HomeMy WebLinkAbout0101 ROSEMARY LANE - Health 101 Rosemary Lane
Centerville
A= 147— 007 - Ol 1
GMEAe
No.2-153LOR
UPC I2534
smeadcom ® Made In USA
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TOWN OF BARNSTABLE
LOCATION Z SEWAGE# ®® "
'VILLAGE C %\V • + ASSESSOR'S MAP&PARCEL 0 0 ?-oil
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY e.k\�� ���U G�l- ®t3Q,4
LEACHING FACILITY:(type) 14 1l1 �LC (size)( W Y. 2U
NO.OF BEDROOMS i
OWNER
PERMIT DATE: .%3 f 0 .� COMPLIANCE DATE:
Separation Distance Between the: 1
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Sce.PkAJ\ lT feet'
Private Water Supply Well and Leaching Facility(if any wells exist
on site or within 200 feet of leaching facility) NA feet
Edge of Wetland and LAching Facility(if any wetlands exist
within 300 feet of leaching:facility). 101 feet
{
FURNISHED BY w�`��
� 0 ko a 3
f3ko _ 4
14-7- 00 -T o l l 00
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ftPliLation for bispo8Af *pstrm Construction 3permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. i C, q0;4 C-M E r L c,4%4 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. n%f 00toci Designer's Name,Address,and Tel.No.
Type of Building: YF
Dwelling No.of Bedrooms :3 Lot Size sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) : gpd Design flow provided gpd
Plan Date ate, kffl Number of sheets Revision Date
Title
Size of Septic Tank �'X�S� `OQd Type of S.A.S. w\lw L C1Q1htM1GkV1_ e`C�
Description of Soil Meo®,4,,,, 9 C,
Nature of Repairs or Alterations(Answer when applicable) ek�A Le,,E to N �
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 issuAbisBoard of Health.
E:y p DateApplication Approved by ' -� Date
Application Disapproved by Date
for the following reasons
Permit No. "' Date Issued
:,.;Pf•.„+. m4.^+-4...i�,w...,�:;�C,k-`e^'-»...:+�fe,:..•v.�F.r/,...-T,,�vt'C'- .- n.,,.4::f«,M>..�-Y..�;. ;-l.r.:-... +_ �.n. r +T�.,.:.� . -�•.
No. Fee
D
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION,TOWN OF BARNSTABLE; MASSACHUSETTS
ftpYication for Misposal 6pst�ent Construction 3permit
Application for a Permit to Construct( ) Repair'( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. I d` RO S C.M c r LW� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel C� i V���( _ b —01
Installer's Name,Address,and Tel.No. �. aq Volo� Designer's Name,Address,and Tel.No.
Sco 'C\z^ -Mt 2J , of ., f 34a c 17z
Type of Building:
Dwelling No.of Bedrooms Lot Size sq:ft. Garbage Grinder(W
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 3 d gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. Cs,N Coo," ,(,ky,r
Description of Soil Meri\y�1 r,.. L� i s
Nature of Repairs or Alterations(Answer when applicable) r e Y g 1r 1 0 rJ -+e hJ
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
4
Compliance has been issued by-t is Board of Health.
*Jed /J Cb p Date
Application Approved by �� //� Date
Application Disapproved by Date
for the following reasons
�7
Permit No. UDate Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(1/� Upgraded( )
Abandoned( )by
at ( ��� [r ,� V\ ,�Q has been constructed in accordai
with the provisions of Title 5 and the for Disposal System Construction Permit No� �'� td1-
Installer !Zr O A r_r_1_.J. VC, Designer
#bedrooms Approved design flow 7,C < gpd
r
The issuance of this per/mit sf�anll not be cYot}�strued as a guarantee that the system will function asry Idsignef f� �DateInspector f�t :_ � ,7� -,I
_ ---------- -- I
No. g _ l
Fee
v THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposai 6pstem Construction jerrnit; *� 4.
Permission is hereby granted to Construct( ) Repair( t/' Upgrade( ) Abandon'(
System located at U �� � t,,,�f (� C v ! \_(L
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 mus a completed within three years of the date of this permit.
Date /, 1-2 q Approved by 4 / ,
wPyof THE t0�♦ TOWN OF BARNSTABLE
OFFICE OF
? DAHI3TADLL rRea BOARD OF HEALTH
1639.
