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HomeMy WebLinkAbout0070 NOTTINGHAM DRIVE - Health ENOTTINGHAM DR.,CENTERVILLE 172 015 �Ill� �� 6 �� UPC 12534 ' IV mmmm 153LOR � HASTIN©S,MN VYe No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r}g PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppfication for Dioozar *wem Com5truction i3ermit Application for a Permit to Construct( 1�12epair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.7/0`�Ne IriogholI4 Vri t j_' Owner's Name,Address and Tel.No. Assessor's Map/Parcel �'^�NT���'��/ /= 1'vo/'1'e- O`j ack rusk/' Installer's Name,Address,and Tel.No. �08—G�°��- LJ73 Designer's Name,Address and Tel.No. Jrt�`�'- JGs hark 461e5r Cron -// i Type of Building: Dwelling No.of Bedrooms '3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations.(An wer when applicable) ZV,5 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been ' ued by this Board of Health. Signed./ Date Application Approved by te�4 Application Disapproved or the following reason Permit No. Date Issued /^ No. Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION -TOWN,,OF BARNSTABLE,, MASSACHUSETTS Rpprication for Migogar 6pgtem Construction Permit w Application for a Permit to Construct( 1,�)-Repair(110'f7pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.7,9 A/a Iriii f hA4,w Ori�/, Owner's Name,Address and Tel.No. Assessor'sMap/Parcel 6/- 4Vnnz 0�acya6&57kl' Z` 7- Installer's Name,Address,and Tel.No. s-d8,112O_ 977,38 Designer's Name,Address and Tel.No. /2, Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage,Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. ! Plan Date Number of sheets Revision Date Title a Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(An wer when applicable) Zysrlg/I 9 t Date last inspected: t Agreement: ` {r The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed .: Date le Application Approved by ��� _ Date 1 Application Disapproved or the following reasons lei Permit No. ''r Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( &)-Repaired( G-)-[Jpgraded ( ) Abandoned( )by 's S at 711 has WeiLconstructed in accordance with the provisions of Ttle 5 and the for Disposal System Construction Permit No.� atd Installer S Designer 0 The issuance of this permit shal}not e construed as a guarantee that the syst tt(n will rs s desig .d. Date (0 Inspector . No.—oze2:::-�17— ----®----------------------Fee-I - ✓""�..»• THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Migpogal *pgtem CCongtruction Permit Permission is hereby granted to Construct( t-rRepair( 44-L-rp—grade( )A�andon( ) System located at D and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constluctiioonn ust be completed within three years of the date of thi ermit.. Date: ! Approved `a t� PP d b Y r ; V Town of Barnstable Rogulatory Services Tbawas F.GeUer,'®irera;:ter° Public Health Division T'horsa-v McKean, Director 200 Mal* 59 4*t,lfysn** .MA 02601 t,fi6;e: SO11462-46444a�s �Di3 7�C�-6 °94 � �x ��r�ea°tl44ca�aas� r bete.. 1� %A Peemaks ' 4. / _ Assessor's M epallraarceD__I 7 Z—®t msitgner: installer-, Address, i2 w—LGLUS 14J!J p Address: �� o�V%%. � c1 e O� / �-n�,.. was issued a permit to installs (dame) t irstaller) septic system et -!L\3,.Ak41�. vvc� (Z- C7 �_. JA f'lbesed are a design dam by . (addrrs3) 1 � uC _ �j, dated 4desi�re�) l certify that the septic systern referenced above was installed substantiatl>, according tv the design., which may include minor approved changes such as lateral relocation of the distribution box andioe septic tank, i u rtiN that, the septic systerra referenced above was in!�aalled with major changes O,e. greater than IT lateral relocation of the SAS or any vertical relocation of any component of:he €eptic system) t?ut in accordance with State Local xesulationas. Plan revision or certified as-bui)t by designer to follow. r ✓r, P�oF M48S, s` 0 PETER T. GJ, (Installer's sixu 'e) z McENTEE CIVIL `n No.35109 Q A� 9F�157EP`��C1�� - _ T signer's Signaturej � 't _ S tamp Here) �t cnea Yk� rA} r�➢ �rA e. ..1 BLAU 1A�w�r= _=>Ltc z , lAurctc>o ast �rau C?:Bigt`tarJ'�.aas�clfIefayatiar C'ceti@icAssaa►F'varra T.Zae-!