r,-- —.-----_ —yam, ———_; T No. 006 �y THE COMMONIIVEALTH OF MASSACHUSETTS FEE 15y- '-'` gmros->J YC BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) t Complete System The unde•signed hereby certify that the Sewage Disposal System;Constructed'(,Repaired( ),Upgraded( ),Abandoned( ) at 3 S L&Ao i i 4 oa n o j ce o4el'I& has been installed in accordance with the provisions of 310�MR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. UU "19 Y dated 3I70/ Approved Design Flow . Nu (gpd) Installer t('\) A ��/ t .,YCI_ I Designer: Inspector / t1.l.. (��.� Date 2�� %,� The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. - FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 — %AjT aS - -- TL — w 01 �i:_n-� 1:CJJM1n_ i �_ - �. II 1 h�' I \ \ b CoLir 1 N - Oeek l_ -'. 2�Is p q tr t'cruFs • \ -' I i `i — _LiUrj.SUT1-E `� •`�,i / I-- F SII ,nl III Hk_ j FL 2..o 41 Ass WL f _ \ of ( Id - � I 1 \ -14 .......... ur-- '21 rill I p n, ZIP Q - An ov m ol Ln ®ro(v— -V, j] �d2^ \ / ' t VfJ I-1 N�SNEn 0 / n \ -I - lhll_4 c0+., (IYl lv'll j i i ji F Town of Barnstable P# 10863 QDepartment of Regulatory Services MA" ' Public Health Division Date 11/30/04 200 Main Street; Hyannis Ma 02601 ED µ►il Date Scheduled 11/30/04 Time 10:00 Fee Pd.S 100 Soil Suitability Assessment for Sewage Disposal Performed By:David C.Thulin Witnessed By: David Stanton LOCATION & GENERAL INFORMATION Location Address: 35 Loomis Lane O\vner's Name: Loomis Lane Realty Trust ✓��� Address: 204 Route 28 ,W. Yarmouth MA Assessor's Map/Parcel: 230101001 Engineer's Name: David C. Thulin NEW CONSTRUCTION EE REPAIR E] Telephone# 508-888-7259 Land Use Vacant Lot Slopes(%) 2-10% Surface Stones NA Distances from: Open Water Body 190 ft Possible Wet Area NA ft Drinking Water Well >200 ft Drainage Way NA ft Property Line 30 ft Other NA ft SKETCH:(Street name;dimensions of lot exact locations of test holes&perc tests;locate wetlands in proximity to holes) aL�Gel Parent material(geologic) Glacial Outwash Depth to Bedrock>20' Depth to Ground water:Standing Water in Hole:NA Weeping from Pit FaceNA Estimated Seasonal High Groundwater 15 Estimated from lake elevation DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: See above Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date 11/93 Time 10:00 Observation Hole# 1 Time at 9' P 4811 Time at 6' Depth of Perc Start Pre-soak Time(�it7 0:00 Time at(9'-6") End Pre-soak 8.00 25 gak Rate Min./Inch <5 Site Suitability Assesment: Site Passed a] Site Failed:_ Additional Testing needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back * * If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to the beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 0-10" Ap I Loam ! 10YR42 NA Org Loam Friable 10-28" B ; Sandy Loam i 10YR6/6 NA Friable, Roots ` 28-48 C 1 Coarse Sand 10YR6/4 NA Loose 48-120 C2 M C Sand i 10YR7/4 NA Loose DEEP OBSERVATION HOLE LOG Hole# 2 Depth fi-om Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 0-8" Ap !1 Loam 10YR42 NA Org. Loam Friable 8-36" j B Sandy Loam 10YR6/6 NA Friable, Roots 36"-120" C I M C Sand 10YR7/4 NA Loose i r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency;%Gavel) ` DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottline (Structure,Stones,Boulders. Consistency,%Gravel) Flood Insurance Rate Man• Above 500 year flood boundary No0 Yes❑X Within 500 year boundry Noo Yes Within 100 year flood boundar Noo 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?_Yes If not,what is the depth of naturally occurring pervious material? NA Certification _ I certify that on 11/93 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was perfonned by me consistent with the required training, expertise and experien5.c)described in 31 QCMR 15.017. A � Date Signature / ANCLOO / MI5 / O 0 N W - N V ' 1 i 1 1 Q I 29 o 1 � 1 O wLn LLJ 1 a 180 z u 130, - I I _ I � N ' O '1041 z r 7 R i' z . � Z Q 150 P ' 7J7f�71-7/70 v17021fl BioDiffuser TM Standard & High Capacity Chamber Specifications 0 76" Chamber a 0_ _ Height 00 All three BioDiffuser sizes can withstand H-10 loads when installed with properly graded , Chamber and compacted soils. A mini- Height mum of 12" of cover is required for H-10 loads. The 14" High Capacity BioDiffuser End is designed for H-20 loads. A I minimum of 18" of cover is 34 required for H-20 loads. 