HomeMy WebLinkAbout0260 RIVERVIEW LANE - Health 260. Riverview Lane
Centervilie
A = 228 101
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UPC 12543
NO �scoNs'��
"ASTINGS,6SN
TOWN OF BARNSTABI L
LOGATION d , V iwtl 11r1iU SEWAGN .Z _ /d�
VILLA E < l if. ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. �. y„sa 7
SEPTIC TANK CAPACITY d--0
LEACHING FACILITY: (type) �`� 61 Dom' L-L (size)
NO,OF BEDROOMS
BUILDER OR OWNER A4- t-
✓i✓� 1 , �
PERMTTDATE: COMPLIANCE DATE:2 0 '
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Botto of Leaching Facility Feet
Private Water Supply Well and Leaching Facili (If any wells exist
on site or within 200 feet of leaching faci ) Feet
Edge of Wetland and Leaching Facility(If y wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No. U ; F($Sn 00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
i) PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS es
Rpplication for &!5paaf *potem Construction Permit
Application for a Permit to Construct( _ )Repair(x4 Upgrade( )Abandon( ) :Fr-]Complete System ❑Individual Components
Location Address or Lot No. 260 Riverview Ln. Owner's Name,Address and Tel.No.
Assessor'sMap/Parcel Centerville, MA Thomas McNulty
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Servi e Daniel Johnson
P.O. Box 1089 804 Main St. , Suite B
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building rP G i d _nt a i 1 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repair$or Alterations(Answer when applicable) We will install a new Title-5
septic system to the plans of Daniel Johnson J-803 dated 9 3 02.
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 provision$of Title 5 of th nvironme 1 Code and not to place the system in operation until a Certifi-
cate of Compliance has been issu d b d of Heal
Signed Date
Application Approved by Aa 440t= Date f::42-122
Application Disapproved for the following reasons
Permit No. 2 oV aYO.S— Date Issued�/�-02
Fee 5 fl 0n
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
" °Yes
"• PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE.,'MASSACHUSETTS.
' -Application, for Digogal *pgtem Congtruction Permit
Application for a Permit to Construct( . )Repair(X4 Upgrade( )Abandon( ) :�]Compiete System ❑Individual Components
Location Address or Lot No. B 6 0, Riverview Ln. Owner's Name,Address and Tel.No.
Assessor'sMap/Parcel Centerville, MA Thomas McNulty
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service Daniel Johnson
P.O. BOx 1089 804 Main St. , SSite B
rs _ dA 02655
Type of Building: -
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building res identa i 1 No.of Persons Showers( ) Cafeteria( )
`* 1ti Other Fixtures
'%•Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Size of Septic Tank Type of S.A.S.
Description of Soil
1
Nature of Reepa rS orAltertions(Answer when applicable) We will install a new Title-5
s p systemi6. to the plans of Danieiotinson #J-803 date 9 3 02.
Date last inspected:
Agreement:
, . •;.;i; Y 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 nvironme dal Code and not to place the system in operation until a Certifi-
}' Cate of Compliance has been issu d byi4iAgd of He
Signed 1 L Date •frQ .
Application Approved by /L t Date —1,2_0?
Application Disapproved for the following reasons
- - -- - Permit No. a.ud a - V os Date Issued la -(/2
THE COMMONWEALTH OF MASSACHUSETTS
McNulty BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(xX) Upgraded( )
Abandoned(( )by .Wm. E. Robinson SeptiltsSeraice
at 206 RiVerview Ln. , Centerville, MA 02632 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a00-2'V 63 dated
Installer Wm.E. Robinson Sr. Designer Daniel Johlhson
The issuance of thins permit shall not be construed as a guarantee that the syst will,f nction as a tgned.
Date t ) 00� Inspector aj 4v, S
No. Fee`$5 0.0 0
McNulty THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
'Wigpogal *pgtem Congtruction Permit
Permission is hereby granted to Construct( )Repair�X)Upgrade( )Abandon(
System located at 206 Riverview L;a. , enterville, MA 02 32
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 t.
Date: 0_ 0 _0 e 1 Approved by I/,/ Akld S
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
PERCOLATION TEST AND SOIL EVALUATION EXElY1PTION
FORM
g- hereby certify that the engineered plan signed by me
dated concerning the property located at
LL
meets all of the
- following criteria:
• This failed system is connected to a residential dwelling only. There are no
commercial or business uses associated with the dwelling.
• The soil is classified as.CIASS I and the percolation iaie is less than or equal to 5
minutes per inch. The applicant may use historical data to conclude this fact or may
conduct preliminary tests at the site without a health agent present.