�1+iu. _ ,/ TOWN OF BARNSTABLE di LOCATION 74 lC�dl/i�gLis�� D/'!✓F SEWAGE # %o0G VILLAGE ASSESSOR'S MAP & LOT / INSTALLER'S NAME&PHONE NO. 0- 1139 r�as�rP� A,f,*`d'OS SEPTIC TANK CAPACITY /D dO LEACHING FACILITY: (type) 2 ',S'0P (size) NO.OF BEDROOMS //-- BUILDER OR OWNER PERMIT DATE: I'2 7— ©G COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 V", ty) Feet Furnished by I �-q u • I QFL� ssJ- J�j0 ~ TOWN OF BARNSTABLE LOCATION �yo SEWAGE # VIUAGE Gr,Y/7'e1l11'11f ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY IeW fallf) LEACHING FACILITY:(type) /-��3- Z4AiA1&1V'S(sue) NO. OF BEDROOMS J7 PRIVATE WELL OR LIC WAT BUILDER OR OWNER C4a111g1-110e ��V// DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No -. ��c�o� �ou5e � ®�,� Nrf 3 � � �� � S, BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address Prop Date of Inspec} /_/;As_�Map Parcel.. „/ Owne PART A — CHECKLIST CHECK IF THE FOLLOWING HAVE BEEN DONE: PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM HAS BEEN RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A. !/ THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE.B THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK WAS INSPECTED FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE, DEPTH OF SCUM. vTHE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON-INTRUSIVE METHODS. THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL No of Bedrooms No of Current Residents _Garbage Grinder yles Laundry Connected to System / 16 Seasonal Use NON RESIDENTIAL: Calculated flow WATER METER READINGS,IF AVAILABLE: GALLONS Pumping Records and Source of Informatio � SYSTEM PUMPED AS PART OF INSPECTION? IF YES,VOLUME PUMPED = GALS Reason for Pumping: TYPE OF SYSTEM: I/ Septic tank/distribution box/soil absorption system Single Cesspool Overflow Cesspool Privy Shared system (if yes, attach previous inspection records, if any) Other(explain) Approximate age all components. Date installed,if known. So rce of information. T / o �.��i SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? VD r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B - SYSTEM INFORMATION (Continued) SEPTIC TANK: t- Depth below grade: Q/if Dimensions: (J r. 5- X 6p, X J / Material of construction: Concrete Metal FRP Other} Sludge Depth un e Distance from top of sludge to bottom of outlet tee or baffle Scum Thickness C»e Distance from Top of Scum to top of outlet tee or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments:f5 Q 106(3 Ste. DISTRIBUTION BOX: /-Jo r rn .d ,e. DEPTH OF LIOUID LEVEL ABOVE OUTLET INVERT Comments: tail eoa / rcS 7`r'r 1L p� d �� �,� o PUMP CHAMBER: Njo in working order? Comments: SOIL ABSORPTION SYSTEM (SAS): IF NOT PRESENT,EXPLAIN: TYPE: I- /000 Q 0 ltlol-). re-C _ V4 /q-) -Comt`Sts Leo a 6 a716 s v CESSPOOLS: 11 Number and configuration Depth-top of liquid to inset invert Depth of solids layer Depth of scum laver Dimension of cesspool Materials of construction Indication of groundwater inflow(cesspool must be pumped) Comments: PRIVY: D Materials of construction Dimensions Depth of solids Comments: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) l SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES, LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' Ace or + ° DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C — FAILURE CRITERIA / (Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not.) Backup of Sewage into Facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the districution box above outlet invert? Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? Required pumping 4 times or more in the last year? Number of times pumped IV Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiltration? tank failure imminent? Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? Within 50 feet of a surface water? IVI Within 100 feet of a surface water supply or tributary to a surface water supply? Within a Zone I of a public well? Within 50 feet of a private water supply well? ,A/ Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)? Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508)771-9399 CERTIFICATION STATEMENT I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE IN THE PROPER FUNCTION AND MAINTENANCE OF ON—SITE SEWAGE DISPOSAL SYSTEMS. CHECK ONE: I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. INSPECTOR'S SIGNATURE: DATE: ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY Fss...,..�..0.... THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH �r"stable Conservation Department TOWN OF BARNSTABLE App1ira#ion for Dig osal Works �nn��r�c#tun s rnit Date Application is hereby made for a Permit to Construct ( ) or Repair (Y) an Individual Sewage Disposal System at: T�� ?6 1� �LV ,4 : -----------------------------------------------------------------------------------------------•- ..............._.... ....... ocation-Address or Lot No. Owner Address a .lc?.B2�c�!1 U✓Gt _v ......................................... ................................................... ...... ......... ....-.-•.--............. . nstaller Address UType of Buildin Size Lot............................Sq. feet Dwelling No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures --------------•--•------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter........:....... Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 11.4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ 0 9 •------•••••.............•••-•--••--••••-••••-••-•-•---•-•-••••••••-•...........•-------••--•.-----•......................................................... Description of Soil............................................................................... ------...----------------------------------------------------------...........------•--• x W ••••-•-•-•••-----------------------••------•---••-•••-•--------------•--••-•••----------•-••------•--- ....... - - - - -------- ------- U Nature of Repairs or Alterations—Answer when Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e has been issued y he board of health. Signed ---- _- --- --------- Date Application Approved By -----------ax_'-...... .... ...2-.Z ............................... Dare Application Disapproved for the following rearonrGy .............................. .. .................... .... ...................................... .... ................ ... ....................... ......................................... .................. ............:.:. q Date PermitNo. .....9.. .... . �-�................... Issued ........................................................... Date No...9�.._._: . FEE... . ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Bisposal Works Tom;trurtion jlmutt Application is hereby made for a Permit to Construct ( ) or Repair (Y) an Individual Sewage Disposal System at: _ T-I� /� Location•Address or Lot No. ................. R,rin_��r� SF I�------------------...------------ ---------... .........---•--........... .............................................. W Owner Address ............... . ......................................... ...................................-.............................................................. Vnstaller Address Type of Building Size Lot............................Sq. feet Dwelling�No. of Bedrooms:: ......................................Expansion Attic ( ) Garbage Grinder ( ) a Other—T e of Buildin a yp g ____________________________ No. of persons_._._.....-......._......... Showers ( ) — Cafeteria ( ) 04 Other fixtures -------------------------------------------- ............. Design Flow............................................gallons per person per day. Total daily flow................................. !:gallons: Septic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth.... ........ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area............./...sq. ft. x Seepage Pit No-_----------_----- Diameter.............._..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--.................... , fXq Test Pit No. 2................minutes per inch Depth of Test Pit................