HomeMy WebLinkAbout0077 SACHEM DRIVE - Health 77 SACHEM RIB.
CENTERVILLE
A = 209 025
UPC 12534
No.2-153LO
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PROPOSED MODIFICATIONS
WVORCOM/tAUNCRY ROOM FOOTPRINT EXPANSION 3MfICHELE CUDILID, P. E.
Consulting Structural f"n freer
Gntenl •. �t••we u••t•�'�� e''o9
Drown t3y MC Dote: 02 1S 10 1.lrai�OliTI�
j 77 SACHEM RM Scale: S N Tiff Rev.
CEN7t:RV1LLE, MA I cv
i __ File Name: Perkins Project No,:2010-25 e•�
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06/02/2010 2 2:4 1 Michele Cudilc, PE N0.256 04
Ski oT n mtAIINAL SCURICATIMS,
1.AA!)workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition.
2. For%lie location and grading information,see Site Plan,by others.
3. Assumed net allowable soil bearing capacity,qa 3000 psf,for a medium sand'gravel composition. Other soils encountered,
contact the Engineer of Record.
4. alp; Minimum 2g day strength,fc a 3000 psi,3/4'sggregate,designed per American Concrete Institute Code,latest
issue,maximum slump m 4",
a.) Anchor bolts ASTM A307 galvanised,min.5t8"diameter, 12"long,w/2•112"hook spaced 4c,pr in concrete piers w?
Simpson ABU-serial base;SPACED 2'oil for slab-on•�de construction(i.e:Garage). !�
V
1.All workmanship to conformto the requirements of the Massachusetts Smote Building Code,latest edition.
5tr,etutai Sinn Loads'
Head Loads,Actual Wcight of Building Components
Live Loads:$now Load =30 psf(plus drift)with applicable reduction
ATTIC Storage=20 psf
Living Floor a 40 psf
Sleeping Floor 30 psf
Decks and Balconies 60 psf
Wind Load: Criteria used for 110 MPH Exposure B
3 fi WJ S=L (ay required)
a. ASTM A3714 Grade S0:shop paint with test inhibitive paint.Thru-Bolts: ASTM A307,1t2"diameter;punched holes:
9'16"diameter.
b, �E� Shop weld cap and base plates to columns;shop weld bearing plates to beams;use E70xx electrodes.
Alternatively,field weld by certified welders.
c. Deflection Criteria: LA60 total load deflection.
4,'� er Framine;
a.All new timber(gaming:Spruce-Pine-Fir No.2 with Fba11000Ps4 E-000,000 psi,or boner,
b.Pressure treated timber(P,T,)�Southern Pino with Fbw1300 psi,E-1,600,000 psi,or better,
c,Laminated Veneer Lumber:All L.V.L.shall be 1,9E L.V,L.with Fbw292S psi,E=1,900 kai,Fv=283 psi,FcJer 07S0 psi,
Fc jar•3035 psi. Pamilalm(?St)-.All PSL snail be min. I.9E ES with Fb■2900 psi,E•1,900 ksi.Fv®285 psi,Fc_pers7S0 psi,
Fc_pa-2900 psi. Note drat Worollsm and Parallsm they be used interchangaobly,
1, Deflection Criteft U480 Live Load,L/360 Total Load
2. Optional: Provide shop drawing submittal of o tgineered lumber systems for approval prior to materials purchasing.
5aftu
a Mau by Simpson Strong-Tie Co.shall be handled and installed per manufhcturer requirements,with all nail
holes G Ill&wd the size nail at Specified by mftr.or heroin.
a. Raft to Ridge Seam: Simpson LSSU<ti les,or Sltnpsatt Stems over top of plywood,Spaced 48"o1c;
ftaitor to Ridge PJM-. Collar ties nrin.l x6 f 48"o/c at top or Simpson Straps over top of plywood spaced 48"a/c
b. Ratter ands to top prate: Simpson H2.5A
C. Berard)Gist: Simpson at 48"Oic
Harts in wood spell be standard inoehine bolts unless noted etherwise.Solt Was in wood shall be 1132"law been
belt liana ter,Beat he&&at%d setts shall bear on atandvd malleable Iron washers,of square plate washers,Ail nuts shale be
rebi d at comliiietion of job,
7 LWAIM
a.)JlGeekias shall M solid blocking,2x mininnm-and flail depth of member,
b.Stud walls:provide bloehint at V-0"o/e,maximum height. Corners to be blocked at 48"orc with plywood e4ge nailing
to this bllili"for the first 48"of these building corners.
