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HomeMy WebLinkAbout0367 NOTTINGHAM DRIVE - Health 367 NOTTINGHAM DRIVE, LACENTERVII,LE =171.080 UPC 17534 No.2-11 33C0R 'bsrco KASTINGS,UN t l I i TOWN OF BARNSTABLE 10CATION D SEWAGE# VILLAGE {htP bl(1 I I e J ASSESSOR'S MAP&PARCEL V INSTALLER'S NAME&PHONE NO. (S' SEPTIC TANK CAPACITY10 LEACHING FACILITY:(type) (size) qr• S-F NO.OF BEDROOMS OWNER C, o PERMIT DATE: 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 le-chi acility) Feet FURNISHED BY wr g ' Z3, 0 0 � g32� 3 �� 28� No. 2Z Fee THE COMMONWEAL—T-H OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Disposal *pstem Construction Permit ompl Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ete Systemdividual Components Location Address or Lot No. 36-1 ' Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 1TU, h 4�69 -Ssis Type of Building: Dwelling No.of Bedrooms l) Lot Size SLI/Dsq.ft. Garbage Grinder( ) Other Type of Building Sr H No.of Persons Showers( ) Cafeteria( ) Other Fixtures p Design Flow(min.required) ,��(� gpd Design flow provided D ' pd Plan Date 25 I!I C Number of sheets Revision Date Title !� 3��1 � Size of Septic Tank` 1 I�/' Type of S.A.S. 2 �fJ �' M_) Description of Soil I�1G( (,{ C'(, 9 — �U�l 1 (r a j,-d l ­ w d . 1!ah d( C-i -- N — ra�- ( . Nature of Repairs or Alterations(Answer when applicable) t1 6ot,x. bi) SLIM 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 Env' ental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of ealt.T n Q Date t, L Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. L.V1 r.:. t' 7' Fee 6 THE COMMONWEH F MASSACHUSETTS Entered in computer: Cj PUBLIC HEALTH DIVISION"-,TOWN OF BARN STAB LE.,`�MASSACHUSETTS Yes appric-ad n"jfor Pis oral 6pstem. Clog Uction=permit Application for a Permit to Construct( ) Repair( ) Upgrade(�AbiAon( ) omplete'System dividual Components R # ) . Location Address or Lot No. -1� h}{T �� ,Owiers Name,f Address;)and;el:No. Assessor'sMIX CLIO ap/Parcel /'vU'+ ' �h ���� �n�� T Installer's Name,Address,and Tel '' "Designer's Name,Address;and Tel.No. A Type of Building: ...'' ; Dwelling No.of Bedrooms ,,..Lo Size sq.ft. Garbage Grinder( ) Other Type of Building - No.§of Persons r'' -Showers( ) Cafeteria `�ti-101 Other Fixtures Design Flow(min.required) 3 90 gpd Design flow provided ,, gpd Plan Date Number of she Revision Date l Title I 1 V Size o Septic Tank I Type of S.A.S. Description of Soil / Me dt , s ` CAikd/ SU tic Nature of Repairs or Alterations(Answer when applicable) W N 1706� (21) sh 64 l K t Date last inspected: 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 Env' o ental Code and not to place the system in operation until`a-Certificate of Compliance has been issued by this Board of �1 'altvred � � � C ;/�,.__ Date Application Approved by , /� ✓ it/ ,d Date ._�' Application Disapproved by V Date for the following reasons Permit No. i Date Issued 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ' " x Certificate of Compliance THIS IS TO CERTIFY, AlJthat the On-site Sewage Disposal system Const cted( ) Repaired( ) Upgraded Abandoned( )by D / Ai / at V I has been constructed in accordance with the provisions of Titl and the for Disposal System Construction Permit No.2 at Installer �0 Vail,>^ :Designer #bedrooms ?i Approved design ow U ". ? gpd U The issuance of this permit shall not be construed as a guarantee that the system will nctio {s designed. Date ; Inspector i t , -----------------------�---------- -----= ----- - - - ------ -- - - - No. / /5 + Fee ✓� THE COMMONWEALTH OF MASSACHUSETTS C PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pztettt CConstruction Vermit Permi ion ishereby granted to Construct( ) Repair( ) Upgrade Abandon(t ) i System located at V '�J 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 ust be 'omp eted within three years of the date of this permit. Date Approved by r . Town'Tt`RArnstable ti egulatory Se * rvices Richard . Sca.li, Interim Direetoi V•,nnftnsraaLe, v"s' Public flealtl2 Division T1110itias McKean,Director 200_'Main Street;kiyannis,CIA{)ZGOI Office: 503-862-4644 Fay:: 50R-790-6304 Installer S:Designer C'erti>ication Form Date: ' ( _( 1 Se�vaye Permit# 1 7) —©'�(J --- -- Assessor s iw�apl.Parcel I)esioner: tCG'c1 1" ttoti t 1_y7� 41eer-, nr L tl5ir 5__11-i Installer: Ot;�,l /1 j S Address: ..... Address: ----- <�' rattle i`�1 Gz /"Ia.asL—'k�su MA aZ��( � -� - _ -- On ��__ _' t s ssu ci a t::,ii:to install awatel /_ 7 (ltlfi[itllel') tilJ)lIC system at -3w ( �v (/ YIG7/l1 f�r —.