_... Depth to ground water........................ a -------------------------------------------------•-------------....-----•....------....---------•--.............................................. ._------••-- 0 Description of Soil...................................•-•--------------.......------------------------------------------•--------------•-----------------------•----- ..._....----•----- x W -----•---------------------------------------------------------------------------------•-•---------------------------s-----------------------------------------------------------•--^= U Nature of Repairs or Alterations—Answer when applicable--rat'!. c-a-..I ".......... 10.0---:3.7�J!.f Z?_-/ ........ ---••---------------------------------------------•-----------------------------...............---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by e board of health. Signed ., �....�. ---------- --------------_---_--------- ----------- Date Application Approved By .. --------- o, �.-.K-.•lam 4 ue. ---j Dare Application Disapproved for the following reasons: ----- ----------------------------------------------------------- ------- -------------------------------------------------------------..............................................................-------- -------- ................ Permit No. ----- ....................... Issued .......-----------........----------- -- --------..Dare Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ge>r#tftra e of Cantlatia ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by---------..Co.R.oto.... .�,1,� 4- i Q—S �� ''� � Installer � at .....---r-//-0-- ra.'NL �I( �(��v• e J --- ---------------------------...------------------------------------------------...---------------------------------------------------- ................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ................................................ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------.................').. - q^p5a Inspector ------�� ......---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L TOWN OF BARNSTABLE FEE....+,.X.�... Roposal Workv Tonstrudiatt 1phrufit Permission is hereby granted-------- CO 2°p'` �v. ............................................................................... to Construct ( ) or Repair ( an Individual Sewage Dis�iasal System at No. O N"-77:���]t!_✓!-_....7C� _e' --=n -I-(<...................................................................................... .Street qq // as shown on the application for Disposal Works Construction Permit No�-,/)--9�Dated.........:................................ •----------------•----------- . • ......................................................... DATE_ ��— Board of Health �� i7. -------- -- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS ` T C, TOWN OF BARNSTABLE LOCATION470 Z7)` ��,, vG SEWAGE # RN '15-6c, VILLAGE C�'�r,��;y� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY �660 61'4/ LEACHING FACILITY:(type) ��4`�&/�o—/��./ (size)3 NO. OF BEDROOMS - PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ChI111, /, 5,T1,1/ DATE PERMIT ISSUED: IXIov- /7-19f'a DATE COMPLIANCE ISSUED: I �.• Ic2 VARIANCE GRANTED: Yes No 1/ y l�PfPrL'� • 's No....- ..9.7------- F$s....�..�._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..........OF...�}iq. !l/�.T..!b�i.� .................. 2 Applir #ion for DiiiVosal lVorks Tons#rurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at ....... 5._... a .1 / Mtn,......��r��........ ...... frv� 1�.. ................. .... ............ `�o t n•Addre / or Lot No. Owner Ad e s a ........,���'?�s_......-1�-•-e-,1o�9y.................................. .....�y�__.._. .��@�J... Ad? . Installer Address UType of Building Size Lot---�'_�_E! ........Sq. feet Dwelling—No. of Bedrooms.......... ________.................ExpansionAttic ( ) Garbage Grinder ( ) Other—Type of Building ._�gl ;: PR/n�No. of persons____________________________ Showers ( ) — Cafeteria ( ) Other fixtures ____________________________ d W Design Flow....................45-Q____________.__gallons per person per day. Total daily flow_..._..