• There is no increase in flow and/or change in use proposed
There are no variances
requested or needed'.
• The bottom of the proposed leaching facility will not be located less than fourteen
(14) feet above the maximum adjusted groundwater table elevation. [Adjust the
groundwater table using the Frimptor method when applicable]*
Please complete the following:
A) Top of Ground Surface Tlevation (using GIS information)
B) G.W. Elevation ! +adjustment for high G.W. g
DIFFERENCE BETWEEN-A and B 23
),�-7Zf1 T fir
DATE:
NOTICE
Based upon the above information, a repair permit will be issued for bedrooms
maximum. No additional bedrooms are authorized in the future without engineered
septic system plans.
q:health folder:percavnp
TOWN OF BARNSTABLEL.
LOCATION a SEWAGE#I
VILLAGE �p�" 1 f
ASSESSOR'S MAP & LOT i 2 --0
INSTALL$R'S NAME&PHONE NO. �� �a'J ?
SEPTIC TANK CAPACITY
A�U
LEACHING FACILITY: (type)
'�,.s �-� �+ �- �L� (size)
NO.OF BEDROOMS
BUILDER OR OWNER L✓�� J ,��
PERMITDATE:
1 �—o'a`. COMPLIANCE DATE:
�'i " .
Separation Distance Between the: Feet
Maximum Adjusted Groundwater Table to the Botto of Leaching Facility
Private Water Supply Well and Leaching Facili (lf any wells exist Feet
on site or within 200 feet of leaching faci )
Edge of Wetland and Leaching Facility(If y wetlands exist Feet
within 300 feet of leaching facility)
Furnished by
7t --�
1
-t8�°1
i
TOWN OF B.ARNSTA LE
LOCATION Z�,C� �\��y�Evv EWAGE
VILLAGE �6�TjE ,�I 1 �, ASSESSOR'S MAP & LOT a�J
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY B5(&P N16 S�4S.-MM
R LEACHING FACILITY:(type) +X/ Fk-CP&T ^Pt'- (sue)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_
BUILDER:.OR OWNER
DATE PERMIT ISSUED:
DATE .COMPLIANCE ISSUED: ..1�= 7
VARIANCE GRANTED: Yes N N_ No
r
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w f a'o� 1�b�►.tiE
V'VWV ka28 (� �Yt�•c ` col
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
1.-- ..W.V.......OF......
Application for Disposal Works Tonstrudiun V erntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
system at: t
•---. ..�(�__....... :�-c_ .v. w.._...rl. .--- --... - t YvA—V--------------------------------......
---• --- -
Locatio.n• dress 1 or Lot No.
....... ......... .. .. v.1..... _--- .......... .�.... .............-•--•-••--•---•••-....-..._.......:
Owne\, �1{3dress
W .L.....�C?c[_.. .. Y �! _.
a .... ..._. ,�.......... ----•- -•............. - ....................•.............•--•-•......
�.
Installer A r
Type of Building Size Lot.........:..................Sq. feet
,.., Dwelling—No. of Bedrooms......... ...............................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtures
d -•--------------------------•-------
WW Design Flow.......... . ...........gallons per person per day: Total daily flow...........:...................gallons.
W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width....................Total Length.................... Total leaching area....................sq. ft.
. Depth below inlet._....- ..�_..... Total leaching area.................s ft.
� Seepage Pit No..__.�............. Diameter_:__1 p � g q.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by........................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ------------------------------- ---••------------....._._....... .............................................................................
0 Description of Soil.........................
V .•-----------------•--•-•••••... . ----•••••-
-------------------------------------------------••-•---------------•-- -----------.._._.._..:
U Nature of Repairs or Alterations-Answer when applicable........14 l�l/1 ........... ---...... Y. -.---��
---------- 5 � 1 CQ -
--------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with,
the provisions of iI'A 12 . 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Comp issued by the board of heal .
Signed... ... :......... -• ••----...----•-•-- ...... --•- - ? K
n Date
Application Approved B
Date
Application Disapproved for the following reasons:---=••--------•-----••-•-••---•..................................•------......:........._..._......_....._....
.....•-•---•-----....-••-...----•..................••-•------•....-------••--•--••-•-•----........•...._.-----•---------•-••----....------......-------------••--••.......----•-----.......•••........_ .
Date
PermitNo.....22.c-..2L-7.!:�..............__._.. Issued......................................................_
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....T-D..w..� ....0'F.......... .�.... s... ,
Appliratiun for Disposal Works Tonstrurtiun f rrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Location•A dress
O or Lot No.
i:�'...
