HomeMy WebLinkAbout0028 STONEY CLIFF ROAD - Health 28 Stoney Cliff Road
�. Centerville
A = 189 017
oo
No. 42101/3 ®RA
100
�I
it
` TOWN OF BARNSTABLE
L DOAs �C ON � forV�x/. C�� 12,440 SEWAGE # �o�a 17
,'�ILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. 06 0i#\�W-14 3 Ski C 775-1"72 fc
SEPTIC TANK CAPACITY (Sr)e7
LEACHING FACILITY: (type) 3 (size) 3 A?< 6 7��
NO. OF BEDROOMS
BUILDER OR OWNER ✓ AU -UJ SMl4,
PERMITDATE: y /SL5 I D 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
• � k
f
No. w Z Fee$S 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIppfication for 3igpooal &pgtem Congtruction 3permit
Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
2Zap ar to
Assessor's cepey Cliff Rd. , Centerville Maureen. Smith
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service Dan Johnson
P 0 Box 1089, Centerville *04 Main St. , Osterville
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Re s i dent i a No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 !U d gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Titlel4r"A'"N3 ENGINEER
ST SUPERVISE
Size of Septic Tank Type of S.A WRITING
Description of Soil sand THE SYSTEM WAS INSTALLED Inl STR T
°O0RDA%^E TO PLAN. 1
Nature of Rep or Alteratiogns(Answer when applicable) Title-5 septic system to plans of
Dan 'o�hnson, #J-749, consisting of a 1 , 500 gal, tank and
3 leaching dry wells
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 Env' onmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this B d ealth.
Signed Date 'A �-
Application Approved by 'T/ Date T• =G �-
Application Disapproved for the following reasons
Permit No. .Z d J 2- " 1-72- Date Issued g-0 I)L-
AL
No. r U� — ' - .µ „ alk" -- r., Fee —
y 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpplication for 35is�pozal *pztem Conotructton Permit
Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
28M Money Cliff Rd. , Centerville Maureen Smith
Assessor's lap Money r'
� -
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson septic Service Dan Johnson
`- P O Box 1089, Centerville t04 Main St. , Osterville
Type of Building: ,
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder'( )
Other Type of Building Res identia'3No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 a od gallons per day. Calculated daily flow gallons.
Plan Date f "" Number`of sheets Revision Date
a- ,
Title
Size of Septic Tank Type of S.A.S.
Description of Soil: sand
Nature f Re orAlterati ns�A s er when a licable) Title-5 septic system to plans of
Ilan pJ'Mson, #J 7n4 , consisting ot a 1 , 500 gal. tank and
3 leaching dry wells.
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 Env' onmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this B d o ealth.,
4_
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. d 2 Date Issued
----------------- ---- —————— --
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Y Smith Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( )
Abandoned( )by Wm. E. Robinson septic Service
at 28 Stoney Cliff Rd. , Centerville has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 fin — 1-7;-2 dated ;L
Installer Wm. E. Robinson Sr. Designer Dan Johnson
The issuance of Os germit shall not be construed as a guarantee that the sy %m` will)function a designed.
Date S � U a- Inspector 1 1AJ 4j -_n,
r
— ————— ----------—--- ----- _.
No. UU a - 1-7)_ F450
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Smith =iqu ar &p.5tem Con0truction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 28 Stoney Cliff Rd. , centerville
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:Construct on must be completed within three years of the date of this
Date: l �S �. Approved by�; �w�A/ �✓�
Q
TOWN OF BARNSTABLE �
LOCATION ,15 !S&al� g_T C1� �rAO SEWAGE # �00a-" 17.E
VILLAGE Cc v-J E&-01 I><' ASSESSOR'S MAP & LOT °
INSTALLER'S NAME& PHONE NO. 06 0'0\S56-1J S' EC. -775-17-2
SEPTIC TANK CAPACITY I50n
LEACHING FACILITY: (type) 3 D (size) 3AK
NO. OFbEDROOMS
BUILDER OR OWNER MI �
PERMIT DATE:CIS I D COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply bVell 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
r'
w
a
x
F
vz �
� o �
No�7s) /S
-------------- �'" O 7 Fps.. ...."`.--'..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD/�OF HEALTH
-O F.....% �fdre...
� a
5 ApplirFa#ion -fair Ui!ipoiiai i Dorki Tottii rurtiiiat Vrruift
Application is hereby made for a Permit to Construct ( ) or Repair ( individual Sewage Disposal
System at e
cati -41dFeA or Lot No.
- .......... ....•-----•-••------••-----_-_-__.._-_....._---___.........•----•--••---•.......................
caner --------------•------......Address
•----•--•-
W Ins tal I r Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms..........................._----------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ------------------------------- - -
W Design Flow............................................gallons per person per day. Total daily flow---------------------------------------------gallons.
WSeptic Tank—Liquid capacity------------gallons Length---------------- Width.........------- Diameter___.-....-.___-_ Depth................
x Disposal Trench—No- ____________________ Width-------------------- Total Length-------------------- Total leaching area-------------.------Sq. ft.
Seepage Pit No_____________________ Diameter.................... Depth below inlet____________________ Total leaching area-------.----------sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by-------- -------- -------------------------------------------------------- Date--------------------------------------..
a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water_____..--__.--.._..._
(i Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_._-----__----.____.._.
O Description of Soil__________________________________ �-_
- - -- ---- - ----- -- -- - -------------------------------------------------------------------------
x
W ------------------------------------------------------------------------------------------------------------------ -------- ------------------------------------ - ---------- ---------------
x
U Nature of Repairs r terations—Answer w pplicab -_ ---.---_ _ _._ ___. _._ .� t(,----_._.-.
Agreem
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has n ssued b the boar
bXhea
•Stgn . . - - - •-`�`�.-•- �--.__..---••-- Vic••-_.��_'�..
Date
Application Approved By.... ...... .....- .................. Date ?�
Application Disapproved for the following reasons:............................ ---------------------------------------------------------------------------------
______________________•••___..-•---------•------------------------------------------------ .............................................................................................................
