HomeMy WebLinkAbout0149 POINT OF PINES AVENUE - Health (2) '[149 Point of Pines
Centerville
A=230-072
IXISMEAD
No.2-153LOR
UPC 12LU
anuodamn - US&to Wu
AI—W—YQ-_4AWb
OIROFM WWOM
May 23 13 08: 18a John Lyons 508-778-2276 P. 1
i
Department of public He tlth-Childhood Lead Poisoning Prevenbon Prognim
Deleading No#iftcation
P1e'dre CUMOitte odl sectir►ns of this form clearly.lncomplift or illegible forms will be returned.
Lead Paint inspector Paula Prior _ Liuctnse 4„3985 inspection Dow 1 D115112
Properly t%mer K ny m� ent_
Prope Owner's Address 4$'I'row6n e_L�i$ht'ewsbury.M1 __ -zip code 01545
Authorised person pgrf'omiing,.r-crk. jgljn P. l yof_ls. Lic)r(Autlt.9.001912
Address of authorizcd perm.72 HidbIhs rowed lid.YarrtlOUth-W;5 ^_-Zip Code. 02673
Telephone Number
Address-~there the work will be donc:
Building Name{if am. .._........_. Flow
149-Porno Ines— A I No. -Street Address ..--•---^-------- .. .....- -------- P --•
City Cnterville _ ._ Tip Code 02632... The propert% is a_multi-ftunih• X 6nLle famih.
i)Mleprlini Melhod(s):
lz Making pains intact(high risk) !2 Making pain) intact(modcralc o Applving vinyl siding on exterior
Cr Demolition risk) Q Component rentovnl(low risk
0 Scraping o Liquid encapsulartt componen(s)
CX Component minevalirepkicement o Covering a 01hcr:-__,- ,..,,,,,
a Dipping o Capping baseboards
The cork will begin on 524f.1 tnd will(finish by _53 1_r 13ne►work will be donc in the X_aEllX pm or X �ticckcnds.
In Case of Emergency Crnnact John P. Lyons.,.-
Day irnc Phone 774-353_6235 _,__,,;._,_.... E-venin.PhoneM 77574066.. .-
The Propem-Owner most complete and.ism the f(dlowing informatiun:
I Certify that'ouly authorized persons who have complied with llu:irdining mquirenients of the Massacliuselts Lead Poisoning
Prevention and Control Ragulatio)1W. 105 CMR 460.0(XI,will conduct delending mmrk. 1 ftathercenify that the authorimcl
PM.ou(s)w ill not esoeed tlx:scope of hislhar aulhanty d""ill be performing only those ucth itics indicated abo%e. All of the
information contained in this document is true and c —t to the best of my knowledge and belief.
Date 5123113 Si ,nod -_-.-.—The f(tllOWint!peoplelagencit%must he notified ten clays Wore heginning work:�
I Occupants ar the chvel litl$unit /V QAIG%
2. All other occupants orthC residential premises.if any work will be done in the common arras
+. Childhood Lwd Poisoning Pres°cmion Prognim,DPH Fax(7R 1)7741d67410
M W"O
S Randolph Street,Canton_MA 02021
4. Aslmstos and Lend Program. DLS
19 Staniford St, V Floor,Boston,MA 02114 Fax(6I7)62(�61)6i,4
5. Local Board orHwillh./Ccxic rnforccntcnt Agency Bamstable (508)790-6304
•Uth4 home is on the State RCgiHicr 01-lh5hxic P3ueC:i,.1111 tom.Mil lii+toriwl Comntissmn at et.i 7)727-8-4711.
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION — TOWN OF BARNSTABLE, MASSACHUSETTS
21p plicatiou for Wgpogal 6pgtem Cottgtruction Permit
Application for a Permit to Construct( ) Repair(W Upgrade( ) Abandon( ) V Complete System ❑Individual Components
Location Address or Lot Noe,0�/ �0� pf40p//'�6'�Rb 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.
���*�o c�stJ��ro..� oe✓'
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building e,?d s. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) " gpd Design flow provided s gpd
Plan Date 'f�o �� Number of sheets 1 Revision Date
Title
Size of Septic Tank o o PAe' Type of S.A.S. c1'CrE
Description of Soil `r A C� �
P T.a.�/f crow A,,or'?,R
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
S' ned Date e —
Application Approved b Date
Application Disapproved by: Date
for the following reasons
Permit No. 00l � '{�� Date Issued
yr 44 ,No. Ct c3 o�
�D t Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION —TOW N—GF,BARNSTABLE, MASSACHUSETTS Yes
application for"'M4 ar *Pmem Cow6tructiou Permit
Application for a Permit to Construct( ) Repair(k�Upgrade( ) Abandon( ) kComplete System ❑Individual Components
��9 ddo/irj ofQa/z..e�S9�Location Address or Lot Owner's Name,Address,and Tel.No. C
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
97$� 03'O� �yEd /G,r ;
Type of Building:
Dwelling No.of Bed o ms Lot Size sq. ft. 'Garbage Grinder ( )
Other Type of Building OZ ce'J^, No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow min.required) 3 4r1 '�i
g ( q ) gpd Design flow provided gpd
Plan Date '��— �� Number of sheets 1 Revision Date
.Title
-_'Size of Septic Tank 4 o c o PAP -5- �J'o o Type of S.A.S.
