HomeMy WebLinkAbout0888 PHINNEY'S LANE - Health (2) 888 Phinney's Lane
Centerville
A = 251 - 100 ,
No. 42101/3 ORA
ESSELTE
10% `
® O O O
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.h.-it does not give you permission to operate.�i'�Ti must first obtain the necessary signatures on this form at 200 Main St., Hyannis.,
Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: Fill in please:
APPLICANT'S YOUR NAME/S: r -
�s tl 1 BUSINESS YOUR HOME ADDRESS: 999 Eh-�-e-rV) C,
�7 4 3 2
TELEPHONE # Home Telephone Number 37 6
EIN OR : E-MAIL: S c� �i'cQY] �'ei CGh7..a t
NAME OF CORPORATION: v a c
NAME OF NEW BUSINESS ' TYPE OF BUSINESS1G r.1,5 C/—.Pr,,,
IS THIS A HOME OCCUPATION? YES NO l
ADDRESS OF BUSINESS P✓ � 026-i�rAP/PARCEL NUMBER ( °00 (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
MUST COMPLY WITH HOME OCCUPATION
1. BUILDING COMMISSIONER' OFFICE ,
This individual has been ' f d of an p mit requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO
COMPLY MAY RESULT IN FINES.
Autho ized Si atune
COM ENTS: CrZIto
ilia
2. BOARD OF HEALTH MUST>COMPLY WITH ALL
This individual has been i�miermit requirements that pertain to this type of business. HAZARDOUS MATERIALS REGULATIONS
uthorized ture** /
COMMENTS: �a
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
TOWN OF BARNSTABLE Date:
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: � � �G d U c(Yv4
Sh
BUSINESS LOCATION: g�� r�hjY4nGYS C��'?�', c_�h L1��� /no� 6731NVENTORYVQ
MAILING ADDRESS: Sc,%'Y�)f_, TOTAL AMOUNT:
TELEPHONE NUMBER: RM 73 i G` d
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: S MSDS ON SITE?
TYPE OF BUSINESS: IG'n a s Gurarc
INFORMATION / RECOMMENDATIONS: Fire District:
Waste Transportation: Jt,� Co)l-ec. ion Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: (Y\OtQ t-- �' ` Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more a month re uires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health and the Public Health Division have determined that the following products exhibit toxic or
hazardous characteristics and must be registered regardless of volume.
_V+,c&d qoee�a-j
� t& Observed / Maximum Observed / Maximum
0-k I Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive
3- ! ❑ NEW ❑ USED Cesspool cleaners
f Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
� Gasoline, Jet fuel,Aviation gas
Photochemicals(Fixers)
Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED -
Degreasers for engines and metal Printing ink
Degreasers for driveways&garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorine
0 Battery acid'(electrolyte)/Batteries Lye or caustic soda
Rustproofers Miscellaneous Combustible
t Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt& roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials
TOWN OF BARNSTABLE
iOCATION �� Vk1�N!TS L fJ SEWAGE# �( 1 G
VILLAGE Ce!",J4r it f ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO
SEPTIC TANK CAPACITY jfpl ,tjr%P
LEACHING FACILITY: (type) a{10 Wo (size)
NO. OF BEDROOMS Z
OWNER L,00,,9 S'0P ry
PERMIT DATE: I J—10-1 C e COMPLIANCE DATE: hP
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BYJ C ��/�
3.P,' G r�
�
�
30
r1� 8
2 "38� � 1r� OUT
v � e
_37'3'r z
No. C� I V l� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS YeS
2pplication for Disposal *pstrm Construction permit
Application for a Permit to Construct( ) Repair(411u,pgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address r Lot No. &V61017ivwelt -j Owner's,�l ame,Address,and Tel.No.
Assessor's Map/Parcel _ (O O �� l
Installer's Name,Address,and Tel.No. Designer's Name,Address,,and Tel.No.
Type o uilding:
Dwelling No.of Bedrooms Lot Size lS sq.ft. Garbage Grinder( )
Other Type of Building (P 5 0@N k No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3�y gpd Design flow provided ofg `� gpd
Plan Date /'//i /�L Number of sheets Revision Date
Title
Size of Septic Tank E X15{Z N� Type of S.A.S. .9, , SC7Ch a,&110N C Ull3vtnkJp�s_
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 1_00, Jl Epp �, '�CT� r LA C�lil Io�FS
W t tyk t i 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 Board of Health.
i
Signed Date �I b e,
C C
Application Approved by Date
j Application Disapproved by Date
for the following reasons
Permit No. ��� _ Date Issued
No. Cat C7 l�J t�� Fee V�
'd THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yess
2pplitatio" n for Disposal 6pstem- Construction Permit
Application for a Permit to Construct( ) Repair(./Upgrade( ) Abandon( ) ❑Complete System l Individual Components
i
Location Address r Lot No.��h11t/.v/°`S �/ Owner's-Name,Address,and Tel.No.