,ate
PermitNo........................................................ Issued•-•.d� -�'(-- - �---•...........•-••-•-••-•-
Date
t7 b
No.( ........ FRu...;P.r...................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
I ..............OF..... ..`�-t....p'y*.t
, pphration -for Ui!ipoiial Works Towitrurtion Vrrufit
Application is hereby made for a Permit to Construct ( ) or Repair (Individual Sewage Disposal
System
------------ ------ ---- -- ---
att�ii A e or Lot No.
=7
-- caner f' ........................Address...........................................
Install r Address
U Type g :.:. -----...Sq. feet .:
T e of Building `'� • • u# � Size Lot.................... -
Dwelling—No. of Bedrooms..........t................................Expansion Attic ( ) Garbage Grinder.
aOther—Type of Building ._.,......._:............. No. 'of persons............................ Showers ( ) — Cafeteria-
Q' Other fixtures . s
W Design Flow---------------------------------- .... g111ons per pea son per yday-,' Total daily"flow" ____......................................gallons.
WSeptic Tank—Liquid capacity .Y ggallonf YYength ---.i....... Width ......::_. Diameter-............... Depth------------- ..
x .Disposal'Trench,.—No. -_:_-___ -` Width.._ ........ .r* Total Length. ..................'Total leaching area--------------------sq. ft.
-See a e Pit No_____________________ Diameter..._.____...--_.:, _ Depth below inlet.................... Total leachin tre 1 sq. ft.
�. P g p
z Other Distribution box ( ) Dosing tank.-{ k)
aPercolation Test Results Performed bY------------------------------•-=- Date.
Test Pit No. 1................minutes per inch 'Depth of Tegt' it--_____-__----_-:_. Depth to ground water........................
rX Test Pit No. 2................minutes per inch De 'tfn'of Test Pit..........___..._ . Depth to ground„water,..-------------------
..
�' -4---- --: ------ i
O ' Description of Soil--------------------------------11' , +� ----------------------------------------------------------------
x i
c.,
W w ---
--•-----------------------------------------------------------------------------
C� Nat re VIR� irs r terations—Answer plicab __,�--..---- - -_�� _____ _ _:Q� J'"""•' '___....�? t -' '�"`'��--- -- --------------
Agreem
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has. en 'sued b, the boar f 4ea
Sign - ✓"3''►
Date
Application Approved By.......�; . -- . ----------------
..... ��'t''� b � � �' ��•...
- -
Application Disapproved for the following reasons:......................................----------------_---------- -------------.---------na----------------
• 4_
---------------------------------
--------------------------:................................ ....................... r............
Date
PermitNo.......................................................... Issued.............. ............. -------
Date s,
THE COMMONWEALTH OF MASSACHUSETTS�
BOARD F HEAL H ,
ro-ZA)........,...OF...... .........................
Trrtifirate 'f 0,11MViianrr
THIS IS TO E FY, That the d- idual Sewage Disposal System constructed ( ) or Repaired (v")
00,
by ^^. nstalle
._-"-4. .... ........... - /---------- •4 -• •.• �. '.----------------- ------.................•--------
has been installed in accordance with the provisio f:•art- e X The State Sanitary Code as describe in the
-----' "' dated--••'..............................
application for Disposal Works Construction Permit No--- ::'7 _: 2
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A G ARANTEE THAT THE
SYSTEM WiLVFUNCTION SATISFA`GYORY.
DATE. �.........---•-----------=1..��1 -•--•------•-•---------- Inspector G -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD .OF HEALTH
17 r 2 ........ ......o F..... f' --
No. FEE----------
4, F . !rante
iI 'a tt .'arks un ixrtioat err tt -
, -
L' Permis ' n is hereby g ______/___ � �. � — -
to Constr t , �) or pa an ividual Se e Disposal ys
at No... r �D�'C 1��j�� .'( ..�...---•-•--...------.
as shown on the application for Disposal Works Construction/Per
0....... . ated
--'--7 _.-_--. � e4e .........................
Board ofHealth
r �
DATE.... -------- ------------------ ......---..........--------------.. /
.a ',FORM �2,55�MH;O'B WARREN. INC.. PUBLISHERS - -
L
JUL-18-2002 09 :51 AM DANIEL JOHNSON 508 420 9316 P.02
D ME 6 I4i SE i.i C f.AC O yii I ZS .
804 Main Street, Suite B
Osterville, MA 02655
Tel : (508) 420 - 1904 F
Fax: (508) 420 - 9316
Daniel E. Johnson, R.S. ,C.S.E.
i.
i
July 16, 2002
Board of Health
200 Main Street
Hyannis, MA 02601
RE: Septic System Installation
28 Stony Cliff Road, Centerville
Dear Roard of Health:
The septic system upgrade at 28 Stony Cliff Road was installed in
accordance to the approved septic system plan prepared by
Domestic Septic Design, Inc.
I thank you in advance for your attention to this matter. If you
have any further questions, please do not hesitate to call.
Sincerely urs,
Daniel B. Johnsen, R.S. , C.S.E.
DOMESTIC SEPTIC DESIGN, INC.
804 Main Street, Suite B
Osterville, MA 02655
Tel : (508) '420 - 1904
Fax: (508) 420 - 9316
Daniel B. Johnson, R.S. ,C.S.E.
April 17, 2002
Tom McKean
Board of Health
200 Main Street
Hyannis, MA 02601
RE: Revisions to Septic System Design
28 Stony Cliff Road, Centerville
Dear Mr. McKean:
Per the requirements of the Barnstable Board of Health members at
the Board of Health meeting that took place on April 16, 2002,
the leaching area has been redesigned to meet the capacity of an
existing four (4) bedroom house. The new leaching area is now
comprised of three (3) Dry Wells with an overall dimensions of
3 2' L x 13'W x 2' H.
I thank you in advance for your attention to this matter. If you
have any further questions, please do not hesitate to call.
Sincerely yours,
A�'-11 12)
Daniel B. J nson, R.S . , C. S .E.
President
r
Commonwealth of Massachusetts U '
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector:
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 16.000).The system:
® Passes ❑ 'Conditionally Passes ❑ Fails
❑ Needs Further Evaluation-by the I Approving Authority
4-17-14
Inspector's Signature Date
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.
****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.
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M s 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304'exist.Any failure criteria not evaluated are
indicated below.
