HomeMy WebLinkAbout0295 NOTTINGHAM DRIVE - Health 295 NOTTINGHAM DR., CENTERVILLE
A= 171050
UPC 12534 '
No.2a 153_R
HASTINGS,MN
A TOWN OF BA']R�NSTABLE
c. LOCATION. 6��'T�I��-�' l� V� SEWAGE# A0 lssa������ `" �3�
VILLAGE CCX.T�V1 C/-- ^AS,,SESSOR'S MAP&PARCEL�`-,aSa
INSTALLER'S NAME&PHONE NO C�4P-(=Q-).( ;
SEPTIC TANK CAPACITY t,b®o kLu&)
LEACHING FACILITY:(type 4±(Mq1 (size) 12.2 X 5
NO.Of BEDROOMS
OWNER Q,V c LL,57(21n10
PERMIT DATE: �� ",��(7 COMPLIANCE DATE: '
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility AJ 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) 1,4 Feet
FURNISHED BY C�� �1�� �� V/Z
A- 1 L
a G
A, 2. = 31. G
Q�1 y2a
2.
z
0
44-
(3.3 , 32.4 '
3�,-3 '
Z
-5 - 3C
'�- 3 - 39 .2'
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:. `
PUBLIC HEALTH DIVISION - TOWN 00 BARNSTABLE, MASSACHUSETTS Yes
ZIPPItrattou for.1"4r� l
l05a *p�tettt Contrurttott Vermtt
Application for a Permit to Construct( ) Repa Upgrade( ) Abandon O ❑Complete System ❑Individual Components
Location Address or Lot No.;Lg y NorxiNG-Ma1&t D _ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel (°(( 150 A95 AS 0-rT1Pe LlV(� P, ��t LL-8'
Installer's Name,Address,and Tel.No. 50'0 4"l—ES Designer' c��s Name,Address and Tel.No. 5762—X1 3 ' 377
C.4?&W(b 6 6)JT00kh6 ES -r C, �tj c,
I5 0-ow' 'WZ<2 0fc, ZT
Type of Building:
Dwelling No.of Bedrooms Lot Size t
I'll 1 0 3" sq. ft. Garbage Grinder ( )
Other Type of Building �LS(8t!'t.l CI$(, No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 3 q9 ,q_ gpd
Plan Date I Number of sheets Revision Date
Title AS lllp-rT/TJ&."4"4, DD CaJT�ja_ --
Size of Septic Tank coo C—A("0 Type of S.A.S.��� �txj C-4 —A-00 c;C*9e06AK
Description of.Soil k4a lUm Si4A,�b 0 6" 1)CQJ
Nature of Repairs or Alterations(Answer when applicable) USE L�(l�<luC—. I t 000 Q—*V_CZ&j
—to N6—W 1)—gioyyM 6�) <sp�� ix.) C.��4E 11d.JC�S C /6GtL3 .S Lqj i-rT4 14 l�—i-
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boa o Health.
Signed Date -"X0 d
Application Approved by Date
Application Disapproved by: Date
Lfor the following reasons
Permit No. ' Date Issued
t A
Fee .01 AM
., THE COMMONWE H OF MASSACHUSETTS.
Entered in computer:
�
PUBLIC HEALTH DIVISION - TOWkO�'BARNSTABLEMASSACHUSETTS
3
Yes
w ZIppricatiou for Di= F ota *patent Cow6truction er, m ,
Application for a Permit to Construct( ) Repair ,Upgrade( ) Abandon( ); ❑Complete System ❑Individual Components
Location Address or Lot No.a9T NOTT(t-<7N o4M AtZ Owner's Name,Address,and Tel.No.
C GUIC..LC-gMO VCCAZQ0r-Z-
Assessor's Map/Parcel ''y /7 a95 tit O-11(04&4 w( p k QQ.l-&1tU f G.CrG
Installer's Name,Address,and Tel.No. 1 _g g SOQ— �'3 O 3"77- I Designer's Name,Address and Tel.No.
C 4?Ew(b E e)J'T
Type of Building: + _
Dwelling No.of Bedrooms C Lot Size ! t j O 3- sq. ft. Garbage Grinder ( )
Other Type of Building R4M(AfLnj 4K- No.of Persons Showers( ) Cafeteria( )
Other Fixtures ,,
Design Flow(min'.required) � � gpd Design flow provided 39 ►"l' gpd
Plan Date -1 - j y-el O l`1 Number of sheets 1 Revision Date
Title al9S jU n t rj&WAA4 !)jZ C ep C7 !(CL45'
Size of Septic Tank 00 Gyk4z&i Type of S.A.S. ('e1� 57G.40 —64WA200
Description of Soil Mal( M SAA. b l V 1 36!1� 4 t514 AGA1U _
Nature of Repairs or Alterations(Answer when applicable) USE W(ST(t.JG- 1,UOC� CAbJ S�Tt G`Ty41V j�
-toN��/ �v � ) l��Ek+rk. r Gft AW8 UU t MA � r, �
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,,6.
