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HomeMy WebLinkAbout0183 PRINCE HINCKLEY ROAD - Health t93 PRINCE HINCKLEY ROAD "Centerville s` , S M E A D No. H1630R UPC 10259 smead.com • Made in USA qgcYC4 2 � y r���l "/D �/�R,�i Chi/cQS �j.�i'Vl/lB 'i J s TOWN OF BARNSTABLE LOCATION \!K 3 k r^Vt SEWAGE# Q\-) - j FqT VILLAGE C C. ASSESSOR'S MAP&PARCEL 1 $� INSTALLER'S NAME&PHONE NO. 5'0y 29 y Obm SEPTIC TANK CAPACITY e),C C-s$ LEACHING FACILITY:(type) CI c",,,,, L ' size) \'X-e .X ILi NO.OF BEDROOMS OWNER gj�k_flr OZ A PERMIT DATE: 15;_I'JT l I COMPLIANCE DATE:a L, Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility e-%, kV G' /ol 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 A 0,. 4 ��I � CoS Q �3�a + f � No. a c) "� 0 Fee f Oct �— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: , Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppfication for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair VVpgrade(s ) Abandon( ) El Complete System ❑Individual Components Location Address or Lot No, \ 3 ff\roc C Nv�kK l qy Owner's Name,Address,and Tel.No. Ev�11-e. e� t Assessor's Map/Parcel \--? ( a,5V vekv 0 Installers ame Addre s and Te.No. Desi ner's Dame Address and Te No. ev �r,t� \� v\�Y�r�►oJ�. OW c� =\eC�/�Address, Cnu�r,.c,nc�w4°K C'mr olcm l 's e_n 2Z c) Qj 'N^t, Type of Building: $O V z co-i O&A U Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder wo Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required`) 122 b gpd Design flow provided 3 3 o. gpd Plan Date S`I 1} 1 \� Number of sheets \ Revision Date Title Size of Septic Tank -0 d Type of S.A.S. Q QS OC s bd (:VCk- Description of Soil Qa in C0a ' �C P.ED r Nature of Repairs or Alterations(Answer when applicable) L�L e-)C 1 t4r, G L.,E�c c-,,- Qi \ 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. Signed nn Date Application Approved by ' '/14 t1 R� �i� Date Application Disapproved by Date for the following reasons Permit No. Date Issued t. No. 0 I`7 I Fee IDOL THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i./r PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Olpffratlon for -Misposal *pstein Construction 3perinit Application for a Permit to Construct( ) Repair(�.lJpgrade(i.,) Abandon( ) E1,Complete System El Individual Components Location Address or Lot No. 3 f r\r`Le "VINIK 1 Ay Owner's Name,Address,and Tel.No. � ` Assessor's Map/Parcel \'7 ( a J ?C-V Q e.S Installer's,�,��1lame,Address and Tel No. Designer's Name Address,and Te No. SC61Nl�L..,A �� 0\d X�r�nO�kn �� t`C✓G - \{iG oaG j\ <aUCiV\ -/\©t.a S Mh C'OiC any 0(31,04 SS G c0 <_ty 6rs Q0 S.Ct\,�wAN M1, Type of Building: Sc V 3(,4 O k,;U Dwelling No.of Bedrooms Lot Size of V O YT sq.ft. Garbage Grinder V OD Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 y gpd Design flow provided gpd Plan Date s )I Z Number of sheets ` Revision Date Title Size of Septic Tank k 0 p C), Type of S.A.S. Q lia CX S(j o G CA., L Lv,,,, 6 trs Description of Soil �^Q. SIC Gnu t o r<,e+ Nature of Repairs'or Alterations(Answer when applicable) (�.Q. (-Q- P x t C_ ue C,C` 3 �- Date last inspected: y: 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. Signed Date Application Approved by ( �� Date Application Disapproved by 114 Date for the following reasons Permit No. Date Issued ✓"-THE COMMONWEALTH OF MASSACHUSETTS , --~'" BARNSTABLE,MASSACHUSETTS . -Certifirate of Compliance IS TO CERTIFY,that the Oii-site Sewage Disposal system Constructed( ) Repaired(V Upgraded( ) Abandoned( )by Sr A. (A ��,r•�%L.. C.vil\ ` at 1 C_-Z F�c`es C12 t i\�-�:C v C) has�een constructed in accordance V with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer S C tj M, N\ Designer yVe r v V ti , ' #bedrooms i t Approved design flow ?