c.SAULLSAWIWL
soil)Bloddng to Soviet 2"8d toanolls ea.side
Blocking ameast S%* 2-10d toelnails ea estd,of 2.16d end-Wis as.End
u
d, HULIngiM Provide U blocking for 2 joisdraf er bays and spaced 48"o!c in joist and MAU plans it all ed F�s
plywooill o4a to this blooltiag
g, MICNELE
AD hug ahali bs in accotdaftce with Appendix 1204 unless noted herein apmtiticaliy. CUOILO
Multiple SAW$ 16d a 12"ahWeftod fro.24774 y
4 Ali nalls tthall bill Irofntnon wire VAillL STRUCTURAL
b.Sub-born where;nits tend to split wood.
9. Headers less dw 41•01,on 2-2x6;all othdra par MA State Building Code Table 5502,5(1)
1g0brk&*Tt'O.'s 110 MYC El UDI
i71, Pa ��1�►ltre M I i to ctme 1 err tr+® t
Drown Br We 41—
0G1*: 1F 0 Drawing
6e;4 raw t V L a cola: AS NOTED Rev, 0 �t '®'
Ito NORM Project No.: !B• w�
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No.34774
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COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION c
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TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 77 Sachem Drive
Centerville
Owner's Name: Alan Randall
Owner's Address:
Date of Inspection: 7/11/2005
Name of Inspector: (please print) Patrick T. Sullivan
Company Name: Ready Rooter
Mailing Address: P.O.Box 371
Sandwich,MA 02563 .
Telephone Number: (508)888-6055 c f =
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the-in,ormation er ported
below is true,accurate and complete as of the time of the inspection. The inspection was performe J based onymy
training and experience in the proper function and maintenance of on site sewage disposal system I am a P:YP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The Sys em: cn M
Passes
Conditionally Passes
Needs Further Evaluation by the Local Authority
Fails
Inspector's Signature: �y Date: 7 /' �6 `
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
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Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
C. Further;Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or the environment. ;
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which,-will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of 'surface water
_Cesspool or privy is within 50 feet f a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety,,and environment:
_The system has a septic tank and soil absorption system(SAS and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is;within a Zone 1 of a public water supply.
1
The system has a septic tank and SAS and the SAS' is within 50 feet of a private water supply well.
_The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other: /{
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Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
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Yes No
Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
Static liquid level in the distribution box above outlet invert due to and overloaded or clogged SAS or
cesspool
1/ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
Any portion of the SAS,cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
Any portion of a cesspool or privy is within a Zone 1 of a public well.
_ Le' Any portion of a cesspool or privy is 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
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0�(Yes/No)The system fails. I have determined that one or more of the above criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
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E. Large Systems:
To be considered a large system the system must serve al'acility with a design flow of 10,000 gpd to 15,000
gpd•
You must in either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no `
the;system is within 400 feet of a surface drinking water supply
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_the;system is within 200 feet of altributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped
Zone 1I of a public water supply well
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If you have answered"yes"to any•q estion in Section E the system is considered a significant threat,or answered
"yes"in Section D above the largw system has failed.The owner or operator of any large system considered a
significant threat under Section or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304.The'system owner shyruld contact the appropriate regional office of the Department.
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Page 5 of l 1
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OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
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Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
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Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes/No
Pumping information was provided by the owner,occupant,or Board of Health
Were any of the system components pumped out in the previous two weeks?
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Has the system received normal flows in the previous two week period?
_ Have large volumes of water been introduced to the system recently or as part of this inspection?
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Were as built plans of the system obtained and examined?(If they were not available note as N/A)
Was the facility or dwelling inspected for signs of sewage back up?
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_ Was the site inspected for signs of break out?
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Were all system components,excluding the SAS, located on site?
Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition
of the bafflesI or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
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Was the facility owner(and occupants if different than owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
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The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes No
_ ECisting information. For example,a plan at the Board of Health.
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Deetermined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable) [310 CMR 15.302(3)(b)]
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Page 6 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):AG Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): � -.p .