�
'°gyp MAY k` 367 MAIN STREET
HYANNIS, MASS. 02601
( , Sewage Permit #
�" t Applicant : ✓f1-t-P'1'J0
Proposed Install
The plan for the on-site sewage disposal syste at LoE 11 ��� ,� ti, t.-ell
has been approved with the condition that the design engineer mus a on-s to
and supervise installation as well as certify in writing that the system was
installed in strict accordance to the approved plan.
Approved By Date
Cow/ GIN To
Y� L 4 N p _51 -7
R ryT'R A T N 7� T� '/'Vy i
+hT-b'-IA.l T�7.1+TI ON'.wfF Yti1 i1't'1. M ..
Depth from Soil Horizon � 0�e
Soil Texture Soil Color Soil Other
Surface(in.) (USDA)
(Munsell) Mottling (Structure,Stones,Boulderes.
Qz, It C Comistency.%Oravel)
DEEP OBS] RVATIC)N)FIQ , LQG _
Depth from Soil Horizon .UY�#
Soil Texture Soil Color Soil Other
Surface(in.) (USDA)
(Munsell) Mottling (Structure,Stones,Boulderes.
J it Consistency.
r
:J)EEP Q13SE tVA T10 HO1E I,QC Dole; .
Depth from Soil Horizon Soil Texture Soil Color
Surface(m.) Soil Other
(USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
CQMsi5tencY,%Gravel
De
DEEPO]3SER�.�i:TION'�IC1L>G I..�JG
Depth from
A Soil Horizon Sod Texture Soil Color Soil Other
Surface(in.) (USDA)
(Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,%Gravel)
I
Flood Insurance Rate IYIa_o
Above 500 year flood boundary No, yes
Within 500 year boundary No '� yes
Within 100 year flood boundary No '� yes
Depth_of_ N, aturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? ye-- s
If not, what is the depth of naturally occurring pervious material?
Certification
I Certify that on /Ponme-nt
date)I have passed the soil evaluator examination approved by the
Department of Envial Protection and,that the above analysis was performed by me consistent with
the required trainin , xpertise and experience described in 310 CMR 15.017.
Signature y `
------ —- �---�. . Date
Town of Barnstable
Department of Health,Safety,and Environmental Services
`EVE Public Health Division Date I 2.40 0g
o� 367 Main Street,Hyannis MA 02601 n yyy
HARNST + Y ,
y 9s.
I+fAS. I
Date Scheduled Time Fee Pd. d0 ov
Soil Suitability Assessment for Sewage Disposal
Performed By: Witnessed By:
LOCATIQ�1 &:CNEIA ;: IORMATION
Location Address ��t ci Ly �L Owner's Name �L /2A-�5C-5�t jay L
/�/ 5N
" /e�V/)/� Address 51+,.A-eC
Assessor's Map/Parcel: oo-7 _G Engineer's Name STE`i�N cv- /•lam S pi
NEW CONSTRUCTION REPAIR X Telephone# �-08 36 Z-0,/32-
Land Use L (
Slopes 1/U G r
p ) Surface Stones Nc)
Distances from: Open Water Body /456�"'F ft Possible Wet Area Jvo ft Drinking Water Well ft
Drainage Way — ft Property Line: /d �t ft Other ft
SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
-fop
� !
rro a.kr-.
•t.
Al
a --
Parent material(geologic) dZyT� S Zvi
(g g ) Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: �d� Weeping from Pit Face
Estimaieu Seasunal High Groundwater
DTERMINATIOlI F+DR SEAONr ....... �TGH VTER TABU
Method Used: ` -��� w.i;'........ .... :.:::::..........::.::.;:::-::>;;:.>:::.:::::.::.:::-::.::::..._;::.
.. :...........::.........
Depth Observed standing in obs.hole: �og 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.__._, Adi.factor_ Adj.Groundwater Level
P +,RCOLFITTIOIY` T..;: : .
Observation
Hole# Time at 9"
Depth of Pere SZ Time at 6"
Start Pre-soak Time c@i 6. "y Time(9"-6")
End Pre-soak
Rate Min./Inch L L
Site Suitability Assessment: Site Passed �^ Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on BacIc j
Copy: Applicant
'AWN OF BARNSTABLE
1.