^ F gpd The issuance.of this permitishall not be construed'asiar guarantee that the system will f nicti{on � s\iigned. Date Inspector � -- - -- - - -- - - - - - - - - --------------------- ---- No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Vgmit Permission is hereby granted to Construct( ) Repair /) Upgrade( ) Abandon( ) System located at—ej Pr t.%t--C H i-N.IX 1© 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 must be completed within three years of the date of this permit.Date . ! / Approved by. l►yt� -4-t'kG�A i Town of Barnstable Regulatory Services Richard V. Scali,Interim Director * BARNSTABLE, KASS. �0� Public Health Division A'fo3�A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Sewage 'Permit# Assessor's Map\Parcel Designer: '0WI/1 (�5Va�,,,OPW�r Installer: Address: &GPI kydpr Address: On was issued a permit to install a (date) (installer) t�3 �nnc� septic system at H,14ckle y 44 based on a design drawn by `- 1 (address) //��,, (©"wr6Vl�l kyr- dated i 6[y t-oGr i 2017 (designer) 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 & Local 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 construct fiance with the terms of the I\A approval letters (if applicable) VzH OF Mqs. DAV I D yG� o D. COUGHANOWR (Installer's Signature) No. 1093 � o p� �5 U IV s Ea �S (Designer's Signature) (Affix DesijfTeTs Stamp 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:\Septic\Designer Certification Form Rev 8-14-13.doc .i IS Town of Barnstable P#_ 3 �7 Departiment of Regulatory Services awnvsTAn�, F Public Realth Division MAM Date 1'639.IN200 Main Street,Hyannis MA 02601 i I Date Scheduled 117_ _ Ti'ma Fee Pd�, • i Soil Suitability Assessment for Se a ,Disposal Performed-By: /CAy� Witnessed By: LOCATION&.GENERAL INFORMATION L WV Address ] ii ''� ��) V Ct;Ie Owner's Name Peter t cevlgw-v� .1 ) pf"',ice, {#r�lGk�Uy 4vl+er-v,(- Assessor's Map/Parcel ` i , 2 S Engineer's Name A ©�,� ��r I��w�•, NEW CONSTRUCTION REPAIR Telephone# 5045 3 !r- 05, q4 Land Use— 1��I� T 1 "l Slopes(96) O Surface Stones 61 Distancoa firm: Open Water Body I O 11 ft possible Wet,Area 0 't ft Drinking Vlfatcr Wcll LO�L ft Dralhage Way GP t ft Property Line +O -+ ft Other ft • i ' SKETCHC(Street game,dimensions of lot,exact locations of test holes&pera tests,locato wetlands-in proximity to ales) qV (71 . . - ---i- • i Parent material(geologic) ` r6i I qcl,&7 Depth t0 pedrook I r Depth to Groundwater. Standing Water In Hot..: V P n __ Weeping ftoln Pit Faoa � Estimated Seasonal High Groundwater _iM 0 F e- +��h � 1 � �a`G?� S d f"F i C i DETERMINATION FOR SEASONAL•IIIGR WATUR TABLE 1 Method Used: De th Observed standing in obs.hole: In. Depth to soil mottiae: D ©•rU�' �th to weeping from side of obs.bolo: In, amundwater Ad)usttatuit fr. IndexWell-4 Rcndlnb-Dzte: — --LndzxWcll layni- Ic'y,14clor',,,�„_,,_Adj.Z)ruutitiwater•].