HomeMy WebLinkAbout0029 NOTTINGHAM DRIVE - Health 29 Notti_aghann .Drive =
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A- 1 72-2-52
hUPC 2 34 � •
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No. �0�0 ^ `� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppliLotlon for Mispo8AY *pstrm ConstCUttion 3pPrmit
Application for a Permit to Construct( ) Repair(s<Upgrade(Z4-'Gandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. q NG rri/9Q#00f V r Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel 72- S
Installer's Name,Address,and Tel.No. p$[f2 0—97 j�' De igner's Name,Address,and Tel.No.
�N�� � //3 ur, C'rosJ r
Type of Building:
Dwelling No.of Bedrooms o ,j Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) '^ 3 Q gpd Design flow provided ' — 3 y? gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterati ns(Answer when applicable) r4/! 1�,O ez/x
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. _.,, /
Signed �4 6�/!/✓'r'ol/ Date 5 5—e 6
Application Approved by Date S" 10
Application Disapproved by Date
for the following reasons
Permit No. 0 10 v I I Date Issued 5 5 f 0
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN:OF.BARNSTABLE, MASSACHUSETTS
0(pplitation for Disposal Epstein Construction Permit
Application for a Permit to Construct( ) Repair(�Upgrade,(Lr'Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. A.U19 ice/�� �"0 Dr., Owner's Name Address,and Tel.No.
Assessor's Map/Pareel w,, 7 2.;ES-2
Installer's Name,Address,and Tel.No. v besignet's Name,Address,and Tel. . S"✓u'y77_j"" f�j
�'_ Jds�p� U� /,J`,�v�'O ��,�,r�•.�.er'i rr y /,va �
/ C saryi�yr-�/7' �� �?��.� �`. ur. C'r'o5 y l�r c�G>' ✓�>! !"%.� /:5fd�'9�r
Type of Building: &'
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.ofPersons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 V ' �gpd Design flVw provided w _ ( � gpd
Plan Date Number of sleets { 'Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterati ns(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed .� � �� Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No.• ;2 U C Date Issued
=----------------- " =
------------------------------------------------------------------------------' = ----------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
l
Certificate of Compliance
THIS IS TO CERTIFY,that the On--site Sewage Disposal system Constructed( ) Repaired Upgraded
Abandoned( )by
at 2 U /N/ /G!f f37 Gre r: 11111 has been constructed in accordance
with the provisions o JTitle 5 and the for Disposal System Construction Permit No.a 010—13) dated
Installer ✓OS�' d! Ze �i �"`'�j Designer /5-:O -e-f-h1 6kI' (.U1l�lC
#bedrooms Approved desig flow gpd
The issuance of this lennit s all not be construed as a guarantee that the system willi, ncti designe
Date '� Inspector i!l
-----No.------ --------- --=-
--------------------------------------- --
a o o 131
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Disposal *pstem ConstrULtion 311Prmit
Permission is hereby granted to Construct( ) Repair // Upgrade((..-ate Abandon( )
System located at /Vd�l ya lxwoJ ,2j"1 yx
ClwaT `llr/l,.--
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit,.-''
Date J ^ 5_ b Approved by C
06/02/2010 10:24 5084775313 ENGINEERING WORKS PAGE 01
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 308-790-6304
Date: (aJtJ k c) Sewage Permit# Ammoes Map/Pareei 17 2 2 S Z
Installer&Designer Ceration Fgm
e her K L.f,,,�-e e
Designer: vt _et rr+�gc��wW , 1A C • Installer: 0eI `S p c S uC
Address: TZ W, Cre4 S-Q-_1 CA 9A Address: �� haw.v�4r{� )Zd
M4 174 y y (ad5At7ms w t1 s, 0z(o y,
T
on ':Y0e `S �t C S v �-was issued a permit to install a
ate) u er
septic system at Z9 Pa-W, 0f_ (eK+, based on a design drawn by
Jaddress)
7 e}-V"7- Nl C-.£,^,i-'C.A i F dated 5�)Lf a _
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor, approved changes such as lateral relocation of the
distribution box and/or septic tank. Stripout (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (Le.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State&Local Regulations. Plan revision or
certified as-built by designer to follow. Stdpout(if required)was inspected and the soils
were found satisfactory.