SEWAGE # e
LOCATIO14
VILLAGE_ �l ASSESSOR'S MAP & LOT 7 �7
INSTALLER'S NAME PHONE NO. AdZGIV 3
SEPTIC TANK CAPACITY '
LEACHING FACILITY:(type),—'-�o (size) /a ' Y A b
NO, OF BEDROOMS ,-7 PRIVATE WELL OR PUBLIC WATER /'4 //L
BUILDER 9P. Q NtR �i� �•9 w� ��
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: la ANN
VARIANCE GRANTED: Yes No--,------
1
33
BSc
Rio �'rF
IT
2. S
No. Fiaii.. .. ..
THE COMMONWEALTH OF,MASSACHUSETTS
BOARD OF HEA T Lj1
............... ........................
......... .........
Appliration for Disposal Works Tonstrurtion Ifermit
Application is hereby made for a Permit to Construct (1,4 Repair an Individual Sewage Disposal
System at:
................. 44 -4 11
..... ...............................................................................................
Address Lot N
0" 4�_ft�'
...................................................... ........ ....►...................kc"'.' I" � n�- 4 dress . W�A........................
... .. . ................................... ...............................................
Installer Address
.................. AnA ....................................................
Type of Building Size Lot...36..X."2 .....Sq. feet
Dwelling—No. of Bedrooms....................�3.....................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of pers6ns............................ Showers Cafeteria
aOther fixtures ........................
< per day. Total daily qow........a 1.0........................gallons.
Design Flow._......._ tb�.........................gallons per A44i��*
Septic k'g ui capacity./OD. gallons Length,3.'.&.'..._ Width;A'19'... Diameter----- Depth.-5..:7.......
P
T capacity./OD.
....P........... Total Length.......24-.'.... Total leaching area..-;--M.A....sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box Dosing tank (' ) 0^
..............
Percolation Test Results Performed by.. .............. Date...2:
Test Pit No. I......4Z.....minutes per inch Depth of Test Pit.....!-o S....... Depth to ground water..A%->
44 Test Pit No. 2.....4:1,'_minutes per inch Depth qf Test Pit..... ..... Depth to ground water...
.....Tl�l..........
0 Description of Soil........... ..... ......
-------------------,lQ --------------
........... .. ....
.............*---------------
......................................................................................................i ---------------------- ................ ............***.......
U Nature of Repairs or Alterations—Answer when applicable..:..... -11DERVISE
....................
J R MiNra
.................................................................................................... I ATV-1V 2- -1
............._= ...-
J IN
Agreement- HE SYSTEv*. VJA- I
The undersigned agrees to.install the aforedescribed Individual�-S-erw':Ii,'e';jb*T""�smal-��ylstem in accordance with
ispo
,L A.the provisions of'I'U- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Ceftificate of Compliance has ben ssued byee boarIoe�lth.
i
.................................
Date
Application Approved By.......• a r4z . ........... .....................................
Date
Application Disapproved for the following ons:...........................................................................\
.7--------
.........................................................................................................................................................................................................
Date
Permit No.....-... ` .-...._. &...... Issued.......................................................
Date
- -- --- -- - --- --- -- - - --- - - - -- ---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........... ..................4...........0.... . ...
..............................................................
Trrtif irate of Tompliana
THIS IS To �ERTIFY, That tho,Udividuhl Sewage Disposal System constructed or Repaired
by.......................... .............. ........71.......................................................e.......................................
I sot Iler
at.................
----------- ..............*------------"".........*...... ......... ....... ......---the provii� s o TITLF, 5 of The State Sanitary Cod aydesQribed in the
-,'--t,-**----------------------
has been installed in accordance with
application for Disposal Works Construction ='t' No......... ... datedy L. .....................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL' FUNCTION SATISFACTORY.
DATE................................................................................ Inspector.....................................................................................
- - - - - - - - - -
No......`:...7_.... � FHB... -....�...........
'°THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
._yl......... . .................... ..........................------........_.....-------...._--•._......._...
Appliratiuit'f or,Bispnsttl Works Tunstrurtion Prrmit
Application is hereby made for a Permit to Construct (tf)o Repair ( ) an Individual Sewage Disposal
System at:
� ^../.Location-Address•-•............................... ......./----.......�./..1......�....� ..og L/ot No.�-------...1........_.....................
(� 1 Owner Address ........................