4" Knockout Universal End Cap Available Sizes 11" 14" High 16" High Chambers Standard Capacity Capacity H-10 H-20 H-10 ADS Prod # 1100BD 1400BD 1600BD Length 76" 76" 76" Width 34" 34" 34" Invert 6.5" 9" 11 .3" Units / Pallet 51 38 45 Units / TL 1071 798 945 ADS / PSA BioDiffuser Chambers can be ordered in pallet quantities. Contact your ADS Customer Service for ordering details - 1-800-821-6710 BioDiffuser� `drench Installation Detail 11 Standard NOTES; L EXCAVATE TRENCHES TO PROPER WIDTH, AND PROPER DEPTH AS REQUIRED BY STATE AND LOCAL CODES. 2. SMOOTH IRREGULARITIES IN THE EXCAVATION, A LEVEL, FLAT SURFACE IS REQUIRED. 3, ASSEMBLE BI❑DIFFUSER LEACHING CHAMBERS AND UNIVERSAL ENDPLATES TOGETHER IN TRENCH(ES). 12' MIN, 4, INSTALL UNIVERSAL END CAP AND SECURE IN PLACE WITH 4' MAX, BACKFILL. 5, PUNCH OUT PIPE HOLE OPENINGS IN THE END PLATES AS NEEDED AND CONNECT INLET PIPES. 6. FILL SIDEWALL AREA TO TOP CHAMBERS WITH NATIVE 11' SOIL (COARSE SAND OR FINE GRAVEL MAY ALSO BE USED: I- 65' NO HEAVY CLAY, SILT, OR DEBRIS SHALL BE INCLU➢ED), IIII' 7, 'WALK IN' FILL TO COMPACT SOIL ALONG SIDES OF BI❑DIFFUSER. THIS IS VERY IMPORTANT TO ACHIEVE LOAD RATING. 36' 8, COVER BI❑DIFFUSER LEACHING CHAMBERS TO A MINIMUM OF 12' OF GRANULAR AFTER C❑NSOLIDATION FOR H-10 APPLICATI❑NS, AVOID LARGE ROCKS OR DEBRIS IN COVER MATERIAL. ADS STANDARD DETAILS DISCLAIMER- 'ADVANCED DRAINAGE SYSTEMS INC.VADS'>HAS PREPARED p REVISIONS THIS STANDARD DETAIL TO DEMONSTRATE ADS' RECOMMENDED INSTALLATION OF IT PRODUCTS BY DATE FOR THE DEPICTED APPLICATION, IN ADDITION TO ADS' RECOMMENDATIONS,THERE MAY BE OTHER NATIONAL, STATE, OR LOCAL SPECIFICATIONS THAT ARE PERTINENT TO THIS APPLICATION ADS'STANDARD DETAIL IS NOT INTENDED TO SUPERSEDE ANY NATIONAL, STATE, OR LOCAL SPECIFICATIONS,AND ADS' RECOMMENDS THAT THOSE REQUIREMENTS BE REVIEWED AND CONSULTED PRIOR TO THE INSTALLATION OF ADS'PRODUCTS. ADS HAS NOT AUTHORIZED, AND IT BEARS NO RESPONSIBILITY FCR, ANY REVISIONS,ALTERATIONS,OR DEVIATIONS FROM THIS ww w wmwm w onaw STANDARD DETAIL.' MAH 11.01.04 SM-901A DWG. SCALE:1:1 5 _s— — 7, t t •1 rA zF r 4vilk Wit, 1 IL a ��" i�'�>•,,. �' `-sue ...� ,�. �, r y r4�,r f y!� • �,•� -f r 0CATION SEWAGE PERMIT NO. Vj,LLAGE Le INSTA LLER'S NAME i ADDRESS 'JO44, a, B U I L D E R OR OWN ER e v � A7. DATE PERMIT . ISS IED DAT E COMPLIANCE ISSUED ]/�� r NA y VN p 0 I I:OC&TION : SEW&C,E PERMIT MO. �AG . IWSTQLLER5 MWE ADDRESS BUILDERS Q [ MF- ADDRESS DLNTE PERMIT ISSUED DATE COMPLI &MCE ISSUED : �' � _ '� > � . S� M ���� � No..... Fxa .�...----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . I�i.....OF...VAK.kk�./.1.A .11t�'................... Appl rkiun for Diupuuttl Works Cgunutrnr#iun Permit Application is hereby made for a Permit to Construct (�r Repair ( ) an Individual Sewage Disposal System at: ...... N'I��' ........................ 1.. ... .............................. .......`��. ........Location /dbress /) ................. ..------... ....._...---••--or-Lot •.No....'----.................»....».».._.. �jj IIWner Li Address ............. '^ Installer Address' ............. Type of Building Size Lot.ZU,5 .5.....Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building _.. No. of persons............................ Showers a YP g .........:....••----•--•- P ( ) — Cafeteria ( ) QOther fixtures ............................•-•----.............................................................. •--------.................... ............... W Design Flow..........._�.1.Q........................gallons per person per day. Total daily flow..."'