SN OF
PETER T.
(InsWler's Signature) MCENTEE
CIVIL
-o ,9 No.36109 O
9 Fps pc�
(Designer s signature A De /6�
TO STAB C D N. CERTMCAn
OT B
C
e:btfim fm=WaiVw=atific&tion fwmdoo
}
4
TRANS,:NO.:
CITY/TOWN:
APPLICANT: ,-75k4 S
ADDRESS:: 2-A
DESIGN FLOW: 33 a gPd
REVIEWED BY: DATE: Ste '
N/A OK NO
Legal boundaries'denoted 310 CMR 15.220(4)(a)] �✓
Street, Lot, tax parcel number and lot number noted on plan [310 ✓
CMR 15.220 4 `u
Locus Provided 310 CMR 15.2204(t)]
Plan proper scale? (1"=40'for plot plans, 1"=20' or fewer for ✓
components) 310 CMR 15.220 4
Easements shown 13.10 CMR 15-220 4 b
System located totally on lot served [310 CMR 15.405(1)(a) for ✓
upgrades]-if not, a variance is required 310 CMR 15.412(4)]
Location of impervious surfaces (driveways, parking areas etc.) ✓
310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR ✓,
15.220(4)(c)]
Location and dimensions of system components and reserve areas. ✓}
310 CMR 15,220(4)(e)]
System Calculations 310 CMR 15.220(4)(0] ✓
daily flow
septic tank capacity(required andprovided)
soil abso tion system(required andprovided)
whether system designed for garbage grinder ✓
North arrow 310 CMR 15.220 4
Existing and ro osed contours 310 CMR 15.220 4 ✓
Location and lob of deep observation holes(existing grade el. on
each test) [310 CMR 15.220 4 h
Names of soil evaluator and BOH representative [310 CNM
15.220 4 h and i
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(i)]
Percolation test results match loading rate? 310 CMR 15.242
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220 4 n
Address Sheet1.of 9
V
N/A OK NO
Location of every water supply, public and private, [3l0 CMR
15.220.4 k
within 400 feet of the proposed system location in the case
of surface water supplies and gravelpacked public water.supply =
within 250 feet of the proposed,system location in the case
within 150 feet of the;proposed system location in the case
of private water wells
Location of all s rface waters and wetlands located up to 100 ft.
beyond setbacks hsted in 3.10 CMR 15.211 and any:catch.basins .,
located within 50 ft 310-CMR 15.220 4 :1
Water lines-and-other subsurface ut lities..located f 3I6 CMR
15.220 4 m °water line cross see 310'C MR 15.211(l)[1])
Profile of system showing invert elevations of all system. ,f
com orients and:.the bottom of the SAS 31.0: ;CA4R15.22,
Scam of desi ser 310 CNM 15.220 1 and`310 CMR 15.220 2-
Stamp of Registered Land Surveyor (required if construction
activities within 5 ft. of lot line) 31.0.CMR. 1.5.22Q 3
Test Holes adegbatte (two in each of the primary and reserve
unless.trenches as permitted in 310 CMR 15.102(2)or as'
approved for.anupgra4e under LUA at 310'CMR I-5.405 1 'k
Test-hole adequate to demonstrate four feet of suitable material?
310 CMR 15.193 4
Test Holes adegµate.to confirm adequate groundwater separation?