Compliance has.been issued by this Boa d of Health.
Signed Date • �1
Application Approved by Date 71,
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued_ 4;�
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( x) Upgraded ( )
Abandoned( )by ( biC
at YF E(V o y'(NEt{Ajjc DR/U€ C E1ulakutt:C.,c has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. al"ll`) --'--3 (0 dated !.
Installer CAPS(,()/pg Designer
#bedrooms Approved design flow i2�;Qo gpd
The issuance of this permit shall be construedas a guarantee'that the system�11 lun ay on designed.
Date I Sof ! Inspector t\ X 2
_ _ __ _._—.---_. _---_------------ ---- ———--
No. I y Fee
(C(�� THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS
wi5po5al *patent Construction permit
Permission is hereby granted to Construct ( ) Repair ( X ) Upgrade ( ) Abandon ( )
System located at ;99 7 N oTp&4a0AtAA DR-t UC-- r-4c5�03,5WlLLIs—
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be prnpleted
^within three years of the date of t) is per it.
Date �t�, ! Approved by _,_
#5611 P. 001/001
Town of Barinstable
Regulatory Services
Richard V
i a►a r
� Ctli,Interim Director
""aa"�WJVI Public Health ]Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 509-790.6304
Installer& Designer Certification Form
Date: A 7 Sewage Permit# ;0V! !k Assessor's Map\Parcel 17 t 'StD
Designer: Inc.. Installer: Gaee.wicle L-"ntcr�rtse5
Address: 2b5y a'nbeE 14 i (nwa Address: 15 5 COm&%crcrvl $Frey.{'
Ecut rt rv► 1'f d2S58 } A
On J'�6"t7 Capewirae 64verues was issued a permit to install a
(date) (installer)
septic system at 9 -� Nab-Erg �a� '0(ive based on a design drawn by
(address)
.-S C 6i,5i neexin I Tho. dated 5uly P, ZQl7 ( eev j : 7..?t-r?)
(des ig er)
I certify that a septic system referenced above was installed substantially according to
the design, w ich may include minor approved changes such as lateral relocation of the
distribution b x and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory,
I certify that he septic system referenced above was installed with major changes (i.e.
greater than 1 Y lateral relocation of the SAS or any vertical relocation of any component
of the septic s ystem) but in accordance with State& Local Regulations. Plan revision or
certified as-bi ilt by designer to follow. Strip out (if required) was inspected and the soils
were found s tisfacto ry.
I certify that a system referenced above was constructed ' e with the terms
of the RA approval letters(if applicable) ���SN 0 Mgss
'�c
a° JOHN L.
u CHURCHILL&
Instal s Si ) C
NO lacy
��oFFgi 1S E
estg er's i e) (Affix Des' er amp Here)
PL ASE RET TO BARNSTABLE PUBLIC HEALT DI SIGN. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK'YOU.
QAgcptir\Desisner Certific tion Form Rev 8-14-13.doc
I*
commonwealth of Massachusetts
Executive Office of Environmental Affairs
Department of
Environmental Protection
Wllllam F.Weld
C.0"Mor
Trudy Cox*
6..r ,EOEA '
David B.Struhs
Comm"ansr
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: --Cf j Address of Owner:
Date of Inspection: /-�.G. % C t n V,//e (If different)
Name of Inspector: c i2 i L'
Company Name, Address and Telephone Number: 3 �► c/? rl r �S�Oti S
fc, e (�.-a -tom (.e _3 2 3 G 4=1:5=
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
LflPasses
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Faits..,
Inspector's Signature: , / wL iwUate:
The System Inspector shall bmit a copy of`this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
\t
INSPECTION SUMMARY:
Al 11. w }
Check A, B, C, or D: 9y 40,4
A) SYSTEM PASSES: ¢ �� �
y I have not found any information which indicates that the system violates any of the failure criteria as �ed in�� CM05.303.
Any failure criteria not evaluated are indicated below. 2P V
B) SYSTEM CONDITIONALLY PASSES: 6
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"mot determined", explain why not)
The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health.
(revised 8/15/95)
One Winter Stre*t * Boston,Massachusetts 02106 • FAX(617)556-1049 • Telephone(617)292-5500
Printed on Regded Paper
i
r
'I
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner:
Date of Inspection:
B] SYSTEM CONDITIONALLY PASSES(continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
_ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
.Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
_ Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT.