Comments:
System is in good working order with no sign of failure.
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complyingse tic tank as approved b the Board P 9 P P pp y a d of
Health.
* A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
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 a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
L
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
oc�M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
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.
❑ 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 fecal
coliform bacteria indicates absent 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:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes"or"No"to each of the following for all inspections:
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 an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/z day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
m
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
- 9 p Y rY
�qM 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® 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.
❑ ® Any portion of a cesspool or privy is within 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 fecal coliform bacteria indicates absent 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
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
1 0,000g pd.
❑ ® The system fails. I have determined that one or more of the above failure
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.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400'feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
L. I
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
C. Checklist
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?
❑ ® 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?
® ❑ 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?
® ❑ Was the site inspected for signs of break out?
® ❑ 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 baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined 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(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°7M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is Centerville MA 02632 4-17-14
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection
information in this report.) ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 3-2014
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): canons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
i
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
° M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
I
General Information
Pumping Records:
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type 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) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�qM 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. CityTTown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
2002
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 12"feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank (locate on site plan):
3
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500 gal
Sludge depth:
12"
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
20"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
Grease Trap (locate on site plan):
Depth below grade:
feet
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:
Date
t5ins•3t13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
l
Commonwealth of Massachusetts
_ W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert;evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped 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:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form!Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Good condition with water at working level and no sign of back-up from chambers.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town . State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 3-500's
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching 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.):
Leach chambers in good condition and empty at inspection with stain line at 6"off bottom of chamber.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
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 ❑ No
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. CityTTown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
- - .k
I
-C-30ir � •
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 12'+
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
® Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database- explain:
You must describe how you established the high ground water elevation:
Original design plans show no groundwater at 12'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
28 Stoney Cliff Rd
Property Address
Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)
Owner Owner's Name
information is required for every Centerville MA 02632 4-17-14
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
SEWAGE# ...
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Town of Barnstable
Board of Health
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,R.S.
FAX: 508-790-6304 Sumner Kaufman,MSPH
Wayne Miller,M.D.
April 19, 2002
Mr. Daniel Johnson, R.S.
804 Main Street
West Dennis, MA 02670
IN
�.:._�s: s.,>.� steer ,. ,�`.•. ,,... «.':,�, ox�'? .n8 .. ,az< t �' f.
Dear Mr. Johnson,
You are granted a variance, on behalf of your client, Maureen Smith, to construct
an onsite sewage disposal system at 28 Stony Cliff Road, Centerville.
The variance granted is as follows:
PART Vill SECT 1.00: The soil absorption system will be located 81 feet away
from a bordering vegetated wetland, in lieu of the 100 feet
minimum setback required.
The.variance is granted with the following conditions:
(1) The applicant shall either (a)" submit a revised septic system plan
designed for four bedrooms or (b) submit revised house plans showing a
minimum five feet opening (without any doors) to the family room, or (c)
submit a copy of a recorded deed restriction, signed by the owner of the
property, at the Barnstable County Registry of Deeds restricting the
property to three (3) bedrooms maximum. A copy of the recorded deed
restriction shall be submitted to the Health Agent prior to obtaining a
disposal works construction permit.
(2) The septic system shall be installed in strict accordance with the
engineered plans.
(3) The designing engineer shall supervise the construction of the onsite
sewage disposal system and shall certify in writing to the Board of Health
Smidim
that the system was installed in substantial compliance with the revised
plans.
These variances are granted because physical constraints at the site severely
restrict the location of a soil absorption system. The proposed new septic system
is designed to meet the maximum feasible compliance standards contained
within the State Environmental Code, Title V.
Sincerely yours,
Susan G. Lsk, R.S.
Chairperson
Smithm
APR-12-2002 09:02 AM DANIEL JOHNSON 508 420 9316 P.02
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APR-12-2002 09 :04 AM DANIEL JOHNSON 508 420 9316 P. 04
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APR-12-2002 09 :04 AM DANIEL JOHNSON 508 420 9316 P. 05
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Oj DATE: / o�
'DIVE® MAR f2p
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tsanrr = TOWN OF
sb a` 1 4 2002 HEALF1sC. BY
�Uv HEALTH DEPT.
oWn Q amgt�D. 711:45/0
�
Board of Health
200 Main Street,Hyannis MA 02601
Office: 508-962-4644 Susan O.Rask,RS.
FAX: 509-790.6304 Sumner Kaufman.M.SP.H.
Wayne A Miller.M.D.
VARIANCE REQUEST FORM
LOCATION
Property Address:
i
Assessor's Map and Parcel Number: 1199 Z/,? Sue of Lot: /s C O o t Jr-
Wetlands Within 300 Ft. Yes X Business Natnc: N I A
No Subdivision Name: I
i
APPLICANT'S NAME: j AV LrC. J0#1V CVN Phone
Did the owner of the property authorize you to represent him or her? Yes No
PROPERTY OWNER'S NAME CONTACT PERSON
Narne: /w4-��t t���! Sri r T/> dame: b,+N/L L
Address: X t S Mk y Lit l'F Gi-4,6e'trC�2v'u.-Address: f3 4 j -4 w ST, 1.)r Te, B 0- it evIcLta
Phone: -7')/ - 13S'o Phone: 4Z-a " 19 v q
VARIANCE FROM REGULATION(uat Reg.) _ REASON FOR VARIANCE(May attach if more space needed)
/ /j JAI �rTff/mot !�c/=J G��T(J4it/6J0 - vSJ%r/L/�•titT o,oew jP,+<.E ON e,tape'-1wry
M .—.4 i.v r'4I AI !o u f r r
NATURE OF WORK: House Addition 0 a:,000 House Renovation C3 Repair of Failed Septic System
Cheat(to be completed by office staff-person receiving variance request application)
Four(4)copies of the completed variance request form
_ Four(4)copies of engineered plan submitted(e.&septic system.plans)
_ Four(4)copies of labeled dimensional floor plans subrmtted(e.g.house plans or restaurant kitcher plans)
_ Signed letter stating that the property owns authorised you to represent hitryiter for this request
_ Applicant understands that the abumers must be notified by certified mail at least ten days prior to meeting late at applicant's expensc
(for Title V and/or local sewage regulation variances only)
_ Fun menu submitted(for grease trap variance requests only)
_ Variance request application fee collected (no fce for lifeguard modification renewals, grease trap variance renewals (same
v+mer/leasce only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems
I [only if no expansion to the building proposed])
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Susan G.Risk,RS.,Chairman
NOT APPROVED Sumner Kaufman,MS.P.H.