..;... �,,,�................gallons. W Septic Tank—Liquid*capacityl&VO.gallons Length_ a'�. Width �-.i.O Diameter'--- . Depth,'- 1- 1 4.�) x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit Diameter......19 .... Depth below inlet.... ....... Total leaching area.Z67:...sq. ft. Z Other Distribution box ( Dosing tank ) Percolation Test Results Performed by......A. _m° vl...rj:.............. Date.... _/.. .... L P P Pit...l LT.�._. Depth to ground water..WjCf x .��. .,a Test Pit No. 1____...�._ f� Test Pit No. 2................mutes per inch Depth of Test Pit.................... Depth to ground water........................ a ................ ... ............. ........................................................................................ O Description of Soil.--. ........ ".'T 1. s t l..__ .40....-..7Z... ... ••-•- U -...!!J�?F -E�........ ....... LL t..... . �-- 1. N C-lair , ... nh�l�? ... . -.- ��C:?.......... UW ....••-•-•---------------------------------•--.............._......-•----...-----------................_•---.....-- Nature of pairs or Alterations A swer when ap licable..........�.. >`._._ . . . ?..✓....--- •�•-Q.�........... a,S... ................ Agreement: The undersigned ag�toall the, aforedescribed Individual Sewage Disposal System in accordance with the provisions of A I T LZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee 's a bo of heaal�th� Signed. ............... ........................................ .... �D�Da/ e z.� /A Application Approved B :3.....�»5... ate Application Disapproved for the following reasons:............................................................................................................--- ....--•--•...................................•--......---....-----..............................----.....................................--•-•----...........................................a.......... Date Permit No...... Issued_............... •'••............................. Date No.... :.�»».:»�/ Fag. .. � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...--... � i ....... Apli iration for Diopooal Works Tonotrudion Frrmit Application is hereby made for a Permit to Construct (-s)or Repair ( ) an Individual Sewage Disposal system at: _ 1 G0 le:UE.:Ie/ �'qI�ti�t � `7 ,.�G�a1�11� ��IJ �........ ....» . �......................... ..... ...... »••• �» ••�• Location.;,Address J -• •••• or Lot No. •~- •'�.: ....... ....... .:.................. ........... •......._.......... ..........._..................».»_».»--___ Qwner `�, `T Address-------•---___-•-- ................ ..:...... ........... ....... .....: Installer L/ Address Type of Building y� Size Lot��...:f�.�..... .Sq. feet Dwelling—No. of Bedrooms.............. ----------------- ...'Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building .........:.................. No.. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures a ........................f••_ --_.... ........ W Design Flow............�_�:2.....................gallons per person per day. Total daily flow......... �r-11)................gallons. W Septic Tank—Liquid capacityMr?Q_gallons Length.!�?.':.C--.. Width: ,'-.i C Diameter..--- '-•==Depth=,..—l.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No...U`..... .--.. Diameter...... .... Depth below inlet.._. ,.- ......... Total leaching area.,�n:!....sq. ft. Z Other Distribution box (�)'' Dosing tank ( ) ''•' Percolation Test Results Performed by._ •� 1 kjf-2L�l V Date... __� � ' •............................. .,-.... s�........ ,a.� Test Pit No. 1...L.::..minutes per inch Depth of Test Pit...!��:... Depth to ground water...L.I n� :.M'_. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ D Description of Soil.... C-?" Baca '2 'r- s'_ t l`a •••;gin;.k,t w ---•_.....••----------------------------------- ....... ..................................................... 1 ....--•--._.... UNature of Repairs or Alterations—Answer when applicable._.._.._.. �- :... ••••.•••••••.