- ba:od on t design (aCl li'SS) ' ✓1�c, `yC si rv�Li� BakedI`7 __ ----._ (des.ioner) — ---- t/ 1. certif,y that the septic system referenced above was installed substantially according to the des:i;n, which may itielude minor approved changes such as .lateral relocation of the distribution box andlor septic tank. Strip o'ttt (if tecluired) was inspected and the soil;, ,'ere found satisfactory. _ I Certify.that the septa; system referenced above \t a:s installed.witli major Chal?,TCs (i.t U. greater than. 10' latent(relocation of the SAS or ally vertical relocation of any cam})onent Of the septic system) but in accordance with State & Local ReQUIatian.s. Plan revisic;n u, c rtifled as-b "it b�, designer to folio\v. Strip out(if roquired) was itlspeMCI and the soils were found satisfactory, I cartify that the system referenced bo,e \vas consu'ticted in c With tlt.e tcrni:ti ofthc I A approval IcIters (il applie rl)!�) �1x Ow w.�SS,q�h PTNRE� rs (lr�.stalter's Signature) 'U No.35109 (IJesi�nler's Signaxurc) (Affix Desi;;ne ere)__.. PLEASE, RETURN TO BARNSTAB.LR .FILiBLIC HEALTH DIVISION. CERTIFICA'I' : OF CUNIPLIANCE WII.,L NOT. BE ISSUED UNTIL BOTH THIS FOR-NI AND AS- BUILT CARD ARI RCLClr IVED BY THE I; BARNSTABI.,E PUBLIC IIL:A I`I-I DIVISION. ISION. f�:'•Se;xic,,;�si�nei•{;ertificaEion Formr;ry 3.14-13.duc Engineers note:Tinis cerUfcation is limited to an as-built inspection of sys,,rm norriponen!z as.instalfec,prior to backfill.The engineer did not supervise construction of the system:Sae instalter.assumes,re ponsibi!a} 'or ail materials,;vor;,manship,backl:lling 10 specitiod grades with pronsr ccmpec.io:,and settuig risers:covers as shown,on the design plan, TOWN OF BARNSTABLE, . 1 L4)CATION -"-34.7 4ia k in5 g4,0aridt- %SEWAGE # N IIMLAGE ASSESSOR'S MAP & LOT i INSTALLER'S NAME&PHONE NO. SEPTIC, TANK CAPACITY es LEACHING FACILITY: (type) (size)I!V vim. NO.OF BEDROOMS 3 BUILDER'OR OWNER ZL&6JV4 _ � PERMITDATE: OMPLIANCE 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 facility) Feet I� Furnished by 1 7 E� A a No. . s.w:R Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIppYication for Migpooal *proem Construction i3ermit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.ZW, NO-ITl A i'Dr(01-- Owner's Name/I,Address and Tel.No. Assessor's Map/Parcel '�( ,_mo Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �A�' ir Q2i �`'��'tia►S Type of Building: Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder( ) Other . Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow3© gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank <,_ec1 qr,wt t UQ'3 Type of S.A.S. VAI 12 `:. jL`tr k uO. Description of Soil 1571 5 f A0 Nature of Repairs or Alterations(Ans er when applicable) �-r—tgrn` gt csg GI T L mac/ / 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 b I. o MSigned 0 Date `" O Application Approved by Date Application Disapproved for the following reasons Permit No. 7— Date Issued y—f n � No. 2 / -`+� Fee --� " / THE COMMONWEALTH MASSACHUSETTS O F MASSA ''Entered in computer: ✓ PUBLIC HEALTH DIVISION -I tTOWN OF BARNSTABLE,,MASSACHUSETTS . Yes Zipprication for Mir bar *proem Cow5truction Permit Application for a Permit to Construct( )Repair(Upgrade( ).Abandon Complete System El Individual Components Location Address or Lot No. MI6 m�'�j_ 4M �(I,e Owner's Name,Address and Tel.No. Assessor's Map/Parcel 11 no Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C�7 O !Tt_t/ OL i s 1''` Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Z30 gallons per day. Calculated daily flow �9 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I Sr'o I 1QQQ Type of S.A.S. � V �—r��Ups Description of Soil N1 SY wCv Ft ,-e— Nature of Repairs or Alterations(Ans er when applicable) N i -Tr,-, c v L// 57`u.n, at ra -t-/y# a ll Date last inspected: b .: + 4f , Agreement: fi , 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`n, operatibn until a Certifi- cate of Compliance has bem4s o 157-IV Signed Date Application Approved b Date Application Disapproved for the following reasons h- f 7 ;Permit No. i.� Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Comp fiance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired ( )Upgraded(er) Abandoned( )by 5 F PCB(.,,., at Nda -�Qcyxo�YA oetve CtSor. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. J8-Z 77 g dated Installer Designer The issuance of taus ermit sha not be construed as a guarantee that the system w' l function as designed. Date ?^ 5- - ;? Inspector q/ .77 lr� No. Re THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS � Ii.5poe al *p$tem Construction Permit Permission is hereby granted to Construct( )Repair Y,)Upgrade( )Abandon( ) System located at 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 completed within three years of the date of this er it. Date: S / " �� Approved by__ ft ,y . 1019197 i • To Be Used For the Repair.Of Failed NOTICE: This Form Is . . Septic Systems Only. OF SKETCH AND APPLICATION FORA CERTIFICATION � DISPO SAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) ! I -ems vb hereby certify that the application for disposal works b me dated - concern the construction permit signed y (a ? " yam- n; ,� meet 3 ca s all of the *perty located at _ following criteria: ' d (✓. There are no wetlands located within 100 feet of the propose leaching facility , There ara no private wells within 1 s0 feet of the proposed septic systettl i There is no increase in now and/or change in use proposed There Anne variance,requested or needed. leaching facility will be located within 250 feet of any wetlands,the bottom of the If the proposed g I ed leachinggi,ou feciligt will no be located less then (14)feet above the maximum adjusted 1 1 �ndwater table'eievetion. 1 please complete the fol ewhigs A)Top otOrouund Elevation(eceording to the Engineering Division 0.1.S.map) I Observed &Vandwater Table Elevation(,according to Health Division well map) B) a: 1 4— r DATE: ' 31011ED: . LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER_.._ i Pilo st!tM pNepeMd eye". INIw llamnd I"dallfr P a ewlfled plot pl2n. lAtlaeh a dwteh deb plan should be submitted). IKsld�IblAert eat s �Q,,,�.�� G '. G v Z U w �a '� �• TOWN OF BARNSTABLE �d SEWAGE I. CAT10N �� /�p 7 �sr ,F} ��IGG VILLAGE C 117' C/ ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO. 00C-6,1 6e,1612 �_ y � D i SEPTIC TANK CAPACITY LEACHING FACILITY:(type)z/,l k NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 40i�iJea DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� CcE:l:t r) .D-7351� v j p-3 �Of f 37 No._-- -.1_as.-Y Fx ..- ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH APPMM S TOWN OF BARNSTABLE D=Rzom Appliration for Disposal Works Tuustrurii air Application is hereby made for a Permit to Construct ( ) or Repair �/�an Individual Sewage Disposal System at: ....�36.? Locat- n-Address or Lot No. . ��. ._se.!, a� ------------------------------------------------- --------------------------•--•-•-•-•-•--------•------•-----------••-----------..............----.. Owner Address Installer Address d Type of Buildin Size Lot............................Sq. feet aDwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------------------------------------•------------- W Design Flow............................................gallons per person per day. Total daily flow.---.-.-----..--.....-.--•---.-----...--....gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter-------.-------. Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_----------------- Diameter.------..-..---.---. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1--------........minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of,Test Pit.................... Depth to ground water--.'.*.................. 9 ----------------------------------------------------------•••--•----•-----------•••-•----•--••----------............. ---- --------- -------------------- •..... 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------ x U ------------------------------------------------------•----------------------------------....-------....--------------------------------------------.---------------------------------------•.......... x ------------------------- U Nature of Repairs or Alterations—Answer when applicable----/,.p..... ------- f -----------------------------------------------------------------------------------------------------------•--------------------------------•-----------------------•---------------------..........