REASON FOR DISAPPROVAL Wayne A.Milky,M.D.
Q:\HEALTH\WPFILES\VARIRF.Q.DOC
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TOWN OF BARNSTABLE
LOCATION o r SEWAGE #
VILLAGE ��`. h-1 ASSESSOR'S MAP & LOT 3
INSTALLER'S NAME & PHONE NO. � @CO
�.) SEPTIC TANK CAPACITY A&P-6)
I
LEACHING FACILITY:(type) l/x s (size) Ll -
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER-A fA
BUILDER OR OWNER 0/1,
DATE PERMIT ISSUED: /d
DATE COMPLIANCE ISSUED: /Li
VARIANCE GRANTED: Yes Now
f
5N ��
ASSESSORS MAP NO:
Nu....: PARCEL
o... F�$...120.00.......
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.........TOWN .....................OF.......AARNSTA$LE........................................................
Appliratiou for Elispoiial Works Tun.ftrurtiou Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal
System at:
_ 28 STONEY CLIFF ROAD, CENTERVILLE, MA_ 02632
.---......- . -------
Location-Address or Lot No.
MAUREEN C. SMITH
W Address
a ........................
Pq
Installer Address
UType of Building Size Lot............._-_-----_.-Sq. feet
a Dwelling—No. of Bedrooms....... -----------------------------------Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ............................ No. of persons........... ..._....._.__.. Showers ( ) — Cafeteria ( )
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 ( )
a Percolation Test Results Performed by......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....................
Description of Soil.......G RAVEL
--- --------------------------------•-•-------•-------... -------------------
•---------------
--------
.---------
•---------------------------------------
U --••----------------------'--------- .............................................-.....................................................................................................................
W
U Nature of Repairs or Alterations—Answer when applicable.__TWO STONE PACKED PRECAST_-GALLEYS............
---------------------------•-------•-----------•---•---------------•-------•------•---•----------------------------------------•----........._.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of 1 i fit...
J of the State Sanitary Code— The undersigned further agr snot to place the system in
operation until a Certificate of Compliance has been issued t Abo Iealth. _Signed--•• -•-•----'•--......----'... �0 �d '�r
Application Approved BY ... 3 V-----...... -------•------••- � `--�
Date
Application Disapproved for the following reasons:•-------•-••---...--'-•--•---•--•••---------••-------------••--•-----•--•-'•-'•----
. -•-----•-----------------•----•-----••---•-•--••••------'
g- [,l Date
Permit No.---•-J�....15.-�--/•--•.................... Issued_
Date
`'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN......................_OF......},.MSTABLE............---------•----......_..---------------------
Appliratinn for U44posal Works Tonstrurtinn rruti#
Application is hereby made for a Permit to Construct ( ) or Repair �:X ) an Individual Sewage Disposal
System at:
28 STONEY CLIFF ROAD, CENTERVILLE, MA. 02632
.....---•-----•--------------•------.....--..................--------------••-_.........---•------ .....--•---•----•-•....--•-••-----•......•--•-•------•-•------------------------------............
Location-Address or Lot No.
........................................................ -----•-----••-------......---------------....----.....----•-••-------....-•---•----............•_.
O er Address x
a ............
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.....3........................ .....Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ............. p 3..............__ Showers ( ) — Cafeteria ( )
............... No. of ersons____.__.._.
P4 Other fixtures ..........................................----
� -------•-•---------------•-----•-•---•-•--•----•---•--------•--•-------------------•------•---._...
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
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........................................
as Test Pit No. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water......................
rZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 •-•------------•------------------•---------------------.........•----•-•--.......-•-----•----------.........................................................
0 Description of Soil......GRAVEL
W
Z.
Nature of Repairs or Alterations—Answer when applicable_TWO STONE_PACKED PRECAST_-GALLEYS____.__--••--.--.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iiT of the State Sanitary Code—The undersigned further ag es not to place the system in
operation until a Certificate of Compliance has bee�issuet bo health.SignedC� .--- --•-•---- ---
Date
Application Approved By----------------••. ................... ......./o.....e:= ��
Application Disapproved for the following reasons:--••-----•-•---•----•--•-•.••---•--•-••-••-•-•----•---•-•----••-•-•---•-•--•---•------•-••-•-••--•---•---•-•--
..---•--•-•------------•----•------••-----•-•---------••--•-•------•-•-•-•----•---••••----•-•---•--------•---•-•-----•-•-•---------•--•--•-•-•---•-------------------•----------••---- .................
Date
PermitNo.--_ s..,�---------V------------------------ Issued.........------------------...-•-•-------------•-•--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....-TO14N..........................OF............BAItNST,F......................--•-------...............
Qrrtifirtttr of Toutpliunrie
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X )
by CETT CONSTRUCTION, INC.
.--------•---------------- -••-----•--------•--•---•-•-•-•---------••------...._---....-------------------•--•-------•-•----•--•-..._......•---
Installer
at-_ 28 STONEY CLIFF ROAD CENZERVILLEI MA. 02632
has been installed in accordance with the provisions of Ti T E j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No............................................ dated__..._-____._.___--._.___.....................
TIME ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY. 1�
DATE................. " I-3..-..� .......................... Inspector......---........�....1../..................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�,l .....OF............................................•---...........
��O O �. `_�•-. FEE........................
• �t��rrrs�l nrku �nnu�rttr�Uan pruti�
Permission is hereby granted.........................................................................................................................................
to Construct�-(7 ) or Repair- ) an Individual) Sewage Disposal System
atNo------------ ���•Y�...... ----•--------••-------•.......................................•-
Street 1-
as shown on the application for •sposal Works Construction Permit No_____
•..............•--••----•-•-•------•---- ........................................