3 10 CMR 15.103(3)1
Benchmark within.50-75 of.s.:stem. 310 CMR.15.220 4
1Vlater-alsspecifications noted. .[various sections of 310 CMR`
15,000
System components not> 36" deep (unless Local Upgrade
Approval-or LUA re .uested) [310 CMR 15.405 1
Addess Sheet 2 of 9
N/A OK NO
Size OK? 310 CMR 15.223 1
Inlet tee located ten inches below flow line 310 CMR 15,227(6)]
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310
CMR 15.227(6)]
Outlet tee with gag baffle or approved filter 310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228 1
Separation between inlet and outlet tees(no less than liquid depth)
310 CMR 15.227 2
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 3ID CMR 15.227(5)) or permitted for
upgrades under LUA 310 CMR 15.405 1 k
Minimum cover . (Tanks buried more-than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232 3
Three access corers (inlet and outlet must be 20" or greater) - .�
middle access at least 8" 7/07 310 CMR 15.228 2
Access to within`6 of grade -one port for systems<1000gpd,
two fors stems>1000 gpd 310 CMR 15.228(2)]
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)]
> 10 ft from builka foundation 310 CMR 15.211 1
Buoyancy calculation Re quire one 310 CMR 15.221 8
H-20 Where a ro riate? 310 CMR 15,226(3)]
Setbacks from resources 1310 CMR 15.211
Required when other than single-family dwelling or flow>1000
d 310 CMR 15.223 1
First compartment 200% daily flow; Second compartment 100%
daily flow 310 CMR.15..224 2 .and .3
"U" pipe through or over baffle, outlet of each compartment with
as baffle or approved filter [310 CMR 15.224(4)]
Address Sheet 3 of 9
N/A OK NO
Located'at least ten feet from any water line? [310 CMR
15.222 2
Disposal piping it least 18"below water line(when water and 7-/
sewer cross, see 3.10 CMR 15.211 .1 .1 ,
Cleanouts required/provided ? 310 CMR 15222 8
Thrust blocks sp22±2d in force mains? 310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
[310 CMR 1'5.222.6
Proper pitch on all runs? (005 within gravity-distributed trenches
and beds) [310 CMR 15.251 9 and 310 CMR 15.252 2 c
Siphonproblem/ ieachfietd below pump chamber
Endca s or vent manifold specified?
Size and orientation of discharge holes specified?.(not smaller than /
3/811not larger than 5/8 ) [310 CMR 15.251(8) and 310 CMR
15.252 2
Materials specified (310 CMR 15.251(5) specifies various pipe
types-allowed)
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steep pitch of gravity sewer) [310 ,✓
CMR 15.323(3)(a)]
Riser if dee er than 9". 310 CMR 15.232 3
Inside minimum dimension 12" 310 CMR 15.232 2
Minimum 310 CMR 15.232 3 e `J
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
310 CMR 15.232 3 d
Capacity(emergency storage above working=design flow)? [310
CMR-231 2
Pro er setbacks 310 CMR 15.211 same as septic tanks)]
Watertight.20-in minium access manhole at least 20"MUST BE
TO GRADE 310 CMR 15.231. 5
Service components accessible (not too deep with piping,
disconnects accessible
Alarm floats - alarm on circuit separate from pumpsspecified?
Exceeds two units must have two pumps operating in lead-lag
mode. 310 CMR 15.231 6 and 8
Stable Com ed.Base[310 CMR 15.221(2)] .
Address Sheet 4 of 9
lBqoyppy calculations needed?Provided? 310 CM R 15.221(8)]
Address Sheet 5:of 9
I
N/A OK NO
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.24 1
Required separation to oundwater? 310 CMR 15.212
A e ate specified as double washed 310 CMR 15.247(2)]
System Venting required/provided?-(system under driveway or
>36" deep) 310 CMR 15.241
Inspection ports specified and within 3"final grade? [310 CMR
15.240 13
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. 310 CUR 15.253 6
Each structure v�ith one inspection manhole(if>2000 gpd must be
tograde) 310 CMR 15.253 2
Aggregate 1' minimum- 4' maximum: 310 CMR 15.253 1
2' sidewall credit maximum 310 CMR 15.253 1 a
In bed configurationinlet evea 40 N. ft. 310 CMR 15.253 6 ]
Width 2' minimum 3' maximum 310 CMR 15.251 1
100 feet -maximum length 310 CMR 15.251 1 a
Minimum separation 2x effective depth or width whichever greater N11,
3x if reserve between trenches 310 CMR 251 1 d
Situated along cpntours 310 CMR 15.251 2
Breakout OK? �10 CMR 15.211Q)[4j and Guidance Document
minimum 2 distribution lines 310 CMR 15.252(2)(a)]
Maximum separation between lines 6 310 CM R15.252(2)(d)]
(/
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2) e
Aggregate depth below discharge pipes 6" minimum, 12"
maximum. 310 CMR.15.252 2
Se aration between beds 10' minimum. 310 CMR 15.252 2
Bottom area used in calculations only 310 CMR 15.252(2)(i)]
Address Sheet 6.of 9
J
Pressure Dosed System ? Provided pump and piping calculations
as required 310 CMR 15.220(4)(r)]
Pressure dosing Tequired on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and UA
Remedial Use ovals
If used in gravelless system -make sure jet is directed as not to
scour soil interface Guidance Document
Inspections once per year(systems<2000 gpd) or quarterly
>2000 dgood to note on plan 310 CMR 15.254(2)(d)]
Construction in fdl -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ?