---- 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 b issue he board of health. Signed . ...... ........... ................................................. --'7 .................................e� Application Approved By ....-- --------- ------- --- -.. Dace Application Disapproved for the followin axons- -- ---------------- - ------- ---------------------------------------------'............................................ .............-- ---------------------------- ------------------------ ------ -- ------------------------------------------ ---------------------------------------------------------------- ---------------------------------------- Da -- Permit No. ------ -..a-,------ 5- �...-------- Issued ------------- -------------------------...................rete Dare No. 1_E._2 Fas + ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEATH TOWN OF BARNSTABLE/ Appliattaan for Bispusal Marks Tottsh n Hermit Application is hereby made for a Permit to Construct ( ) or Repair 9/5"an Individual Sewage Disposal System at: ... .? ��rr-�_.1�.-_��`c-------------_-- L -___ --- ___--------- -—_—--- oca''°II-Address or Lot No. ------------------- Owner a - ------- ------------------------ Installer ------------- -------------------- A ----------------�---- Address Type of Building Size Lot_----------------____.-Sq. feet a Dwelling No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building - ( ) a Other—Type g ____________________________ No. of persons----.-----------------____-- Showers ( ) — Cafeteria 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------- Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-_-----___--_-_-•----__. rX4 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------- 9 -------------------------------------------------------------------------------------------- ------ -- -- -- -__---- 0 Description of Soil------------------- W V Nature of Repairs or Alterations—Answer when applicable___-- LV_e'----- jfr T✓�T? -C'X' �, fyZ -1 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 Compli �a has issu �y e board of health. Signed0 ----------------------------------------- ---�-�--- ApplicationApproved BY -------------------------- ------------- & _-^"-`- - ------------------------------------------ ---- -� -_ nre Application Disapproved for the following-r axons: -------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------ _- qq.. ------------------------------------------------------------------------- ---------------------------------------------- ---------------------------------------- Permit No. ----------1-- ---'----_-___S Issued ----- ----------------- - ----------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE fler#tftcale of 010mytiance THIS IS TT CERTIFY, That the Indivviid�ual wage Disposal System constructed ( ) or Repaired ( ) ---------6 = - --- ---------------------------------------------------------------------------------------------------- by c . Ins�aller at ---------------- ?--------- - has been installed in accordance -I ovisions of TITLE f The/S� tate Environmental Code as described in the application for Disposal Works Construction Permit No. _.- a-"3_Z _�_-____-_--_ dated -_____________________--______-_-___--__-_- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED ASFA.GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE -�-�---� --------------------- Inspector ---- - ------------------------------------------------------------ V------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q� y No.---- TOWN OF BARNSTABLE FzL-3 r) .?__rah....-�,�f' 14sposal Varkii Tonsfrns#Wn f rrtni# Permission is hereby granted--------- f" `� `' --------------------------------------------------------------- to Construct � ) or Repair a Individual Sewage Disposal System at No.------------5 6-- ?-------------------- Street � ^ as shown on the application for Disposal Works Construction Permit No__--- FT Dated------------------------------------------ -----------------v-f\_a 17--)----------------------------------------------- ^-�- � Board of Health DATE-------------------------- „! / ----------------------------- FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS TOWN nE BARNSTABLE ,--U CATION ae.Lz 1 r ng-AA m f�rl�_SEWAGE 'S MAP &LOT VILLAGE ASSESSOR � "INSTALLER'S NAME&PHONE NO. �_.