®Val PERCOLATION TEST Date shci 1 Time 4!,O; Pm Observation ` Halo# Time at 9" �1 I Depth of Pam 111 Time at 61' n f Start Pro-soak Time @ 00 _ Time(911•611) 2 A End Pro-sonk I " 10 I Rate Min./Inoh m P t � y r Site Sul tabllity Assesament: Sitd Passed`� Sitp Failed: N Additional Testing Nee ad(YIN) --sd— Original: Public Health Division Observation Hole Data To Be Completed on ack--- ' '"'"*If percolation testis to be conducted within 100' of<wetland,you must flrst notify the U1 Barnstable Conseirvation Division at least one(i)week prior to beginning. Q:\SHPTI VI RCFORMMOC i �l DEEP•OBSERVATION HOLE LOG Hole# Depth from Sell Horizon Sall Texture Shcl Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. a tsletancy.96'Oravall DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Sall Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Z- �3S Cr Ad ill 6►IK (.a K17- ' Lop sQ DEEP OBSERVATION HOLE LOG Hole,# Depth from Sall Horizon Soil Texture Sall Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soll Texture Sall Color Sall Other Surface(in.) (U4DA) (Munsell) Mottling (Structure,S;opes;Boulders, Flood Insurance Rate Man: Above 500 year flood boundary No— Yes .V____ , Within_500 year boundary No y Yes Within 100 year flood boundary No.7 YES Depth of Naturally Occurring Perylous Material Does at least four feet of naturally occurring pervious,tmtiterlal exist in a)I dress observed thrpughout the area proposed for the soil absorption system? eS If not,what Is the depth of haturally occurring pervious material? Certifiication �� �7 I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the requir fining,a ertisC? ertence 1described - In 10 CMR 15.017. �I A OFyg S Signature Dat$_� 61 DAVIDsq�y � o D. " COUGHANOWIR Q.\RHPT1C1P81tCPORM.DOC ��/CENSER 0� VAL0 a t,ld TOWNYE; BARNSTABLE LCrCATION. /`lK(-.e I)l SEWAGE #,` VILLAGE �Pvl� ✓ I�f�ll�`_ ASSESSOR'S MAP & LOT I �( INSTALLER'S NAME & PHONE NO. J, Z, SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) ^G NO. OF BEDROOMS PRIYATFI W 2 L OR LIC �E'R v BUILDER OR OWNER�,�� DATE PERMIT ISSUED: " 7 sJ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r. ari 9 O (Lz� rrh ibl .� I �L) �k L d CAT I N �'�z1b6 SEWAGE PERMIT M0. _ldr 8=rince Hinckley Rd. 80-294 VILLAGE Centerville. MA. y\nr 1-71 — 2Sr I N S T A LLER'S NAME i ADDRESS Alfred Fuller 995 Cotuit Rd. Marstons Mills, U I L D E R OR OWNER Alan E. Small, Inc. Box 536 Centerville, U. DATE PERMIT ISSUED b Ape. DAT E COMPLIANCE ISSUED I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE A I o�1ao ( • -C'/ Sc Appliratiou for Uhiposal larks Tomitrurfivit rratt# b J Application is hereby made for a Permit to Construct ( ) or Repair 4X)§ an Individual Sewage Disposal 1 Syst at 1 ince Hinckley Road Centerville ................ ................_......-•-........-----•--•••••-••••-•.••---••--•--• -•••---•-•--......_........�. .i.......... ............................................. Location-Address or Lot No. Peter Best W J.P.Macomber Jro,ner Address Installer Address UType of Building 3 Size Lot............................Sq. feet ' �., Dwelling—No. of Bedrooms..............______________________________Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) P-4 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...............................-...................................................... ---•------ --- ---------------------------------- •-------•-•-- 0 Description of Soil------------ •-- x Sand & Gravel U --------------•-----•-••-••-••••---•--•------•--•------------------•--•--•---------------------------------•-----••---•----••-------•---•-•----•-----•-••-•-••----...: x --------------------------------------------------------------------------------------------------------------------------------------------------------------------- .............................. U Nature of Repairs or Alterations—Answer wh n bl�all__ . on---iffac-h--pzt-;---- -�-t----- -�;- ------ .....----- ' --------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the ard-o health. Signed * �.... ............:. 