Impervious barrier and/or retaining wall ? Guidance Document
Impervious barrier installation must be supervised by designer
310 CMR 15.25 5 2 b
Retaining wall must be designed by Registered Professional
En 'neer 310 CMR 15.255 2 a
Side slope not exceed 3:1 ? 310 CMR 15.255 2
Breakout retluirements met? [310 CN1R 15.252(2)and
Guidance Document
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended 10 CMR 15.255 2 e
lippigg
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a g1ote on the plan regarding the requirement for
perpetual maintenanceagreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has licarit submitted a EM of a maintenance a eement?
Are the variances listed on the plan? [310 CMR 15.220
4
RLS Stamp.-necessary on plan if a component is within five
feet of property#ine 310 CMR 15.412 4
Address Sheet,?of 9
y
New construction or increased flow proposed - [Refer to 310
CMR4v15.414 .,
Address Sly 8 d 9'
N/A OK NO.
Is the system in a Designated Nitrogen Sensitive Area(Zone Il for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.21§ - also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ?
310 CMR 15:214 2
Are the nitrogen loads proposed in compliance? [310 CMR
15.21 11.
,4
Pumping to septic tank ? 310 CMR 15.229
Shared System 1- CMR 15.290
1
Address Sheet 9.of 9
Town of Barnstable P#
' Department of Regulatory Services
e�►aHar�Ai Public Health Division Date �, o
630.hie 200 Main Street,Hyannis MA 02601
AA1tl
Date Scheduled S v Time Fee Pd.
Soil Suitability Assessment for Sewag Disposal !
Performed By:
Witnessed By: A.0
LOCATION& GENERAL INFORMATION
Location Address eLc1 �.� h�vh Owner's Name
ekvtlZ. l AddressZq n5l raw
Assessor's Map/Parcel: �S Engineer's Name
NEW CONSTT�RU_�CTION REPAIR IK Telephone# 97 .
Land Use Slopes(%) 4-1 0 Surface Stones rj/0-
Distances from: Open Water Body 7 LrJ ft Possible Wet Area ?l.a� ft Drinking Water Well 2L5 ft
Drainage Way 2(Q ft Property Line � )r� ft Other
ft
SKETCH:(Street name,dimensions of lot,exact locations.of test holes&perc tests,locate wetlands in proximity to holes)
Ll
�G
2�
I�f,✓t
N(>-irv-6-}-tA-M PJZI V1
Parent material(geologic) `'�` �` `s~ Depth to Bedrock, N In—
Depth to Groundwater. Standing Water in Hole: NIA Weeping from Pit Face
Estimated Seasonal High Groundwater 1 3'
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: __in, Depth to soil mottles:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj,factor— Adj.Clroundwater Level..—
PERCOLATION TEST bate Thne.��.
Observation •r-�
Hole# Time at 4"
l
Depth of Pero M. (o G Time at 6"
I
Start Pre-soak Time® Time(9"-611)
End Pre-soak
Rate MinJlnch.
Site Suitability Assessment: Site Passed 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 beginning.
' .Q:ISEPTICIPERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole.# r
Depth from Soil Horizon Soil Texture .Soil Color, Soil Outer
Surface(in.) (USDA) (Munsell) Mottling (Structure,"Stones;Boulders..
o
t v1
DEEP OBSERVATION HOLE LOG Bole# Z-
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders
consistency,%
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color._, Soil Other
Surface(in.) (USDA) (Munselp Mottling (Structure,Stones,Boulders.
it -e
DEEP OBSERVATION HOLE LOG Hole*
Depth from Soii Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
t
-_
Flood Insurance:RateMan:. . �. ..
Ab6ve,300 year'flood boundary .No_ Yes .