Boar of Health
DATE............... --------- 3-6----------
FORA 1255 HOBBS & WARREN. INC.. PUBLISHERS
-- „_
77
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...i ..i i:'::
E C TANK
,
PT ,x
.:. ".: i'
O 1. N y : r
MD DEL:TK• N 1500 HEA CO CRETE I. ::' '
1S ) R EQUIV NT
.
-. ,: ,. Ally
Sc4cE . - ,
FINISHED GFIAOE
,
- 9
,. D n e John so E.. _ .._ `...'_. ',
Performed By. a i 1 B s n, R.S. , C.S. _ _
24 to 24 DIA IN
w. p g 24
DlA
. -,,
,
:,•- :,_ '
, -, , date January 31 2002
,, ;,
,. .. . 10
.>,t ,. ,
.,
3" S,. H.
.
_' , .
TP_1 AIL. = P9.9) s" ,
,„, 6'
. 4., >
C E Of I .
E �' 5---� B o G ti.
0" - 18" AI Fi 11 Loamy sand 4"SCH 40 14"
Bob ;. �. 117 ZAB&L FILTER A•100
Flaw LE
18 35 BwB,10YR5/8 Loamy sand
SEPTIC TANK TO MEET r, 4"SCH 40 TEE
35 102" Cl, 2.5Y513 Fine-med. sand 4'LIQUIDLEVEL REQUIREMENTS OF. . .. ,.�.�.- .- '.--.,.._..,. • . 102 2" C 2, 2. 5 Y 512 >'i A4 s t3 n d GAS BAFFLE 310 C MR 15.226 FOR
No C7bs+��cved ESHWT ;
4"SCH 40 WATER TIGHTNESS,
f TEE ETC .. No-t?bserved 'Groundwater E
._. . _ _ _____._ ALL WALL SLEEVES/GASKET5
SHALL BE CAST IN PLACE OR V. (MIN.) p:c t? MECHANICALLY
. P18RCOL�1'fZtRi 'P'1'$'�` t�A'1"A INSERTED AT FACTORY 0 COMPACTED
/00'o 0
' ;, 1 STABLE LEVEL BASE CRvSHEa STONE
1a.�t January 31, 2002 ! <41VDIA,
gi 1� ' SEPTIC TANK DIMENSIONS: 10' 6"L X 5' 8"W X 5'9"N
- -. /
Soil Class: Class 1 10.74 G/SF')
1
-•. Wooa ^-, .
-- - - ._-.._.__.._
- Fero i�4tC+ : ? MF3 tTP-1 )
. - "
.
_.,,
- 1x F L�+Rt th . s E' j" "t R : !"3►• ,. N I DISTRIBUTION BOX
9r vs t 9u. - P 3
91- --- 13 , s 1
.____.�_�___--�
H• 0
4 Ai 73 -- : ' 8CR>M = or 1114VATIONS + REMOVABLE COVER I� ,
4 SCH 40 QUfiLET LATERALS •
7-- - - -11 . . {DISTRIBUTION BOX TO MEET SHALL BE SET LEVEL FORA
Mg,•,gRANE 99 ..- ,
MINIMUM CIF THE FIRST .
InV tat 1"o>arldst.itala (tlxx<:It itz ) REQUIREMENTS OF310CMR fiw+0
SSE & l
_. t�x1 TERTIGNTNESs. FEET AND CONNECTED TL1
9�f' r ', A�' c��' xnv, , 1ri Septic 'Tank �7 .00I „w. , -. , .
,e A , ,.
(�rA EACH DiSTfliBUTiON UNE .
_ GLINSTRUCTION,I~TC) -�
I t �,
,, V. KE Inv, 0 a ep :1e T41nk tt . 7,x """ WiTHI3OL10 SC.TI/OPVCPIPE .
Q3 LO" „ 9 ,
I Inv lrtt pi.stt"ik�utioh Boast . 7A t SCI+40
.... NO,OC OUTL:ETS 2
DAY WELLS 6 „
. V C1 t 1 ......,.., _..,..�,
1ri Out Distribution ox >.'s .
L,� i3 w><A N
-- q : ��1 t�ni6 ,+
j 0 0 , a MECHANICAL,LYCAUSHED
,o Trio, 2n Laahi,tl t,V1_ltG �L� 0 6 (M►N) o 1
9 .0 ry3 �_ ° ..... ,...,.. . . "�. 6TON1: (<•311+c 0111.►
oar;4 �t Bot om of Lo-ac iinq Dr W�1 lI� �� ,'4A
STABLE.:LL BAq ,
Er 1, I ... S Sott. ('S P 1 } No obs , aw/t�i}3W`C OP , 4
F t,PSIr1r ,+ G#3wi.P641Ls
.✓ - , D
set tore Q y,I
N
L>6
, ,x- I-„ . - - 0., 1 f 0 0..,& t.vPN, . ' LEACHING DAY WELLS •5M GALLONS
0 98 L'gDy ' SLsp'trLl7`�►•�IhC; Existitto Contour .. .. .: ��i .. .. ., .
i *TND"C SS SECTION
o 'A '' - .,
At?
b
S NGNr►�Flt.k i"ro h ri C:o n t'Gu r MOf�l=a'1. smonre p1�row CONME TE
o�cr; to al ""'"� FIN t CR O!• TL18F S A LtTF t�
PfSaB"�L,?tcto
t A A , T 81
99t3 fo�Gl r@ Ct ( LOP'h
j " . 141 T� 7 es1~ P!•t ```, F�NI''HCD iT1iA E a «.02).
r ,,.,... F0.N0A-rioAt: -7TFR1 I I to 1 11�
.
Firli;rheci FlAor £:levatian FPE " ( 'IMN}
. T, 10
H.
fFE=Iv4D7t Basemrant~ Floor Flevatign BE ,M...�.�.., a
,-
la��o 0 3
a
f'rx7 LEACHING DRY WELLS ' 0 -
11
Bf E° n'l t � IV L X 4 1 Q' W X 2"I H
.I.II 4;%:-.I.d,V'I,�.A..�--..1 1.I�1,,,
..l
..I..-r rI
S�-.--o�
i I ca , 14 T 1i2"DOUBLE
WASH iEA STONE
Water i n e ------ W............» °�1 , 3.6'
�1--I",t-�-
.R:.It r�I-
.I�fl.-I�.