6/ .........7/9C ......... ate-......---....... ApplicationApproved By ----------------- -- --- --° ---------------------------- .---�-..�..- - CJ........ ....................................... Dace Application Disapproved for the following reasons: ------------------------------------------------------------------------------------------------------------------------------------ --------------------------------- -- ---- ------------------------------------------------------- ............................................................................. ------/y.........------------------- Permit No. ....------/.. .`�-------------------- Issued -......... Date 171 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ( OWN`OF BA#RNSTABLE 1 �},Sc Allpliratiou for Diipniial Works Toustrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ZoXh) an Individual Sewage Disposal Syst at: p.1T nc , Hinckley Road Centerville _ 5 Location-Address or Lot No. -Peter Best ............. ..............= ....-•••-•...... Owner Address C W J.P.Macomber Jre a ..... ................... } .._.. Installer Address QType of Buildin Size Lot----------------------------Sq. feet U Dwelling yNo. of Bedrooms.................3 ........................... Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' 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. I 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..................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ----------------------------------------•----------------------•--------•---•-•--...-----------•---.........•....--•---.....................-----•----.--•••- 0 Description of x Soil..............5 anc---&---G r a-v el....-------•-•--• ........:----- -----•-•--. •---------- R ..._._..--------------....---------------------------------- ---------------------------------------------- ---------------------------------------------------- ...................................................... •••••-•••--•--.................................................................. U Nature of Repairs or Alterations—Answer when a ble...>.............. ......• __................. t-.1UI8, gallon ieeZ�� L ...' , Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,issued by the oard of health. Signed .-...- /�. . .... ... 6/?7/gC Date ApplicationApproved By ........ .. ------ ._...... -� ---------------------------------......-------- ------------. ------.Date J Date Application Disapproved for the following reasons: .............................------------------Q........---.................................----------........................................................................................... ------......................------------ Permit No. % ��...�.. .d , Issued �^ _ Date .................. ....--.................--. .......................Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cer#ift ate of (gantylianre THIS IS T6LCERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired XXX ) by............. P..........................mb -- Jr....................................... ' Installer at ............. 83....Prince Hinckley Road Centerville ----------------------......................................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in t the application for Disposal Works Construction Permit No. ......51,---i-2..-.P.I.