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HomeMy WebLinkAbout0039 WARWICK WAY - Health 39 Warwick Way, Centerville i \ 1 d I i 2Q I rTOWN OF BARNSTABLE LOCATION c:.) I Llil��\�{ �[ I��y SEWAGE# Ct VILLAGE G° iQT&Zss.c ASSESSOR'S MAP&PARCEL 142 U INSTALLER'S NAME&PHONE NO. a4p6wt 0 SEPTIC TANK CAPACITY b�[� LEACHING FACILITY.(type) 2 ® (size) (X. )K NO.OF BEDROOMS OWNER S're—rsoo -Ti4Ai6 L4,-«. PERMIT DATE: —�l4 COMPLIANCE DATE: 9 3"A0(9 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 I site or within 200 feet of leaching facility) A)(/, Feet Edge of Wetland and Leaching Facility(If any wetlands exist within L,4 300 feet of leaching facility) Feet e FURNISHED BY � ( y o. d � No. t l Fee V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pficatiou for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System individual Components Location Address or Lot No. 31 usQfZu�.Z,(., &,,eEubr Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /�✓ �(® 2-$ ✓j CAS rc jti t Installer's Name,Address,and Tel.No. /�3 Cc,/st sxt> N/S r Designer's Name,Address,and Tel.No. 5'"Q 6-27'3 0 3 7-7 Ro6&,,F 8 oug- ul &c y.-b� ' ��'�`'` C_ 2l.su e­e_-ftt k­� Type of Building: Dwelling No.of Bedrooms Lot Size Ir no t sq.ft. Garbage Grinder( ) Other Type of Building Sim,l No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 9 Fj gpd Design flow provided 3 Iq[. 11 gpd Plan Date 2d / of Number of sheets Revision Date Title 3 1+iJA1,hJ 1-?-4 Ltl� Size of Septic Tank ! j t_46 I til Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ew Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Signed Date u Z �cy l of Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 9-0 1 ct"3 Date Issued l No. Fee S / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Misposal 6pBtem Construction 3pPrmit Application for a Permit to Construct( ) Repair( ) Upgrade`(/,) Abandon( ) ❑Complete System XIndividual Components Location Address or Lot No. 3 1 w aaA&.),c L,, cmu.A, Owner's Name,Address,and Tel.No. S"t L o n ;ten e7 "rS Assessor's Map/Parcel t Y�s f�'�G +oii it 2- Zara, Installer's Name,Address,and Tel.No. /y'3 Co. rn�lc�r►/��� Designer's Name,Address,and Tel.No. is I O 3 7 r o f R UDC �ci {Acre- �... + !hG•lii,ra 2'I3f`./ G�''Njy."y /L�wy �l /i[1vZltt t'it aryvo. !, Type of Building: i Dwelling No.of Bedrooms Lot Size i s, 3x n - sq.ft. Garbage Grinder( ) Other Type of Building �,`�, �,+ drew . No.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design Flow(min.required) "3 gpd Design flow provided q, gpd Plan Date ' Z ► — 1 CY Number of sheets Revision Date Title bt l/a/t/nJ;(.I. U4,21 Size of Septic Tank /00,-) Type of S.A.S. d 7- i Description of Soil I Nature of Repairs or Alterations(Answer when applicable) Al eu) (2 ) "b Z� �� i i ~ Date last inspected: U n 1610,.Am Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health.^ �, Q Signed �.__ ,, /~ Date Application Approved by (_IVIP ry 2;; '0 c-4j Date "' c/ Application Disapproved by W Date for the following reasons Permit No. /� d �"` Date Issued ' I r ,- -- --_- -_-- -- - - ----- ----------------- - - -- ---- THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO C,E�RTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(� Abandoned( )by in )A - cc, at u,0 ek+ ",)t c,.k.n �. t.�k' t_. : has been constructed in accordance with the provisions of Title 5 and the for Dispossal^,�System Construction Permit No.o�O tj'312-dated ' - j Installer N ove4A . n:,,JOL l,u. '�.t,t,�. Designer . A l`. #bedrooms Approved design flow , gpd The issuance of this permit shall not be construed as a guarantee that the system will functi n as esiined. Date i'�{ Inspector C -- _ _ - -- -- ------------------ ----- --- -�-,- .-1--- ---- i No. ;'0loy J � Fee ! �y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar 6pstem Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(X) Abandon( ) System located at 3 t.•t,) Ala-to 4--, le. -J c and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date Z5 ( � Approved by _ " `' CN. 