Installer Address
Type of Building J Size Lot.. .....Sq. feet
aDwelling—No. of Bedrooms................... ?...._..__.__._._____.Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No, of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures ...........................................
Design Flow............I Lv_____________________•__gallons per person per day. Total daily flow........-3U........................gallons.
W Septic Tank—Liquid Liquid cap�ity�Q?n�_gallons Length.�'en....... Width:..`�,.10(�_ Diameter:.._- --.__ Depth�:.7::..__.
Dispo&A-Trench—No. ______.:? ?. Width....L._.__.._.. Total Length leaching area_____-`___:_.-.....s ft.
x --------------------Total leachi � I 4 q.
3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box Dosing tank (_ )
Percolation Test Results Performed by..........
........................... Date._............`.. ' z ..
Test Pit No. i____L!_____minutes per inch Depth of Test Pit.....1.4.`::._._ Depth to ground water._A?.A*iln::.? 7
44 Test Pit No. 2.....L 2__..minutesper inch Depth of Test Pit.....Atz'__.._. Depth to ground water._.&1?..`.�:.�..:._Z���'
4... I : 6'- 2 f.... ...1.; .. <.,,b 7-o - .. c I ....P SI ::4:.......
Description of Soil..........
. _-_..---.__-{{-��___...•______...._________________•---•------..._...... ............
........
U .............................................. .. .Z_._._..v....'��:.. 0 ? .�-;��� --r"�••_--• .l1)•L." •-!,�'C:b`� •NON - ......::.}r��
_.....---•-•-.._..•....................................................•--•----__••-•--................-•__..-------•------•-•'--•••---•--._._.._...._.__._._._........_-----••---...........-•--•-.._.
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 II T LW 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board-of health.
Signet...................,�. .. � !� ...................................... / S �
Application Approved By•--__-••--nil ............ /J --..... ,...--•--...._-••••• -........._..._._..-•-ate............... ...... .
Date
Application Disapproved for the following `asons:.............................................................................................................
.................•--._................._......._.....----•---•----...........................................:..-•-•--------...---•------•-•----•--............_.._.._._.....__•••-•-•__...............
�� Date
PermitNo.......................................... ...... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
'BOARD OF HEALTH
.............. ...........
Zertifiratr of Toutpliattrle
THIS IS TO CERTIFY, That the`Individual Sewage Disposal System constructed ( ) or Repaired ( )
l r�l C1�. a.. C_1t,�o j_
by........................................( ..... _...._.._........................ , •Insfaller..........._._..............----•-•••-•••-.......-..........................................
at..................::r.... --- _......`... ....:41. .Ct 'l: tl!!!!� 1' '�-::.. .........
.-
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.__..1. `?— '� dated.... ?......_..............................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................•--......_............_........._-•-•-••-•....... Inspector.................................................................................... ,
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
� .......................OF...... ......................................................
No...f.:................. Fzz........................ j
Disposal 15orks Tunstructiun ramit
Permission is hereby granted................. / ; . " ' °'- ._._..........---.............•--......................._.
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
atNo_______________•-•-------------___--____---______----------____-____.--------------_--_---------•-_-- ---------------••••••-••---•---------------•----•-- --•----•-----••-•-•_--••••-----
Street '
as shown on the application for Disposal Works Construction Permit No......................Dated........._ .��.._.... ?.............
...............................................-=....................................................
Board of Health
DATE............................................... -•--•-._.....__.._.._.........
let.(508)362-4541
939 main street rt 6a fax(508)362-9880
yarmouth port
muss 02675 down cape engineering
civil engineers& land surveyors
structural design June 18, 1991
Ame H.Ojala P.E.,P.L.S.
land court Richard R.Fairbank P.E.
surveys Thomas McKean, Health Administrator John McElwee,P.L.S.
Barnstable Health Department
Barnstable Town Offices
site planning 367 Main Street
Hyannis, MA 02601
sewage system Reference: Sewage Permit #87-78
designs
Lot 11 - Rosemary Lane, Centerville
inspections
Dear Mr. McKean;
permits
Per notice of the Board of Health, dated February 12, 1987, the
plan for the . sewage disposal system on Lot 11 was approved
contingent upon the, presence of the design engineer on-site
during installation and the subsequent certification by the
engineer, in writing, that the system was installed in
accordance with the approved plan.