Description of Soil T��
t
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions 6f 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. j
Si,�ned_,�S��.. Date 3
Application Approved by Date r
Application Disapproved by: Date
for the following 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 ( )
Abandoned( )by �/ L tBOc�Ui ,J'�Gal/G ✓'c�a!y iC d`
at y9 moo♦^i/1 0� d��i✓�P iq!�E" C c'w
4 l has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.C�Z/�`d 6 - ' dated 3 A /
rx-
Installer �/�71 e�BoC`G� Designer aq'G/p ,� /17ij✓o y DQ J'
#bedrooms 3 Approved design flow 3<51 gpd
The issuance of this permit shall not b construed as a guarantee that the syste n'will fu otia as �esigned.
Date �� oi—� / Inspector
No. __ -----_�--_—— _--_—_—_----_—— r - _. Fee —_----
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
'Wi0 ogal Construct� p$tem tort Vermtt
Permission is hereby granted to Construct ( ) Repair Upgrade ( ) Abandon ( )
System located at X
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special condit, s.
Provided: Construction must be completed within three years of the ad of this per it.
Date � - Approvy
i
i
Bk 26174 Ps 67 615130
1 •
r
DEED RESTRICTION
The Barnstable Board of Health requires that the following restriction; that
the dwelling be restricted to three (3) bedrooms as defined by the
Massachusetts Department of Environmental Protection and interpreted by
the Barnstable Board of Health due to the need,for a mandated Title V Reed
Restriction fvr septic systems that have a capacity of 330 gallons per day,, be
placed on the property at: 149 Point of Pines Ave, Centerville,
Massachusetts, Map 230, Parcel 72, as currently owned by James DeMarco
C/O Geni.ne DeMarco, 6441 NW 42"d CT, Coral Springs, Florida 33067, as
property referenced in the Barnstable Registry of Deeds as Book 18573,
Page 050.
I, as the owner/executor of the
property/trustee referenced above acknowledge the deed restriction(s) being
placed on the property.
Owner /Executor Signature Date
t he person named above: 9 a h i n e. e..r c_y
acknowledges the foregoing instrument to be leis/her flee act and deed,
before me.
tat„'� MARY A.TROIA
Notary Public•state of florids
My Comm.Expires Sep 17,20t3
Not ry tC r'� Commiesiop#DD 892693 .
My Commission Expires: ui 3
BARNSTABLE REGISTRY OF DEEDS
I
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
AB = Public Health Division
KAM
i39 `� Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-740-6304
Date: foZ Sewage Permit# ��� 66 Assessor's Map/Parcel
Installer&Designer Certification Form
Designer: -7-pa Installer:
Address: ��-k�� t Address:
x(�5� �'TS lt' �rtTlS
On was issued a permit to install a
( (installer)
septic system at _P101 V_T1 OF I_P1L1%1 E:S based on a design drawn by
(address)
dated /a
(designer)
11 1 certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Stripout (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (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&Local Regulations. Plan revision or
certified as-built by designer to follow. Stripout(if requir cted and the soils
were found satisfactory. ��t9 OFt,Jgss4
o DAVID G3
B. Gl
MASON
(Installer's S' afore) v NO.1066 4 ;'
s GISTS
AJjTA.
(Designer's Signature) (Affix Des ignc� amp 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.
q:',office formsldesignercerti twation for n.doc
l'd LL LZ-££8-909 uoseW uaepoO d 2:60 Z 6 Z l AV
AsBuilt Page 1 of 1
TOWN OF BARNSTABL'E' '
LOCATION f�� �arir�Of�/i►'�' SEWAGE#
VILLAGE MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY oo - is'o�rpd T��s Co ,�ift/�J.�bj
LEACHING FACILITY:(type) (size)
NO.OF BEDROOMS 3
OWNER .+6�-::/0P,4QC O� G"'
PERMIT DATE: COMPLIANCE DATE:
j Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on _
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
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0 A 1. 1 -
0
3 - 3-
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http://issgl2/intranet/propdata/prebuilt.aspx?mappar=230072&seq=1 4/4/2013
TOWN OF BARNSTABLE
LOCATION ir� 'A'4;e SEWAGE#
VILLAGE �e~����OZZ&ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
r LEACHING FACILITY:(type) (size) 0
NO.OF BEDROOMS
OWNER G"
PERMIT DATE: —' e�� COMPLIANCE DATE: '"
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on _
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY ���
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o
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}
OfIHETp� Town of Barnstable Barnstable
Board of Health ;wicacft
k BARNS-TABLE, "
9Q MASS. 200 Main Street, Hyannis MA 02601
OA 039. �0
rf4 MA'I a,
2007
Office: 508-862-4644 Wayne Miller,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
March 27, 2012
Mr. James LeBoeuf
LeBoeuf Septic Co.
71 Beth Lane
Hyannis, MA 02601
RE: 149 Point of Pines Avenue, Centerville A = 230-072
Dear Mr. LeBoeuf:
You are granted variances on behalf of your client, James DeMarco,'to construct an
onsite sewage disposal system at 149 Point of Pines Avenue Centerville.
The variances granted are as follows:
310 CMR 15.211 (1): To install the soil absorption system two feet away from the
property line, in lieu of the minimum ten feet separation distance required.
310 CMR 15.211 (1): To install the soil absorption system two feet away from the
foundation wall, in lieu of the minimum twenty feet separation distance required.