Number of current residents: 3
Does residence have a garbage grinder(yes or no):,�. �
Is laundry on a separate sewage system(yes or no)gJ�[if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use: (yes or no):A-k:� 3 = a`3 6� P.Q
Water meter readings, if available(last 2 years usage(gpd))i��
Sump Pump(yes or no):,t,�
Last date of occupancy: <Z �.
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): -and
Basis of design flow(seats/persons/sgft,etc.)-.,,'
Grease trap present(yes or no):_ ✓/
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the/Title 5 system(yes or no):
Water meter readings, if available/
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: .k,��•.,c-�1— - - \1, c� �{�
Was system pumped as part of the inspection(yes or no):A_'XZ�
If yes,volume pumped: gallons--How was quantity pumped determined?
Reason for pumping:
TYP OF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool
_Privy
_Shared system(yes or no)(if yes,attach previous inspection records, if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
Other(describe):
Ap roximate age of all components,date installed(if known)and source of information:
LMti� \`C
45
Were sewage odors detected when arriving at the site(yes or no)A3C::) �`�\ � ���-Z.
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
BUILDING'SEWER(locate on site plan)
Depth below grade: ICD C"
Materials of construction:_cast iron_Z40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK:Z, (locate on site plan)
Depth below grade: l c�
Material of construction: Vconcrete_metal_fiberglass_polyethylene
_other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions: \e J P X S-.. 57/ k
Sludge depth: ,.
Distance from the top of sludge to bottom of outlet tee or baffler
Scum thickness: lf'a," Vz, �
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle: s"7:•
How were dimensions determined:`'— --
Comments(on pumping recommendation , inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
c�r
GREASE TRAP:_(locate on site plan)
Depth below grade:
Material of construction:_concrete_metal_fiberglass_polyethylene_other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
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Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
TIGHT or HOLDING TANK: (tank must be pum d at time of inspection)(locate on site plan)
Depth below grade:
Material of construction:_concrete_metal fiberglass_polyethylene_other(explain):
Dimensions::,
Capacity: gallons
Design Flow: gaarrons/day
Alarm present(yes or no): ;
Alarm level: Alarm[working order(yes or no):
Date of last pumping:
Comments(condition of and float switches,etc.):
DISTRIBUTION BOX:�(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: C-!-')
Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
(no kj-tf
PUMP CHAMBER: (locate on site plan)
Pumps in working order(yes or no): ,
Alarms in working order(yes or no):
Comments(note condition of pump chamber,c /dition of pumps and appurtenances,etc.):
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Page 9 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:_
leaching chambers,number:
leaching galleries,number:
leaching trenches,number, length:
—1zleaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
etc.):
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CESSPOOLS: (cesspool must be pump as part of inspection)(locate on site plan)
i Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool: /
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition ofAoil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
PRIVY: (locate on site plan)
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Materials of construction: f
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
;
Page 10 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.,Locate all wells within 100 feet.Locate where public water supply enters the building.
p5 3 0 0 -�-
Gr! -
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Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 77 Sachem Drive
Centerville
Owner: Alan Randall
Date of Inspection: 7/11/2005
SITE EXAM
Slope
Surface water
Check cellar; ✓-
Shallow wells
f
Estimated depth to ground water 6 feet
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Please indicate(check)all methods used to determine the high ground water elevation:
V Obtained from system design plans on record—If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with the local Board of Health-explain:
Checked with local excavators, installers-(attach documentation)
Accessed USGS database-explain:
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You must describe how you established the high ground water elevation:
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TOWN OF BAMSTABLE E
LOCATION SA e �@ SEWAGE
{
VILLAGE 0� aV A ESSOR'S MAP & LOT �O
INSTALLER'S NAME&PHONE NO. �17# CPA3
SEPTIC TANK CAPACITY o7 CEO �.
� �� a3- y
LEACHING FACILITY: (type) (sine)
k, l0 NO.OF BEDROOMS
C BUILDER OR OWNER
S
PERMITDATE: .3 C COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within.200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility.(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished:by
I . .
L��7`£'
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V.