The engineer was not present at the time of installation to
certify the 25 foot removal of unsuitable soil and placement of
clean fill in its place. However, the system was located on
April 15, 1988, by a field survey and an as-built plan has been
done. The installers records may indicate. stone quantities and
soil removal . We do not .have this information, as we did not
certify it.
The location of the system, both horizontally and vertically,
substantially complies with the proposed plan. The enclosed
plan shows both the proposed and as-built locations .
If you have any questions, please call me at (508)362-4541 .
Yours truly,
Arne H. Ojala, P.E. , P.L.S.
Down Cape Engineering, Inc.
LWH
7,;2 -
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14 27 Lso l,
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,s 0a (7,,Jr; 1-��I r-. � o�,l�l�(� ,�pZv,�oS#=,7 Ex�s'�►�C,
SFVJAC,r o�A�o�
E�btn Of `H OE
l,a i IZo�cMA��( I.Ar�E
A LA H.
ovit. LA �i
Am
Town of Barnstable
�F 1HE
Regulatory Services
Thomas F. Geiler,Director
* BABNSfABU,
9 MASS.i639• Public Health Division
` ♦0
M Thomas McKean, Director
200.Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
e
Date: z- 'Z4 a9 Sewage Permit# Zc�9- 03Z Assessor's MaA\Parcel /V7-4-0-7-6/I
Designer: A- /A3-5, PC Installer: SC,,77— .q. ' -
Address: 97-3 Address: //3
1-6-7S_ 1_e,4, 67 cc l
On Z /3 a$ was issued a permit to install a
(date) (installer) ,
septic system at `a/ A6 S&—x-14VW based on a design drawn by
(address)
5 , t L , S dated Z-A /,a
(designer)
L110 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.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS 5or 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 ner to follow. a 4}
�r=-
t ; �'.
"Ilk
�TtaRHEAt
A.
CIVIL
F,
G1Vdt_4�t: d uY
(Installer nature) No.35461
,Cp• qy, } p�pp0 p �l
(Designer's Signature) (AffixDesigner's 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.
QASeptic\Designer Certification Form Revised.doc
rreoarauon or rians ana wectncations
The plans and specifications.for every on-site system shall'be*prepared as follows:
I (1) every system shall be designed by a•Massachusetts Registered Professional Engineer
or a Massachusetts Registered Sanitarian.provided that such Sanitarian shall not design a
system designed to discharge more than 2,000 gallons per day pursuant to 310 CMR 15.203.
Any other agent of the owner_ may prepare plans for the repair of a system.designed to
discharge not more than than 2,000 gallons per day pursuant to 310 CMR 15.203 provided
they ate reviewed by a Massachusetts Registered Sanitarian and approved by the approving
authority;
/ (2) Every plan submitted for approval must be dated and bear the stamp and signature of
the designer,
(3) Every plan for a new system or plan for the upgrade or expansion of an existing system m
which requires a variance to a propertyline setback'distance,'must.also reference a plan
which bears the stamp and signature of a Massachusetts_ Licensed Land Surveyor in
accordance with M.G.L.c: 112, § 811);
/ (4) _Every plan for a system shall be of suitable scale(one inch=40 feet or fewer for plot
V plans and one inch = 20 feet or fewer for details of system components) and shall include
depiction of:
(a) 'the legal boundaries of the facility to be served;
(b) the holder and location of any easements appurtenant to or which could impact the
system;
(c) the location of the all dwelling(s)or building(s)existing and proposed on the facility
and identification of those to be served by the system;
'(d) --the'location of existing or proposed impervious areas, including driveways and
parking areas;
(e) location and dimensions of the system (including reserve area);
(f) system design calculations,including desiga daily sewage flow,septic tank capacity
(required and provided); soil absorption system capacity (required and provided); and
whether system is designed for garbage grinder,
(g) North arrow and existing and proposed contours;
(h) location and log of deep observation hole tests including the date of test, existing
A / grade elevations marked on each test, and the names of the representative of the
!� approving authority and soil evaluator;
(i) location and results of percolation tests including the sate of test and the names of
the representative of the approving authority and.soil evaluator,
_ ) name and certification number of the Soil Evaluator of record;
(k) location of every water supply,public and private,
1. within 400 feet of the proposed system.location in the case of surface water
supplies and gravel packed public water supply wells,
2. within 250 feet of the proposed system location in the case;of tubular public
water supply wells, and
3. within 150 feet of the.proposed system location in the case of private water
supply wells;
location of any surface waters of the Commonwealth, rivers, bordering vegetated
wetlands, salt marshes, inland or coastal banks, regulatory floodway, velocity zone,
surface water supplies,tributaries to surface water supplies,certified vernal pools,private.
water supplies or suction lines, gravel packed or.tubular public water supply wells,
subsurface drains, leaching catch basins, or dry wells; and the location of any nitrogen
sensitive area identified in 310 CMR 15.215 within which portions of the proposed
system are located.