Assessor's Map/Parcel ( - I O O r `
IInssttaller's Name,Address,and Tel.No'.( Designer's Name,Address,and Tel.No.
, rL L, G 6CA.cJ� 1 -qCQ-7/S
Type of`B/uilding:
Dwelling No.of Bedrooms -3 Lot Size I J`_. sq.ft. Garbage Grinder( )
Other Type of Building CP t Df.N!r G No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3?w gpd Design flow provided ,Zwe ,-7 gpd
Plan Date _// / b L Number of sheets Revision Date
i�
Title
Size of Septic Tank e-0 ►S i 1 N Type of S.A.S. .2
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 1 #C�Il 2
CCU t �t 1-( 1 S t CD roe
Date last inspected: 1
r
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 j
Compliance has been issued by this Boarrd-of Health.
Signed c\ — Date // /b
Application Approved by 1 K L-yc,' ,Q_Q �_. Date
Application Disapproved by Date
for the following reasons
h
Permit No. go i I'd Cn Date Issued
------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
i
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(!/r Upgraded( )
Abandoned( )by �( (r(���,� /ur,
at e9R IP►'11- NNPVS L N cm� C�Cy� has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.a10 �'T� dated I /�
Installe� Designer
iv
gn
#bedrooms '_� Approved de flow d gpd
The issuance of this permit shall not be construed as a guarantee that the system wi to as designed.
Date { 1161 1 (o Inspector �► (�J LW
^� (� -- -----------------
No. ( 0( {(i : C Fee ,
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Vermit
Permission is hereby granted to Construct( ) Repair(t/) Upgrade( ) Abandon( )
System located at 88OA i� �� ,--� r p J t C'/J
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
f
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit. j
Date �� / Approved by l C
Town of Barnstable
Regulatory Services
Richard V.Scali,Interim Director
s�nsrAar,�,
� Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 0260.1
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: _kJ Il 1 �p Sewage Permit# 90 3Rc( Assessor's Map\Parcel 25) k 0
Designer: v`�?:�nti.e !,3c rLkj 1,,. k,_ Installer: P<A - 4�Ca-u,3 \cn--L
Address: I Ccz,c`'1i� \c t��1 Address: Lt S
J
On / o Co P.A• ' -ai t uL L was issued a permit to install a
'(date) (installer)
septic stem at Q j mi-C yl 1 S
A Y �� V r'L C_ec�l' based on a design drawn by
(address)
0 L 6; t-e:C f tl= dated d•1 17 G
(designer) J
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical.relocation of any component
of the septic system) but in accordance with State &LocaI Regulations. Plan revision or
certified as-built by designer to follow. Strip out (if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in co liance with the terms
of the AA approval letters(if applicable)
o PETER
( nstaller's Signature) o McENTEE
Civic
No. 35109
r�SjE ��`��
(Designer's Signature) (Affix Desi Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. 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.
QASSepticwesib er Certification Fonn Rev 8-14-13.doc
4
Town of Barnstable P# I
gyp' Department of Regulatory Services 1
Public Health Division 10
• n�rwar,�ce, • slon Hate �
'200 Main Street,Hyannis 02601
MA �
Date Scheduled Time Fee Pd. ( �b• �,,:
Soil Suitability Assessment for Sew e P SPOIR71
Performed By: PChem M L Ch i-�P, 5 "-1 ��2Witnessed By:
Y l)
LOCATION& GENERAL INFORMATION
Location Address Owner's Name.
Ayiete-
I-er�/,1 I_0 Address 3 9 M C,u Vt !1 2V�
Assessor's Map/Parcel: _ ' G CZ''t
2 Q (D�?'Engineer's Name 2 Z
6VV 5i n-0_e—N,'5l c/v'
NEW CONSTRUCTION REPAIR- Telephone
j.