_ The wstem has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
_ ,The wsten-. ha, a septic tank and soil absorption system and is within a Zone I of a public water supply well.
,'The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
_ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water
supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is
C" /free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen 'is!qual to or less than 5
,ppm.
DJ SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for tbis'determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Backup of sewage into facility or system component due to an overloaded or dogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
(revised 8/15/95) 2
n..
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: ,n� 4- ]4v.
Owner:
Date of Inspection:
D]SYSTEM FAILS (continued):
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well. ,
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50,feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above:
The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety
and the environment because one or more of the following conditions exist:
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised B/15/95) 3
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: �T
Owner: i'm 4/✓L'e
Date of Inspection:
Check if the following have been done:
Pumping information was requested of the owner, occupant, and Board of Health.
L�_<one 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 volumes of water have not been introduced into the system recently or as part of this inspection.
built plans have been obtained and examined. Note if they are not available with N/A.
✓he-facility or dwelling was inspected for signs of sewage back-up.
The system does not receive non-sanitary or industrial waste flow
'--_�The site was inspected for signs of breakout.
t✓AI1 system components, excluding the Soil Absorption System, have been located on the site.
y, `�he 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.
The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
The facility ov ner (and occupants, if different from ov ner) were provided with information on the proper maintenance of Sub-
Surface Disposal System.
(revised 8/15/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ,
PART C
SYSTEM INFORMATION
Property Address: 1fv'G t flit /4 V t- �v-
Owner: .� rti
Date of Inspection:
RESIDENTIAL: FLOW CONDITIONS
. '
Design flow: gallons
Number of bedrooms: .
Number of current residents:6)
Garbage grinder(yes or no): /U
Laundry connected to system (yes or no):
Seasonal use (yes or no):l
Water meter readings, if available:
Last date of occupancy:
COMMERCIAUINDUSTRIAL:
Type of establishment:
Design flow:_gallons/day
Grease trap present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non-sanitary waste discharged to the Title 5 system: (yes or no)_
Water meter readings, if available:
Last date of occupancy:
OTHER: (Describe)
1,-Last date of occupancy:
GENERAL INFORMATION
PUMPING RECTS and source of information:
System pumped as pan of inspection: (yes or no)_
If yes, volume pumped gallons
Reason for pumping:
TYPE OF STEM
Septic tank/diW4xftion box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Other(explain)
APPROXIMATE AGE of all components, date installed (if known)and source of information:
Sewage odors detected when arriving at the site: (yes or no)-/U
(revised 8/15/95) 5
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .•
PART C
SYSTEM INFORMATION (continued)
Property Address: `�S Nof"f"i v 5 �►'� '`��`�
Owner: 3 v s
Date of Inspection: I -Z io 5' L
SEPTIC TANK:i/
(locate on site plan)
Depth below grade:�:'&/L -
Material of construction: Ic6ncrete _metal _FRP —other(explain)
Dimensions:
Sludge depth: _
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:_
Distance from top of scum to top of outlet tee or baffle: , ;J
Distance from bottom of scum to bottom of outlet tee or baffler
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid If vel in.relation to outlet invert, structural
integrity, evidence of leakage, etc.) G�' C 14' I✓
GREASE TRAP:_ t
(locate on site plan)
Depth below grade:
Material of construction: _concrete rnetal _FRP —other(explain)
Dimensions:
Scum Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom ni crwr t^ hottom of outlet tee or baffle:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of.leakaee, etc.)
(revised 8/15/95) 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: ,� rUG t,w j A-4,41
Owner: p_ U Y L
Date of Inspection: k/✓ �S
TIGHT OR HOLDING TANK:
(locate on site plan)
Depth below grade: .
Material of c nstruction: concrete_metal _FRP_other(explai
L
Dimensions:
Capacity: l C� v Qallons
Design flow: L., eallons/day
Alarm level: r'✓
Comments:
(conditj9P of inlet tee, condition of alarm and float switches, etc.)
f
DISTRIBUTION BOX:4-//
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and d,, tribuno�-. i<.equa!, e%i.4 ce of solids ca-yover, evidence of leakage into or out of box, etc.)
PUMP CHAMBER:
(locate on site plan)
Pumps in working order.(yes or-no) ��---
Comments:
(note condition of pump chamber, conclitipnUr nances, etc.
/J
(revised 8/15/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: +i ws ('LA AC
Owner: ,$4,v•�—r3$
Date of Inspection:
SOIL ABSORPTION SYSTEM(SAS): c--
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
.Type:
leaching pits, number:
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) 411 a,vrvyi Ai%.�•S
Jf rt 4: 43'?' / rya,) cJ r
0
CESSPOOLS: _
(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert::
Depth of solids layer.