�� '�- SEPTIC TANK CAPACITY r � :. `:LEACHING FACILITY: (size) "NO.OF BEDROOMS ::BUILDER OR OWNER .TERMITDATE: U _j 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 Feet on site or within 200 feet of leaching facility) :Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by e� A � ► - f �� 4, LC� CAX1014. SE AGE ,APERMIT NO. V IIL L A D E IN.STA LLER'S NAME & . ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED -� ,�7 .. DAT E CO-MPLIANCE ISSUED J i E I 4 No......... ...... ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® -OF HEALTH Torn...............oF...Barnstable ---- ------------------------------------------•-------- Appliration for Mqpwial Workii Tomitrur#ion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: 367 Nottingham Drive _.. ..... ..... ..............._................................................................................ ................•.• ................ Dennis Dri"sco1cfon-Address Centerville or Lot No. ----•-......--••--•.......................................•--------------.......--------•--•-----• •-••--•-•-•-•-•-•---••--••--•-•--•--•.........................................--•----•-....•..... Owner Address a J....P....Macomber & Son...Inc . Centerville. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................:. . . .Expansion Attic ( ) Garbage Grinder ( ) .-� Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a4 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-------•-------------------------------- ,a_l Test Pit No. •1................minutes per inch Depth of Test Pit---------.--------_ Depth to ground water---------------.-....... fi Test Pit No. 2................minutes per inch Depth of Test Pit---------.---------- Depth to ground water------•................ . ---------------------------•------..............----------------...----•-•-••-•......---•-•......---......................................................... O Sand & Gravel Description of Soil ----- -- --- ------------- x ---------------------------------------- ---•----------------------------------------••-----------••--•----•--••-••---•-•------ U Nature of,Repairs or Alterations—Answer when applicable.-1-1000 gallon overflow --------------------••-•--••---•-•-•--••-••------••--•- ---•-••--•----•-•---••----•-•-•-•••--•-----•---•--•--•••----•----------...------•---•--------------------------- ....----------••--•--....•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT .1. p of the State Sanitary Code— The undersigned further agrees not to place/th , ystem in operation until a Certificate of Compliance has ee n sued by theh d o h alth. Sign 4o�h � Date ApplicationApproved By------... --------------------------- ---------------------------------------- Date Application Disapproved for the following reasons:.......... ..................................................................................................... ....--•---•-•••-•:.................•---•-•----- --•---••-•-•••••••••-•-•-•---••-•---......-•----•--•-•....••••-•--•--••--•--------•--•--••----........--•---•••--------•---•--•---••--------•-••-•----. . ....................Date Permit No.......................................................... Issued__ ._�,�--`� -• Date No............... F�$:.... : :1 ...... THE COMMONWEALTH OF MASSACHUSETTS ,,,.M . . ... ,.- BOARD OF HEALTH .o� ........::......op..Barnsbab jg....-- ..... or at Works (foubfrurtion Prruttt Application is hereby made.. or a' Permit to Construct ( ) for,Repair (.; ) an Individual Sewage Disposal •System at Ott .......- •--- ....14 ..............•..._..:_.._..... _--•-•--- =.. .,. n• r ocgion-Address or Lot No. Dennis Drisco�x Centerville ..............•--••--... .....- •-•- -•--- Owner f Address a l acomber- & � ---------•-• -••-•-..c e ville...................... Installer w Address r Q Type of Building Size Lot____ Sq 'feet i Dwelling—No. of' Bedrooms "' Expansion+Att>c , Garbage Grinder 4 ( ) ( ) pa, Other Type of Building-'Bililding-'t< <' No. of persons_ + ' :'._ Showers'( ) Cafeteria ( ) t ! I Other fixtures ...................................................... = ••--•..._._...... .. ...... W .