•••••••••••• Agreement: G The undersigned agrees to-install the+afored_escribed Individual Sewage Disposal System in accordance with the provisions of TI' L.t 5 of`the State Sanitary Code—The undersigned.furtlieragrees not to place the system in operation until a Certificate'of Compliance has b t ned`/byf`� ard of health . a k d � Date 1 ��'igne : .S ..........................�- ......... .................... .3 ... .. .-; .- .... ..., • ,Application Approvd�By_ , ...-i.- .. � Date Application Disapproved for the following reasons:......................••---------•------------..........---._..........-•---..............................»».. •••••••-----••••-•.................................••------.....................................••-••-•---••._...•••....._........__....._........_.....-••....__.....................................» Date PermitNo..... ---..----��2 �..»» Issued....................................................... Date ------------- THE COMMONWEALTH OF MASSACHUSETTS j- rwt BOARD OF HEALTH ...............d.�..................OF...;/.1../i�•::.a �.. �t? ...................... (Intifiratr of Tantplittnrr f THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............ . :........1'k= p ,?' _ . .... ") .................... . ..... »»....... LInstaller G/ at...............b_ ..__ /......r I.. :_.._.._.. ��/�.::_macJ.r r,/ !?!-^-••L->YT/ }. .................................. has been installed in accordance with the provisions of TITLE , of The State Sanitary Code as,described in the application for Disposal Works Construction Permit No._..K_Z_-.....zw.Y...... dated..... � �......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... •` •.----•••--•-`-••-_'............................ Inspector...... °. (-......-•••-••--•......._......-••--•............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH ... ....................................... .... No.._.r.�....-•--•. ...�/7 G Fes.. Disposal Works (gonotruction Frrmit Permission is hereby granted......__'' ...............:::. to Construct ( �)-or Repair ( ) an Individual Sewage Disposal System P4, / ::.... - ..,.... Street r ��. as shown on the application for Disposal Works Construction Permit No._�_ i' ���Dated..._ 2j.! _ �� . C.. / t /'\ I ', 1�/ Board of f{ealth DATE......... ......-•--......... .................!'?.............. No........ ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - -- -------.OF....0 �.�Lt. Z ........................... Appliration -for 4%ipoottl Works Tonitrurtion Vaniff Application is hereby made for a Permit to Construct ( ) or Repair ( )✓j- an Individual Sewage Disposal System at: ` .......... ----------------------- -----------------------------------•---------------------- ti Addres �rv,`�/oC`-`y or,Lot "o. Owne dress Installer Address Uype of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------- ----------------------------------------_-_----------------_--- W Design Flow.................:..........................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth-._-_----.----- x Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------. Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area-----.------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) - aPercolation Test Results Performed by.......................................................................... Date--------------------------- ------------ a Test Pit No. 1________________minutes per inch Depth of "lest Pit.................... Depth to ground water...... ................. CT, Test Pit No. 2................minutes per inch Depth of Test Pit.-____-__________._. Depth to ground water---------.--__-.----.--. Ix -------------- -------------------------------------------'--------'-----------------'--'-'--''-'----'-' -- O Description of Soil---.J_-.1., .-.J(,r(1 ____"_,.� - V -=.....................................................................