��...... dated .......................... . THE ISSUANCENOF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ "` ------------------------------------------- Inspectof:<<-T-Zlg_ 'r.. .... ,-- -----...... _---------- THE COMMONWEALTH OF MASSACHUSETTS \ BOARD OF HEALTH TOWN OF BARNSTABLE No...!ll.... .. _ FEE......3�..00.. wousal urk.5 Tunstrudion "truth J P Macomber Jr. Permissionis hereby granted----------- ......................--...-•--------•••••-•-........•-•-•--•--•------••-•----•-........................---.......... to Constru t ( ) or Rep i X) n Individual Sewage DisposalSystem 1 3 Prince i? c X...ey lKoacl t,en C.erv:Le. atNo. -•............ .. ..•. ----•- -------... Street pp as shown on the application for Disposal Works Construction Permit No,/�' _ y&.(�/_\__ Dated.......................................... .................................... -4......—6-- ----••---------------•--------•-•------- Board of Health DATE. .`.. .'.../)........................... FORM 36508 HOBBS a�WARREN.INC..PUBLISHERS r 7/ I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA T- �j(tw�� ...............OF........................................ ........... •1� -71 o�v Appliration for Disposal Works Tonstrurtinn Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal tem at Sys -- ..... . . �... -... Locatio Address r Lot No. ... -- . ...: ... ..........................• •-•••---••--.............................. ........................................... Owner ....... ....... . ..-- :_.. ._ . -- . .-- -----...... •-••---•------•-----------•---••-•-•------.... s Installer Address Type of uilding Size Lot..? t _Sq. feet Dwelling—No. of Bedrooms___........ ---_--------------------_..__Expansion Attic ( ) Garbage Grinder (A9!6 aOther—Type of Building ............................ .No. of persons............................ Showers ( ) — Cafeteria ( ) d Ot r fixture .....------•----.---- w Design Flow------ ------------- gallons per person per day. Total daily flow........` -..----......dons. WSeptic Tank—Liquid capacit)� allons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N . .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No _ .. Diameter.. u_..... Depth below inlet.................... Total leaching area..a2.C_./..sq. ft. Z Other Distribution box ( ) Dosin a% ) '-' Percolation Test Results Performed b Y.. {,�: Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........._............. w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 .........••••-•••---•- ---------•- ------•------ .---------. ...--•-...... Description of Soil.....:"...Z. w UNature of Repairs or Alterations—Answer when applicable.......:....................................................................................... ...-----••-•--------------------------------------------•--•---•--------•-....------........-----•------•-----••---------------------------...-------•-•-------------------------------....-----•-•••--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys t in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees no to ace the system in operation until a Certificate of Compliance has bee ' s d by th5�oard health. gSi ne ........... .. ........................ �> Date �--------- Application Approved By........ -Z�s....._... ./ 24 �' Date Application Disapproved for the following reasons:-----•------•-------....-•-•-•--------------------------------------------------•---------------------.......... ........................................•---•-----••---------••-•-------•-•------..........-•--------...---••-•----------•-••--•-----•----••--------••-•----•--•--•------......----••......-••...--•--- I Date PermitNo......................................................... Issued..... ----- •- •-go)...............