` Design' Flow.....................ti..............._ r` rgal'lons .per person per day. Total daily 4iow ..........._...._ .:gallons R� ° S�ept>csTank;'--'Liquid capacity `� F', gallons Length----------- Width : Diameter__-___ Depth I ¢..... W . ...Total leaching area _........s ft. x Disposal Trench—No Width.................... Total Length._.__._.. g q. Seepage.Pit No......................'Diameter.................... Depth below inlet._....' L Total leaching area..................sq: ft. ry .; Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed-by------------------•--.-••--_-___-••••- ......__.... Date........................................ s Test Pit :No. 1................In upte`s per inch Depth of Test Pit _ :._... ...•.__ Depth to ground water•..._._____ ._-_. f=, �.,f, Test Pit,No. 2................minutes per,,inch Depth of Test Pit ____..._: D-epth to ground water ._._..:: a O Description of.'Soil- .......Sa,t�d..... Q'rB Ve 1° .........................................� w : -- x 1-1t7C?4 kallon k©verrlow U Nature of Repairs or Alterations t''Answ&r when applicable________ _______ . .............................................. ..._...._ "._.._.. --- •-----•-•-•-...••• -- 4,�igreement t t s. The undersigned agrees to�mstall' the �aforedescribed'Individual`Sewage:Disposal System in accordance with stfiezprovisions of TITLE 5 of the-State'Samtary Code—The undersigned further agrees not to place the system in t operation until a,Certificate of Compl ance.has een issued by the bo d o 1 lth t 3 Y x: ' Sin r. ,. -� r ..... � � a h y;,L• , g •-- -• -• ---• gyp, ..'fit r -Date t Application Approved B 'f ____________________•--- ........................................ • Date !Application Disapproved for the following reasons______________ _____________________ ________ __________________ '_ .......... 4. ......................:........................................................ •-••-...........-•••-- --••••--•---•••••-•. Date + Permit No. _--•-- t ....__._ t. ;Issued? ...................................... 4 r ..'Z L, ` Date a r THE COMMONWEALTH OF MASSAC'HUSET7S t Y `BOARD OF HEALTH (�rr#ifiratr of Tamphaurr. I THIS IS4T0' CERTIFY,"That the`�Individual Sewage Disposal_Sy9tem`constructed (' ) or Repaired (: ) ;bya Jo: eY�. -`• - C ;x+ ion CnC . :.. ; I k Installer 1.11P. .... ............. •--- has been installed in accordance with the provisions ofOIP4F'. 5 of The State,Sanitary Code as desc ed tothe applicatioii'for Disposal Works'Co istruct'ion Permit N _____ _____________ ____:____ dated.-.. '�^ ____ :_:. ..._..... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE rTHAT�T-HE �.SYSTEM WILL FUNCTION SATISFACTORY. " y� gDATE__:. .rr�: :` . y Inspector ..... . # sFr 'THE,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 't Y /Y I = N,O. ............. FEE_ n Disvos f Works T>amdr ott rrmft 1 ,l € Permission is hereby granted' tC3Pl�. Mecgrti?e '._$ . 429_' ...................... t xo�cgistruct ( ) or Repair O an Individual Sewage Disposal Systeir f� l at,No: �y _l O tar hatn nr4v , Genterv': 3e Driscoll: e �� t ^' treet, z.`� '"� ! �kn Ns, shown on the application for Disposal WorksaConstruction �it Dated---7 4 t •k� 4 $ y' lrBoard of th _DAa € FOR1N4 i'1,255 '140 S & WARREN, INC PUBLISHERS --64-- EXISTING CONTOUR N x 60.98 EXISTING SPOT GRADE d�°Rd (6 6 —W EXISTING WATER SVC. IA) �e G'�`° —G EXISTING GAS SERVICE N p ec1n°t Rd Hodcodo—$H `" sm a— OVERHEAD WIRES � reo TEST PIT s Pfectnct Rd LOCUS �\ck 5� �• BENCHMARK LEGEND Me„del W °` � ROSett,o�Y �o � ecno�d C`o`"c�r 0 xvi ncono S P� 58 40 `I 105 99' w LOCUS MAP r NOT TO SCALE i LOT 70 17,797±S.F. PARCEL ID: 171 -080 Uj oL � Lri Z tr) � Ul � o 99.27 x *10 1EXISTING 99.98 HOUSE(#367) T.O.F.=101.6t' 99,50 EXISTING SEPTIC TANK 10 .2-V (TO REMAIN) I Dili TOP OF TANK, EL.=99.40t INV.