310 CMR 15.211 (1): To install a septic tank 3.5 feet away from the property line, in lieu
of the minimum ten feet separation distance required.
i
310 CMR 15.211 (1): To install a septic tank three-feet away from the foundation wall,
in lieu of the minimum ten feet separation distance required.
310 CMR 15.211 (1): To install the septic tank six feet away from the waterline, in lieu
of the minimum ten feet separation distance required.
Section 360-1 of the Town of Barnstable Code: To place a soil absorption system
82 feet away from a wetland, in lieu of the one hundred feet minimum separation
distance required.
Section 360-1 of the Town of Barnstable Code: To place a septic tank 77 feet
away from a wetland, in lieu of the one hundred feet minimum separation distance
required.
Q:\WPFILES\149PointofPinesVariancesLeBoeufSepticMar2Ol2.doc
1
310 CMR 15.212: To install the soil absorption system four feet above the maximum
adjusted groundwater table (Lake Wequaquet elevation 34.8), in lieu of the minimum
five feet separation distance required.
These variances are granted with the following conditions:
(1) No more than three (3) bedrooms maximum are authorized at this
property. Dens, study rooms, offices, finished attics, sleeping lofts,
and similar-type rooms are considered "bedrooms" according to the MA
Department of Environmental Protection.
(2) The applicant shall record a properly worded deed restriction, signed by
the owner of the property, at the Barnstable County Registry of Deeds
restricting the property to three bedrooms maximum. A copy of the
recorded deed restriction shall be submitted to the Health Agent prior to
obtaining a disposal works construction permit.
(3) The septic system shall be installed in substantial conformance with the
revised engineered plans dated March 8, 2012.
(4) The designing registered sanitarian shall supervise the construction of the
onsite sewage disposal system and shall certify in writing to the Board of
Health that the system was installed in substantial compliance with the
revised plans dated March 8, 2012.
These variances are granted because the physical constraints at the site severely
restrict the location of the septic system components due to its close proximity to the
wetlands.
Sincere yours,
Walie VI iller, M.D.
Chairman
Q:\WPFILES\I OPointoMn.esVariancesLeBoeufSepticMar20l2.doc
�11KEE 1p� DATE:
r FEE: mod-
r
• BAIIPtS1'ABLE,
MASS.
1639. REC. BY
-
Town Town of Barnstable
SCHED. DATE:
Board of Health
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Wayne A.Miller,M.D.
FAX: 508-790-6304 Junichi Sawayanagi
Paul J.Canniff,D.M.D.
VARIANCE REQUEST FORM
LOCATION
Property Address: /Y'9 FOI k-I r Cr 7>74JE.S J 4MC Ce4V7e-P—V/(,tf,'
Assessor's Map and Parcel Number: Z 7 Size of Lot: d, z AjaJCS
Wetlands Within 300 Ft. Yes P Business Name:
No Subdivision Name:
APPLICANT'S NAME: « -f j _ Phone — 775-
Did the owner of the property authorize you to represent him or her? Yes 4 No
PROPERTY OWNER'S NAME CONTACT PERSON �� y�
Name: :r UZ5 -D��.�Lc Name:^I 'Al'_ f�-�5 IF-40-" 6�eMe-
Address: —I 4 �/Y Z Address:
3,�067 Phone: (Z� _�S /�� Phone: O 8 "5— C)L r—)-7
VARIANCE FROM REGULATION(List Reg.) REASON FOR VAMANCE(Ma attach if mores ace needed)
or �OOAJ L
Z/ G
� V
941
NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System
Checklist (to be completed by office staff-person receiving variance request application)
Please submit copies in 4 separate completed sets.
Four(4)copies of the completed variance request form iv
Four(4)copies of engineered plan submitted(e.g.septic system plans)
Completed seven 7 g g' p y p y g g g `
p Opage checklist confirming review of engineered septic stem Ian b submitting engineer once tstered sanitn
Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) t --,
Signed letter stating that the property owner authorized you to represent him/her for this request cJ g
_ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title
V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
CJ q
Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/Wee only
outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[oUly if no expansion to
building proposed]) N) it 87
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Wayne Miller,Chairman
NOT APPROVED Junichi Sawayanagi
REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet
Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Sig Tfure
item 4 if Restricted Delivery is desired. X A.✓ � t
■ Print your name and address on the reverse [IAddressee
so that we can return the card to you. B. Received by(Printed Name) C. Dap of elivery
■ Attach this card to the back of the mailpiece, �J i
or on the front if space permits. 11��e�P
D. Is delivery address different from item 17 ❑ es
1. Article Addressed to: If YES,enter delivery address below: ❑ No
Serv$p.Wype
��\\ rtified Mail ❑Express Mail
V 3-Z ❑Registered ❑Return Receipt for Merchandise
v ❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
I
2. Article Number
(Transfer from service label)
t� t�i 7O1� O29� ��O42-;1,;9121 15,79 f i
PS Form 3811, February 2004 Domestic Return Receipt 10259e-02-M-1540
UNITED STATES POSTAL SERVICE jiff
first-Class mail.
Mrs
Fb�PaidU�7rc�t ii
.. ,.y
i • Sender: Please print your name, address, an�'Z-lPv) I'n
02531
I �
lilt I11111i,Ili,1,IIJ1111111111,I,I,I111111111Ii1
COMPLETE
0 Complete items 1,2,and 3.Also complete A. Signat
item 4 if Restricted Delivery is desired. ❑Agent
■ Print your name and address on the reverse ❑Addressee
so that--we can return the card to you. B. Rec ived by(Prix ,.d Name)• C. Date of Delivery
■ Attach this card to the back of the mailpiece, '
or on the front if space permits. ?