Within 500 year-boundary No Yes
Within 100 year flood boundary No 4� Yes
Depth of Naturallv Occurrine Pervious Material
Does At,east foar`feefof naturally occurring pervious materiat exist in all areas observed throughout the,,,
area,proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material? .. .
I certify that on ' l� l 4) (date)I have passed the soil evaluator examination.approved by the
with .
was rformed b me consistent
artment of.Environmental Protection and that the above analysispe � Y
•De e _.
the:required training,expertise and experience described to 10 CNM-15.1017
Date G
Signature -- --
Q:\SEPTiCVERCP0RM.DOC
TOWN OF BARNSTABLE
LOCATION go aA*,*, Dri(a SEWAGE # Z!:W0 -- /3/
VILLAGE ASSESSOR'S MAP & LOT l72'2SZ
INSTALLER'S NAME&PHONE NO. LO8- Y20-973J )o3el-,:114 Q-c/ft4l�'ry S
SEPTIC TANK-CAPACITY 00
LEACHING FACILITY: (type) Rain of y Car 0 D i I'Pd
NO. OF BEDROOMS 3
BUILDER'OR OWNER PETS` -�#.14
PERMITDATE: ,5'^ S ID COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by J/W ' t Atv-ri
' Parr
No.. FB$...2-:....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD. F HEALTH
7 '1........... OF........ �..................
Apphratinn for Disposal Morkii Tort rudinn Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Location - .. 1(1 i or Lot No...........................................
........... 1g± .. a xr. .. .................... ... .::!:..:. .......... ..............
- ner -address
r . i.�
... ....... ....... .. ..... ...... ........... .
Installer Address
Type of Building Size Lot..... ......Sq. feet
Dwelling—No. of Bedrooms......... .......:........................Expansion Attic ( ) Garbage Grinder ( )
a •
aOther—Type of Building ../ d.. n^ No. of persons..........�4.............. Showers ( ) — Cafeteria ( )
dOther fixtures .............._.......................................---•------........_...._..........---.._......--•--•---•-•-•-•------..........._........_------
W Design Flow.............-..........................gallons per person per day. Total daily flow............. ..............gallons.
�4 Septic Tank—Liquid capacity/ gallons Length................ Width................ Diameter................ Depth................
xDisposal Trench—No..................... Width................... Total Length-------------------- Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter... �,�S d'`'Bepth below inlet.................... Total leaching area.3�.. "...sq. ft.
Z Other Distribution box ( ) Doing tan ( )
aPercolation Test Results Performed bY.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--_-.-._________--_____.
� •.y�
O Description of Soil—_z:JG . -------------------------------------------------------•........... - - ----•-- ---------•-•--•---------
x
U .---------------•••--•-•--••••---------------•------•-•--••--•-••--••--------------•-•••-----••-•----••......-•--•-•-------•-•----...•--•-•••••----------••-•-•-----------••••----•---•-----•----•-••-•-
w
x ----------------------------------------------------------------------------------------------•-----...••-•-•--•--•-•------•...---•-----------------...•••--------•-•••--•--•--•-•--•--------------•-•-
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 XI of the State Sanitary Co The undersi further agrees not to place the system in
operation until a Certificate of Compliance has been s ed by t1 'oa of th.
Sig ....I.-• --•------••-------------- ................................
ate
Application Approved B
Date
Application Disapproved for the following reasons:----•-------------------------------------------------------------------------------------------••-•------------
-•-••-•---•-----------------•-----•-•-----•--. ...................................................................................------ --- .........................................................
Date
PermitNo......................................................... Issued........................................................
Date
No.. •J/------------ ...................._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9F HEALTH
.... ems.. OF......../... ... :" ' / d; ;. ,.
Appliration for Uhip a iat 19orkli Tou' drurtion Ptrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
/ram c {(.
_•_ ... d ... sA.{A ...:.P. f�............... j...«va:�!k;.J ..... ...................................................
Location.Address { or Lot No.
..........., '� s..^,!z......as:..?:^....:.3a:: ................•................... . . dress t l.r ...........,_..-...
owner #d e % `w.- ..