(m) location of water lines and other subsurface utilities on the facility;
io(n) observed and adjusted ground-water elevation in the vicinity of the system;
) a complete profile of the system;
(p) -a note on the plan listing all variances to the provisions of 310 CMR 15.000 sought
in conjunction with the plan;
(q) the location and elevation of one benchmark within 50 to 75 feet of the facility
which is not subject to dislocation or loss during construction on the facility;
(r) when dosing is'proposed, complete design and specification of the dosing system
proposed including but not limited to dosing chamber capacity (required and provided),
pump curves and specifications, number of dosing cycles and depth per cycle-,
(s) when a Recirculating Sand Filter or equivalent alternative technology is required or
-proposed,a complete plan and specification for the system,including a hydraulic profile;
t a locus plan,to show the location of the facility including the nearest existing street;
the street number and lot number, if any, of the facility; and.
v) the materials of construction and the specifications of the system.
SECTION.- .SEWAGE --------- r-- ---_�.--- F-4�0C14 _MA12-V
ToP'oF L� ATsi< cot?uE� R�S�t`/9 A
SEPTIC TANK — � ' _ „p„BOX — '
TOP OF FDNr . . -
��'d 3 -
(MSL)• _..2..OFt/aTO IIt ZONE it �c, / S .t / -''
WASHED STONE
FR T 20' _ � Oil
Tr ` /IN-
`!J
OUT• IN• cc
6
1�QQG IN. mom 4 ` i> �..
SEPTIC } J
3q.A TANK 2.Q 11 �1 ,. L` \
q�
ELEV. �J�d IQ 1 ,
ELEV: ELEV. „J
ELEV. 0 (1 /
33.�9 �y
ELEV. ELEV. I,C�'
If
/e I �7 (� _�QIaE vF lao I3uFFEiz;z� /r l WASHED STONE t, A�AF
A*J \4 E�. I,E\! I. 0KAU1c�1JW AI.TIA �L L"(jZt� - �Z
TEST HOLE LOG T� i: P go41 = 290' ��dt\/IPn!�Y �ASEMEt`f'f /o' TF 3�0
TEST BY I FAif_)EAOK/ I_Il�t`� Cf�•O,I-I�
I n BEDROOM HOUSE a J
TEST DATE 7- 11- IV• I,E t � DESIGN z� D
rg,
2
_aG ELEV. 7��U ELEV. 3(.J NO
I. aM „ sLlgyol V
/� ,2`j:�. PERC RATE Z- MIN/IN: DISPOSER DISPOSER ` v
`U LEA FLOW RATE/lb i 3)(GAL./DAY)
L E I Ell l M SEPTIC TANK
V'5J= 4 A 333nnn
AtJ REO'D SEPTIC TANK SIZE U
M PI MAVJ N r]Zg.�' `� (
AIJ a ADJ AX023.OLEACH FACILITY �, U�. Ili ,�` S• 42_
T7SIDE WALL ��0 122�2� 5(��=r!nl•�(2 S) _ /S 3. �° G/D. G Q (�
76�_ WATrR 2S,s ��----W40?7 2d'$ BOTTOM /v>!2.2�2�E� o ( /.p ) _ 220. 0 G/D. ��/)`i \ C�I�/IIJIDt�1V�EF11��1-�
D ' �LI�L TOTAL 8 s� _ 3�3.C� 6f ,itl � ! � \ \ C61lIPAt.l1! VASCKAfI I.JT
WEL , Alk/- Z'3U
AVJ 3'Z' USE: . Tti/o �t,ov�ll7 "Fi1IS 3"Tpl�l
2
Zy c L-I%U L�F4 i o'OFF Y�I t D I
YES WATER ENCOUNTERED I� AREA
E/-t
NOTES: (UNLESS OTHERWISE NOTED) a : \ <�- COxI►�1R UI�IKtJ U�.li�l�
1,DATUM(MSL)+TAKEN FR M-__ �I - \ n i �/ (� rr
171C�SlI__l�_-.---._.-...QUADRANGLE MAP - y-� \` AI' FI_,nx- 2S-7 C 1 o F I'/1/ tI\I 1 0l•r1-I2 Z��ri
2.MUNICIPAL WATER_----_-_l .____._____._-.........AVAILABLE
ttO ®�
`A\
4.PIPE PITCH:4. 'PER FOOT I I- -_44
4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- G `--
ARISE H.