Land Use Slopes(%) 2 GG' �� Surface Stones._A'd i\4-
Distances from: Open Water Body L6 ft, Possible Wet Area AJ1 ft Drinking Water Well ` t
Drainage Way ft Property Line 15� ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to Les)
Y �
�I
I
7.,
1Jzu,i
a�
d
Parent material(geologic) w`S Depth to Bedrock �
Depth to Groundwater. Standing Water in Hole: '� Weeping from Pit Rice_-.. a UC)e- -
� � 3 � 1i
Estimated Seasonal High Groundwater I
I
DETERMINATION,FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: - __ ___. in, Depth to soil mottles:. � in.
Depth to weeping from side of obs.hole, in, Groundwater Adjustment �e. fr.
Index Well# Reading Date: _ Index Well level Adj,factor— Adj.Groundwater Level
_ I
PERCOLATION TEST Date �.v Time!�
Observation �p�f ' j
Hole# _ Time ath"
Depth of Perc CjJ4 Time at 6" _
Jr
Start Pre-soak Time Time(9"-6") _
End Pre-soak _
s i
L Z 13' 114.1 -1
Rate Min./Inch '
Site Suitability Assessment: Site Passed_X1 Site Failed: Additional Testing Needed(Y/N) _
Original: Public Health Division Observation Hole Data To Be Completed on Back------------
i
***If percolation test is to be conducted within 100' of wetland,you must first:notify tl}e.
Barnstable Conservation Division at least one (1) week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC '
i
]DEEP.OBSERVATION HOLE LOG Hole#�I
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surfa4(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
— Consistency.% ravel
r&S
Ze
rF* '
r-DEEP OBSERVATION HOLE LOG Hole# v
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.% rave
yz
%..A -Z
0
Ld 5� 2tS 6�6
]DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface m. (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
( )
Consistency. o Grave
L
:DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.% yell
i
Flood Insurance Rate MaZ
Above 500 year flood boundary No_ Yes^_____
I
Within 500 year boundary No X Yes
( ' Within 100 year flood boundary No ef:� Yes
DQAth of Natui,ally Occurring Pervious Material
Does,at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed fir the soil absorption system?
If not,what is the depth of naturally occurring pervious material? _
Certification
I certify that on _ �E(date)I have passed the soil evaluator examination approved by the
Department of I?nvironmental Protection and that the above analysis was performed by me consistent with .
the rc uired trai.ni , xperdse and experience described in 310 CMR 15.017.
Signature
:Date 1
Q:\SEPTICVERCFIORM.DOC
TOWN OF
BARNSTABLE
LOCATION ��`i lhl c� y, j 4�yP � SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT zS( . loD
INSTALLER'S NAME&PHONE NO. �c d
SEPTIC TANK CAPACITY C n S k s, a va,
LEACHING FACILrrY: (type) (size) I-q --4-C
NO.OF BEDROOMS+ 3
BUILDER OR OWNER L.uvyK99
PERMITDATE:_ @ J_27 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 facility) Feet
Furnished by
t
of 3
1 0 0
No. ,... Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01pprtcation for Mizpoml *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.g—gr P�v wK>S _ Owner's Name,Address and Tel.No.
Assessor's Map/Parcel �s ,mil
Installer's Name,Address,and Tel.No. g .O(,.. / Designer's Name,Address and Tel.No.
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 33 (] gallons per day. Calculated daily flow 3`4 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. �-
Description of Soil yy,a p S
Nature of Repairs or Alterations(Answer when applicable) fi v—
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 ode a d not to place the system in operation until a Certifi-
cate of Compliance has been issued!!��t�his B d o t��
rgned Date ;L 7
Application Approved by /�" Date , —)s=��
Application Disapproved for the ollowing reasons
I
Permit No. Date Issued
( 00
No. , !` Fee
COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
application for 0i!6pogar *p.5tem Construction Permit
Application for a Permit to Construct( )Repair(/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No:�"�8 ��„,v fs — Owner's Name,Address and Tel.NO t
Assessor's Map/Parcel aS —1 y
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
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 33 U gallons per day. Calculated daily flow 3 y gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank �.z��s't J S."� Type of S.A.S. '� v� -� 1¢O� ��u off•
Description of Soil 0& .S w w\D
w
Nature of Repairs or Alterations(Answer when applicable)
4w�D lg p t :ts Y t Y:W '-T V
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 ode and not to place the system in operation until a Certifi
cate of Compliance has been issued b this B gd of Health.
t ned Date �---���7
Application Approved by Date .,?
Application Disapproved for the ollow-ing reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired ( )Upgraded(✓S
Abandoned( )by
at Law..P- e_ee -r rvA'\•, has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 9-7 �' 7 dated _1-�?_r g .