Depth of scum layer:
I _
Dimensions of o :cess o
P _
Materials of construction:
indication of groundwater:
inflow (cesspool must be pumped as pan of inspection)
Comments. (note condition of soil, signs of hydraulic failure level of Ponding condition of vegetation, etc.)
PRIVY
(locate on site plan)
Materials of construction: %-'� Dimensions:
Depth of solids:
Comments: (note condition,of'soil, signs of hydraulic tailure, level-o(.ponding, condition of vegetation, etc.)
(revised 8/15/95) 8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM/INFORMATION (continued)
Property Address:
Owner: C/e✓"L4 4-y v,- 4 S q ru Y s
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks .
locate all wells within 100'
\ V `
:_DEPTH TO GROUNDWATER
l,5
Depth to groundwater: feet '
method of determination or approximation: �S S '` �✓ T e L 7ZI-0 i
r
(revised 8/15/95) 9
TOWN OF BARNSTABLE
i:,OCATION 6� �11'� /�7�4l�Y) SEWAGE#
VILLAGE. nJe�2 y i ( t' ASSESSOR'S MAP&LOT
n
INSTALLER'S NAME&PHONE NO.�ti�/���1 /pB91J — 1� / A101,71K2
SEPTIC TANK CAPACITY f d o (D
LEACHING FACILITY: (type) /a <,Z�t t-9f (size)
if
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE ATE:
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 facility) Feet
Furnished by
C
���� �_�
� _ �
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L
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'C�-
No....... Y•.... F$s.....��'...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............rP.WA)...........OF.......
� ARIV.$- �?O�G.... ............
Apphration for Bitipnsal Works Tnntrutiun Vantit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
� 6c System at:
-Ip�ation•Addi7l. Sr Lot No.
....... � ......................................... .......... .............................................
vner Ad ss
W J,.Mes------....VA&AW.A •--..-----•.. ----..0hj. ^i..... ��..1.........ccNT�¢
Installer Address
U Type of Building Size Lot....
---------Sq. feet
Dwelling—No. of Bedrooms....................3..................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building _-___W-90 G`.. �P__M& of persons............ .._..._.. Showers —
a g -- Q-------------•--P--• �-•-• ( ) Cafeteria ( )
dOther fixtures ----•-•-••••••••...........•---• •••------•----••••-•--•••••--•--•-•••••---.....-•---•--•-•-••---•••.................•---••••-.
WDesign Flow............................................gallons per person per day. Total daily flow...........3 .........................gallons.
WSeptic Tank—Liquid capacity/M. ---gallons Length................. Width................ Diameter....._.......... Depth...............
x Disposal Trench—No..................... Wid Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No............... 6Y S�Ou Cr
3 .._._: Diameter.___....�t�. Depth below inlet.................... Total leaching area....�o.a_._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.._-__--___-__-________-
G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------------- -- .-- ............................................................... ---------- ----- --......-- •••.
O Description of Soil........SAm l............
x
W
---•--•-•-•------------------------------------------•---.-.......................................................................--•-•-----•••-•---•----•-••._...---•••..................--•••••••.
V Nature of Repairs or Alterations—Answer when applicable.__.............................................................................................
.....--••--....------•------------------------------------------•-•-•••----••-•---••-•--•-----•---•-•-•--•--........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Cod The undersig further agrees not to place the system in
operation until a Certificate of Compliance has bee ed by tboa of health.
Sin --•• ..................... ...... ............... �1 7:....".
/Date
Application Approved By .. . ..,.L< _ ............................
Application Disapproved for the following reasons-----------------------------------•------------------••-------•---•-•-•----------•-•--............-----........
I
.........................................---------------------------------------------------------------•---••••----••....••-•-------•--•-•-•••-•-•-------•-•---•-••••--------•...........---••---.....
Date
PermitNo......................................................... Issued........................................................
Dt...��...�..�.�.�.y..�._..... ... - -. ._ .����.�...............�..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............ w.�...........OF........f ..: �.�'�:�.s.. ..... ..-.... ...
Apphra#iun for 11isposai Works Tnns#rudinn Vamit
Application is hereby made fora Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at ye /'�
..... tf .... ...0....... tI 6 1 t��� ,!Y ........., f:.t.w '.....................is .1 �:. 1./J,
anon Addi'2ss or Lot No...................................
........ I 123. .......:?° .............................................. .......... i.!" ....... �. ::. :...............................................
..
W �• dyvner A Address ,
------.... ��r <: . ................................... ... ----...... ...... .........