ELI%-
0 0 - b
0-or
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TOWN OF BARNSTABLE
A'r'r) ^ �r j � w. . SEWAGE
ASSESSOR'S MAP& LOT
LMSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHNG FACILITY: (type) f.-�k.- . Zt`c-Q (size)
NO, OF BEDROOMS��_
BUILDER OR OWNER
PERMIT_DATE:-I .COMPLIANCE DATE:f7 4/--(D<0
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
V��Furnished by ^-�
Fl
A,�) p 14 j ` a
-1
TOWN OF BARNSTABLE
LOCATION � S e ;24 SEWAGE
.,IIULAGE 0� 1& A ESSOR'S MAP &LOT �D
INSTXLLER'S NAME&PHONE NO. Ae�-I
SEPTIC TANK CAPACITY oZ 000 �..
LEACHING FACILITY: (type) (size) a3
NO.OF BEDROOMS CO
BUILDER OR OWNER
PERMITDATE: ,3 LM5 COMPLIANCE DATE: ILOO,4
Separation Distance Between the:
i .
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200,.feet of leaching facility) Feet
Edge'of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
f
r3-17��.C�
TOWN OF BA.RNSTABLE
LOCA'I ION SEWAGE
VII..L A^AGE ESSOR'S MAP &LOT —�
INSTALLER'S NAME&PHONE NO. ,ei-I °C,en
SEPTIC TANK CAPACITY o7 00
LEACHING FACILITY: (type) size) a�3
NO.OF BEDROOMS r
BUILDER OR OWNER
PERMITDATE: G COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within.200 feet of leaching facility) Feet,
Edke of Wetland and Leaching Facility.(If any wetlands exist
within 300 feet of leaching facility) Feet':
::.:::,.Furnished by.. ;. .. ..
TOWN OF BARNSTABLE
LOCATION SEWAGE #
VDLLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: 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
,3
_o .3Y.�
AT
r ,
f k3_ 3)
13
No. 7i 7/ '�. Fee t.
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIppYication for Migotai 6pgtem Cow6truction Permit
Application for a Permit to Construct( )Repair( )Upgrade(>Q Abandon( ) '&Complete System ❑Individual Components
Location Address or Lot No. ''77 S czc."cvK D r i vc- Owner's Name,Address and Tel.No.
Assessor'sMap/Parcel `71 5acL ,-wc j ccnJ_cvJill
/yhf}r✓ 2cxj �//QGC2 Z� b- �
0
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 'tZa-`i 13 1
f�cwlz. N je Z I-folr»�rrr�
�12 /Yl�ao 6f'rccf, QSfzr�vr`/�c �
Type of Building:
Dwelling No.of Bedrooms Six Lot Size Z11 7C0 sq.ft. Garbage Grinder(�)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow v c - r g�day. Calculated daily flow 660 gallons.
Plan Date f/7 z�a�r_m Number of sheets ova Revision Date
Title SnA,itc- 5rskwi Upff P._Vx_ - 77 Skejtrt_.-, Oyiu-e
Size of Septic Tank eldp^n 21-itCM.4 Type of S.A.S. kc-grv, act o
Description of Soil 1 0 vrr-t k,CJ ur(Zm. rKslz.1(c hc�,
Nature of Repairs or Alterations(Answer when applicable)_ Po h.p c_o Rif cx;s h;3, ce_c-�iQrxo
ry,�tacs ta,�?n scol-ic 'f`etviFt n�is�t^i�1'icA+
Date last inspected:
Agreement:
The undersigned agrees to ensure the constructio and maintenance of the afore described on-site sewage disposal system
in accordance with the provisio f the E ironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has b issued b oard H
Sig Date
Application Approved by a Date �f—/3—
Application Disapproved for the following reasons
Permit No. 74f ' 2 Z-- Date Issued 7.t7'r773"
046 `.' Z Z �4.r'` Fee
No. �. z z
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACH.USETTS
ZippYication for Migaal *p!tem Construction P' ermit
Application for a Permit to Construct( )Repair( )Upgrade(X)Abandon( ) AComplete System ❑Individual Components
Location Address or Lot No. C-w+ 1]ri I.e Owner's Name,Address and Tel.No. ( �
C GvAIZV V 1 IIQ
-,,&jAR. 1QR.mI6 TrvS� �f®�
Assessor's Map/Parcel I7�►A/� 247ci� �a4ez. Z$ 77 S&V kA . Dr ikX � 4ty v
0
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
•, f3axFL..- Nye� 1-folvnyrm
' 812 Nam S/rac/-, OSlrrvi//c �
Type of Building: t
Dwelling No.of Bedrooms Six Lot Size Z417CO sq. ft. Garbage Grinder )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 0 gwtfmm-put^fiay. Calculated daily flow gallons.