----••-•--•-•----------•--------'----------- -------'----'--- ----- --- ----------------------- UW -----------------------------------------------------------'----'-------------------'--'--'•-"-"' ...................... 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system-in operation until a Certificate of Compliance has b n ssued by the boArd W�Ihh alth. Q fSigned. = " 6 _.7-1- b Date ApplicationApproved By-----............................................................................................. Date Application Disapproved for the following reasons-------------------------------=--------------------------------------------------------------- ----------_--- --..--'------'---'---'---'-'------....'-"------'--------------'-----------------------''-'-•--'-•---'--...----'------------------'------------------. ------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........oF._��1��1) 2 1 �z°� ................---.---- Trrtifiratr of f�lam rlt nrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by............� �-1 �1s' ...%l�!/+/to ..��I _:��" ..f.k . .i =l-----------------------------------------------•------------- � y /J Installer at /-- 7.I� i1'f ..`r��% / __L__/1 1 11�?.'t E ! r'f1i' 1(�---, .,.1< ---------------------------------- has been installed ifi accordance with the provisions of : icle X'I of Th' State Sanitary Code as described in the application for Disposal Works Construction Permit N .- -/ ---------------------- dated. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCjj0N SATISFACTORY. ......- Inspector0 --- \ .DATE__.....� THE COMMONWEALTH OF MASSACHUSETTS ,ter BOARD) OF HEALTH 2 /t .. ..... .. of.: 'C<_% 31 / tea.......................... No •-•--,��•/-•--•. FEE....................... Di Vap- 1 irk u�c tr rti�at rrutit / Permission is hereby granted---- .�' 11.. �' �7f1' ='•', `. _1 �. /1l. f�' ....................... to Construct or Repair (Y`)an Indivl gal Sewage Disposal System y atrJs. .1/� /Street/ as shown on the application for Disposal Works Construction ' mit No,7_..I-. /-. Dat -.- ..r -------------------•------------- DATE---•------------------------------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No. .`!....... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........OF..... _.%;�:�. -�� - . .................................... Appliratinn -fur 'Mipuiittl Works Tvntrnrtinn Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( !`)an Individual Sewage Disposal System at: ........... c t'en•Add ss �'v or Lot No ...._..... �?�,t. •G %w-1�L/ .� C� 7 �i711�,/(—.E, = - ------------------------ -----•-•--- ._.......--•-------•----•---•---..... J� Owner, 1 n Address a ... r. v , ?1 �` ll' :j 3 L ',!ti.�,...._t;: ?...... ,�. .......-,....,L....C17eLz... - ----- --------------------------------------------- Installer ° Address pe of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons-........................... Showers ( ) — Cafeteria ( ) p' Other fixtures .••---- --------------------------------------------- ---------......---•--•-----------...-•-----•--------•------------------•------•---........._.. d W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width................ Diameter__.._.....-.-.-_ Depth....._.--_------ x Disposal Trench—No-____________________ Width-------------------- Total Length.................... Total leaching area---------_..........sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date....................................... Test Pit No. 1----------------minutes per inch Depth of Test Pit...---_-_-__--_----- Depth to ground water----------............ .. rX Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-.-..---_---.--.-_--. - Ri -----------••---------------•-------------_----------------------------.------••----•---.-------------• ------- --•------•--------•-----•----•- O Description of Soil---1"- �>, - �� ��- ? 1 s-Y : e - %. lfZ�?%✓lufl� V ---------•-------------•--•---------...----_-.---••--------------------•----•---•--••---•------•...............