__._____._..__..._.__gallons. WSeptic Tank—Liquid capacityA gallons Length................. Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Wi th .. _____ Total Length.................... Total leaching area._.__._._._.._ ...sq-ft. Seepage Pit No_____________________ Diameter. X _. epth below inlet.................... Total leaching area_._ ........�sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water-----------_______-.-_-. L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------- -- O Description of Soil SA A., . a... '� ' •••••-----•-------•---•••--------•-••-----••-----•-----•--••-•---•----•••••-•••-•.....................••-•••-_____ x W UNature 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 underAigned further agrees not to place the system in operation until a Certificate of Compliance has bee ued by bard f health. Signe - I - .................. Date Application Approved By......... •---•• at Application Disapproved for the following reasons:-----•-•---•--------••--• ._.... ••-••............................•••-• - ----•-•---•-------------••--•----------•----...--•--•------••-••--•--•---•••-•.._...-----•-•-••••--------.-._._.._.__••-•---•----•_____. Date PermitNo........................................................ Issued......................................................... ......�.. ��-.�__�_ Date -- ------------- --------------------------- -� No. •5...9-7----•--- Fxs.."`1. .._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OR HEALTH p IL Allnlf.raffou for Bispood ]Parks Toustruriiott Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......... ....7 .....,-'.�/I C.t' 7{ `.`t7^':`':.......:stlf.�.. .......... .... '{j . .': ..... .. .....,............................ /f 1�/!�i L Looatton Addres„�,... -��-„ ,e or�Lot.No, ..n.....1, '} a�L.ei.l .., I Ai f�sr....... . i:..�.:....... .............. .... :� .(�'I�`r .vb e�:e.:..`i.. ......................,... . .....,......... r.. W Owner : j Add ess a .......s l i'•3�". .... _j .Ll:f_.` e...........................:..... ::r f X.- '. �* .�......................... ............. Installer Address U Type of Building Size Lot----Z-Z._i•'��'=;4:........Sq. feet Dwelling—No. of Bedrooms............_ ............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building __{xt :_:`� +?.___ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .....___---••................•-------._........---..._----•-----•--•----__.._..._..--•--•-••---------------•-•---._._..______- WDestgn Flow.................... _ _______________gallons per person per day. Total daily flow............. ...................gallons. W Septic Tank—Liquid capacity gallons Length................ Width................ Diameter................ Depth............... Disposal Trench—No.____________________ Width .. ._- Total Length.................__. Total leaching area.............. sq. ft. Seepage Pit No--------------------- Diameter__...:.-::_:______t ;th below inlet.................... Total leaching area........: ........sq. fI. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fMl Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... Rai . ......••-•-•-•-•... ........... r ••-•-......•••-•-......................................................... O Description of Soil........... -Ai1 t . x U ...........••••--•••••--•--••••-••-•••...---•••-••••-••-••••--•-------•-••....•••••••••••--•--•••••-•••••••-••-•---•-•••----•-••-•..._..••-••••••-•••••--•••••••--••••••----......--••••......•---••••-- W UNature 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 undegned further agrees not to place the system in operation until a Certificate of Compliance has be; by e oardrof health. Signed ••. ••..:..s . ---.....••_••••. ` Date Application Approved By..:•-•-• mil Gam'• - --- ------ ----1.,2. D If af Application Disapproved for the following reasons------------------------------- ---------------._.._..--•---------------•--...----------•--•-----------------... .....•••••--_.._..•••...••_..._._....••••••--•-••••----•••-••-•.....-•---•••••-•_.._....