Installer Address
Type of Building Size Lot_.........................Sq. feet
Dwelling—No. of Bedrooms.....................,,,:..................Expansion Attic ( ) Garbage Grinder ( )
A4 Other—Type of Building .....W_kt,'=(._&R-r`I . of persons.............!............. Showers ( ) — Cafeteria ( )
a' Other fixtures ..........................
W Design Flow............................................gallons per person per day. Total.daily flow..........
AT........................gallons.
Ix W Septic Tank—Liquid capacity. M .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.... 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-_---.--___-____--___.-.
fT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 -----------------------------
•------....... ---•------••----•----...............................................................
O Description of Soil......... '. .. _ ................
U .-----------•--••---••-------------••--•-----------•--•••-------...........---------•---•-----•----------------•...........--•---......_..--------•--•-----------•---•-••----•---..........---...-•------
M --------------------------------------------------------------------------------------------------•------------------------...--------------......------......---------- ..............................
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 Cod The under.sig further agrees not to place the system in
operation until a Certificate of Compliance has bee ed by th bza �of�health.Si n -• •. . ._.....
Application Approved B `"4 4��_ �� . .r Date
-------------
. �....-----7'ate
Application Disapproved for the following reasons:................................................................................................................
---------------------------------------------------------------••-•-------•-•--------........-------•-•--•------------•--•----•--...-------•-•---•-•-•--------••••--------••-•-•----•••-------..........
Date
PermitNo......................................................... Issued......................--................................
' Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
L.!d f�✓.......................OF.... ��. ..... ....:
f�rr#iftr��r �r� f�nnt�rti�tnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by. .ja o rt r�3 j ! I IL;h:
- •----•-
fInstaller
at......rl.•� _.� ..-_ rretir � -------- f- ' a ' A
has been installed in accordance 4vith the provisions of Art'cI X of The State Sanitary Code s described in the
application for QXV}
pp n o Disposal Works Construct>on Permit No f _......._...._.... dated.............
�._aZ
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION-SATISFACTORY.
DATE............................. •----_.... Inspector.... U,�Z4..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..... `%� F............... OF.......,f. ItA5
.. ......
No..........I.........I.�.... FEE.. ..............
Bispupal Works ,S ouptrndiun rrrntif
Permission is hereby granted......1 --........ ®1.fg. �....._ _
to Construct ( or Re,p�air ( ) an Indivt 1 Sewage Disposal,`System
at No......4rd! �1/u !N Armt ti ��
Street °'
......... .....
�>
as shown on the application for Disposal Works Construction P rit No. .. d Dated.. . -- -. ",..,,,.
� .. ..
.........r'.;,
Board.of Health
DATE......... .........................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
Town of Barnstable P#
' Department of Regulatory Services
t' Public Health Division Date
MA&S
200 Main Street,Hyannis MA 02601 01
/ j
Date Scheduled�- ,/ `� Ti'ma � Fee P I 0QQ
X,
Ems._
0
Soil Suitability AsseSSment for Se 'ge isposal
t'k
Performed•By:_4tC elII / IrneleI , /
elT 1 s
/ Witnessed By: r
i I
LOCATION&.GENERAL INFORMATION
FlncaflanAddrc�ss Owner's Name G()1( �U Q \/6 �5I'� ( Address;g$ t• a"tt.�,el ssessors Map/Parcel: ` (, ` 1 050 Bngincer's Name SL ,
NgW CONSTRUCTION REP AIR _ Telephone# �() •�l(7 -'��c rL-� �j0�-eZ73 ( c��7
Land Use d AC1P Slopes(%) D-1 � surthco Stones N 114 j
Distances from: Open Water Body �) d ft Possible Wct,Area L/15fl ft Drinking Water Woil 2 f SO ft
Draihage Way XQ ft Property Line 21 d ft Other f1
SIOTCHe(Street name,dimensions of lot,exact locations of test holes&Pero tests,loeato wetlands-in proximity to holes)
C,
. I •
Parent material(geologic)�L` Cr Depth to Bedroak
Depth to Groundwater. Standing Water In Hole: i3 d�X -�3�5 Woepingfr0lll PltFnaa
Estimated Seasonal High Groundwater
Ddl vAIJON FOR SEASONAL-HIGH WATER TABLE
Method Used: irGC (�i Y 1ip/1
Depth Observed standing In obi.hole: > In, Depth tq sell mottleSt •
booth to weeping from side of obs,hole, 6 !n, Oroundwnter At(Justmont fr.