Plan Date 3//7 ZRMD Number of sheets 4ftZ Revision Date
Title Scto,+_s L r ire
Size of Septic Tank "00 q.kVA.4 Type of S.A.S. kc-mctn F,.L1dt 3`r')c 23
Description of Soil 10 -Vac ucr t 1 c� l�czr�. �5(z IIc ha+�
t
Nature of Repairs 1oorAlterations(Answer when apLp-licabll�e) Puv%l? cjr(shrlol ccs �oc�{S
rc.(�lctcg, :'Col�il SG7�"IC )-4✓I�L � �Ii+Y 1�r lG►1
Date last inspected:
Agreement: /'
The undersigned agrees to ensure the constructi ii and maintenance of the afore described on-site sewage disposal system
in accordance with the provisi s- it e f the ironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has en issued s 'oard. ..�
Sign Date
' Application Approved by Date 3 747'?7 ;
Application Disapproved for the following reasons
Permit No. 7.4-&w -2 'Z Z_ Date Issued Ze f3
THE COMMONWEALTH OF MASSACHUSETTS-,,
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CER , that th On-site ewage Disposal,S� stem Constructed( )Repaired( Upgraded( )
Abandoned )by /�� i'�i b /�i�(/if
at 7 3 4.Cam- " 4� l has been construct d in accordance
with the provisions of Title 5 d the for Disposal System Construction Permit No. �'�� Z dated
Installer Designer A
The issuance of this�p t sha o/ be construed as a guarantee that the sys�m`zyi�71u. ctio a},��es�g: ed.
Date / Inspector r� '��
__ _
No. it�ll/U -- Z ZZ- ------- -----------=—=---- - --Fee �'�.
2U 9'0
Z 5' THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Miopogaf Opotem n0ruction Permit
Permission is hereby g�ranted o Construct( ) . epair( )U grade )Abandp n( )
System located at 77 J C-G
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 o special conditions.
Provided:Construc io mu be completed it i t Years of the date of i e t
Date: �Approved by
•LOCATE N • SEWAGE PERMIT NO.
-7 7
VILLAGE
A & B CESSPOOL SERVICE
128 BISHOPS TERRACE, H ANNIS MA 02601
BUILDER OR OWNER
�AIV
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
FP®IVr-
rb
/ F�$. Oa.��
No.-----•-•-•-_.._.......
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
76 /l/ oF...... .............................
Appliratiou for Bispoiiaal Works Cfuaa.itrurtiou Permit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
.7.7.... .......
Location-Address 7 _ or Lot No.
.......................... 7.r1 ...�CN-�vr �D�o
Owner - Address '
a .1� ........
J .G : Q.a R_>l? �4..._.. 18..,G(sitpf',s 7R/�.._.h!Y1v ! ----------
{4 Installer Address
C� Type of Building Size Lot............................Sq. feet
UDwelling—No. of Bedrooms......................................Expansion Attic ( ) Garbage Grinder ( )
p., Other—Type of Building ............................ No. of persons....._ 1L ................ Showers ( ) — Cafeteria ( )
a 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fi Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
a' •------------------------------------------------------------------------------•-••--.......__..............................................................
O Description of Soil......... /Af .
..........................................................................................................................................
x
----•----------------------.............................................................................................................................................................................
V Nature of Repairs or Alterations—Answer when applicable....//�!.!!S-TF1_L:4------ff._..._.�.,�_ a.....
.pop...............
----------5 -aw. ........................•-•----------------------------------------•---------------------------•---•---.............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL% 5 of the State Sanitary Code- The undersigned further agreIto place the system in
operation until a Certificate of Compliance ha e sued by the bo f 1
e l� a.
Application Approved By----..... '=• -- ....................................................................... t .....
Date
Application Disapproved for a owing reasons:................................................................---------------------------------•---•---------
--------------•-----•-•------------•--------•---------------------------------------------.....--•--......------------------------------ --••----------------------------------------------•-----------
Q"7 Date
U-
Permit No.... -J ...---•--•....-- ----------------------------•----------.. Issued--•------•-----•--•-------• ------
Date
��^^�� A 6v
No._�.`'.._.._f��� Fxs. v.._..sr. .......
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
...._.._�W l..............OF.....