•••••••••••-_---•-••••••••••••••••••---•••--•••-•-...---••------•••-•••-•• .................................... Date PermitNo......................................................... Issued....................................................... Date THE .COMMONWEALTH OF MASSACHUSETTS BOARD. OF HEALTH,, _. oF..... .............................. ............................................. Tntifirate of Toutplitturr THIS ,S TO CE•RTIF That the Individual Sewage Disposal System constructed ( or Repaired ( ) by.............kJ/?. '_1._.. 1�''/ + ;caK! 4 J r nr# fl,i . .1................................................... F lnst filler has been installed in accordance4ith the provisions of Article XI of The State Sanitary Code as deWDd in the application for Disposal Works Construction .Permit No____________________t'�_ '`7__ dated.._._._._ . _{THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ........ Inspector..__.___ '+ n DATE................ ............................................................... ..,F.--..........P��Y)..----................................ THE COMMONWEALTH OF MASSACHUSETTS I BOARD,MOF HEALTH No......................... FE ._...................... Disposal Marks T_,> kstritriiun Vrruti# Permission is hereby granted....... %.._ ` ...... .. �— �`'�<�� .....................� ............................................ to Construct.( ) pr Repair ( ) an Indivi�Sewage Disposal S em r' at No.......... :.......... :Wj �''` ".. .... '. t. *......°.' ',:. 1 ..... ,� Stree as shown on the applicatiori'for Disposal Works Constructioimit "! � ..... " t -/ Health Board of Health DATE---=--------- ----- -/-------�----.._....-------------: - - • FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS _y LEGEND go s BENCHMARK: MAG NAIL IN BITCONC. Q� ELEVATION = 100.0 78 PROPOSED CONTOUR 9 °°�� ac,� LOCUS �o (A55UMED DATUM) PROPOSED SPOT GRADE ° EXISTING SEPTIC TANK 79 mhPyQ car°`` 9� TOP 4OF TANK=96.87 INV.(OUT)=95.54t —97_�� EXISTING CONTOUR -`'�`3 EXISTING LEACH PIT TEST PIT ti TO BE PUMPED & WITH SAND W EXISTING WATER SVC. '9 �-- EXISTING INFILTRATORS TO BE REMOVED (SEE NOTE 11) BENCHMARK J 19 539°05'O �'' ' Epp ( 1 LOCUS MAP N.T.S. 155.00' �o TP-1 TP-2 Q o , M GENERAL NOTES: - —/ DECKBITCONC.�_PR _P.,. S.A.S..::,� 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 5LAB r__ - - - BOARD OF HEALTH AND THE DESIGN ENGINEER. \ 00 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 1 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE _ VENT LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: NO. '70 1) 310 CMR 15.405(1)(b) CONTENTS OF LOCAL UPGRADE APPROVAL: A 2' variance, S.A.S. to Slob, for on 8' setback. -- l03 .1 ? 1 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR WD, FRM, TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE tu i DESIGN ENGINEER. — T.O.F. . SHEDSHEDT.O 10593' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING N FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �9 O O I ENGINEER BEFORE CONSTRUCTION CONTINUES. r 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. r N — — In 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF Q Z THE CONTRACTOR HEALTHFOR PROPER INSPECTIONS DURING CONSTIFY RUCTION.CONS TRUCCAL BTIION. OF 7. WATER SUPPLY PROVIDED BY TOWN WATER. .. Q 8. THERE ARE NO ABUTTING WELLS LOCATED WITHIN 150' OF THE S.A.S. 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL -BE RESTORED AN 172- 15 , _�� PETER T. s TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 17.051 ±5F McENTEE �_ 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY o CIVIL ' THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CI No. VIL CONSTRUCTION. SOILS } RfG(SZE� �Q 11. WHERE IN THE AREA BESNEATSH ANDTSFORS5ALL FT. ON GVE ALL ALL SIDES OFUNSUITABLE THE E S.A.S. ► `FSS/ AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). . 12. CONTRACTOR SHALL EVALUATE STUCTURAL INTEGRITY OF EXISTING t \2 SEPTIC TANK PRIOR TO CONSTRUCTION. �. 