.-
I-..
-N,�DX0-:�I�
II�-I.I-,.'
.,O_II,I_11.I�-II.
OVEFIALL LEACHING,AREA 314"•1 UT-DOUBLE
3A'L X 13'W X 2'H 71' WASHED STONE ,
. = .
r . '
0 a5r) 3 LEACHING DRY WEU.S
. W t0 CDMFLY WITH THE
.c 8'6'
..-_.- ._______"-"_`-I REQUIREMENTS OF
_ ._ ~_
. I 31fl CMfl 15 2'St 'r
. •. „_�
.
.
I.r,�I...UU��iI"I,.
, , . w
' R ,zc .
too,oo NOTES .
�s
.
f
ow « e L �` t! {1
'�f O .
�y p ,' > r 0 e
'o�. w E 0o 1 All ..onstr ucticn methods shall conform to the Title V 310
o t ► F r,� _
. , : <
. ; , ,, 1 ce" •` aew N �� «+ CMR 15} and the Barnstable Board of Health Regulations.
�' LA ��x��r° 0: j 4 ,
. .: t#OISV 4t drrow oAfA
Ko -V 4 : , „ * 2. There are no known rivate or tabiic well w ;
R:,f F P s ithin 100
- F. x, .
• ► )/w �� , „ feet/400 feet, res ectavel from th
r. r� Iot�S P Y, a proposed leaching
�• + �► r x
____-._.._ . , 4 area.
�+r�
Nt 4� * 1 w v 4, w °
f c 1l. M I' �h '
4 E}{18t1n Ce�S ols
w cNAp. �' 9 Po t4 be pumped `and removed rior to
mow° t ,, t o P
„' 1. ; . , , Fro o,t�, t r i n s t a l l i n ; . . '
a�� It 0• i��ti o g the new septic tank.
�� y �:��
M D p� .
TJ O W4 1{ y .
4 4 . C Chan E!8 ar ,..
E IvI : r r,,� F g e t0 be made in the field without the a ,oval
P< o f r`E of '1 L SY ST �r"c & 4 � �- +r pP
c . of the Loard o, Health and the design enginQer.
. :.- ,' ,. + _ �+G}1I1Z '"lam MC�� ��4tLLt�
fFE- 1og1
7t SC,tLE ; �4S Sffo,.0- t � 4wt.NTrER
o �,,
��+ �/ �. ��ruM s. Prt�posed leaching area is not designed for use with
�.. f
IS
A `%*% « . ;. ''$7r* ° A` b g{axbagt disEio €t' .
109 „ r f YiYt, - *1'�#R �rNr ♦ ��dr r rA
`t�Ds �,,� p .N'y''4 R e . ,A 6. rontrac;tor to not.f,fy Dig Safe 77 hours prior to
.
,
,gil y"`{�� `• 4t'l.0 , 4c const tact i-on . (80q} 144-7233.
s +sue 40°� 40 9F VW � odc (
. . �cr 7
P r'oa o rt,� , p y lima infdrrnitic�n taken from Subdivision Plan in
.) I; �i JMtit' r a .
.1�IY/r ► pet Cotitc rviIIc (Snrn,it.at,Io) , pr'eparod by CharIe'I Saver Co. ,
,t,�
So t: 1,E_ Flan riot to bra u'�e.
1oa i + , , � „ ^ +`,. ' �,�►� � fat e�.i Ai�ri1, 15, 14�",C. G' P d asy
. t 4 „ol. �' . .00 ,N I x,� ., ,r:, 1 i.rsr ~ ca r Vy y.
P . It mravO � i'0et. hor can :A �
.,: A � � ix t l iy arc �rnrl t1y�r per Pased .l, tac hind ar..c <
• «. t an vrx't,ica11 a �r�axm?1t a. . :
Yr P CA y 3 1 ,.et (trl,sQi1 , , crt.stl ,
o (ll )ADd r0pl.ACO with TiLlo V i'1.11 (1tr+E tF�nCt, )lfl CMF�
1 c �,,� Efi57•/nt6� 13Ir
1 � . + i'o r. :4} r` ific`atior:;s cat t�;ill (stand) ) . The t:c)tal. amount
(It C111. rr>gU1x-od is �approxim te.ly 70 cubic nrds.
``. F o y
9 `� : I
• '
t.9f ?exo VI4AIi11�eZ: larnakabl• B.0,R Rog*.
Enr5riNG ` •
3; 97"0 1 . Res u�3 t varl ant., ► to rods 'co t he of f'sa�t of t ho f'rc� aged :
D ._ ___._ % ,`,` ! IOAC,hing 6rear� t O the. Adge, of thc� Bo from 100 Fe( t:' to 81
bfE- qp,l ! 5
.f00t, SOCtiOn 1 . 1 Goner-al Roquiroments (1 . 13) .
9�,00 i _ I . '----- ----
,)S ��~ >hu CALCt? ATION8
, �EiN
,t ,s3 a
y6k
h ,
. b,R� .a;, or�E , t 9 Bedropm: (Exist lri } .
yb, o gts" IN, 0 '�
,
,
i 1.10 GPD/Sed.room h I Bedrooms - 44�
1 �, GAO ,
. _ TP-•1
W ' .
1
Pe`r.colat, ion Rate < 2 MCI ( )
.`'
c : , Sail Cl,t3gs : Crass 1 (0. 74 G/SF')
„
4
94 t TK-I Q Q ri 04 r' - , , , . PROPOSM L1 C8IN�'i MA: .
T)(5 .
8 X
•
X .
„ , ,
3 -EA
=e; ,
." - r. ., ,
hng r Wells• 3at3d h 3W7H
> o i "' L - ��.+ Side tea: 180 SF ?� 0.79 G15f 133,E GPD
.- /Soo &4 LC n/ Da- W C LLS , s ��hMB -
1 - ►� r :',
y /1ra '•E. ,? ., .
IT i p .' 4 G F
TANK ,>-, _ 93D J, :.;. /S a�. .,
g S£PrrL 3;,L, 1I v� ti;ff ,y; a` �n >nf rl' �tr .4r 8attom Area • '916 F X (}. ?