Appliration for Disposal Works Tonstrurtion, Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (, } an Individual Sewage Disposal
System at:
...... ..
Location Address �J�j _ or Lot No. _
l �l3/L/ _"4A4 if/.,'L 4.x.•....... ................. ...d1 �i`�C/.....JV) f_��, Ci>/✓Te/�!//GG.I:...
._.... .. ........................t .-------
Owner Address
M Installer Address
U Type of Building Size Lot............................Sq. feet
Dwelling-No. of Bedrooms..................................---•..._._Expansion Attic ( ) Garbage Grinder ( )
WOther—Type of Building ----------------_--_--_ - No. of persons........ Showers ( ) — Cafeteria ( )
04 Other fixtures ...r....................
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.................... 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........................................
W
Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water................._......
fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
W ----------------------------------------------
•...
•---------------------------------------
•-•--------------------
O Description of Soil-•-•------.1.qr�.r3------------------------------•.....------------------------------------------------------------------------------------....----••------.
W
U Nature of Repairs or Alterations—Answer when applicable..._.. --_-_-L_.�.,J......./4?a4...............
!---------_5?_j�21 zl. -•-•-•------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T ITIE 5 of the State Sanitary Code— The undersigned further agrees/Cot to place the system in
operation until a Certificate of Compliance has'he n ' sued by the 4-o i h.
,rSG --� '................••... •............................................
'gl'1' ...0/.. .........�.
to
Application Approved By..--------- '... _k!_
r
Date
Application Disapproved for e`f.. wing reasons-----------------------•----••------------------------------------•----------------------------------•----------.
............................................................-----••----•-----•-•--------....•--••----•...-•--•-•-•-••••---•---------•-----------•••-----•......•--•-•-••-----------•----•----......-----
Date
PermitNo.--- - ..-......---•--------------------------...... Rued-.......................................................
Date
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Ov 0F......... ` 1�'J`/S
(9rrtifirFatr of TnutpliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired )
by........t;Q-....!=S:..:f...c�..... :5!_........c .............
` 'i Sr/o/, ......... 2 � /�!`/r iVii/i s
... .......... .................
Installer f
at....� ...... ------------- ( .f -.......r...i../G?...G
has been installed in accordance with the provisions of TITLE of The State Sanitary Cod as d23'cr'i in the
application for Disposal Works Construction Permit No.__ _.._ -7../-----_-------- dated_.I/.- . ...4�TIEE
...................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUAR THAT THE
SYSTEM WIL t.FU TION SATISFACTORY.
DATE... .. ..............•--------•-----•---•---•--•-•------- Inspector..... _. _.. ---------------------•----••-••••---------------.._.....----......_....•-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF' HEALTH
'F/
FEE........................
Disposal Works Tonotratinn rrutit
Permission is hereby ranted t?! ..C Si<- c_:�'''!c-�, f / /Ui�s i-, t2
to Con truct ) or Repair ( an Individual Sewage Disposal ystem
at No.. 6EA� ! r>'_ r .,no 02 t�iO.c.i ,oc?: 1'�r-?r�i�Ji- L .
Street
as shown on the a lic on for Disposal Works Construction Permit o .- Dated..........................................
Board of Health
DATE...//.--�```�... ............................................................
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
35.s Leaching Area Requirements
LEGEND Design Schedule ELEVATION g q
BENCH MARK L\ �P� N
H
TOP OF SPINDLE yS EXISTING FIRST FLOOR 41.97' 6 BEDROOMS AT 110 GPD BEDROOM = 660 GPD
WM 4 /
EL. = 39,50' LEACH PIT �� FINISHED BASEMENT FLOOR :_- 33.72
O � WATER .:VALVE a
#520 Q FINISHED GARAGE FLOOR _ 40.42 ADDITIONAL 50% FOR GARBAGE DISPOSAL N.A.