-�-�� / wner / L__ � y�� �Xd-dress
a ......--»'__'_•.:..li t�l--:_,._c Ltd ..L.........!�.::::5.1!....,2......... ...................E. ..��.(_:.!e:.? .:•4«�-------------------------------•------•----
Installer r Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.•....-�------------------- -Expansion Attic ( ) Garbage Grinder ( )
.............. No. of ersons................._.......... Showers — Cafeteria Other—Type of Building ______________ p ( ) ( )
WOther fixtures ..------•---•---•---•-•--•-•........-•-•----......._._....
WW 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.
3 Seepage Pit No....../--:--_-____.- Diameter.....� Depth below inlet.......... Total leaching area.................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY...................................................................a...._. Date........................................
1.4 Test Pit No. 1................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........................
x ------k---------------•--•-•-----•..........._..._...........---------------•----------------------------------------------....._ ._............
0 Description of Soil------------------------ ----------•-••-•--•----•--••------•--•---••--••--•--•-----------•---'...............----•----•---•--............._...............--------•---
W
V ••••----------------
----------------
-----------
•------
-------------------------
.......................
-----------
.......
---------------
•--------
... ----------
-......... ---------------
W -----•------------------------------------------'---------------------------------------------------------------------------------
........-----------------------
... ....----.-------•------
UNature of Repairs or Alterations-Answer when applicable.........��A s ./1��....._.._•1�7 ........ �- ....- . T
--......--1� :.�... .....<.f i?/:u--c.:�----'.�T-.?---- ..�`1 T_�rc ...1 r- r�r; --. .......................
�. ;
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 place the system in
operation until a Certificate of Comp1, has-been issued by the board of health.
Signed �
--tea ... Date
Application Approved BY.........
Z:7--- — •` a �� =7............................. ....................Date -
----•--•---
Application Disapproved for the following reasons---------------•-••----••----•------•--....-------•-----•----••.......-•----------........_..._............_....
..............•---------••-...---•--.................._......----••--•----•------•--.....----•---:-...._......--•--•--•-•-----...------......------------------•-----------------......---------......»
Date
Permit No.__._ Y -« Issued....................
. -�•---.. .---7----------------------- Dom.......----•--.....»..._....« � --
----------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......................................-.OF..........
Trr#ifirate of Tuntplianrr
THIS ISZO CERTIFY, That-the Ia3&vidual e��'age Dis osal System constructed ( ) or Repaired (t )�
Installer l
at........... ::. a.l.�............... .........Q. ............................................ ........... .`.. . .........
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No....9--7'--�-.?.t7e--------.- dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE......................... - l r. ' � . -•--- Inspector---N- -. '�,` _ram.= - -•----...........
.... U
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH`
0F.......r4......... 4-:?�l.`.u`: -0.LA ��.....................•--• ,.Ln
Diupusnl urku�[Tunutrudi att lirrutit
Permission is hereby granted.............. ... �.._ _ ..........................................................
� -to Construct ( ) or Repair ( `)an-Individual Sewage Disposal System
I... = =�' •-- /
at No................................... +:..- --2..-•----. _ ....ti:� -- ...........
Street
as shown on the application for Disposal Works Construction .Permit Nod.7:9-7. •_.. D'ated..........................................
------
•-------
--
Board of Health
DATE----•--•-•---------------------------------••-= •-----......-•------• ......
7
7
I
7,
777
.4 11.4,11 "', , , ' r 7 .". 1 11 I'll 7�77`
J,
p
y� �4i
i47
500 CIALL
VALENTI
MODEL
1 Ok'§tk[C TANK
TK-15M(SHEA CONCRETE) 10A EQUt
z
DJATA ISHED
FIN
PrT
TZST-
DIA.
J.
S'NIN) 2�"DIA
to d By: Dan el B. 7ohnson
24"DIA 24
Per rme
4.�
311
- H-10
August 23, 2002
.. . .... Date.
4"SCH 40
99.6)
TP (EL.
FLOW LINE
4"SCH 40 14-1 - EL FILTER A-1no
ZAS
28 A/Fill Sandy loam —SEPTIC TANK TO MEEI
28 -120" Ci 2 . 5�5/6 Medium sand 4"SCH 40 TEE
4'LIQU
ID LEWL REQUIREMENTS OF
e : GAS BAFFLE 310 CMA 15.226 FOR
4"SCH 40' WAT P IGHTNESS,
No 'Observed Groundwater 'ETC
TEE
T bATA ALL WALL SLEEVES/GASKETS
PERCOLATT.ON TZS MECHANICALLY
6- (MINI)
SHALI BE CAST IN PLACE 01; COMPACTED
INSERTED AT FACTORY. CRUSHED STONE
STABLE LEVEL BASE
Nt TRATION SEAL <-34'DIA.