M 1"?. I'4a1 Leadhin Ca aci :
94 -: : I 9 p tY' �191 GPD .
' ` � ' �ljCW e o k 1,o c./�rt 0 A/
O
.y4f r+� : i
" "S " ort ,
^ ME 1�C,
.
-
k
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n'
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Y ,
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f ' • ,Y.
.,
_x '
, e� 9 1>�1 !t
e�l�ll�Q t;t.'.4 cr�ine� ,+A-e.q TE9 /N c2�'tSL' t�¢f'
,. , ., ��,r� b a ,-P, SUBSURFACE SZ%AIGE DISMSAL SYSTEM ,
. K_ o M -� t3 0.N MEe o 9l t ! �.
, .,
. ; ,,rv .,, T L', 28 Stony Cliff Road, Cantorvill� '
=j
�r � r
^o T.7c+a." , ,-+i �,_ u�IVe.� 1,, APPROVED BY
S I r� .n•�t^�ty► SCALE' DMWN BY
/►�
,, '
'.? �' A ;4
S. r o I I . I el D TE: /
} F r ' 2/25 02 Daai�l S Jot�tu�on D•71.:2ofmMpa`d ,.,at °:
ti
� , ;,, ! i -
r... , j f,` �,.,''r:�. 't, •fit
l/axr..n ttsith (SOtiy Tti oaso
W e g -; .. "r�';: ,,,.,.,-:"':..--.. ." t':; Me�rt font lii 'llod, °atforril3.°, 11S 2632 ..,;,.
I- ' fir.:; r.. a .
0400 O+(D p+x0 at30 044 O+S'O C>f�t0 I � ,, . » O / r a,
< (?2
, , 2M, ABC. is") 420-1"4 Dmwt; IIU1ABEf1
,
a
w: t 1 1
C >tS?!IC Ceti
- j •0�
/0 , . , _. t >K: i, S, oo McMillt+, 10l 4Yiti5 7+4j1'
m .
. , .
+ , .
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4 .,
r , R ;t
r+r- w +Ar1
L• IV SEPT!6 5ysrtm r.
15006ALl.ON SEPTIC TANK
r o' PEST PIT t ►Tx - T)
• y
"
SCALE -
I�ODEL:TK-1S00tSFIEACONCRETE) .[OREQLAVALEN
AMS14EDFADE
Performed By: Daniel B. Johnson, R.S. , C.S.E. __
"
Date: January 31, 2002 2�'D� 2•"D1A 9'1MM 2CDIA
3r' H•1D
TP-1 M. 99.9) s••
y.., g0G w
r'SCH
bab 0 Y$" A/Fill Loamy sand 9*SO4 f0
18" - 35" Bwfi,10YR5/8 Loamy sand 7A6EOVER A o4ibc °
35" -142" C1, " 2.5Y5/3 Fine-med. sand �•SCHIOTEE 4. '. . . • . . .. - 102"-132" C2, 2.5Y6/2 Fine sand;
LIQU D LEVEL sRIrL REMEMtS OF ET.
No Observed ESHWT � E wA�R 1t�1TA�S
3o O s rved Groundwater
T
b e
EE 'ETC ,
ALL WALL SLEEVESIGASKETS PIRL0fj&ItET SHALL fly CAST RI PLACE OR
'PEST DATA
I M
, V
..,
r
o.oo INSERTED A7 FACTORY. rC►; ;
c�
Date. Janua 31, 2002 STD IEt�ELBASE '
..Soil ,Class•• Class I (0.74 G/SF
SEPTIC TANK DIIIEltSi01r15: #0'C•L_X 5 IL' W X,�5�#
Vj
oA
Perc Rate < 2 MP2 TP-1
( )
N fs ri i� Depth of Pe rc test: 35" ,- 5 3" ; DISTRIEKITION KOC k
40 ,.^,L
µD tE 93 -- - _ r ZriM TIONl3
q -- �, 9 9 j T pENOVABIE COVER ,�"SCH 40 CUTLE T tit DER%LS
M E B s�4NE 9 - DIS RIBi1T1ON em TO MEET SHALL EE SET LEVEL VM A
9s Inv. Out Foundation (existing) 98.9 +ore NOTE UL64 AEQtAR£MENTSOF310CMR �OFTHEpi1STt1MD
Inv.. In Septic Tank 97.00 15.2321"TEI1TiGNtHESS. FEET AND CONNECTED TO .
LEAcN/nt(r fb - 96 C!Sf.4Kf rCK 6.4cl�
Inv. , Out:Septic -Tank 96.75 1` -VMS"SC.
H40PVCPIPE
- � CONSTRUCTION.ETC 2' EACH DkSTi�tlTlDli UI3iE
v1L WELLS Inv. In Distribution Box 96.70 f SDI40 6!.
NO.OF OUTLETS:2
q C 71 ` -`' 9� Ef�J r in�6 .' Inv. (Jut Distribution Box 96.53
....__.
SAJ Inv. " In Leaching Dry Wells 96.40 °, " °°°o S"1 l •o o sT�Cgi15H
9 ..r..
roiE� Bottom of Leaching Dry Wells 94 .40
[ DWI
_ -- 9g Bottom(TP-1) - No Obs. GVESHWT 88.9 ! 5TA8LELEVELBASE
gZPLALE 1� -- =�-- E-NST/Kfj LC'SJPooLS
SEE 14dr8 oy�r� f
U
o W p_g° I�. �. - 99 /Sov U.AoK tEQ3*NGDAYWELLS•=CA 0 iS
.._ -
o �a -- SEtTIc, t��lK Existing Contour - - - 98 - - ..
"M-CROSS SECTION
P
'� 1ENGNM�4�k'A I'
Rtt�r a Et,=�Oo,00 Proposed Contour 98 L SHOREYPRECAST ATE
flNk GRADE TO 6E STABILED
7w 0 /oo*S 101 ?Da of Cc*KREra
Test Pit ® FINISHED GRADE(SLOPE-.02)
JAl O A�1'/O N
E��sT/Nb Novf£ DECK 'o Finished Floor Elevation FFE
H 10
fFE=I04 t /oaxo v
BEE- 9>,l t Basement Floor Elevation BFE
o
t.EACHlNG DIRY WELLS:2 c
N.