Index Wall# Reading Dato: index Well lmvol Adj4hotbr,,,a_,r Adj.Grtlundwatd,.L8401
PERCOLATION TEST >nuta -l0—1 Time :�tj_c n,
Observation -
Hole# Time at 4"
Depth of Pero-5`f Time at 6"
Start Pro-soak Time @ X 15�ri " Tlmo(9"•6")
Had Pro-soak
< a
Rate Min./Inch , '• ii � '
Site Sultabillty Assessment Slid Passed��� Site Failed: Additional Testing Needed(Y/N) /IV
I
Original: Public Health Division Observation Hole Data To Be Completed on Back '
• j
***If percolation test is to be conducted within 100' of wetland,you must ME it notify the
Barnstable Conservation Division at least one W week prior to beginning.
Q:\S EPTIC\PBRCFORM.DO C
I
I
i
DEEROBSERVATION HOLE LOG Hole#
Depth froin Sall Horizon Soli Texture Shcl Color Soil. Other
Surfaeo(In.) (USDA) (Munseli) Mottling (Stnueture,Stoned;Boulders.
tsistancy. Uravol)
"
(� 11
v ,
DEEP OBSERVATION HOLL LOG Hole#
Depth ttom Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders.
DEEP OBSERVATION HOLE LOG Holt;#
Depth fioni Soil Horizon Soil Texture Sall Color Sail Other
Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders..
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soll Other
Surface(in.) (USDA) (Mansell) Mottling (Structure,Slopes;Boulders,
consistency, QMVPI1
Flood Insurance Rate Man: /
Above 500 year f load boundary No_/ Yes V
Within 500 year boundary No V Yes
Within 100 year flood boundary No.,/// Yes
pepth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the
area.proposed for the soil absorption system?
If not,what Ig the depth of naturally occurring pervious material?,._.._____......
Certi—, fication
I certify that on _2�" (date)I have passed the soil evaluator examination.approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required training,expertise and a arlence described In 10 C VIR 15.017.
Signature DattsJf"z 7
Q;%SgpT1GlPR11CPORM.DOC
I I
' FINISH GRADE OVER CHAMBERS = -5$.5' - 59.3' �, _ " DOUBLE WASHED
T.O.F. EL.= 61 .6f FINISH GRADE OVER D-BOX = 59.2 t G F N E RAL N OT F S
SLOPE @ 2% MIN. OVER SYSTEM 3/4 TO 1 1/2 DOU
PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
WITH COVER OVER INLET& RISER TO WITHIN 6" OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS
FINISH GRADE OUTLET TO WITHIN 6" OF F G. ° 2" OF 1/8" TO 112" DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
@ FND. EL.- 60•5�f F.G. OVER TANK EL. - 60.3't / 5" DIA. OUTLET(S) MIN SLOPE 1 /° � BOX TO F.G. (SEE NOTE 21) � STONE OR GEOTEXTILE FILTER FABRIC -, CODE AND ANY APPLICABLE LOCAL RULES.
- -- 1 � -- � 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
f i F SAS = 56 O TOP .33' PLACE RISERS ON ALL DESIGN ENGINEER.
PROPOSED 4" }} 9"MIN. _ CHAMBERS WITH
1 f 36' MAX. 9 MIN. I p � 3 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
----- SCH. 40 PVC �- 55.5C 36" MAX. BREAKOUT EL = 56.00' - INLET , IPES TO OF 1
�.� SEWER PIPE --
FINISHED GRADE I SYSTEM UNLESS OTHERWISE NOTED.
�� 3" DROP MAX 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
6 3 - 2" DROP MIN 3 g„ ,I L_68 t PROVIDE WATERTIGHT _ o ELEVATION = 56.33' FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS A
MIN.SCOPE(�7
4" PVC IN FROM F ' JOINTS (TYP.) i O r !^� ��� �� O = = O 40 M!t_ GEOMEMBRANE LINER IS PLACE:AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
13" L_J
14" ( SEPTIC TANK 4' PVC OUT TO o o • THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
CONTRACTOR TO PROVIDE i LEACHING FACILITY oQ ��� ��?? �---� r� r� ;�� , o 0 00 �-1, f-- 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
SPECIFIED DROP BETWEEN 1 oo --' L___J !-! U ,, 0 --� L
INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL \ , 12 f6 I oo °° 6- THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
SHALL VERIFY SIZE 48"' VERIFY CONDITION OF OUTLET TEE 55.87 -MIN. 55.70' 2 Q 0 0 0 C� 00
� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
AND CONDITION OF EXISTING TEES
REPLACE AS GAS BAFFLE 6" CRUSHED STONE o L� �' o 0 oa �� �- C� oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
EXISTING SE OVER MECHANICALLY o _ NOT 1 O BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
TANK NECESSARY COMPACTED BASE I
4.0' I ! I , 4.0' I I AND DESIGN ENGINEER.