5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. N -
M
6.PIPE JOINTS SHALL BE MADE WATER TIGHT �11)Il
7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS.
STATE ENVIRONMENTAL CODE TITLE 5 No. 30792
-�Ils t�1.A►J FOi?ppRURos v.IORK ou�Y AIJP:SNoIJI.p I�OT `a
s� a<<�' o� SITE
PLAN
�E U�,tiD FW PeopE�-IY I,I�IE srAK►I�►U fo ••� ,��� rs� Locus: `,o I I t fZosEtna�Y I,a�IE'
R-
�E►�I0vC U�Ku 1-(PCi�I; soi To Et,. 29 S.' Fob TS' _ G �alar�a: ti� GE►.ITF12 �I.` MA
REG.PROFES AL ENGINEER > H, f �"
ARovuD pEPLALE viral Ct,s►�l WEPIL,0 epLlf2. �t OJALq 1 REF:
�I/ /
.}W®wn Cdpe enfh7eeCIftj �f A�?STTE PREPARED FOR: \JAI,A 0 t`l.�
!r� CIVIL ENGINEERS -
BOARD OF HEALTH ' LAND SURVEYORS --- �� ---
3 1RQiJ1 YOR rt . r ,
CONTOURS (EXISTING)...... i i1C3�1;__ ,Ya�smNr✓r.AlA scALE = V Z 8 A
REG. RVE
(PROPOSED)-O-O-O-O- APPROVED DATE- MA - �'r /
\ 11= R.IJ DATE,. 3� L z
�. 4
9'M/N COVER
ACCESS COVERS MUST BE WITHIN INSPECTION J6- MAX COVER INVERT ELEVATIONS : DES I GN CR I TER 14 : GENERAL NOTES
6" OF FINISH GRADE PORT
FIRST 2 • TO CLEAN SAND BACKFILL INVERT OUT SEPTIC TANK: 34. 55 DESIGN FLOW.
FIL TER FABRIC AROUND AND 2" OVER CHAMBERS INVERT IN DIST. BOX: 34. 47 3 BEDROOMS AT 1 /0 G. P, D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
_ BE LEVEL OVER t/NI r
INVERT OUT DIST. BOX: 34. 3 BEDROOM EQUALS 330 G. P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY.
4- DIAM PIPE INVERT IN LEACH CHAMBER: 34.25 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS
BOTTOM OF LEACH CHAMBER: 34. 0
3.4, 55 34. 3' 11 F
SET. SEE S l TE PLAN.
GAS 34. 0 EST HIGH GROUND WATER: 29. 0
a BAFFLE -34. 47 '0 34.25 _ - SEPTIC TANK REQUIRED:
13 OUTLET - RtAv FILTER FABRIC 2' OBSERVED GROUND WATER 26. 5 330 G. P.D. X 200x - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND
EXISTING D-BOX 9 CULTEC CONTACTOR FIELD BOTTOM OF TEST HOLE sl : 25. 5 SEPTIC TANK PROVIDED: 1000 GAL . EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL
I000 GAL DRAIN C-4 'S IN BED FORMATION. 3 x 3 CONFORM TO MASS. D. E. P. TITLE 5 AND LOCAL
SEPTIC TANK 13 'r x 24 / x 3'd
SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEAL TH REGULATIONS.
� 6' CRUSHED STONE OR DESIGN PERC RATE l 5 MIN/INCH
COMPACTED BASE SOIL TEXTURAL CLASS - l 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
EFFLUENT LOADING RATE - 0. 74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
PROFILE NOT TO SCALE 330 GPD / 0. 74 GPD/SF - 446 S.F. REQUIRED THAN 4' IN DEPTH SHALL BE CAPABLE OF WITH-
PROVIDED: 9 CUL TEC CONTACTOR FIELD STANDING H-20 WHEEL LOADS.
r DRAIN C-4 'S IN BED FORMATION. 72 LF 0 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
I
FR 6. 7 SF/LF-482 SF x 0. 74 GPD/SF-357 GPD APPROVED EQUAL .