� � I r ,J
i::?v ..............` , Cst f.... ........................... ...F.S..I..r< �.}.. f.............................................a s
s` Installer Address _
YP g o, Size Lot._.._�e'..;4_��..$`.�':......Sq. feet
Q Type of Building
Dwelling—No. of Bedrooms..........:......a':°......................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building
�-
a Other—Type g :__ No. of persons......_................ Showers ( ) — Cafeteria ( )
Otherfixtures ------------•-------•--------------•----------------......-------------------------------------------------------•-••---••-•-•-•--•--•--•..........-•
W Design Flow............: . ........................gallons per person per day. Total daily flow._..-------• Via__..................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__:``._�. _:°�epth below inlet.................... Total leaching area.. 4:.::?` ..sq. ft.
' f
Z Other Distribution box ( ) Dosiyn:.g tank ( )
aPercolation Test Results Performed by.. ••---------.................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fT_I Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
- �} ...#.........................................--•--••---........................................
Description of Soil----�1l'� ✓• .......P.d n. c _..--•••-•---•---•--------•......---
V ........................-................................................................................................................................................................................
W
x ----•-----•••--•----•--------------•------•-•-••------•-•---•---------••------------••••--••-•---•-._.._..----••...._..-----•-------------------------•---•••-••••-----•--------••-•----•-•--...........
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 XI of the State Sanitary Code;;,--The undersigge-4 further agrees not to place the system in
operation until a Certificate of Compliance has been vid by tV'Ooay 'of health.
- ff
.........ed....'l. -,.ta ,,.
ate
Application Approved BY . ................. / .7�"..._.._..
Application Disapproved for the following reasons:._. __. ,/..............":.._____._.__...___-----_--_--•__----------------------...-•---•........................................
Date
PermitNo.......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
,t, w
.........:/'�..`)2ln.7.'7............ %t.• i <3�*�s t n>
OF........,r r.......................................................................
(Irrtifirat>e of Tout rliamle
THIS'-'.IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired
r ( )
d a'1 t
b E/t s sr d }� e S Fi
�+ �)'" �/J �'",'� � Jj�� �I lnst�llei jr .1 / L y� ............
..... ... ......---..
$r,. ._ ,ri...... s
has been installed in accordance with the provisions of.Article XI of The State Sanitary Code as d scribed in the
application for Disposal Works Construction Permit No.................J./---.._________-- dated.-VUARANTEE
, . _ --_.THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A THAT TIME
SYSTEM ILL U,NCTf SATISFACTORY.
f
DATE................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD. OFHEALTI-�,
` . OF.
No...... 1..
FEE ..................
Dispaiial:: aarks To�c�.gtra rttrcU Pr it
Permission-is hereby granted.-.........
,��, ;• r"` s .
to Construct �) or Repair ( an Ineividual Sewage Disposal Syst
at No.................'...._L ......A.'d ..r._.:.'_� .,.: H �.t._......r.,eCE ?".._. .L. . .
x
�� Street 1
as shown on the application for Disposaal Works Construction rmit "1� , . Dated.,/.:":m;!'.Z..tI T .....