-----• ---..... -•--------.-•-•-•------------------------ ------ -- -- W -•----••---- ---------------•--•------------------------------------••..........------•••---•-•......__.........__�._ . -- 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 Article LI of the State Sanitary Code—The undersigned furtheragrees not to place the system in operation until a Certificate of Compliance has be issued by tjhe bo d o(//h lth. Signed...../:`....�.....^......_. ...... ..._OCUt�,(..Cites 6-A.) ,�----- Date ApplicationApproved By-----------------------------------------------------------------------------..................... ------------------------------------•--- Date Application Disapproved for the following reasons::_----------------------------............................ ................................................... --------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date { 1 �-xi _. x. . r ECTION WAG • - . . SEPTIC.TANK �j'`. . _"D'v BOX- . _LEACH TOP. F FON (MSL)• •'2".OF IIOTO.lh-'. WASHED STONE S� - OUT• IIY• OUT• �III'hl.I 1 ` n AA ( `i 6. SEPTIC /ELEV. A • ' --�— ��1dJ.StI TANK .,:✓L � �/f�� LI w t ELEV. ELEV. " ELEV. ELEV. ELEV. + f t A ? q WASHN. OF ED STONE t TEST HOLE LOG C(2v. .z f-N TEST BY �F•FAIQZANKS IpOLDl\j WITNESS K. all TEST DATE /a 2 A't�ram_ 3 BEDROOM HOUSE ib DEIGN - T.N. r 1 T.H. 2 : CR 2�_: �,' ELEV. $ 1•Z ELEV. NO -(oP PERC RATE L 2- "MIN/IN.. OISPOSER 'DISPOSER f Sv►3SOIL f� FLOW RATE 3°�f L:�AN SRNO � • - GL'AYEL. w.J SEPTIC TANK ' ..J� (I,'1.a 'tRAGE S OF REO'DSEPTIC TANK SIZE 72' SILT Z LEACH FACILITY sN N SIDE WALL -G/D. BOTTOM ( lo/zl2cc.= fig. `� -0) - "1.b'.s G/D. ,ram_ TOTAL 7,0 • USE: �'��= - LEACHING 10 art="i�lcl"1. c= - 2T'1-! 11n' WATER ENCOUNTERED - NOTES: UNLESS".OTHERWISE NOTED) 1.DATUM(MSL)=TAKEN FROM LOTSJ I T QUADRANGLE MAP 2.MUNICIPAL WATER I AVAILABLE 3-PIPE PITCH:k%"PER FOOT -1 -44 �j 4.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO- -- Zoui LI 6.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(2)FT. j;{ nr ,:\ 6.PIPE JOINTS SHALL BE MADE WATERTIGHT EYE -- -:_v,` h 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH.COMM.OF MASS. c� DI e STATE ENVIRONMENTAL CODE TITLE S APNE H' �; "'� SUE a.. �r�ham:^� 8. ru-a.� pa l FoL T Y�7e��c� .�coci� a.�``C a.�a �+�Ca��� O �OI .� LOCUS:—W�" �oT •��• �� �o� ���,�� �..�. �-�.�,,._.� . `='• � 5I nos --- - i! ` .o _P14 10 RE ''PROFES f0NAL � . INEER i 4P�N Af f' . � oaf E �y REF: (�� down CQlpe enwIneerin.0 o A � PREPARED FOR: jj CIVIL ENGINEERS " �3 LAND SUR VEYORS --- BOARD OF HEALTH i �� R. SCALE—IL-API CALE 1 I-gfll 1�nA (EXISTING)............. . - ±OONYOURS (PROPOSED)-O-O-0-O- APPROVED DATE A( T — MA Y� •YK 7s r 1500 GALLON SEPTIC TANK �} (EFFECTIVE LENGTH) C'4 O In ' I 75" cr6 STANDARD INFILTRATORS n � NO STONE I Lai 00 . o- co j osO DIST. BOX a FR�OvSE = CD INSPOPORTSTANDARD INFILTRATOR CHAMBER i __ 50.0' J Q MOUND FOR PROPER DRAINAGE ESTABLISH VEGETATIVE COVER ! _ _ _ _ � X 23.5' TOPSOIL TOPSOIL I6co " MIN., NON-TRAFFIC AREAS / p U 12" MIN., H- LOAD AREAS ! N �^ U Q . NATIVE UNDISTURBED NATIVE I _ _ C)6J W p M O BACKFILL EARTH BACKFILL !L� �O _ _ I Q z cV 12" '/ J Q CLEAN SAND TO CROWN OF INFILTRATOR % -I U) 00 00 00 36" 102" MIN. 1 36" 5 try O a Q UU)j INFILTRATOR TRENCH DETAIL LIMIT of UNSUITABLE SOIL � 5 0, p N W o NOT TO SCALE REMOVAL IF REQUIRED PROP�R�� ��NF SEPTIC SYSTEM DESIGN DATA SAS RESERVE SEWAGE FLOW ESTIMATE SOURCE UNITS GPD/UNIT QTY GPD COMMENT SEPTIC SYSTEM DIMENSION DETAIL . SINGLE FAMILY RESIDENCE I BEDROOM 1 110 4 1 440 310 CMR 15.02 (13) SEPTIC TANK TOTAL ESTIMATED PEAK DAY FLOW 440 GPD - NO GARBAGE GRINDER GENERAL NOTES 4. THE LOCATIONS OF UNDERGROUND UTILITIES SHOWN ON THIS 6. REMOVE ALL UNSUITABLE SOIL. Ap AND 8 HORIZONS FROM - PLAN ARE APPROXIMATE. AT LEAST 72 HOURS PRIOR TO ANY WITHIN FIVE FEET LATERALLY AND UNDER THE PROPOSED SOIL TOTAL FLOW X DET. TIME = 440 GPD X 2.0 DAYS = 880 USE 1500 GALLON TANK EXCAVATION FOR THIS PROJECT WORK, THE CONTRACTOR SHALL ABSORPTION SYSTEM AND REPLACE WITH CLEAN SAND MEETING. 