- 8.5' (TYP) 4.0' I _ I 4�0
5 OUTLET DISTRIBUTION BOX 1 4.83 8 ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 60.00,
'( (TYP.)
TO BE INSTALLED ON A LEVEL STABLE 25.0' i ___ ESTABLISHED ON A NAIL IN AN OAK TREE AS SHOWN ON PLAN.
BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 47.50' f 9 CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PIPES TO BE LAID LEVEL. Ir3.50 12 83' -- --
THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK CROSS SECTION VIEW 2 - 500 GALLON CHAMBER 5' MIN. VrtHiVitSl�hCrVu v Icv V 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES, REPORT ANY DISCREPANCIES
*CO - _ TYPICAL CHAMBER PROF' � -- .-. TO THE DESIGN ENGINEER.
�,.NTRAGTC�R TO VERIFY EXISTING ��• PT �.. ►-° a;L..� j'' C�
ELEVATION PRIOR TO ANY WORK& �- DIS i mi ou i iy�� DUA O�TAi L C i�A § � i�`-' 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE
-- ---- 11 NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE DEEDED R ZONING
_ - �:• '/< • FAT PIT nATA
REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
SWING-TIES • . • , . •� ../
~ •` + PERC NO. 15406 APPROPRIATE AUTHORITY.
HC-1 HG-2 • •• •ram' '/j INSPECTOR Donald Desmarais 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
DESCRIPTION Q , , 1( , ' ,�. UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
t� ;j' ; ••• ;� EVALUATOR: Michael Pimentel, E.I.T. _ TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
CORNER OF STONE (1) 29.2' 46.4" '� i . /�/ -�•• •� <
• , • ` �;�f .j' �f +� • < C.S.E. APPROVAL DATE: Oct. 1999
CORNER OF STONE 2 41.4' S5.5' 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
O • ` ' 1 .��' •l�:r•• ; :Q� DATE: July 10, 2017
•� �'�f• _ 14. WHERE REQUIRED CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
CORNER OF STONE (3) 41.9' 43.8' ,k... . i ;'• //• TEST PIT#. - 1
• m •��• •�(. MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
• ! • `;+ • �' ELEV TOP = 58.50' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
CORNER OF STONE (4) 30.1' 31.5' r .f - -
j ' .,f: �� FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3),
74
LOC U C '(j• ELEV WATER = _ <47.50'
V ° ' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
• �� � •.j4t PERC RATE _ < 2 MIN/IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
' •':�'. ' f ' DEPTH OF PERC = 36"-54" 16. PROPOSED PROJECT IS LOCATED WITHIN:
00
O. u • .,•
o �� rod f t •' •?`mot •+�. ' - - ASSESSOR'S MAP 171 LOT 50
__.. i f '• '�O ;`. .. TEXTURAL CLASS. - 1
a --
b •�'•l�' 0 OWNER OF RECORD: GUILLERMO VELAZQUEZ
MAP 171 f'l -
Cd LOT 51 26 2; M OPT 4971 i ; - ' ' 0" ------- 58.50' ADDRESS. 295 NOTTINGHAM DRIVE
m� �`;' „ ` FIII _ CENTERVILLE, MA 02632
Cranberry ; 4 58.1 i'
Bog FEMA FLOOD ZONE X
?t Loamy Sand -
B 10Yr 5/6 COMMUNITY PANEL# 25001CO561J
17. DEED REFERENCE: BOOK 20509, PAGE 344
PLASTIC
926�oO1y 36" 55.50'
LISTING LEACHING PIT • Pe ` i 18- PLAN REFERENCE. PLAN BOOK 24 AGE 84
_ 7 P
TO BE PUMPED ANC ^
STEPS C�,u� 6 / `--- ' � -�= j 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
FILLED WITH CLEAN SAND Cra n berry 2r • • 54'
� O
', '�1,_ '' ���,t Va Ky,f3O ,��� 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
#295 4 \ \ Pond
S; •. FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
Lw-rnr,-
LP Po1 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
EXISTING (0 , Medium Sand
2-BEDROOM / '4> >; j y' C 2.5Y 6/6 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