't, cuiy I V: Z I MIVI No. 3453 P. 1 Town of Barnstable Regulatory Services ; Richard V. Scali,Interim Director ,Pr 1659 a�� public Health Division . F Thomas McKean,Director 200 Main Street,Hyannis,MA 02,601 Office, 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form .Date: 9-y-19 Sewage permit# 2-01c[_322 Assessor's Nap\Parcel y 5� Designer: TS, E 5(o eecinj 'Tv a Installer.- Caee_wicie_ LhF�r Pr(Se�. Address: 2b'iN Granbzrr j},—�wox)r Address: 153 com,v t-ccfal East War cim . HPr oz,5h$ Hasl��eea NA t)2(a`l 'I ' On On g'd - l� GA �wtde Lrtr�r rise$ � � was issued a permit to instal( a ( a�) (installer) septic system at_ 3 W G f(.0 ck Way based on a design drawn by (address) S C E�n�t,nee to of , arc dated _ Aysusk Zl U I9 (designer) _—Z I certify that the septic system referenced above was installed substantially aecordin'' to the design, which may include minor approved changes such as lateral relocation of�the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes greater than 10'. lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory, I certify that the system referenced above was constructed ' e with the terms of the M approval letters (if applicable) H OF Mqs O�y� cy JOHN L. CHURCHILLdR. ( nstaller' Signatur a L N '� No 18t1Y �'0��9 lSTE ( igner's Signature) (Affix Des' a amp Here) PL SE RExUR1v TO ARNS PUBLIC DEALT DI SION. CERTIFICATE OF COMPLIANCE WILL NOT DE ISSUED UNTT)J )BOTH THIS FOiR1VCANDAS- Jg AN CATtD AR>;R C�I'V+D l3 Y 'per DA�STADI.+ pY7BT.IC�ALTH DIVISION. THANK YOTJ'. Q:1Septic\Designcr Certification Form Rev 8-14-13.doc TOWN OF BARNSTABLE LOC:e'PION SEWAGE # VILLAGE c,-e eA;,,! �F' �r-, t,/� ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. 'Se?F SEPTIC TANK CAPACITY ELM LEACHING FACILITY: (type) /(;� S" (size) NO.OF BEDROOMS 3 BUILDER OR OWNER�_1 PERMTTDATE: `�" Iq--9 7 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 �� - �� � �- �� � ���s� . � \ i � ��.0 �i ,; : � � ��" ., �i v\\m � l' � � / 1 -- a Town of Barnstable PT# TP-19-117 Department of Inspectional Services Public Health Division FD 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Date Scheduled 8/20/19 Time 10:00 AM Soil Suitability Assessment for Sewage Disposal Performed By: John L. Churchill, Jr., PE, PLS Witnessed By: Dave Stanton, RS LOCATION& GENERAL INFORMATION Location Address: 39 Warwick Way Owner's Name: Stetson R. & Jane G. Hall Centerville, MA Owner's Address: 28 Rambler Road, Osterville, MA Assessor's Map/Parcel: 148 5 Certified Soil Evaluators Name: John L. Churchill, Jr., PE Certified Soil Evaluators Email: jchruchill@jcengineeringinc.com New Construction or Repair: Repair Certified Soil Evaluators Telephone# (508) 273-0377 Land Use Residential Slopes(%) 1-2% Surface Stones None Distances from: Open Water Body >150 ft Possible Wet Area >150 ft Drinking Water Well >100 ft Drainage Way >10 ft Property Line >10 ft Other ft Parent material(geologic) Outwash Depth to Bedrock >132" Depth to Groundwater: Standing Water in Hole: >132" Weeping from Pit Face >132" Estimated Seasonal High Groundwater >132° DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Direct Observation Depth Observed standing in obs.hole: >132" in. Depth to soil mottles: >132" in. Depth to weeping from side of obs.hole: >132" in. Groundwater Adjustment N/A ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level Observation PERCOLATION TEST Date 8/20/19 Time 10:00 Hole# 1 Time at 9" Depth of Pere 30"-48" Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch <2 min/ln Site Suitability Assessment: Site Passed X Site Failed: Additional Testing Needed(Y/N) 'r Deep Observation Hole Log Hole#• 1 Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (USDA) (Munsell) (Structure,Stones,Boulders, Consistent %Gravel 0 - 6" A Loamy Sand 10YR 3/1 6" - 30" B Loamy Sand 10YR 5/6 30" - 132" C F.- Med. Sand 2.5Y 7/4 Deep Observation Hole Log Hole#: 2 Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (USDA) (Munsell) (Structure,Stones,Boulders, Consistent %Gravel 0 - 6" A Loamy Sand 10YR 3/1 6" - 30" B Loamy Sand 10YR 5/6 30" - 132" C F.