0 35.7 35.2 SEPTIC TANK Gv OUTS 2
GAS VALVE FS SEWER INVERT AT FOUNDATION -_ 38.39,
❑ DISTRIBUTION BOX M,9 SEWER INVERT INTO SEPTIC TANK 38.19'
•�� 0 � IN
#928/5 ® C. METER -BOX STAKE L CUS . O� ST SEWER INVERT OUT OF SEPTIC TANK_ 37.94'
ELE Q - LTAR = 0.74 GPD/S.F
35.' :," �► V SEWER INVERT INTO DISTRIBUTION Bir,( 34.07
-e- TELEPHONE & ELECTRIC POLE rI TREE L 012 - 1 E► OAK O� _( ,
D E C I D U U S V / SEWER INVERT OUT OF DISTRIBUTION BOX 33.87
3 7.0 q-� � _ MIN. LEACHING AREA OF S.A.S. :
oO° v EXISTING HYDRANT PINE STREET SEWER INVERT INTO LEACHING SYSTE•Ii 33.67'
v° 660 GPD 0.74 GPD S.F. = S.F. MIN.
g _ 892 S
2 50.0 SPOT GRADE _
, CONIFER' TREE 012 16 PINE ,
� BOTTOM OF LEACHING SYSTEM 33.0 / /
3s.7 � 1
FLUME OUTLET 26.2 _
Gv CONTOUR .... PROPOSED SYSTEM NO SIDEWALL
36.5 200
LOCUS MAP ss7 S.F.6.636 36.1 - EDGE OF PAVEMENT „ BOTTOM 23 X 39
3 7 HOLLY TREE 010 SCALE I = 2,000
3
• ASSESSORS ._....__ `
38.6 37.8 7.2 C
MAP209
37.7 37.4 v 3-HOLLY TREES PARCEL 25
37.7 �/' 0 36.8 2-HOLLY TREES
1 8 2 ,,MZ� GENERAL NOTES. ;
v o
ZONES
38.8 SER o
• E
3
3 8. vE � ,
a o 39.2 *1' R PREP 1 A.P. & R D-1 ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH
39.2 p•2 '
7. 38.5 0 5 TITLE V OF THE STATE SANITARY CODE DATED
1
38.7 MINIMUMS MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE.
39.7 9 ROE 7 AREA = 43,560 S.F.
GP f FRONTAGE = 20'
40.6 3�• c _ ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING
39.7 9.2 WIDTH 125 BY THE DESIGNING ENGINEER.
40. 39.5 ca FRONT SETBACK = 30'
0 1 39.8 ,RESTRICTION LINE
9. V an 100, FROM POND SIDE SETBACKS = 10'
40. v �'�, REAR SETBACK 10' WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
40. o
H-20 LOADING 2. o c� _ NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT
DISTRIBUTION BOX 40.9 o� r y 37., o BUILDING HEIGHT 30
FOR INSPECTION.
0 40. 10' �`�v $ RELOCATE WATER
MZN LINE AS NEEDED
PROPOSE 2,0t0 GAL. ,� N THESE ELEVATIONS MUST NOT BE `CHANGED WITHOUT WRITTEN
SEPTIC TAN1
ENGINEER.
APPROVAL BY THE DESIGNING
ENGI' .
40.4 40. /
EXISTING SEPTIC o 40.1
SYSTEM LOCATION 40.2 i0�
0 40 3 40.0 35�2 _ r DISPOSAL SYSTEM PIPING TO BE 4" PVC.
BY OWNER FROM st Z 40.3 � ALL SANITARY
z \ .,
NOTES BY 0'
❑MAN CONSTRUCTION o 3 .8 o wA L 3z 33.9
EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING
TNv 3.5 r8 SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER
LEACH PITS TO BE O 39. 0 E�• ` EX�5�1NG 3\ 3
PUMPED & REMOVED i IR�C�E� 33.3 34 39, 310 CMR 15.255,
OR FILLED AS NEEDED
15. ,�� BE 9EGK 33.1 30 / VENT
CUT EXISTING SOIL PIPE ZNG Npus 30.4
vMB NG 1,9� ,& 31.7 23 22.82 a. PROJECT BENCHMARK SEE PLAN
PLUMB TO NEW SEPTIC TANK pL 15�1 A • . .
EX ., 2 32.8 5 ,.
F• E 33i b .' 'a
F• E�, ONE: WALK 2_ / d F, 3 '•' ''• . .. . .; e� LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND
B 3 :, d. . .. .. .. 1-1.5" WASHED STONE o
: :,..': : . •: APPROPRIATE
33 33.431.412 } . ••.a SHOULD BE VERIFIED IN THE FIELD BY THE AP
33.4 0 :... ... •' .. UTILITY COMPANY PRIOR TO ANY CONSTRUCTION.