f{ r
a�f � 7P f dHalth
1 �
31' of
DATE.:... ......... •-••_7� ....------------------•----.............._, ;
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
n
.b
f_
LOCUS x 3.13 '�
Cranberry Bog
s� m .51
_ _ _ _ �G
'P�o �o ,P 11 81.59� %�
car 09 1 GJ20 -�'� 84.78
ti °�� a \\ 83,76 Vk 2� FENCE-
---BG• ---�-SPt.1T RAIL
�e 4.2 84.23
�9 e
1 �
�a 1
00 �6
LOCUS N o S ALE <'
1�/�0$ 84.62 GQ
•ti _-
LO OD
+ 84.52
85.26 '
t INSTALL 40 MIL POLY LINER
1 1 0 1' OUTSIDE EDGE OF S.A.S.,
SHED + 85.21 + 84.81 AS SHOWN
85,33 BOTTOM EL.=86.5
1 BOTTOM EL.=85.0
86.11
t 1 1 x �-
\1 storage ent EXISTING LEACH PIT
x (approximate
94.72 (\�. \` \�� \� \` ��- TO BE REMOVED-SEE NOTE 11
\ 85.46
EXISTING SEPTIC TANK
bP
85.26 (TO REMAIN)
TOP OF TANK, EL.=87.76t
�X, 85.99 I INV.(IN)=86.68E
�\ �- \�\ f• 85.00• INV.(OUT)=86.43E
DIRT 0' F_rom_
1 ,\`` DRIVE _ o � E ge Of Boq
Benchmark Set �34io& + 5.� -
1
Orange Paint/Deck Footing 92� ;i`P i 3 `8 - o
EL.=92.19 (Assumed) , 8` L
VENT x \
z 94.95 � 2.90 ���L O + 9.3 88.72 86.48
co
0 94.29 x DECK 86.53 I
O o\ EXIST. SEWER A6.79
TOP OF CELLAR FLOOR V. EL.=88.2t \ (9
EL.=87.95 EXISTING '1 00 1
TOP OF BIODIFFUSERS I HOUSE(#29) 9� 11 It
EL.=86.33 T.O.F.=95.1±' 9Q I 1
REQUIRED SETBACK=10' la l=8 9 1 I `e r l
j 94.64
j PORCH �94.2 x 93.5$ ��` GC
CD I
95. 0 i - jI 1 89.2
LOT 18 I
I N
1 17,838E S.F. °' \ x 88.40
-'_1 011 APN: 172-252� �c, GS
'Co \ 15.65 x 94.91
9� x - PAVED ,fix 93.59 90.7
J4 N1 DRIVEWAY I�-J6 �\
99.82 i I / I II x 97.1�\ `� �
X ) x
• 9.73 96.75 95,,86 _
IP F D \�� �f 100.00' _ J `� 92.9)
,��
`9 x 97.2 / 92.87
�97.86 2 w 96.07X 5.53
92.73 .94
97.22 96.08 edge 94.68 Of pavement PK SET 91.72
GENERAL NOTES: 92.33
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NO TTINGHAM DRI VE
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW:
-310 CMR 15.405(1)(b):
1) A 3' variance to the 3' maximum cover requirement, for 6' of
max. cover. S.A.S. shall be H-20 and vented.
PRIOR
3 TOEINS ECTONAGE IANDSAL SYSTEM AP APPROVAL BY TLL NOT BE HE BOARD OFC D HEALTH AND THE P��� OF MgSS�� LEGEND
DESIGN ENGINEER.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING o PETER T. --100--EXISTING CONTOUR
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN MCENTEE gg PROPOSED CONTOUR
ENGINEER BEFORE CONSTRUCTION CONTINUES.
5. ALL ELEVATIONS BASED ON ASSUMED DATUM. o� CIVIL N x 100.98 EXISTING SPOT GRADE
35109
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF No. -W EXISTING WATER SERVICE
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �£C/Sj��F� �Q -G EXISTING GAS SERVICE
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 90F �� H.W OVERHEAD WIRES
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. `� TEST PIT
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS l 1' U BENCHMARK
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
10: IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 29 NOTTINGHAM DRIVE, CENTERVILLE, MA
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND �r• Prepared for: Peter Williamson, 29 Nottingham Drive, Centerville, MA 02632
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
12. AREAS REQUI LE MATERIALS SHALL BE ��� f Engineering by: SCALE DRAWN JOB. N0.
IN:
B HEALTH D��®RO BACKFIL Engineering WorlhO "=20' P.T.M. 143-10
13. THISPLANIS EM PURPOSES ONLY AND P,r Inc.nC.
IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. f 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
PLAN REFERENCE: LAND COURT PLAN 38671-B ( LOT 18) (508) 477-5313 5/4/10 P.T.M. 1 of 2
r
NOTE: TO PREVENT BREAKOUT, A 40 MIL POLY LINER
SHALL BE PLACED 1' OUTSIDE THE S.A.S. AS
SHOWN ON THE PLAN AND SET LINER BETWEEN
EL.=86.5(TOP) AND EL.=85.0(BOTTOM)
SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S.
INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL INSPECTION PORT OVER END UNIT
T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE CHARCOAL VENT
F.G. EL: 92.3(MAX.) CONNECT ALL LINES
F.G. EL.=89.3t F.G. EL: 89.8f TO VENT
EXISTING
MAINTAIN 2% GRADE (MIN.) OVER S.A.S.