- Med. Sand 2.5Y 7/4 Deep Observation Hole Log Hole#: Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (USDA) (Munsell) (Structure,Stones,Boulders, Consistent %Gravel Deep Observation Hole Log Hole#: Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (USDA) (Munsell) (Structure,Stones,Boulders, Consistent %Gravel Flood Insurance Rate Mai): Above 500 year flood boundary No Yes X Within 500 year boundary No X Yes Within 100 year flood boundary No X Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not,what is the depth of naturally occurring pervious material? N/A Certification q I certify that on r (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date SKETCH: (Or you can attach a separate sheet) (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) SEE ATTACHED SITE PLAN DATED AUGUST 22, 2019. LOCATION 2q SEWAGE PERMIT NO. LOt 27 Warwich Way 83-475 VILLAGE Centerville, Mass. INSTALLER'S NAME i ADDRESS Robert B. Our Co. Inc. Great Western Rd. North Harwich S U I L 0 E R OR OWNER Louis Gordon DATE PERMIT ISSUED �/ 7 DATE COMPLIANCE ISSUED/ �� • - � � � J � �6 �. � �. ' �� ,�'"� 3®► "O FE$.............................. No------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........OF-----------------------------------------------•----------------------•----••-----•------ J�VpIirativu for Uhipoti al Workii Tnnitratrtiun Vamit Application is hereby made for a Permit to Construct (V ) or Repair ( ) an Individual Sewage Disposal System at: {� - -9�7 ....... -'' Location-A ress or Lot No. -•w•••• ------ ..•- --•-• •-...--•••••........................................................................ ............................................... Onerr---••--•-•--•----------- Address Installer Address dType of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms_____________ _._.__._.__.- Expansion Attic ( ) Garbage Grinder ( ) p l Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures ... --•........................................ W Design Flow..........� 5 ---.••----•---•--- gallons per person per day. Total daily flow............... .. -•-------------- Mons. Septic Tank—Liquid capacitv/_VP0---gallons Length•-4- ........ Width..---�_._ ._.. Diameter________________ Depth-----. x Disposal Trench—No.___•---------------- Width .._.)._......_.. Total Length //......._._._.. Total leaching•area__•._ sq, ft. Seepage Pit No_______ ........... Diameter._ ��.-.--- Depth below inlet i�r�.A!..._... Total leachin a�,ryryrea_--, 40..__sq• ft. 14Yy/a r Z Other Distribution box (� Dosing tank*( X !! 0-4 la V.� �)�-/1,''.f;' .�.��r Date----�' �`� r�� --- Percolation Test Results Performed by.� - R Test Pit No. L -_-•-minutes per inch Depth of Test Pit_.�!� '�_... Depth to ground water ) fit ail Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil-_-.s..? .. T � - � x - U ------------------------------------------- -----•------•------•-----•--------•---- -----------•--------------------------------------------------------------•------------------------------------------------=--.--•--------------•-------••---•---• Nature of Repairs or Alterations—Answer when'applicable.::•__----__•-__.•_____________________•---__•---__-_-:_---_---._........__._...____.___.__.___. U ----•-----------------••-----•-----•---•---•-----------------•--------------- Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of m nce been issued by the board of health. ned...................................................................................� ---_.••--•- Application Approved y....--- -----------------••--•-•---_..._ .................... Dace.............. Application Disapproved for the following reasons:..................... ------•----••-•--••----_•----•---... ----•--••-----••-•--•-••............. ...__....---••------------•----•------ Date Permit No--------------------------------------------------------- Issued_..-----...._._..--- te---------------------•--------- .---... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... TrtifirFatr of Tuntith anrr IS TO E FY, That wt, I d vidual Sewage Disposal System constructed ( ) or Repaired ( ) * _-_ -- - ---------------••----------•-----------•----------•----------- ........ ------•---•--- - �1 l Installer at------------------------------------- ----•-----•------ ---- - /Z64F T F has been installedin ac dance with the provisions of"F L.. The State Sanitad in the application for Disposal Works Construction Permit No......................................... dated_.