6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED
SO l L TEST PI T DA TA & PRECAST CONCRETE OR APPROVED POLYETHYLENE.
R\ CATCH BASIN INDICATES �_ INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL 8E WATER
PERCOLATION OBSERVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE
® TEST - GROUNDWATER OUTLET.
Bk-TAG Bar i5sl I TP s/ P•12463 TP *2
EL-36.04 -yCOV�F�T� , 7. BEFORE CONSTRUCTION CALL DIG-SAFE
r
19 HORIZON TEXTURE COLOR RIZON TEXTURE COLOR 1-888-DIG-SAFE AND THE LOCAL WATER DEPT.
R-52. 50 IA HO
0" 35. 5 0' 35.5 FOR LOCATION OF UNDERGROUND UTILITIES.
T
Z 3519' E FILL FILL
I6
38' 32. 3 24' 33.5 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
. _ DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION ;
f _
OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THt
f \ -
CONSTRUCTION INSPECTIONS.
MEDIUM /OYR MEDIUM IOYR
EXISTING 1' I �� I SAND 616 I SAND 6/6 9. EXISTING LEACH PIT TO BE PUMPED DRY AND
LEACH PIT 3 �< W �\ BACKF I L L ED.
i
' /0. ALL UNSUITABLE MATERIAL (FILL)
52" ENCOUNTERED BELOW THE INVERT OF THE LEACHING
TP•2 ' FACILITY TO BE REMOVED FOR A DISTANCE OF 5'
SOIL REMOVAL AROUND AND REPLACED WITH SAND I N ACCORDANCE
108 26. 5 108' " - 26.5
SEE NcrE lo. , ,,, �� I � _ = WITH TITLE 5.
I 9 CUL TEC CONTACTOR C�7(y�
FIELD DRAIN C-4'$--- �TPrl7 y, ,) ' 120 25. 5 /20 25.5
DATE: JANUARY 30. 2009 •
/ TEST BY: STEPHEN HAAS
/
O �l it / I i m 29.0 WITNESSED BY: DONAL D DESMARA IS
I 1
i
t0 WETLAND r� ' / I I _ PERC RATE. ! 2 MIN/INCH
:
165 P D-BOX I ; cn �W 2 f �� "' V �=q4� STEA.EN yG it
\ 28.6
/ EXISTING CML
'*'J�
SEPTIC TANK p� I \�/ I / yr �?
/
3 28.8 �p / IL
A /
' NN 4
I 9 /
/ I
/ I
° l/
(� YG I NM 5 /
tiC I
1
S EP T / C S ,yS TEM DES / G/V
ROSF-A,-f 1 R Y L_ .A /VE . M,4 P / -47 . PARCEL 007 -
f cF 1
I p
°Fc C7 A R /V S TA p L. E • < C E/V TER V / L L E MA •
I ' 1RE/: !'A RED F_OR
I
I LEGEND
■ CB CONCRETE BOUND �� ��
-W- WATER L I NE S CA L E : / - .2 0 F-E B R LJ,A R
�azp LOT I I O HYDRANT
GAS LINE EAGLE SURVEY NO I NC
o r Py
ao5 _ UPL AND 0NW- OVER NERD WIRES 9 2 3 R o u t 6 A
-LOCUS L IGHT POST _
,55, 425± S. F. TO TA -E- UNDERGROUND ELECTRIC LINE � �� �� Y a r mo u t h p o r t MA 02675
py L L4fBERT -r UNDERGROUND TELEPHONE LINE / / /' //1 ( S O 8 > -361 -32
4 3 2-5 3 3 3
POND -CT V- UNDERGROUND CABL E V I S I ON LINE
r A5 A 4- 40 4 SPOT ELEVATION
,m, 226 AO \ --40- _ EX 1 S T I NG CONTOUR
5 �_ PROPOSED CONTOUR
L S MA o I c 20 JOB NO 09-00 r F /FL D:CF w/EEK CAL C: SAH/CFW CHECK: CFW T-ORN. SAH