V6"LXt'1O*WX71-H Q c c o 14 1/2"OOL�LE .
WASN PEA STONE
Water Line W�----- OVERALL LEACHING aaTEa 3/4"-11/2"DOU9LE
2V L X 13'W x Z F WASHED STONE
Gas Lire Gtu
�+LEffl 3
b y EI•�• TLCOMPLY
O YpfVATH HE
- ~- REQUIREMENTS OF
a
310 CMR 1132
Svotopd Fd
sem K" AO c ' , p°off :! n
SToN� CLIFF �,c,qb �__ ... ____� _ i - ( 10
Apr r oN ` - ,,,�e
�� o -: -L- -�';,"s�' � w°ppvAtc - .:"- i-- t A33 c� -:�-Fb•'°�s sht•� conform to the Title �r 3
tARsc ' c[ LA '
efp CMR 15)1,4 a ;d t►e 3 rnsta-le Board of Health Regulations%
ctassrt L
-._are.vr` � R2NGArAT 2• There are nc kncwn zr_vate cr public wells within 100
c�F?Jtr r°¢ LOGS " feet/4Q feet, Tasre,rtively, from the proposed leaching
c A °�' +��'p +* ; et�r area.
` " •
cwArA �°•� .►� t �, 3. Existing cesspecis to be p1ed and removed prior to
� / ? rnp
0O•c,, 'J5`* rt �o~tANc c installi nq the -e�1 se-*is tank.
f- d F(LC OF SEPT( C SY STE/''� Rto
r ~, of
° � got �` � ' 4 • No chances a__ tc b_ cad in she field without the approval
P � r � r. �O � -� as a •-C.
A .� `F ` y
fFE= /04.72 Sc•4 c E : �4 s Stfo�,a.J
`' f a� i , 3 ,<<e of the Board c_` : calth and the design engineer.
CENTER CN 4Q R'p rj14 t1V 001%.
*,r V�LL E �Acw 8 t 5. Proposed ieachina area is not designed for use with
•
Afro+` o garbage
� ♦ ocr
V4 VA
`[E's Oil ' ` 0� 40 + �VLLFR t t cA 6. Contractor tC nst fy Dic Safe 72 hours prior to -
.F�►e rt4rr ' .w 1[6Lp~ ?! ► RO = COnst e r. f t
..�� r c_�o-. 344-7233.
I �it`�- *p e- e4'+ Er4� c tAE[ 7. PrcPerty _i::e •'.f£�'=mt `C^ taken f Subdivision division Plan in
ion low® ��? = o e oa �e Sarnstat-'e) , prepared by Charles Savery Co. ,
MAP 46 dated A r=j 19E6. Septic Plan not to be used as a
to` o Jo AMQ` �f� s c t t'rr�t OLD
~ac prOpE:�'j- _ins sue'-`ter!.
I SCUOO r* �� % KALMA
WA ; : L►K� 8 . Remove 5 fPc` hcrizc^Cali y around the proposed leaching area
" ar. ; •�er.;ca_ _:, apercx=^ate: 3 feet (topsoil, subsoil,
led �� Et�Sr/Nlz �R-RDt
pthitle V fill (Reference 310 CMR
=5.2=5 `vr spur-f:ca=:cns c _`i__ (sand) ) . The total amount
9K of
r G� s apprcx -rately 50 cubic yards .p i fig.. E^'.:._ :_
g.9t ` i° '
98 Y.o VxRIlLttC,B: Bass tables B.o.H Rags.
9 �q 9).0 f 1 . Reauest var_a-:ce to reduce the offset of the Proposed
leaching area t;; ed �:; the Boo from 100 feet to 81
0
fee _ . _ era: Rec•,:iremerts (1 .13)
9.oo
G )S ° • o ,«N• FE/''i ou e # CALCTTLATIOIRS
�•t 96 I , S 3 I �g P� cE
,,► ..J..ag i f;6,, 1
96,)0 96.4b I SEE Kc rr 3 Be
drooms
3 Bc.j.. � _ �
_cc:-__ 330 Gta rc
> + I Percolation Rate - < 2 M I iTr-i) vv Oz U1 t
or
Soil Class. .''lass i €C.74 GISz , q�Tyo'�s�
9q q 9
DtS"T/z�t30T/on/ D \ FpTgt��F
PROPOSED I AREA:
OF
Z LE 041A,G Leaching r} _ 4 X Z V
/,Soo C 04LLOa WEt- S o r► M,g0,4NE RT fL - », o Sidehi a D W -'-`: ` , . 4 G/SF 3' X52� K ��
�, E S' X i ® NL
D y L 7aP F E p Area: SENJAMN s<
S£PTr L TANK Z 0 g GPD '� s.•
I 9� z4'L 13'w x;Z H Bo TTo� aF Ie,*18A,+1Ve .4r E1- = .23,o t y.
BottOn. A ea: -i2 S= X v.74 C/SF 21Q-9 ,Pi) JO SG�N
EE ?LAN v/�w Foy locAT�°n/ Total Leach?nc Capacity: ( �.1G�7
340.4 GPDa
p S►S of ME�6�.sN -
0
W L r
CC
2
SUBSURFACE SEWAGE DISPQSAL S STEM
OIL •� i P-1 t-L= '.� l DANMEEL -o?
28 Stony Cliff Road, Centerville
{o�v 98,9�
o /�0 O WT t s'_r[ J7kr�r4O ' ca`+!" SCALE: DRAWN BY
� g f (TW .. K� '���' APPROVED BY
o N D6 S E S�f � No.1G WAi 77 DATE: 2/2S/02 DX a Johnsen V.S.D.i. Jobasc
" 0 .
ftepared b4mrren Spots (508) 771 - 4I'li'•
W ..� .•.-..L ,�''yt • lief: 2111 fle
WiDANICALY
7
ets Clio Vasil, contw rius, Mk 02612
0400 o+ro p+..o Ot3o 01F-40 o+ro 0t60 pr�v o+So p*90
0'� , nec 4SOi) {20-114{ DRAWING NUMBER
{/ DOWSTiC szrr C mum
or: 004 Rain nz"t, suite:s, astwWwA, ph **as ;; 7-'T49
r;