1. ALL MATERIALS AND CONSTRUCTION METHODS SHALL CONFORM MAKE THE REQUIRED NOTIFICATION TO DIG SAFE THE REQUIREMENTS OF 310CMR 15.255. TO THE PROVISIONS OF THE COMMONWEALTH OF MASSACHUSETTS (1-888_344-7233). AND THE CENTERMLLE, OSTERVILLE, SOIL ABSORPTION SYSTEM ENVIRONMENTAL CODE TITLE V. MARSTONS MILLS WATER DISTRICT 508-428-6691 FOR 7. WATER SUPPLY FOR THIS LOT IS PUBLIC WATER CONNECTED VERIFICATION OF LOCATIONS. AT THE STREET LINE IN THE APPROXIMATE LOCATION SHOWN. STANDARD INFILTRATOR DESIGN 2. EXCEPT AS OTHERWISE NOTED, ALL PROPOSED SEPTIC SYSTEM THE PROPOSED SEPTIC SYSTEM SOIL ABSORPTION SYSTEM IS NOT PIPING SHALL BE 4" ' SCH40 PVC SET TO-THE LINE-AND INVERT 5. CONSTRUCTION OF THE SEPTIC SYSTEM SHOWN ON THIS PLAN TO BE LOCATED WITHIN 150' OF AN EXISTING PUBLIC OR PRIVATE z PERC RATE = 2 MIN INCH CLASS I TYPE SOIL = 0.74 GPD SF WATER SUPPLY. Z / ( / ) ELEVATIONS SHOWN- THE MINIMUM PITCH OF PIPES CARRYING IS SUBJECT TO THE INSPECTION OF THE TOWN OF BARNSTABLE O 440 GPD e 0.74 GPD/SF = 594.59 SF REQUIRED SEWAGE OR SEPTIC TANK EFFLUENT SHALL BE 1/8TH INCH'PER HEALTH DEPARTMENT AND THE DESIGN ENGINEER. NO PART OF 594.59 SF e 6.53 SF/LF (CHAMBER REDUCTION RATING) = 91.05 LF REQUIRED FOOT IF NOT OTHERWISE NOTED. THE SEPTIC SYSTEM SHALL 8E BACKFlLLEO OR MADE 8. WHERE SERVICE PIPE IS LESS THAN 10 ' FROM AN EXISTING > 91.05 LF _ 6.25 LF CHAMBER LENGTH = 14.56 CHAMBERS OR 15 CHAMBERS TOTAL INACCESSIBLE UNTIL INSPECTED AND APPROVED BY THE HEALTH OR PROPOSED SAS IT SHALL BE SLEEVED IN 2' 160PSI HOPE OR w ( ) 3. PRIOR TO CONSTRUCTION OF TIE SEPTIC SYSTEM DEPICTED AGENT. THE CONTRACTOR SHALL SCHEDULE INSPECTIONS AS SCH40 PVC PIPE. NOTE: FOR NEW CONSTRUCTION, NO SYSTEM SHALL BE CONSTRUCTED WITH A SOIL ABSORPTION ON THIS PLAN, THE CONTRACTOR SHALL OBTAIN A DISPOSAL REQUIRED. SYSTEM AREA OF LESS THAN 400 SF Of ACTUAL CHAMBER BOTTOM AND SIDE WALL AREA. WORKS CONSTRUCTION PERMIT FORM THE TOWN OF BARNSTABLE 15 CHAMBERS x 25 SF/CHAMBER(4 SF/LF x 6.25(CHAMBER LENGTH)) = 375 SF OF SYSTEM AREA HEALTH DEPARTMENT. d a < 400 SF OK 400 SF a 25 SF/CHAMBER = 16 CHAMBERS REQUIRED = 100 LF OR 2 ROWS OF 50 LF (8 • U p U Oz o ~ 60 CHAMBERS PER ROW) - USE TWO TRENCHES, 8 CHAMBERS/TRENCH t o o N w U) w m a U) SOIL TEST DATA < <_j E; Q Y In _1 J O DATE: 11/30/04 - 10863 O O O N 55 TOP FOUNDATION 53.5 EXCAVATOR: BOUSFIELD r- B.O.H. AGENT: D. STANTON C4 O ENGINEER: D. THULIN W Q PROPOSED FINISH GRADE LOCATION: TP-2 Z a' P c 49.22 z 50` s=o.o o - EXISTING, GRADE ELEV. DEPTH Ap _ ORG. LOAM z ~ f749.83 LOCATION: TP-1 49.6 0.0 < Qo---- - --- - 48.9 0.7 a_ 0_ �49.47 46.35 46.21 ELEV. DEPTH Ap - ORG. LOAMB - SANDY LOAM ! wQ 47.4 0.0 V J a" PVC 46.6 0.8 46.6 3.0 to J O >- S=o.199 46.5 _ B - SANDY LOAM C - MED. TO COARSE j U 1- 45 45.1 2.3 SAND • in W_ W INLET TEE 4" Pvc C1 - COARSE SAND to O I w � 10" BELOW 1500 GALLON 5=0.000 43.4 4.0 11 IO w z LIQUID L VEL S PTIC TANK a PVC 2 TRENCHES - 8 STAND RD INFILTRAT S BOT EFF. DEPTH 45.67 PERC <5 MIN. IN S=O.o35 NO STONE - INFILTRATORS TO BE SET I , / a- J w OUTLET � � Of AS BAFFLE C HORIZO SOILS 06 C2 - MED TO COARSE ,^ � � 40 SAND 39.6 10.0 L J Q 0 18.0' 13.6' 3.9' 50.0' NOT GROUNDWATER O_j 37.4 10.0 BOTTOM NO GROUNDWATER O 35 Hn -10 0 10 20 30 40 50 60 70 80 90 100 110 o7-021 SECTION THRU SEPTIC SYSTEM SHEET 2 OF 2 0 WEOUAQUET p p LAKE LOCUS Res,, Edge of wafer 1/7/05 o a t w Line of f/ags found a' �° cc)d ° �► C' JLjj ao O CN O / C0� "9� Q) p O 'n Z �C Wood fence � �o D 0 O WEQUAQUEI LAKE / ASSESSORS MAP 230 PARCEL 101/001 1 PLAN REF: PLAN BOOK 451 PAGE 92 p PLAN DATE: JANUARY 8, 1986 / '01 DATE OF SURVEY: JANUARY 7, 2005 �Q) OFFSETS TO PROPERTY LINES FROM / /E,risling L wn 119,00, PROPOSED HOUSE 17001 / S7g•51'1gE,E 1 LOT AREA: 61,950±SF o0 l / ls�? ,N / r - 5 � / // // �.