APPROVED PE
METHOD REQUIRED
SEPTIC TANK DIMENSIONS: 1V E7'L X 5' &'W X 5"
3 0,eY wELLS
3;,S't, 13'vv s ;04 Rato, 2 MPI (TP-1 )
DISTMOUTION BOX
Depth 4611 REM(VPLE COVES
let
Or ZLMTXON8 4"Sai 40 OUTLET LATERALS
SCRIMULZ
SHALL BE SET LEVEL FOS A
DISTSMUTION BOX TO MFCT
MINIMUM OF THE FIRST TWO
REQUIFItMENTS OF 310CMA
cc�f POOL fTET AND CONNECTED TO
15,232 fWATES TIOH T NESS,
EACH DISTAIDUYION UNE
UCTION,rTC1
CONSM
VATH SOLID SU440 WC ME
Ifiv. Oil t Torik
4"SCH 41n7
NO,OF OUTLEM I
Inv. oull, D I r i b i o 90
1tiv In 84 , prit4, Txnk
STONC jo 3/4"DLkj
N I
100
S TAM f LEW,,L PArir
0 W H Wr
9
LFAD Df1'e%1LL01
40
"END11 CnOSS SECTION
n q Co ri t r
+ Oki r.
0.4 Propo.,,5ed, Cont FINA1.ANAII)f M
A
Ouse:',
Tet Vit
n FFE
d Floor Elevatio
JAMN(74 D WWWELIS :3
. B FE 1.11 r7l I X 4+1 rr,W X EA STONE
WAS14 P
4 4'
OVf WL VAWNI AnrA 1 I/Z'DOUBLE
W
,,,/3/4"
D&L X 1TWX 214 WASHED STONE
Gas' Line G LEACH ING.DRY WELL$,
Overh
OHW TO COMPLY WTH THE
614. SEQUIREMENTS OF ,
310 CMn 15,252
PA
OVANCY3
AD
OR
&j
V oe- _,4A/E
0 CS
�JACA PC
N
NOTES
2
All construc orm
ns.
2 . There are no kno �W15D
respectiely, fro the proposed la'chinl'
v m
a
etl6nd eet ofthe
0
b -4 e
X o leaching ,area, s d leaching ar 'a
4t
tA
AV e n
A
4
rova 1
r�r4 y 4 . app
ineer.
�,A of the Board of Health and the de-slgn -eng
ojA IA 14 4A
k 11 --ield is not. designed for use with
hing
L
flux
.........
'72 hours prior to
-)ntractor to notify Dig Safe
C4
Property line. inform
d te c embo r 14 8(�ptic Plan riot', to be' u.,;Pd as,
d Do
rvoy.
4's
-4 4 0-1 E7$'
yb,if A I V el,r i.r y 1,1 p 1 umb i n 9
from existinq Atrklctur(�
W1. 1 I ho connoctod to. the nqw yitom prior to
ooroqt ruct tot) lr ony oxJ ,.itjnq plumlAtiq "xitit
7, J to bo, (11 f tho. thAt ihowti (in tho
PlArl, tht� t ho
t)(") 'Continctold Row
yt;t om, I% �1 ot ho r-W i so tooe I t)is rp-I AV rl'D t4
CALC=TXONS
PXy &ELL
4 Rodroomti 4 Be-droorms GPD
zj
PROPOSZD LEACHING AM:
Dry Wells: 3 at 33. 51L x 131W x 21H
—sottom Area : 435 . 5 .SF X 0. 74 G/SF 322 .2 LPQ
70 -
4
Total Leachinq Capac�ty: 59. 9 GPD
At 0 0
ri 0 09�
SUBSURFACE SEWAGE DISPOSAL SYSTEM
260 Riverview Lan
DRAW
SCALE: � k sy
9/3/02 Daniel B Johnson
DATE:
repared Tom McNaulty
IL 0 0" rot 260 Riverview Lane, Centerville, NX �02632
0+40
T.
�(500) 420-1904 DRAW
Prepared DCMSTXC SEPTIC DZST=, INC. ING NUMBER
By: 904 main street, suit* a, Os Lile, bM 02655
tot""