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date `�, - C�-I Inspector
ti (( ,,
L J
No. 9 7`e 7 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE., MASSACHUSETTS
Mi5po5al *pg;tem Construction Permit
Permission is hereby granted to Construct( )Repair(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 pemlit. /
1,4.
Date: c� - �- 9 7 Approved by ( ?���1�'�
NOTICE: This Forin is to be used for the Repair of Failed
Septic Systems Only
CERTIFICATION OF SKETCH AND APPLICATION FORA DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
hereby certify that the application for disposal works
construction permit signed by me dated �c3`� �7 , concerning the
property located at 1`! �� y��-��S 1—� —� C��` meets all of the
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED
1 DATE:
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
j:cert
C7
0
888 PHINNEYS LANE, CENTERVILLE -
A=251-100
QQ TOWN OF BARNSTABLE
LOCATION �BCJ 'h/��-u5 �c� SEWAGE# '
VII.LAGE C-e�"�� 2v°� ASSESSOR'S MAP& LOT -� • 100
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) ���' "�'� (size) ` C
NO.OF BEDROOMS 3 n
cor-'
BUILDER OR OWNER
PERMTTDATE: t11�—`,_COMPLIANCE DATE: ? -
Separation Distance Between the:
Feet
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
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 Feet
within 300 feet of leaching facility)
Furnished by
So Z)0
� o
a �
T
N ——101-- EXISTING CONTOUR fence
G \\-
-1 x 100.98 EXISTING SPOT GRADE lin�
Lakeview Ave Ra �° BENCHMARK `"°'n x 76.14
07 W EXISTING WATER SVC.
g6� P WOOD PLA TE/ BULKHEAD CORNER 75.86 I
NoH Lakeside Dr aa`O �o G EXISTING GAS SERVICE �GP 30 EL.=76.90 EXI. TING SEPTIC TANK
Point Rd e' ° �.H.-*--OVERHEAD WIRES
TOPI OF TANK, EL.=75.86
a ��
TEST PIT lN�(OUT =74.53t(1/ERIFY)
BENCHMARK I
ide Dr We I I 1�0� 74.37 x
75 6
.� LEGEND x 6.49
x
x 76.0
4 o �
75,22 x 0
enfe
C La ¢ r
a
LOCUS EXISTING S/A.S. I 76.25
We ua vet Lake a roxi ate x
TO BE ABANDONED SPIKE4 x 76 20
O
LOCUS MAP / /
74.70 i
NOT TO SCALE / / x 5 73 x
/ / I x �. 76.30 x 7 .56
x/ 76,50
x
S
/ ,...- --r--- 22'1 1 EXISTING / �n
HOUSE(11888) 7 6,12 7 z
00
N_r:`; ` ''i I I 98 T.O. 5.55
F.=77.45E x stockade fence
°.� 76 00\ 76,25 5
i 1 .. PROP. S.A.S..:J
SPIKE3� / / 25 \
I I 76
TP-2 \
LOT 24 11
x 9� I 7 =
15,014 0
tS�` /� 74. x 74,9
0
/ /
PARCEL ID. , 251-100
17T,14 75,09 75,03
CB / SPIKEI p•:.. ox x
u
0
69,59 L=168.00' // // 75,17 + 5
R=901 .28' r 122.84'
/ N 26'07'20" E
CB
/ 75.20 x 74,60
74,29 74,47 x 74.30 I
74,19 = x 74,30
73.48 edge of _
pavement
OF PHIN 9 74A4 74,14
��\� MASSgC NE Y S L A NE 74.57
o PETER T.
g MCENTEE PROPOSED SEPTIC SYSTEM UPGRADE PLAN
888 PHINNEY'S LANE, CENTERVILLE, MA 02632
VIL
No.. 35 109 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
SIN
OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
r (q e LOUNSBERY, ANNE ELIZABETH Engineering Works, Inc. 1"=20' P.T.M. 229-16
1 39 MICAH HAMLIN ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
CENTERVILLE, MA 02632 (508) 477-5313 11/1/16 P.T.M. 1 Of 2
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:72.00 GENERAL NOTES:
SEPTIC TAN FOR A DISTANCE OF 15' AROUND THE
K S A. .
INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S. 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROPOSED S.A.S. BOARD OF HEALTH AND THE DESIGN ENGINEER.