'Is delivery address�ifferent from item 1? ❑Yes
1. Article-Addressed to: ✓/' "'
If YES,enter delivery,address below: ❑No
roq
Certified Mail ❑Express Mail
❑Registered ❑Return Recelpt.for Merchandise
❑Insured Mail ❑C.O.D.
i 4. Restricted Delivery?(Extra Fee) ❑Yes
2 'ArH6leNumber . i' 17010;;02.90 00021 1912 111586
(transfer from service Iabeq {
PS Form 3811, February 2004 Domestic Return Receipt .102595`024-154Q
UNITED STATES POSTAL SERVICE IV
" f-Cla§s Mail
v: :, fi is t2gg 8'`frO Paid
I
• Sender: Please print your name, address and"Z,f��bb)�•
I
ZOO
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Letter of Authorization
I Genine DeMarco, authorize James Leboeuf Septic
to present before the Barnstable Board of Health the
septic design and variances as shown on the plan of
land for 149 Point of Pines Ave, Centerville as
prepared by David Mason, RS dated February 17,
2012.
Ge ne DeMarco
Date
Ioi(Ip /�
iy"X 0 i
13 r3�o'
pokes
18,
f
TFIE r DATE: C.
<.�.
II FEE:
* &U NSTABLE,
Ti MASS.
7 iegq. ♦0 REC. BY
Town of Barnstable /
SCHED. DATE: �
Board of Health r
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Wayne A.Miller,M.D.
FAX: 508-790-6304 Junichi Sawayanagi
Paul J.Canniff,D.M.D.
- -VARIANCE REQUEST FORM
LOCATION
Property Address: /'�/n j�011ti pvf �>)W CS i'VC (f6N7�V I L ,(,
Assessor's Map and Parcel Number: Z J� �. Size of Lot:
Wetlands Within 300 Ft. Yes Y Business Name:
No Subdivision Name:1ti/,r�
APPLICANT'S NAME: « --�. � Phone O —' 775— Q DJ
Did the owner of the property authorize you to represent him or her? Yes No
PROPERTY OWN. v'i, �, f- -�— CONTACT PERSON .�'.
Names � +mod ` ' Name:--
Alr _ d
�LU
uu ` ' 7 wls r�l
Address: �-1� I �,yY �C.� C.. � Address: r
Gam 5�p6 _ �'f� 7 -
Phone: s5012 _"175�/�� Phone: 60a '-�
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(Ma attach if mores ace needed)
/61 Z110 0104) CCA 14PC a L
2/ G
NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System .
Checklist (to be completed by office staff-person receiving variance request application)
Please submit copies in 4 separate completed sets.
_ Four(4)copies of the completed variance request form
_ Four(4)copies of engineered plan submitted(e.g.septic system plans)
Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registe ed"sanitarian Q
Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)
Signed letter stating that the property owner authorized you to represent him/her for this request ' .
_ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicao's expense (f5 Title
V and/or local sewage regulation variances only) l
Full menu submitted(for grease trap variance requests only)
Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only],
outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if po expansion1574�,he
building proposed]) Ln
_ Variance request submitted at least 15 days prior to meeting date
W
VARIANCE APPROVED Wayne Miller,Chairman _ N M
NOT APPROVED Junichi Sawayanagi
REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet
Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC
� } approval of the design flow by the owner.
.10 ice` 9) The existing leaching or cesspools shall be pumped and filled with material
per Title V abandonment procedures. Those within the proposed SAS shall
• P P P P ,
be removed alon with contaminated soil and replaced with clean sand per
Title V specs. — !,Zwrih�151_ _ flvc/► .o. --._..- -
10)System components to be 10 feet from water line. Sewer lines crossing the
water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if
i applicable. The proposed SAS is being installed below the water service
_
E M DES I G N line. The line is to be sleeved as aforementioned and maintained in place.
11) If a garbage grinder exists it is to be removed and is the responsibility of the
owner to ensure such.
12)"fhe installer is to take caution in excavation around the gas line if such
�0 GAL/DAY/BEDR001A - (3AL/DAY ' S exists.
3)"I'lie installer sliall,verify the location, quantity and elevation of the sewer
lines exiting the dwelling prior to the installation.
14)This plan is representative only that a systcin can fit on a property meeting
Title V requirements.
i DAYS - l GAL
J SEPTIC TANK��00
SYSTEM10 TaOVW PA -1
_._-----
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EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 3/13/2012:
B. Jim, LeBeouf, LeBeouf Septic, representing James DeMarco, owner—
149 Point of Pines Ave, Centerville, Map/Parcel 230-072, 0.21 acre lot,
septic variances due to site constraint, repair of failed septic system.
David Mason, Engineer, and Jim LeBeouf were present. There will be a slight
mound three tiers high on the SAS which will amount to 16" of railroad tiers.
The new abutters, Laurie Connolly and husband, at 153 Point of Pines, had not be
aware of this until today and were concerned with the mounted system and any
effects of the leaching to their property. The Board explained that the mounding of
16 inches will be low and should not be unsightly. The leaching should not cause
any issues with the neighboring area.
Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board
voted to approve with the following conditions: 1) A 3 bedroom deed restriction be
recorded with the Barnstable County Registry of Deeds, and 2) a proper copy of
the deed restriction be provided to the Public Health Division. (Unanimously, voted
in favor.)
t
t
TRANS.NO.:
CITY/TOWN:
APPLICANT-
ADDRESS:
` `
ADDRESS:� ( 9 2Dl itil l � �f )k C,�1b A &
DESIGN FLOW: gpd
REVIEWED BY: DATE:
N/A OK NO
GENERAL
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot,tax parcel number and lot number noted on plan[310
CMR 15.220(4)(u)]
Locus Provided [310 CMR 15.2204 t
Plan proper scale?(1"=40' for plot plans, 1"=20'or fewer for
components) [310 CMR 15.220(4)]
Easements shown[310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is required [310 CMR 15.412(4)]
Location of impervious surfaces (driveways,parking areas etc.)
[310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220(4)(c)]
Location and dimensions of system components and reserve
areas. [310 CMR 15.220(4)(e)]
System Calculations 310 CMR 15.220(4)(01
daily flow
septic tank capacity(required andprovided)
soil absorption system(required and provided)
whether system designed for garbage grinder
North arrow 310 CMR 15.220 4 )
Existing and proposed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes(existing grade el. on
each test) [310 CMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and(i)]
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4) i
Percolation test results match loading rate? [310 CMR 15.2421
Certification statement by Soil Evaluator[310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)
Address ��9 �OIgr CF ':FiWe�7 J}Y Sheet 1 of 7
N/A OK NO
Location of every water supply,public and private, [310 CMR
15.220(4)(k)]
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water suply
within 250 feet of the proposed system location in the case
within 150 feet of the proposed system location in the case
of private water supply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins ✓
located within 50 ft. [310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] if water line cross see 310 CMR 15.211(1)[1 )
Profile of system showing invert elevations of all system
components and the bottom of the SAS [310 CMR 15.220(4)(o)]
Stamp of designer 310 CMR 15.220(1) and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 310 CMR 15.405 1 (k)
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103(4)]
Test Holes adequate to confirm adequate groundwater separation?
310 CMR 15.103(3)]
Benchmark within 50-75' of system [310 CMR 15.220(4)(q)]
Materials specifications noted? [various sections of 310 CMR
15.000]
System components not>36" deep(unless Local Upgrade
Approval or LUA requested) 310 CMR 15.405 1(b
Address (� / �o�" + Ri E, Sheet 2 of 7
Y
N/A OK NO
SEPTIC TANK
Size,OK? [310 CMR 15.223(l)]
Inlet tee located ten inches below flow line 310 CMR 15.227(6)]
Outlet tee 14" or 14" + 5"per foot for increase ft depth[310 CMR
15.227(6)]
Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)]
Separation between inlet and outlet tees (no less than liquid
depth) 310 CMR 15.227(2)]
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15227(5)) or permitted for
upgrades under LUA [310 CMR 15.405(1)(k)]
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (by 7/07) [310 CMR 15228(2)]
Access to within 6 " of grade -one port for systems<I 000gpd,
two fors stems>1000 gpd 310 CMR 15228(2)]
All at-grade covers secured to unauthorized access? [310 CMR
15228(2)]
> 10 ft from building foundation [310 CMR 15.211 1)]
Buoyancy calculation Required/Done 310 CMR 15221(8)]
H-20 Where appropriate? [310 CMR 15.226(3)]
Setbacks from resources [310 CMR 15.211]
Multi-Compartment Tanks
Required when other than single-family dwelling or flow>1000
g d [310 CMR. 15.223(1)(b)]
First compartment 200% daily flow; Second compartment 100%
daily flow 310 CMR 15.224(2) and 3)
"U"pipe through or over baffle, outlet of each compartment with
gas baffle or approved filter[310 CMR 15.224(4)]
01 TI C
Address � T "�� � � iW �y�! Sheet 3 of 7
N/A OK NO
BUILDING SEWER AND OTHER PIPING
Located at least ten feet from any water line? [310 CMR
15.222(2)]
Disposal piping at least 18" below water line(when water and /
sewer cross, see 310 CMR 15.211(1)[1]) 1/
Cleanouts required/provided? [310 CMR 15.222(8)]
Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
[3.10 CMR 15.222(6)]
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)]
Siphonproblem/(leachfield below pump chamber)
Endca s or vent manifoldspecified?
Size and orientation of discharge holes specified? (not smaller
than 3/8"not larger than 5/8") [310 CMR 15.251(8) and 310
CMR 15.252(2)(h)
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed)
DISTRIBUTION BOX
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided?(when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323(3)(a)] ✓✓✓
Riser if deeper than 9" [310 CMR 15.232(3)(f)]
Inside minimum dimension 12" [310 CMR 15.232(2)(b)]
Minimum sum 6" [310 CMR15.232 3 e ]
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
310 CMR 15.232(3)(d)]
PUMP CHAMBERS
Capacity(emergency storage above working=design flow)? [310
CMR 231(2)]
Proper setbacks [310 CMR 15.211 same as septic tanks)]
Watertight 20-in minium access manhole at least 20" MUST BE IZ
TO GRADE [310 CMR 15.231(5)]
Service components accessible(not too deep with piping,
disconnects accessible)
Alarm floats- alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. [310 CMR 15.231(6) and(8)]
Stable Compacted Base [310 CMR 15.221(2)]
,Buoyancy calculations needed?Provided?