(OUT)=98.05t x 100,77 STUMP 100.73 ;. is 100.69 100.33 + ( N 00.79 - 10' min ) - 3- EXISTING S.A.S. (FROM RECORD AS—BUILT) ABADONED I T 9 00 99.18 PARTIAL STRIPOUTI- - 25'-JW -12 _ SEE NOTE 11, SHEET 2 — ' 99.74 x 99,46—— — - 99.40 160.009.69 '- SB — -99 N 59*19'00" E -— --1 Rt AR 98.48 ---98— -------_ 97,54" I 97.88 97.78 PK SET 97,66 edge of pavement 97.21 97.56 97.71 POSSIBLE OLD LEACH PIT NO T T I NG HA M DRIVE REMOVE IF ENCOUNTERED OF ,yq o PETER T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN McENTEE _4 367 NOTTINGHAM DRIVE, CENTERVILLE, MA � CIVIL "' Prepared for: DS Developers, LLC, 32 Gordon Ln, Yarmouth Port, MA 02675 No. 35109 OWNER OF RECORD $TES HSBC BANK USA, TRUSTEE Engineering by: SCALE DRAWN JOB. NO. \ 32 GORDON LANE Engineering Works, Inc. 1"=20' P.T.M. 190-19 YARMOUTH PORT, MA 02675 9 9 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. ✓�f !? ,(� %DS DEVELOPERS LLC (508) 477-5313 5/17/19 P.T.M. 1 Of 2 I NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL.=97.0 FOR A DISTANCE OF 15' FROM THE EDGE SEPTIC TANK OF THE PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & PROPOSED D-BOX OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT PROPOSED S.A.S. COVER SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND T.O.F.=101.6t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT F.G. EL.=100.9t F.G. EL.=100.8t F.G. EL.=100.3t F.G. EL.=99.0t MAINTAIN 2% SLOPE OVER S.A.S. L - 5' L = 13' SCH4 (MIN.) © S=1% (MIN.) 2" LAYER OF 1/8" TO 1/2- 6' 4"SCH40 PVC 4"SCH40 PVC DOUBLE WASHED STONE 10"I as S as (OR APPROVED FILTER FABRIC) 14" 8 BB6aOaa0 EXISTING 48' uoulD Baaaaaa �--3/4" TO 1-1/2" DOUBLE LE 4' 4.8' 4' WASHED STONE ADD INV.=97.72 PROPOSED INV.=97.55 GAS BAFFLE • INV.=98.05f D-BOX EFFECTIVE WIDTH = 12.8' EXISTING INV.=96.50 EXISTNG SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED NOTES: TOP CONC. ELEV.=97.3t 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BREAKOUT ELEV.=97.00 INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=96.50 aeaea aaaaaaaaaaa 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE aaaaaaaaaaa ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BOTTOM ELEV.=94.50 STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 4' 2 x 8.5' = 17.0' 4' 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. PERVIOUS MATERIAL 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W., EL=88.2 - . SEPTIC SYSTEM PROFILE GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 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. /EXISTING 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR HOUSE(11367) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE T.O.F.=101.6f' DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. 5.-ALL ELEVATIONS BASED ON AN ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. aiz . �C� 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. LA N W 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 'cp, Mcp' �+ �10. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS -AGREED UPON UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY i PROP. S.A.S. i w THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. {�-25' �I 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 REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). SEPTIC LAYOUT 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND SOIL LOG NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC DATE: MAY 14, 2019 (REF#19-18) SYSTEM COMPONENTS NOT SHOWN ON THE PLAN SOIL EVALUATOR: PETER McENTEE PE(SE#1542) WITNESS: DAVID STANTON R.S. HEALTH AGENT ELEv. TP-1 DEPTH ELEv. TP-2 DEPTH 99.8 q 0„ 99.5 A 0�� LOAMY SAND LOAMY SAND DESIGN CRITERIA 99.3 B g" 99.0 B 10YR 4/2 10YR 4/2 g" LOAMY SAND LOAMY SAND NUMBER OF BEDROOMS: 3 BEDROOMS 10YR 5/8 10YR 5/8 97.3 30" 97.2 28" SOIL TEXTURAL CLASS: CLASS I c1 C1 MED. SAND MED. SAND PERC DESIGN PERCOLATION RATE: <2 MIN/IN 30"/48" 2.5Y 6/6 2.5Y 6/6 DAILY FLOW: 330 G.P.D. 10% GRAVEL 10% GRAVEL DESIGN FLOW: 330 G.P.D. 93 3 C2 78 93 C2 78 GARBAGE GRINDER: NO-not allowed with design M-C SAND M-C SAND LEACHING AREA REQUIRED: (330) = 445.9 S.F. 2.5Y 7/3 2.5Y 7/3 .74 88.2 138" 88.5 138" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PERC RATE <2 MIN/IN. "C" HORIZONS PROPOSED D-BOX: 1 INLET, 3 OUTLETS, H-20 RATED NO GROUNDWATER ENCOUNTERED USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 367 NOTTINGHAM DRIVE, CENTERVILLE, MA SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: DS Developers, LLC, 32 Gordon Ln, Yarmouth Port, MA 02675 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:.............................................................. 471.2 S.F. Engineering Works, Inc. N.T.S. P.T.M. 190-19 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD (508) 477-5313 5/17/19 P.T.M. 2 Of 2 5 J