PROVIDE ACCESS TO GRADE OVER OUTLET COVER INSTALL WATERTIGHT RISER & PROVIDE ONE ACCESS MANHOLE TO WITHIN 3" 2. AL THE AND
ATE E MATERIALS
SHALL
CONFORM TITLE O THE
REQNY UIREMENTS
CABLE
T.O.F.=77.45E
COVER SET TO 6" OF GRADE OF FINISH GRADE, FOR INSPECTION PURPOSES LOCAL RULES AND REGULATIONS.
F.G. EL.=73.4t F.G. EL.=75.Ot 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
F.G. EL.=76.3t F.G. EL.=75.Of TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
MAINTAIN 2% GRADE (MIN.) OVER S.A.S. DESIGN ENGINEER.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
L =76' L = 6' ENGINEER BEFORE CONSTRUCTION CONTINUES.
SCH4 (MIN.) ® SCH4 (MIN.) 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
4"SCH40 PVC 4"SCH40 PVC
s 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
io"I s aSaaa THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
EXISTING 48" LIQUID
14 aaaaa HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
MEkFFECTI
4.8' 4' 7. WATER SUPPLIED BY TOWN WATER SERVICE.
��vGAS BAFFLEiINV.=74.53
INV.=72.27 PROPOSED INV.=72.10 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
D-BOX VE WIDTH = 12.8'
:-INV.=71.50 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
EXISTING SEPTIC TANK (VERIFY)
2-500 GALLON LEACHING CHAMBERS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
SURROUNDED WITH STONE AS SHOWN DIRECTED BY THE APPROVING AUTHORITIES.
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
H-10 RATED THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
TOP CONC. ELEV.=72.3f CONSTRUCTION.
NOTES: BREAKOUT ELEV.=72.00 aaaB 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
INV. ELEV.=71.50 aa00 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE a®aaa aBaaa
INVERTS, PRIOR TO INSTALLATION. aaaa aBaaa REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
BOTTOM ELEV.=69.50 4' 2 X IFF
8.5'=17.0' 4' 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURRING i INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL EFFECTIVE LENGTH = 25.0' 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION
4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON BOTT. OF TP-4, EL.=62.7 THE OUTLET TEE. 3/4" TO 1-1/2" DOUBLE
WASHED STONE
3" LAYER OF 1/8" TO 1/2"
SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE bh
(OR APPROVED FILTER FABRIC) ,
SOIL LOG g o GARAGE
DESIGN CRITERIA �T T EXISTING
DATE: OCTOBER 31, 2016 (REF#15,191) 47.0' 2,5 HOUSE(#888)
NUMBER OF BEDROOMS: 3 ✓ SOIL EVALUATOR: PETER McENTEE PE(SE#1542) 00
SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R.S. jHEALTH AGENT c,�I PROP. S.A.S. i
DESIGN PERCOLATION RATE: <5 MIN/IN ELEV. TP-1 DEPTH ELEV. I TP-2 DEPTH
(0.74 GPD/SF LOADING RATE) 74.5 A 0" 74.2 A 0" 25' �
DAILY FLOW: 330 GPD SANDY LOAM SANDY LOAM 47.0
DESIGN FLOW: 330 GPD 74.2 10YR 4/2 4„ 73.9 10YR 4/2 4„
GARBAGE GRINDER: NO B 8
SANDY LOAM SANDY LOAM
LEACHING AREA REQUIRED: 330 GPD GPD/SF_ C1
) 445.9 SF 71.8 10YR 5/6 32" 71.7 10YR 5/6 30"
.74
PERC C1
M-C SAND M-C SAND SEPTIC LAYOUT
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 36"/54"
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS / 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN.
USE 2-500 GALLON LEACHING CHAMBERS IN SERIES ✓ 5% GRAVEL & 5% GRAVEL &
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 68.0 COBBLES 78" 67.5 COBBLES 80" 888 PHINNEY'S LANE, CENTERVILLE, MA 02632
SIDEWALL AREA: 2 12.8' + 25.0' X 2 = 151.2 S.F. C2 C2
( ) Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
2.
BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. ME5 SAND MED. SAND 5Y 6/6 2.5Y 6/6. Engineering by: SCALE DRAWN JOB. N0.
TOTAL AREA:.............................................. ........471.2 S.F. 63.0 138" 62.7. 138" Engineering Works, Inc. NTS P.T.M. 229-16
DESIGN FLOW PROVIDED: 0.74 GPD/SF(471 .2 SF) = 348.7 GPD PERC RATE <2 MIN./INCH ("Cl & C2" HORIZONS) 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
NO GROUNDWATER ENCOUNTERED (508) 477-5313 11/1/16 P.T.M. 2 Of 2