---••- Date No9..2_ 7 "/ ---, ,u 90 % Fxa- ................_..._.. _._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ..OF................. f� . Appliration for Disposal Works Tonstrurtiun thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System t ....... ..........................•* Ao�e /..Zv, ..... - Location Address for Lot-No. ------ --- ... ........................... ..................... ,��f....7 �/ Installer a/' Address Type of Building Size Lot..�Kj q.. .........S feet Dwelling—No. of Bedrooms............':�.........................Expansion Attic ( ) Garbage Grinder (,4)� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................•-------------•----•-•.---- _:....A.. W. Design Flow----_ ... .....................gallons per person per day. Total daily flow.......... ...:. "`2.............gallons. WSeptic Tank—Liquid capacity r" ..E gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N w............... Width.................... Total Length.................... Total leaching area... _. ` sq. ft. Seepage Pit No:'.' ":...... ----- Diameter..�i''............. Depth b ow inlet................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin Percolation Test Results Performed by..Y`. . .. ..._ �~ ._ � ....._. Date.......................................� Y�� a ----- - Test Pit No. 1.. ............minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.:_:._..._...._....._... Description il.i. _...�._..__.. `� --------------- W U Nature of Repairs or Alterations—Answer when applicable-----------------------------------------------------------------------------------•----------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to plac he system in operation until a Certificate of Compliance has bee "ssued sby th/�e,board ofliie1aJlth. } .... Sign e l ..... .. •- ---•------•••--...... ��... '''','f Application Approved By......... ..P el _ `2plats ------ Date Application Disapproved for the following reasons:.............. .............................. ...-------•---------•--------------------------•------------------------••---------------•---------------------------------------•---•------•.--••------- Permit No.................................................. Issued.--.LG.-- �- ............... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .OF..................... ..............................r.................. ntifiratr of f-Vuut pliFanrr THI ISO C We-IF ,f the Individual Sewage Dirs�osal System constructed ( ) or Repaired ( ) by "� �•-----�- .! ..- .. ••` L y j /i w � ' at............................................................... --•••---•-•--------•-•----•------.• ........ 4 •.__q Y.---------- has been installed in accordance with the provisions of T ` 6� tate Sanitary Cod'e_as�c sf,- ,the application for Disposal Works Construction Permit No.. ....................`_-..-.......... dated....._.......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFAGT DATE............... . ... ----..-----.•... �------. ......-- THE COMMONWEALTH OF MASSACHUSETTS V -•—���BOARD Off'„'',HEALTH No......................... FEE......................... 'Disposal PPfrho � "�/5 ' inn erutit Permission s ereby gra ted... .......................'�__ •� to Constr�at� A r e i ( n Iiivisua�j �ewDas s S� } � 1r�'/ atNo....((�� �'....-0..'."..........................................------ ............ --••------• .�,...,.,.r..-.j... Street-') ,rJ _ as shown on the application for Disposal Works Construction Per"1640.................