?•[310 CMR 15.221(8)]
Address Iq -FO)W ed or Sheet 4 of 7
N/A OK NO
SOIL ABSORPTION SYSTEMS (SAS) GENERAL
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)]
Required separation to groundwater? [310 CMR 15.212)]
Aggregate specified as double washed[310 CMR 15.247(2)]
System Venting required/provided? (system under driveway or
>36" deep) [310 CMR 15.241]
Inspection ports specified and within 3"final grade? [310 CMR
15.240(13)]
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document]
GALLERIES,PITS,CHAMBERS 310 CMR 15.253
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. 310 CMR 15.253 6)]
Each structure with one inspection manhole(if>2000 gpd must
be to grade) [310 CMR 15.253(2)]
Aggregate 1' minimum-4'maximum. [310 CMR 15.253(1)(b)]
2' sidewall credit maximum [310 CMR 15.253 1 (a)
In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)]
TRENCHES 310 CMR 15.251
Width 2' minimum T maximum 310 CMR 15.251 1 b ]
100 feet-maximum length[310 CMR 15.251 1 (a)
Minimum separation 2x effective depth or width whichever
greater(3x if reserve between trenches) [310 CMR 251(1)(d)]
Situated along contours 310 CMR 15.251(2)]
Breakout OK? 310 CMR 15.211(1)[4] and Guidance Document
BED SAS (Maximum size of bed or field 5000 gpd)
minimum 2 distribution lines [310 CMR 15.252(2)(a)]
Maximum separation between lines 6' [310 CM R15.252(2)(d)
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)]
Aggregate depth below discharge pipes 6" minimum, 12" /
maximum. 310 CMR 15.252(2)(g)] i/
Separation between beds 10' minimum. 310 CMR 15.252(2)(01
Bottom area used in calculations only [310 CMR 15.252(2) i)]
Address
0('`►t "1 1{ Sheet 5 of 7
r
N/A OK NO
DID THE PLAN INVOLVE
Pressure Dosed System ? Provided pump and piping
calculations as required 310 CMR 15.220(4)(r)]
Pressure dosing required on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and I/A
Remedial Use Approvals]
If used in gravelless system-make sure jet is directed as not to
scour soil interface [Guidance Document]
Inspections once per year(systems<2000 gpd) or quarterly
(>2000 d) good to note on plan[310 CNIR 15.254(2)(d)]
Construction in fill - Did the plan specify that the fill shall meet
the specification of 310 CNM 15.255 3 ?
Impervious barrier and/or retaining wall? [Guidance Document]
Impervious barrier installation must be supervised by
designer[310 CNIR 15.255(2)(b)]
Retaining wall must be designed by Registered Professional
Engineer[310 CMR 15.255(2)(a)]
Side slope not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document]
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended) [310 CMR 15.255 (2)(e)]
Gravelless System[UA Approval Letters]
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
Alternative Septic System[UA Approval Letters]
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a copy of a maintenance
7Z-
Variances
Are the variances listed on the plan? [310 CMR 15.220
4)
RLS Stamp necessary on plan if a component is within five
feet of property line [310 CMR 15.412(4)]
New construction or increased flow proposed- [Refer to 310
CMR 15.414]
Address-4 ) t fO1 l Dr --FiWfS I�K j Sheet 6 of 7
N/A OK NO
Nitrogen Sensitive Areas
Is the system in a Designated Nitrogen Sensitive Area(Zone 11 for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ?
310 CMR 15.214(2)]
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1)]
Miscellaneous
Pumping to septic tank? [ 310 CMR 15.229]
Shared System [310 CMR 15.290]
Address 1� �0' rt" I��,c/ "�"� Sheet 7 of 7
I
I6� b
�lv IIZ/
3iIl
Xo Iy� A ,5�
�,�►�
III
z �3P l
Po►&H
r
f
EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES-3/13/2012:
B. Jim,,LeBeouf,_LeBeouf Septic, representing James DeMarco, owner—
_149-Point of Pines-Ave;-Centerville,.Map/Parcel 230-072, 0.21 acre lot,
septic variances due to site constraint, repair of failed septic system.
David Mason, Engineer, and Jim LeBeouf were present. There will be a slight
mound three tiers high on the SAS which will amount to 16" of railroad tiers.
The new abutters, Laurie Connolly and husband, at 153 Point of Pines, had not be
aware of this until today and were concerned with the mounted system and any
effects of the leaching to their property. The Board explained that the mounding of
16 inches will be low and should not be unsightly. The leaching should not cause
any issues with the neighboring area.
Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board
voted to approve with the following conditions: 1) A 3-bedroom deed restriction be
recorded with the Barnstable County Registry of Deeds, and 2) a proper-copy-of—
the deed restriction be provided to the Public Health Division. (Unanimously;voted
—in--favor)
F
A
Town of Barnstable P#
Tiffs
gyp, Department of Regulatory Services
• .n�rsreate,M,p: Public Health Division Date �l
059. �6 200 Main Street,Hyannis MA 02601
Date Scheduled /[ Time / t Fee Pd.