r I DWELLING °,o �^�� DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A
o TOF = 61.6'± �-�OL REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
PROPOSED N�N� �,,� y/
i
DISTRIBUTED :" / 22. OWNER /APPLICANT/CONTRACTOR SHALL.BE RESPONSIBLE TO OBTAIN ANY AND ALL
BOX �/! GARDEN PLASTIC ,� LOCUS PLAN � REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
PROPOSED 2 500 SHED .1/�k,� SCALE: 1" = 1000'
GALLON LEACHING 132" 47.50'
_
CHAMBERS•-\ am } HC-1 ��� / P�
CEDAR g~ kQ � No Mottling, Standing or Weeping Observed
a
PROPOSED (1) _ �►�� r,>"� / �O
INSPECTION 1 I 1 1 L /-
18" /
PORT 3ASKETBALL--, / / �'�
PERC NO. _ 15406 _
HOOP HC_2 / INSPECTOR: Donald Desmarais 50x0' EXISTING SPOT GRADE
-� ____.r� \ NUMBER OF BEDROOMS 2 (3 MIN. DESIGN PER TITLE 5)
/ BIT. DRIVE EVALUATOR: Michael Pimentel, E.I.T. - 50 - EXISTING CONTOUR
/ 0 (4) \ BUSH (ThP) / DESIGN FLOW 110 GAL/DAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 1999
v � ,r PROPOSED CONTOUR
�o' �` �59 4' CEDAR`so- / S9 TOTAL DESIGN FLOW 220 GAL/DAY Jul10 _
- { DATE: Y- : 2017
^� �� �✓ TP 1 ti�� TP 2 l "11 " P 7 ° = 660 S0 PROPOSED SPOT GRADE
! 15" 9 2 OAKS / DESIGN FLOW x �00 /° GAL/DAY TEST PIT#: 2 F
58x5 (3) 58x5 1 15 �� / J� USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP =A 58.50' EXISTING GAS LINE
Benchmark STUMP (TYP)
/ QQ"4, ! ELEV WATER = <47.50' EXISTING OVERHEAD UTILITIES
Nail in Oak Tree A
Elev. = 60.00' OAK / \`? PERC RATE _
A prox. M.S.L. ~�'° �1�e INSTALL 2 - 500 GAL. CHAMBERS wl AGGREGATE -
EXISTING WATER LINE
Q~' ak, DEPTH OF PERC
Q^ oo• 8 OAK �` , , I A` �' SIDEWALL CAPACITY '� TEST PIT LOCATION
�� v0 �SAPPLING (TYP! MAP 171 j TEXTURAL CLASS: 1
(�'` `�O
(LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAL/DAY
r70 LOT 50 �p� , / / (25.0' + 12.83') (2 ) ( 2' ) ( 0.74 GPD/S.F.) = 112.0 GAL/DAY EXISTING 1,000 GALLON SEPTIC TANK
17,103± S.F. 0� t
p 0" 58.50'
PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE
BOTTOM CAPACITY -- Fall
®'� 1 22 BOO ✓ _ - 58.17'
Q- / (LENGTH x WIDTH) (0.74 GPD/S.F.) GAL/DAY 4„
n PROPOSED DISTRIBUTION BOX
/ (25.0'x 12.83') (0.74 GPDIS.F.) = 237.4 GAL/DAY Loamy Sand
11'' OAK B tt
L z 71.61 10Yr 5/6 t O PROPOSED 500 GALLON LEACHING CHAMBER
t TOTALS:
v v / r-
-58 t TOTAL NUMBER OF CHAMBERS 2 36" 1 7-21-17 MCP
55.50` JLC Design flow data (3 bedrooms to 2 bedrooms)
,/ I I
J TOTAL LEACHING AREA 472.2 SQ.FT. REV DATE BY APP'D. DESCRIPTION
/ TOTAL LEACHING CAPACITY 349.4 GAL./DAY
PROPOSED SEPTIC SYSTEM UPGRADE
PREPARED FOR:
Medium Sand CAPEWIDE ENTERPRISES
c
2.5Y 6/6
LOCATED AT
295 NOTTINGHAM DRIVE
CENTERVILLE, MA 02632
NOTES SCALE: 1 INCH = 20 FT. DATE: JULY 17, 2017
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 132" - 47.50'
EACH SEPTIC SYSTEM COMPONENT. g g p g o icl 20 ao so FEET
- No Moulin Standing or Weeping Observed
`sµ of -,
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF RESERVED FOR BOARD OF HEALTH USE JOHNL c+ PREPARED
THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST o? �� JC ENGINEERINN
G, INC.
CHURQHILL
PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL vCOV -4
807 2854 CRANBERRY HIGHWAY
BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA.
'' EAST WAREHAM, MA 02538
3.) ENTIRE PROPERTY IS LOCATED WITHIN THE GROUNDWATER SITE PLAN 508.273.0377
PROTECTION OVERLAY DISTRICT AND THE ESTUARINE WATERSHEDS
SCALE: 1" = 20' I Drawn By: SJI Designed By:SJI Checked By MCP JOB No. 3870