33.4 •. • .. . '
2 7 ch
PP a •:. .:.. '. . d'' . . • .' ::: ALL COMPONENTS SUBJECT TO TRAFFIC OR BURIED MORE THAN
N o 36.9 3 .3 Z"� . . ' . '; d.: " >. .' 4' MUST BE H-20 LOADING
0 0 0 25.0 . .
W ro e 3.4 0 31.3 •.
•,.a •.; :. a �.•
CD OD
Y
0
H` 22.85
. 5
T A d
3 0 24., .d ;. . ' d H SYSTEM
. ' LEAC S S
3 / A'..L. rir co I a.J a�: 'J�.n[U�iLi. T,v v
TRIBUTI❑N BOX ,
DIS „
22.82 � : .
USE'7 4 DISTRIBUTION LINES
0 2 PLAIT OF LEACH FELD iN A 23 X 39 WAS.QED STONE FIELD AS SHOWN
NO 'SCALE
2bo25.0
Q FINISHED GRADE
\ \ \ \ \ \
\ice\i\i \i�i\i\i\i i\,\i\\i�i\� i,\i i,\i,\i COMPACTED FILL
22.88 \��(/\�/ /�\�/.�\�/ \ \l\ \ \ \ \ \ \�i36 MAX. 12 IN COMPACTED\ \ \�\�!\��,,�\��\ �\�\ ,
��\�\\�\\ \i\i>✓ \\\\iv\\ \ice\\i\\i\i���\ \\\i \\i��\i\ \ y� �� � y i\ `�\�\i \� FILTER CLOTH
...................... ...... . ...... .. ................................ ........ .... ................. ,
O 29. D ......................... _ d 2 PEASTONE
of 2
1 .•
v
.d '• DOUBLE
o- a :: •.} • • • dr.
. ..• . . . d WASHED STONE
y1 �a. r :. d •. •i. '�.
F.�V o
� Fv 6' 6' 6' 1.5'
1,5 6 6 6
O
22.87 Y Q Q
29.9 w LEACH FIELD SECTION
NO SCALE
PREPARED FOR
RAN DALL REALTY TRUST.
22.87
TITLE
20 0 20 40
•,SCALE IN FEET Septic is System Upgrade
:
22.87
SCALE: 1»= 20'
77 Sachem.. Drive
•
Centerville, Massachusetts
Finished Grade = 40'f TYPICAL SYSTEM PROFILE
Exlstin CONSTRUCT ACCESS
NOT TO SCALE M.r BAXTER, NYE & HOLMGREN ]NC.
First �loor MANHOLE OVER INLET C
TO TANK TO A7 LEAST Registered Profession J
Elevation = 41.97' ,: WITHIN 6' FINISH GRADE
Engineers and Land Surveyors
FINISHED GRADE OVER TANK 401t FINISHED GRAD.: OVER A BOX = 40't
FINISHED GRADE OVER LEACHING FIELD = 40't 812 Maul Street, Osterville, Ma. 02655
- Phone (508)428-9131 Fax (508)428-3750
4' SCH. 40 PVC
: FIRST 2' (TO BE LEVEL)
(TYPICAL) -= 4' SCH, 40 PVC 12 <Min> Cover
-6' caw' We 0" 36' (Max) Cover SOIL SUITABILITY TO BE DETERMINED AT THE TIME (.)E INSTALLATION
' PVC o
o' CI tees AS BAFFLE , 4' SCH .40 PVC
Finished 2'Layer 1/8'tol/2 0 WATER EL. = 35.72'
Basement
Floor - 33.72 •.: ..; Peastone
Sloe = 0.005 (MIn )
Reinforced Concret 6' CRUSHED . d
srONE BAs ,
4 PVC/ A. de ATE: 3117100
FOOTING --
a
D
4 a °: •.Y� V �u
_ REV. DATE: REMARKS
BOTTOM ELEV. - 33,0' Ey
_.....
No ®.
GALLON SEPTIC TANK DISTRIBUTION BOX
2000 G = FLUME OUTLET WATER LEVEL w ���, DRAWING NUMBER
TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTA:_LED ON A LEVEL STABLE BASE 26.2 LONG POND FL
a
SEPTIC TANK TO BE INSPECTED & CLEANED ANNUALLY
H: 1 993 93081 93081 CSP.DWG
LEACHING FIELD
93081 CSP.DWG