�Dat�&r_.-....._........_............`....... ....................................................................................... I ................................••-----------------------------...-----•----.... ............. } zf Board of Health DATE.......... •---••------•------•----•...................•-------....•--- -FORM 1255 HOBBS' & WARREN. INC.. PUBLISHERS {� �1t-,jGl.� t~M/l►l_`� - � �3>=Dt?.oCa�t/� � v'� � �• 2aat L%4 FLow _ 110 14 3 = 33o G.P.V. U Sc—_ t OOb 6,A 4_. 0\ ' lVVi D' ,UZWAL- AZEA = 150 S.F. '� •� 't, BV TT /A AOMA r C�;o ISP-. 40 SD A 1 .o - SO S.PD. p TOTAL 1:;>G-S16W = 425 Toro L DA.1��( F(..Dw = 33D F,.PD. r ' PtT F Pr -0L T1oQ O&TE : J"lu I-MIW' OIz t --%. c 1 .tzo ell OF 4'x" 1 ' '� T fix`• w mesT Lo;M d'PPe . I not, iuv iuv- 91:a SµH4a11.Z. 4"PlP W GOL 8ox Sync iuv TIAWK moo& l000 q4,o tv . `iG8I a A'r PIT ••S 51z • w�rL1 r> .I� M •3 WAS►IED _ STowiE p AO� LOCATI oI-J LG�1Tf'I lrL , IL Igo Getz-rtF-q T14A-r T14G- t'oUQtA-nV$l 5taow►J t_�►tJ jZ _�L ►.1G 1- St Z tZ-Ml l CcaAAPLI,lS VJ I' to T1-IG: 51 V EU"E1 - - I _ ,-2A AWt-> Sc.T6,ACV lVc4U►VEticE-uTy OP THE UATGuG- RCGISt�( E.D LA.►.lt� SU�v�Yo�.S T'%4IS IS 1-.IOT LASC-V 01,3, 4W OSTEI'V1Lt.G v I�Xr�S�i. 11.IS(eJ.VAC:W i >Ut:�/t_�{ J.T��t_- o9zt�C-A , Z,14 IJ .I> APPLI C_A,"-r A 1.k>r CC-- U,ec> To LC)-r - f.�(.Ah1 �j/1�IAt.I.. •• i CENTERVILLE, MA BCD `k, STgQF Ap THIS IS A O �L"� /�i aQ ao COLOR _ G�D�C�� //�/ i Q�Q NOT �- _-� U �/J(� Q SCALE PLAN _� EDGE �" ��LEy Ll USE COLOR PLAN ONLY n 44.18 tt —�F PAVE ENT � OA D + 0 FOR INSTALLATION p FULL DETAIL IS BEST �— .............. VIEWED IN / \ `��� z FULL COLOR \ I.6S rl9 ft 65 / \ \ � o � SEPTIC COM Zr LOCUS MAP _ PONENT y� w Q EXISTING LOT (92A � �\ MINIMAL 1000 GAL - \\1 GRADING O. \ SEPTIC TANK P AREA = 28085 Sf+- } PROPOSED rn ' PLAN BOOK 343 C PAcB4-6 EXISTING W Q� LE H PITI 01 ASSR MAP 171 PCL 258 I Q [� �y p O CESSPOOL 460 O DISTRIBUTION BOX 0 / r TEST PIT 1 P 0 o _ ® � ;Is ;n P 0 OAK rn 0 V ® O ( / z I S in PINE — / 1%,eM '`r ® 1` *15n i `(H OF Mass P`jN Of Algssq PINE rZOUGHANOWR AVID 9G o� DAVID �41- D. ,, D. COUGHANOWR . 1093 No. 461 z PROPOSED SOIL �FGISTE ° S -1PPR0�° \HYDRANT i 2 p1 f S ABSORPTION q" G VAL SYSTEM (r(1 \ o 65 EXISTING LEACH P pl 2 Z I 2017 Vv�v -SEE DETAIL PITS TO BE PUMPED r PL N ON BACK FILLED & ABANDONED OR REMOVED -- �oT� SEWAGE DISPOSAL ® DRAIN SCALE: I i'n 20 ft �� ` �' SYSTEM PLAN o 20 40 -TO SERVE EXISTING DWELLING - - PETER AND o Io 20 0PBN51ABLEGISD JOANN BEST p�►u GARB R EL E V A T I O N �� = O O�� OWNERS) OF RECORD PRINT ON ll x 17 In or PAPER FOR PROPER SCALE Aq� 66. 14 0� pG� , 183 PRINCE HINCKLEY RD' OWED �' THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM NT SPOT ON S1EQ ` 155 Goo R der Rd .S ;' CENTERVILLE, MA DEPICTED ON IT. FOR ANY OTHER HANGES TO THE PROPERTY INCLUDING y PROPERTY ADDRESS --- Chatham. MA 02633 POOLS, OWNER DovidcouOHotmoi PLACEMENT OF ADDITIONS, SHEDS, FENCES OR SWIMMING Lcom 'DATE: MAY 18. 2017 —J SHOULD CONSULT WITH A MASSAC,IUSETTS REGISTERED LAND SURVEYOR. --- - 508 364-0894 P v2 JDB# ETE-4173 I�B�oE p p DATE: MAY 10, 2017 _ � n nn . e LEVEL SOL TEST LOG. PERC# 15354 DESIGN CALC�L A l! �ON �AL LON ::SEP,TI� `:T,�'I\IK DISTRIBUTION BOA X ►: • SOIL EVALUATOR: DAVID D. COUGHANOWR. ASE #461 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD ® ® ® ► ► T OR DIMENSIONS PIPES EXITING ►BEFOREFEET � • ►e WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS TANK TO BE PUMPED DRY AT TIME OF INSTALLATION TEST PIT 1 PNOCGTOUONDWAT2RM NI NOCUNTERESOILS