Soil Suitability�Asss/e�s`s/ment for S e Disposal
Performed By� V�tD . � It�!_A'/ Witnessed By: A
LOCATION&GENERAL INFORMATION
Location A/dyd/r�ss Owner's Name
l `? /�rIn./r/�- CF �/�,�C S Address
�.►C� Y�`� O, 1
Assessor'sMap/Parcel: Zit, 7� Engineer's Nam r �6 G v/
NEW CONSTRUCTION PAIR �� Telephone# ' 2�—� — 1617
Land Use Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations o£test holes&pert tests,locate wetlands in proximity to holes)
cizoUqT
y
Parent material(geologic) ft Depth to Bedrock I
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
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 ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION TEST Date Time
Observation
Hole# Time at 9"
Depth of Pere Time at 6"
Start Pre-soak Time Cu �. Time(9"-6")
End Pre-soak
Rate MimAnch t '
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100'of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
� O
002
Off
Aq %-001
2,10 (U/ �01
.� f1
,V
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.%Graven
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No— Yes
Within 100 year flood boundary No_ Yes✓/
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring perv'o erial exist in all areas observed throughout the
area proposed for the soil abso tion system?
If not,what is the depth f na rally occurring pe ous material? _
Certification u
I certify that on ` (date)I have passed the soil evaluator exarnmati approved by the
Department of Enviro ental rotection and that the above analysis was perform d by a consistent with
the required training,expertise and exp a ce escribed in 310 CM 15.017.
Signature Date �i ,� ZD` 2.
Q:\SEPTIC\PERCFORM.DOC
Town of Barnstable P#
of TME ro,,
gyp` Department of Regulatory Services
BARNMEIM Public Health Division Date
,639. 200 Main Street,Hyannis MA 02601
fD M0 I l J
Date Scheduled /( Time d 1. Fee Pd. _
Soil Suitability Assess/ment for S e Disposal
Performed Bye 1 V D 0t4- Witnessed By:
LOCATION&GENERAL INFORMATION
Location Adddiess Owner's Name
r , �/ OF_ :Pj &� Address 1
G� vim- ,
Assessor's Map/Parcel: 30 7 Engineer's Name NEW CONSTRUCTION AM �� Telephone# ' ^ " 16)
-- T - -- -- -- Land Use Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
FQ0
Y
Parent material(geologic) �" t`��' 1� Depth to Bedrock t I V V
Depth to Groundwater:Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
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 ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST Date Time
Observation
Hole# Time at 9"
Depth of Perc � �_.� Time at 6"
Start Pre-soak Time Q (_�-/A` Time(9"-6")
End Pre-soak /f
Rate MinAnch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100'of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
O
t,
lit
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel) -
a
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%(iravel)
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No— Yes
Within 100 year flood boundary No_ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring p4rvo
gt enal exist in all areas observed throughout the
area proposed for the soil abso tion system? /Ifnot,what is the idpth f na lly occurringus material? _
Certification (�
I certify that on ` (date)I have passed the soil evaluator examinati approved by the
Department of Eno ental rotection and that the above analysis was perform d by a consistent with
the required training,expertise and exp a ce escribed in 310 CMR 15.017. '
Signature Date Z ,� ZD1 -
Q:\SEPTIC\PERCFORM.DOC
ASSESSORS MAP : �c�O
NOTES:
SLOGS
PARCEL: 72
SU I L �VAI_UA I Uh: t 1 he installation shall coin l with 'Title V and'Town ofglU Board of
i FLOOD �UI�L. C' p y
J �g�7� WI TNESS :2120 � mm'seJ Ilealth Regulations.
r'. REFERENCE._ Ala TE; ) The installer shall verify the location of utilities, sewer inverts and scl)tic
DA 20 I: 2
1
/PL� ��'�- ��9 �? �6j' I�r� PERCOLAT!ON RATE: ,4 Z }rV(1W, 14
components prior to installation and setting base elevations.
3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first
,38,OD two feet out of the d-box to the leaching shall be level.
--- -----_.__ _ 4) This plan is not to be utilized for property line determination nor any other
2•i�L,y �L A L`A'i t* 0 1,Q14M4 'WI2 purpose other than the proposed system installation.
0 00 et .o �p l� y 1 ,I 10 k4 f I 5) All septic components must meet Title V specifications.
� ,, fo r� itµ 6) Parking shall not be constructed over H 10 septic components.
_ 1� G 1p 7) The property is bounded by property corners and property lines.
LOCATION MAP J 01� I Yr�t1.1/!� 3✓ / �5 8) The property owner shall review design considerations to approve of total
ib,. / design flow and number of bedrooms to be considered for-design. Receipt
r 'C l , �J �1 ����j l� of payment for the plan and installation based on the plan shall be deemed
it r approval of the design flow by the owner.
6"�s%DUE o� P G li �L 41 t i� 9) The existing leaching or cesspools shall be pumped and filled with material
a'!1 A 7E0
R��QM ��° YID o� �Ttr - art per Title V abandonment procedures. Those within the proposed SAS shall
_---- _ _ �_ ' -� $ , ,,� 1 be removed alon with contaminated soil and replaced with clean sand per
_.. _ft,2UP,rU�C-_G��1'._�D_1u�_I�J.��---._...--- � �,_._� (e�' �
1at� Z Title V specs. t� wt� l�•I..offG'RfA _ O_ul/1�� --..........._.
Z• emu- '1'Q1Gi4'(.. .'-1�!�r.RMll CT _ .�._ �1�'Q�, � '
10)System components to be 10 feet from water line. ewer lines crossing the
14 / '�' water line shall be sleeved with 4 inch SCI-I 40 PVC with ends grouted if
applicable. The proposed SAS is being installed below the water service
line. The line is to be sleeved as aforementioned and maintained in place.