'A1 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 155.00' 1 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. N39005'20"E cli�� OHVv H 4 - OHW i,W TELEPHONE PROPOSED SEPTIC SYSTEM UPGRADE SERVICE 70 NOTTINGHAM DRIVE, CENTERVILLE, MA EDGE OF PAVEMENT ' 1 Prepared for: Lynne Obuchowski, 70 Nottingham Drive, Centerville, MA 02632 a I Engineering by: Surveying by: SCALE DRAWN JOB. NO. NOTTI NG11AM DRIVE EnglneeringWorks HOOD SURVEY GROUP 1"=20' P.T.M. 210-06 ( 12 West Crossfield Road P.O. Box 1724 DATE CHECKED SHEET N0. Forestdole, MA 02644 Mashpee. MA 02649 9 2 06 i (508) 477-5313 (508) 539-7799 P.T.M. 1 of 2 i „ 4 NOTE: TO PREVENT BREAKOUT, THE PROPOSED F.G. EL: 97.5(MAX.) FINISH GRADE SHALL NOT BE < EL:94.5 T.O.F FOR A DISTANCE OF 15' AROUND THE (EXISTING) F.G. EL: 97.5t VENT PERIMETER OF THE S.A.S. EXISTING F.G. EL: 97.5t(EXISTING) MAINTAIN 2% MIN SLOPE OVER S.A.S. 4 SCH 40 PVC PERFORATED PIPE WITH SCREW CAP SET TO WITHIN 3" OF FINISH INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-�OYjb?PGALLON LEACHING CHAMBERS GRADE TO SERVE AS INSPECTION PORT. TO WITHIN 6" OF FINISH GRADE WITHIN 6" OF FINISH GRAD!BI SERIES_W IL-al ONE ALL SIDES ,. INSTALL RISER W/ HEAVY DUTY FRAME 77 -7-1L =2' L=20' & COVER SET TO FINISH GRADE 6n. . 4" SCH 40 PVC 4" SCH 40 PVC 2" LAYER OF 1/8" TO 1/2" T0" " EXISTING 14" ® S= 1% (MIN.) a &? S= 1% (MIN.) ®aa�aaa DOUBLE WASHED STONE 1000 GALLON aaaaaaa SEPTIC TANK 1 INV. ELEV.=95.40 INV. ELEV.=95.23 2' EFF. DEPTH aaaaaaa 4' 3/4"-t 1/2" a...q.'.'. (SEE NOTE 12 -SHEET ) EXISTING ADD Ag D-BOX 4' S•2 DOUBLE WASHED BALE INV.EL: 95.54t EFFECTIVE WIDTH = 13.2' STONE INV. ELEV.=94.00 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION. 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE TOP CONC. ELEV.=95.0 -BREAKOUT ELEV.=94.5 ON A MECHANICALLY COMPACTED SIX INCH CRUSHED ease STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). c INV. ELEV.=94.00 eases 3) INSTALL INLET & OUTLET TEES AS NEEDED. ®®®® aBaaa aaaa��aaaaa 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM ELEV.=92.00 2 x 8.5' = 17.0' I 3' AS MANUFACTURED BY TUF-TITS, ZABEL OR EQUAL. 3' � r r 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 23.0' SEPTIC SYSTEM PROFILE T.P. EXCAVATION OR G.W. NO G.W. ENCOUNTERED LEACHING SYSTEM SECTION (3) 4" DIA.OUTLETS 22" N.T.S. BOTTOM OF TP EL: 86.8 (TP-1) � , r N.T.S. -+I �-4" TYP. -.1. NOTE: CONTRACTOR SHALL VERIFY 501E CONSISTANCY j WITH TOWN OFFICIAL OR ENGINEER AT LOCATION 4" GRAVITY 1 22.5" OF PROPOSED S.A.S. PRIOR TO INSTALLATION, PETER T. �' -"ouTLeT(TrnENTEE .0!71.5" v CIVIL " i T � DESIGN CRITERIA Na. 35109 �a t 4" a- NUMBER OF BEDROOMS: 3 BEDROOMS D-BOX SHALL HAVE H-20 RATING SOIL LOG SOIL TYPE: CLASS I 6 N.T.A DESIGN PERCOLATION RATE: 2 MIN./IN. ` DISTRIBUTION BOX DATE: AUGUST 24, 2006 (P-11,434) DAILY FLOW: 330 G.P.D. N.T.S. 23_-_-_-1 SOIL EVALUATOR: PETER T. MCENTEE C.S.E. DESIGN FLOW: 330 G.P.D _ -__- � INSPECTOR: DON DESMARAIS - BARNSTABLE AGENT GARBAGE GRINDER: NO I I LEACHING AREA REQUIRED: (330) = 445.9 S.F. M PROP. S.A.S. I _ Elev. TP-�1 depth Elev. TP-2 Depth .74 -.rEzIE03 ® 0 ®®®® I __ _-J 97.8 01197.5 A 011 EXISTING SEPTIC TANK: 1000 GALLON CAPACITY (ESTIMATED) ®®®®®®�® 37" L------ ®®®®�®®® FILL FILL ®®lt�®®®®® 97.5 B 4" 97.2 B 4" USE 2-500 GALLON LEACHING CHAMBERS IN SERIES M-C SAND SANDY LOAM SIDEWALL AREA: 2(13.2' + 23.0') X 2 = 144.8 S.F. 102" No. 70 95.8 tOYR 5/6 lOYR 58 24" 95.5 / 24" BOTTOM AREA: 13.2' x 23.0' = 303.6 S.F. i 5TY.` C 42" C TOTAL AREA: 448.4 S.F. 4" KNOCKOUT 2°" DIA. COVER , i FRM. [` PERC DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. " KNOCKOUT O/ /4' KNOCKOUT 62" ! { 54., ' COARSEM-C SAND 2.5Y 5/6 PROPOSED SEPTIC SYSTEM UPGRADE 4' KNOCKOUT 2.5Y 6/4 70 NOTTINGHAM DRIVE, CENTERVILLE, MA Prepared for: Lynne Obuchowski, 70 Nottingham Drive, Centerville, MA 02632 500 GALLON CAPACITY, H-20 LOADING 86.8 132" 87.5 120" Engineering by: Surveying by: SCALE DRAWN J08. NO. CHAMBERS NO G.W. ENCOUNTERED Engineering Works HOOD SURVEY GROUP NTS P.T.M. 210-06 1 N.T.s S.A.S. LAYOUT PERC RATES < 0 12 West Crossfie Road P.O. Box MA DATE CHECKED SHEET N0. 2 MIN/IN. ("C" HORIZON} Forestd°le, MA 2644 Mashpee, MA 02649 9/2/06 P.T.M. 2 of 2 (508) 477-5313 (508) 539-7799