USE EXISTING 1000 GALLON SEPTIC TANK IF IN AND EXAMINED FOR STRUCTURAL INTEGRITY. INSTALL , NEW PVC OUTLET TEE EQUIPPED WITH A GAS BAFFLE. ND STRUCTURAL CONDITION. IF NOT, INSTALL NOT TO 12 In ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHERW 1500 GALLON SEPTIC TANK. REPLACE WITH A NEW INCHES HORIZON TEXTURE (MUNSELU MOTTLES 1500 GALLON TANk'"% ��� SCALE - MIN 64.30 0-6 A SANDY LOAM 10 YR 3/2 NONE FRIABLE DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 1 in IF CRACKED. ROTTED -� p TAPER 63.80 6-30 Bw LOAMY SAND 10 YR 5/8 NONE FRIABLE SOIL ABSORBTION SYSTEM: OR OTHERWISE C FROK TO 61.80 COMPROMISED. TAN - 30-138 C MEDIUM SAND 10 YR 5/4 NONE LOOSE THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE 5A5 52.80 SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES O PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. o NO GROUNDWATER ENCOUNTERED CID1(` 6 in STONE BASE TEST PIT 2 2 MIN/INCH IN C SOILS THE 24 ft x 12.5 ft x 2 ft LEACHING GALLERY DEPICTED BELOW CAN LEACH: o I NOT 5 f ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER v TO /5.S '. �5 CROSS SECTION VIEW INCHES HORIZON TEXTURE (MUNSELU MOTTLES BOTTOM AREA = (24 x 12.5) =-300 sq. ft. � 64.35 0-8 Ap SANDY LOAM 10 YR 3/2 NONE FRIABLE SIDEWALL AREA = (24+24+12.5+12.5)-x2 =146 sq. ft. n SCALE 63.68 .8-32 Bw LOAMY SAND 10 YR 5/6 NONE FRIABLE TOTAL AREA = 446 sq. ft. 0 52.85 32-138 C MEDIUM SAND 10 YR 5/4 NONE LOOSE FLOW CAPACITY = 0.74 x 446 = 330.04 Sol/day 8 ft-6 2 t x 12.5 ft x 2 INSTALL A f 4 ft GALLERY AS CONFIGURED BELOW. FLOW CAPACITY = 330.04 gal/day WHICH EXCEEDS SYSTEM • INLET OUTLET THE 330 gal/dog REQUIRED FOR A THREE BEDROOM DESIGN. e• •► e r VER CO COVER 3 IN DROP DRYWELL 24.0 ft -> �l FLOW LINE UNIT FROM = � -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE BUILDING 10 in = 14 TO '^ D-BOX w STARTING WORK. w �, -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM 48 U/p GAS '� ® ® �" U REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC �i ' N O CODE (310 CMR 15). LEVEL BAFFLE M -INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND I c� ITI UTILITIES BEFORE EXCAVATING FOR SYSTEM. -- STONE -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION 6 i STONE BASE IF NEW 3.5 ft 8.5 ft 8.5 ft 3.5 ft OF LOW FLOW FIXTURES & APPLIANCES. AND PERIODIC SEPARATION BETWEEN INLET & OUTLET PUMPING OF THE SEPTIC TANK. TEES NO LESS THAN LIQUID DEPTH 500 GALLON DRYWELL ISO -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. CROSS SECTION VIEW DIMENSIONS & DETAIL INSTALL ONE INSPECTION DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. Q RISER TO WITHIN THREE USE _ INCHES OF FINAL GRADE H-)O & INDICATE LOCATION ON AS-BUILT i1 UNIT F L 0 LF 0 i Op�A,D. TOP OF FOUNDATION RAISE COVERS TO WITHIN =AND BE 4 in SCH. 40 PVC P EL = 66.54 +- b in OF FINAL GRADE O PITCH AT 1/8 in/ft MIN 102 in 64.3 CROSS SECTION VIEW INSTALL AN APPROVED GEOTEXTILE FABRIC OVER STONE D - � eOo � 3 - u M A X USE H-20 % 0�1 r 28 3/4 !n TO EF in o 3/4 In RA 6 2.2 5 I-1/2 In GRAVEL DEPTH I V Em 1-I/2 GRAVEL EXISTING 10 00 0 GALLON � o-o�q d�a�� ��� 46 in 58 in 46 in �o�o o; � PRECAST ao� o �o yoga D; °4 �C PT�C� TQN� 62.65 61.63 o o DRYWELL o° 6°�� r. oqo° 150 in in EXISTING REFER TO DETAIL BOX STONE SON. Q o SORpT ON 61.80 -REFER AT EXISTING 6 in STONE BAS IF NEW o � BASE SYSTEM REFER TO Ep�p� �NN�© E 20 ft 5-12 ft DETAIL BOX q 0 COTE S C�G�- US NO GROUNDWATER V BELOW 58.50 MOTTLING OBSERVED _ 52.80 -- -- - - � SEWAGE DISPOSAL SYSTEM PLAN MA 183 PRINCE HINCKLEY RD CENTERVILLE. MAY 18. 2617 _ ETE-4173 PG 2/2