• / 5� 51.8 z 1ST. FL. DECK / / / _', . .8 N° / o Q x 51,7 // / �Q/J�((��ti [52.51 5 8 / Ln lP O 01 i / F \ x 50.9 0 \ 51.8 Edge of,00vement x 50.8 !y\ 16 �6.39E 20 E S s80 \ PT�F�✓ ®\ / 51.7 \ x 50.8 LINE OF STAKED HAY BALES g I \ \ TO BE IN PLACE AT WORK LIMIT PRIOR .TO ANY N 10 \ . \ DISTURBANCE OF THE SITE V ' x 49.7 \ ' DRIVEWAY APRON FOR \ �;s NtiJ c EROSION CONTROL 7- LEGEND 019E �O — EXISTING CONTOUR _�`50)—' PROPOSED CONTOUR EXG. TREE/SHRUB LINE (' N EROSION CONTROL f rr 01 X EXISTING SPOT ELEVATION 1 V 4' �_ 1. AN APRON OF 3/4" CRUSHED STONE 3" IN DEPTH OR (702) - O_ 2" OF BITUMINOUS CONCRETE BINDER SHALL BE PLACED PROPOSED SPOT ELEVATION I'D AT THE PROPOSED DRIVEWAY WHERE IT JOINS EXISTING ' ' ! �c PAVEMENT. THE APRON SHALL BE IN PLACE AT THE TIME TEST PIT LOCATION OF THE FOUNDATION INSPECTION AND SHALL BE _111 MAINTAINED UNTIL THE PERMANENT DRIVEWAY SURFACE IS —W— WATER SERVICE cl1 CONSTRUCTED. ALL SOILS, VEGETATION AND (1 " (� CONSTRUCION DEBRIS FROM THIS PROJECT SHALL BE /1 b Ye � CONFINED TO THE PROJECT SITE DURING CONSTRUCTION. p S I W (,a PERMANENT SURFACES INCLUDING PAVEMENT, LAWN AND I I)I_�r o LANDSCAPED AREAS SHALL BE PROTECTED BY PROPER ( O GRADING, MULCHING OR OTHER CONSTRUCTION AS MAY BE REQUIRED UNTIL STABILIZATION OF THE SITE IS ACHIEVED. 4� 0 20 40 80 Ti / 160 a ( IN FEET ) S� �P'\' kkOF s� 1 inch = 40 ft. �Sk10Ftijq `+9 SO 58'35E E DAVI °y a� DAVID C+ N C. cGn o O C. . TNULIN '. g T1 IULIN v' 60.00E N E 0 �NCo'394003Pv � '9 CIVIL TBM TOP CB F pHJNNEYS LA ELEV= 51.81 sv NGVD No s�vE' ���,►�. �' UT PROPOSED SITE PLAN DRAFTER: DCT PST REVISIONS: i m 35 LOOM I S LANE CHKD BY: PST DAviD C. THULiN, PE, hLS I DESIGN: DCT 211 MILL ROAD -• O CENTERVILLE, MA SCALE AS NOTED I�f O N ASSURANCE CONSTRUCTION EAST SANDWICH, MASSACHUSETTS 02537 71 -. JULY 16, 2007 ti 550 WILLOW STREET, WEST YARMOUTH, MA 02673 WPo1 SHEETt (508) 888-2345 FAX (508) 888-7259 MORE LL RESIDENCE eo I — - .JJ ILL,WORTi SGNbf)Vlf. •"fX1Uly5-EX7E0.+OR ._ .-----------� -- "--- - - 2- f _.MR_6080 SAL_ -----_. --_- _ _ -- '_ P47T�.6pIN�s..--� •� 3__ 1_:�Y4160g655 :-.:.. -:- I 6 66bAP - I __ _ _ KFY NET% OtSC lQTccw . .. -- 17RrIX_f5 Tt�.�6Z[v-"C'RTFM- :7wttx.Lf as.1 I7CCtI/�. n GZ: T�42. •L �44- - 1 Q j. ..� •:t i. -..- i +1N al .. Coca¢Ry TIcm-evrout - t L:Az USE SlbvE ORBtfnJE VC NEE _.K- 5P_?$S3.Vl.LTnNE L • _/�5.5UR1CtJCE. RUIt.17Et�.i __. CNATHAK MA. J IS�y1ZELf--�=5117LNCF=�(IX?lKi6:L-n1JE ' 'I74.2d9•�7SD . - pwap'ct IUEMIBMK4t �,Tvq-VENT • _—__�� - t-- 4.E — ysNUnl-7 ---- ' Ll I I �I _ --- - - © _. f i _. .__ -- — IY.I. l 1�T..1-•T�� rl'IT IITr j111i-I� / �! •1 I .Illtll CV.c 5ulti.4YtE5 -- —. Ge BUn:T.Ak:«�.KET -t 1 i�I. 1�II_A�I llt,III_ S. j' \YkI1TE.`CE97�R 3Ff`�7�L6$--�----r- � I •_� I. j .. 11!1 mut- , 1 I16I1,. +,I . • to ",V cRc�vti,.>�1-:�tg5:an..ts3_Elta.�rr• 75 C'uFCC=.EF7Li3 c.Ei—T _mvAsZD I fc- 7.... ._.. .. -. -_ _ - i' Clay' - - °p1ci1'fly. _ ;cvtFlr7-'. - - e a -Lill1 7 t I y' L_ L .1 _. �rySIa.SCS171V�15t-- I - I 4T 1 I t I t _ _ t l Ljt j 1 I L 1. 1 1 Icy Il I .r)o-R I I I �•i. I ! I11; ao-1^. III �I fI VC.M5 K i � �G1 L'lCPQ9 FJ _. vht�R-v4yst� Taw _ i I / .. 1�.�3lJFtiA�F3�E._�LS.LT-]"5ER✓ .: LYl.Oi! anWN� V KUCE DEVLIN DESIgNS eHATHAM, MA. o.,E rd3ia� P,ES(f)EFJi E �2�� LJ I, - I I 1 AAETAL RUUF 1 ep14 ty1 J fNjLn'.IG -�- - (ZIP GE-VEu_r.- jT IT v � I C� C706IL -- - FEAR Ukv LA -- - - *l 1/♦/mil}/ �.y(p)/y��� d SSUfid£I.�E_.FSIi Zr? - - - - Fi I.A.f Y.AA,IP—A XXrIY7F-1( vtc { - 0"DIA•CONC Fllte r.!Z3V61U82S aii 2°j.Z°nl°_iPR.CiYNc flG, — 'roo-LL uAL'POR 6k6 P6 NS 4.o'/4° Io3" �q., 6q" Io 3' I4.O., iI SEE I7ErAIL"TO. 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AItNI:G VGYLI/11 I/G����3 ecAal`J2'-'1-O.. veovcve.: o�te:7 3 O wevieev CH,•T{�rA�l r/�+MPAn. _RESIDEF ICE-35 LC)OAA S VINE j 106-7n4O/]V Px19.RAMPS�PxB,HIPS.:.pp1TOM D_&t.EVE�1" . — ��-�7iaTpi`LtiL2JNDER _ - i r -'l-t.GT3711S_�'`- I 2 RLAERAtTE I` .. fti'c•�1 "-"LVL R.t- E:•-. ___ "' %;. R'rani't2:1.VL.kti?iE` .__ 1 41AW7 r iJpnE2_ I i dr. a , W -W)CC rAtl wiKE3..'taz'_-.— -------- - r $RULE pEVLIN DEStCNS o.�,;s� ,4,:_A_. . ar ae�,eFo CHATHAM, MA. _ _