L = 9' L = 8'(MAX.) INSPECTION
® S=1% (MIN.) 0 S=1% (MIN.) PORT
4"SCH40 PVC 4"SCH40 PVC
6"13-
�"I 6 11.3" TO
14" INVERT
EXISTING 48' LIQUID I I
LEVEL ADD INV.=86.32 PROPOSED INV.=86.15 r4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25.0'
GAS BAFFLE
INV.=86.43t D-BOX INV.=85.94
EXISTING 4 OUTLETS (MIN.) SOIL ABSORPTION SYSTEM (PROFILE)
- EXISTING SEPTIC TANK
ESTABLISH VEGETATIVE COVER
BACKFlLL WITH CLEAN NATIVE OR
PERC SAND TO TOP OF CHAMBERS
NOTES: BREAKOUT EL.=TOP EL.
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP ELEV.=85.33
INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=8 .94
2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM ELEV.=85.00
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 2.83'
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE BOTTOM OF
T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=11.3'
3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE NO G.W. AT BOTTOM OF TP, EL=78.4 - MATERIAL
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL.
4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS
WITH NO SEPARATION BETWEEN EACH ROW & NO STONE
SEPTIC SYSTEM PROFILE TYPICAL SECTION
XT.s
N.T.S.
(3) 5" DIA.OUTLETS
SOIL LOGS 5.5" 16" 2-
DATE: MAY 3, 2010 (REF#12,820)
SOIL EVALUATOR: PETER McENTEE (SE#1542)
WITNESS: DAVID STANTON R.S. 15 5" E
12"
HEALTH.AGENT rELEV. TPDEPTH ELEv. TP-2 DEPTH p91.6 A 0 91.4 A 0" ..
SANDY LOAM SANDY LOAM
H-10 LOADING 2"
91.1 10YR 4/2 6" 90.9 10YR 4/2 6„
B B D-BOX
SANDY LOAM SANDY LOAM
10YR 5/8 10YR 5/8
88.6 36" 88.4 36"
C 48" C
PERC 75"
60"
M-C SAND M-C SAND
2.5Y 6/4 2.5Y 6/4
>20% GRAVEL >20% GRAVEL
78.6 160" 78.4 160" 76 _
PERC RATE <2 MIN/IN. ("C" HORIZON) PROFILE
NO GROUNDWATER ENCOUNTERED
16"
' 11
�-�--34"---�
DESIGN CRITERIA SECTION END CAP
• NUMBER OF BEDROOMS: 3 BEDROOMS 16" HIGH CAPACITY (H-20) BIODIFFUSER UNIT
SOIL TEXTURAL CLASS: CLASS I MODEL 16" HICAP
DESIGN PERCOLATION RATE: <5 MIN/IN LENGTH 76"
NOTE: UNIT CONFlGURATION AND AVAILABILITY SUBJECT
DAILY FLOW: 330 G.P.D. EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
DESIGN FLOW: 330 G.P.D. SIDE WALL HEIGHT 11.2" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
GARBAGE GRINDER: NO OVERALL HEIGHT 16"
LEACHING AREA REQUIRED: (330) = 445.9 S.F. OVERALL WIDTH 34" 4640 TRUEMAN BLVD
•74 13.6 CF off4se HILLIARD, OHIO 43026
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSTEMS, INC.
PROPOSED D-BOX:: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 4 ROWS OF 4 - 16" (H-20) ADS BIODIFFUSER UNITS
W/ NO STONE FOR AN S.A.S. WITH DIMENSIONS 11.3' x 25.0' 29 NOTTINGHAM DRIVE, CENTERVILLE, MA
Prepared for: Peter Williamson, 29 Nottingham Drive, Centerville, MA 02632
SIDEWALL AREA: NOT APPLICABLE SCALE DRAWN JOB. NO.
/ Engineering Works, Inc. NTS P.T.M. 143-10
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.7 SF LF OF BIODIFFUSER) Engineering by:
16 UNITS x 6.25 LF x 4.7 SF/LF = 470.0 SF
12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET No.
DESIGN FLOW PROVIDED: 0.74 x 470.0 = 347.8 GPD (508) 477-5313 5/4/10 P.T.M. 2 Of 2