SEPT I C SYSTEM DESIGN 11) If a garbage grinder exists it is to be removed and is the responsibility of the
f
_— owner to ensure such.
O' F LOW ESTIMATE 12)The installer is to take caution in excavation around the gas line if such
P/n " � O , .S exists.
N Es AT 110 GAL/DAY/BEDROOM -� GAL/DAY 13)The installer shall,verify_the location,quantity and elevation of the sewer
ES
Ii lines exiting the dwelling prior to the installation.
P�.�o ` E• U EP T I C TANK 14)This plan is representative only that a system can fit on a property meeting
,� / ,� ; 'Title V requirements.
COT h M :')1))_GAL/DAY x 2 DAYS - l6 GAL
0
�2�5 52, •
USE �00 GALLON SEP,T I C TANK
6— SOIL ABSORPTION SYSTEM __ ._ ...
I, ��� OL--1 I'�atVI1--�,Ir ^ 'r�'�'µ;lj ;+
.,`\ • - / ��'lw� ►�2,oVu.,l'p, 3�aa5 of _ C 5 �
`:� / ,,o y11(,'►�U� t'�o }- �'. to �� 3,5 '?aae 6,5 V�2 AN6C
,t: 0 21 gNIT5 x x 4. -5 = 9 b I
d�pfl G rf�tr•I�,�b �oU�1DA 0� , 10 ��1�• ����� j'l.'V�•!�G�.. _.._
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SITE AND SEWAGE PLAN
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Q UE T ..._..��. DAVID B . MASONV6 DATE: 2,111 01Z
LAkEDBC ENV I R014MENTAL DES I GI•�S
b , EAST SANDWICH . MA
-- DATE , ,
HEALTH AGENT ( S 8 ) 833- 2 177
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ta� �1 t ASSESSORS MAP : NOTES:
lTEST HOLE LOGS
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SU I L.. VALUA I Ult���I � `�� 1) The installation shall comply with 'Title V and 'Town ofAWO&Board of
��57 � WITNESS : ' )Ir•j 'JC�7M �L� - I lealtli Regulations.
REFERENCE: -'�E� 30C _ ... _. DATE:
1: l� 2,) The installer shall verify the location of utilities, sewer inverts rind Septic
PERCOLATION RATE: ,Z, 2 l' pV.�, 1 components prior to installation and setting base elevations.
3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first
— �i►- _ _____ / ' " two feet out of the d-box to the leaching shall be level.
TT _ 4) This plan is not to be utilized for property line determination nor any other
2�i� �L A l c+ u 4� LOAM purpose other than the proposed system installation.
0 o i +� ib 1 10 �� 1 5 All septic components must meet Title V specifications.
q?At►1 i l,�l�, �o � ) �� -L '�{ 119 6) Parking shall not be constructed over 1I10 septic components.
n - �JF l t t P I0 4 6 7) The property is bounded by property corners and property lines.
LOCATION MAP f 04 uaA YAL Vr, _ -m f 4 ------- 8) The property owner shall review design considerations to approve of total
design flow and number of bedrooms to be considered for design. Receipt
' N- D of payment for the plan and installation based on the plan shall be deemed
?� approval of the design flow by the owner.
6 tSIDktE M 6"P4G�,D g4oE V! 'CJ �1f 1+ 1� 2� r 9) The existing leaching or cesspools shall be pumped and filled with material
AL.AQ-M ?-u � WV n y?�,, ou., �Tg I� `'` r9l � per Title V abandonment procedures. Those within the proposed SAS shall
L 2- Git2GtAT_�?2b_� _�t"C, __ ..___ �e � _\ ��� `, be removed alon with contaminated soil and replaced with clean sand per
2 UELz aZ tC,�---- �� Gnu l t �
°� Title V specs. rl _ vil
1 + 10 System components to be 10 feet from water line. ewer lines crossing the
) Y P g
- - - --" _ �� water line shall be sleeved with 4 inch SCII 40 PVC with ends grouted if
applicable. The proposed SAS is being installed below the water service
- - - - SEPTIC SYSTEM ' DESIGN ( line. The line is to be sleeved as aforementioned and maintained in place.
- � }� -�~' � " ! 11) If a garbage grinder exists it is to be removed and is the responsibility of the
�'`""'�•.�,_,_�.._.-�'" � � � owner to ensure such.
POW/� ' FLOW EST 1 MATE 12)'I'he installer is to take caution in excavation around the gas line if such
�/ � OF � , S exists.
PI N� 3_BEDROOMS ATM�� GAL/DAY/BEDROOM -� GAL/DAY 13)The installer shalLverify the location, quantity and elevation of the sewer
sA a
VE lines exiting the dwelling prior to the installation.
p� SEPTIC TANK 14)'Tliis plan is representative only that a system can fit on a property meeting
`. / /� Title V requirements.
�6 LOTGAL/DAY x 2 DAYS l GAL _.
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SITE AND SEWAGE PLAN
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_ ��- - ���y DAV I D B . MASON VS r DATE:
z , DBC ENV I ROtJMEN�TAL DESIGNS
GI'JS
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W HEALTH AGENT ( 5 �3 ) 833— 2 177
DATE f 4 ; .
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