-..___-_._.-.____-__.____---------_---_----_-. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ED AS A GUARANTEE THAT THE SYSTEM WI F ICTION SATISFACTORY. DATE./ /� ... Inspector . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... FEE... ..... No--------_---_-------- " viar n tr Wins rrnti# Perere an -•-- • • _•-........... • --------•------•...•--••-•---•••••..............•...........---....••-_..... to jog rust ( or a air ( n ual Sewage osal System atNo.--- ............... -••-•-•................................... --•--• •..........-• Street �� as shown on the application for Disposal Works Construction Permit. ... .......... Date ._ ..................................... ............. ---------•----------------------•-----------•-----------•-----.-.__- �o'�_�f�•� � Board of Health DATE------./ ---•-----•-b----------------•----.._..---••--•-•-----•----...._... / FORM 1255 A. M. SULKIN, INC., BOSTON - i, �0 Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH . ...........................................OF......................................................................................... Appliratio t for Dhipaiia1 Workfi Tomitrurtivit Famit Application is hereby made for a Permit to Construct (� or Repair ( ) an Individual Sewage Disposal System at ��c�TE2 }�/CALL— �OT.----1 . . .... Location-A ess or Lot No. ..............'..... - .�:Sr.1c..- -- ................ ................. .................._........ ..........----------•----........................................ �'I wne Address Installer Address QType of Building Size Lot............................ et' U Dwelling—No. of Bedrooms_..........�........................Expansion Attic ( ) Garbage Gri r Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafet ' ) Q' Other fit es --------- -------------------- -- W Design Flow........... ..........................gallons per person per day. Total daily flow--------------3 -_-_ _._............gallons. WSeptic Tank—Liquid capacity/.A420..gallons Length....Y._...... Width__..•...... Diameter................ Depth_._..__.._.. Disposal Trench—No. .................... Width_.____._ Total Length..________.._....._ Total leaching area....................sq. ft. x ,---------- j Seepage Pit No..................... Diameter...Zd.......___. Depth below inlet.. Total leachin area..,;Q1...sq. ft. Z Other Distribution box (V� Dosing tank )) _ �� $&�' 9,FV, '-' Percolation Test Results Performed by..,� W_G._K,&L6t-__ �G-:.._._ __-• Date_____ ...............................20 a ,� Test Pit No. 1...�v�....minutes per inch Depth of Test Pit--- Depth to ground water._ f1lc_.__. (%, Test Pit No. 2................minutes per inch Depth of Test Pit-----------------_ Depth to ground water------------------------ P4 ....•--••-------------------•••-••--•--•......---••---•-------- Description of Soil---c'EC... 9 ....-f��= ------------------------------------ ------------------- --------------------- x W ---------•--------------------------------------------------------------------------------------------------------------------------------------------------•-----------------------................... V Nature of Repairs or Alterations—Answer when applicable_____________________________________•----____-_-______________._________--_____•-•--__--__-__. ..•--••••...........................•-•-•••••••--•--.....--••---•-••--•-•---•-••-•------•---........._..._....._..••••--........-•---•-•--••----.... .............................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary C e— Th undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ssued b t�hy board of health. igne - ..................................................... •- -•------- Application Approved BY • ......• ..--••- -••-••-- z� .... Date %�� Application Disapprove or e following reasons:............................................•-•____._..........__.__._.___.......__ Date -••------•-••----••--- Issued....................................................... will ' Date APPLlCAT'10N FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION .2 7 G� ,° _ NO VILLAGE GG�cJT��2v/G,LE DATE ' APPLICANT FEE Z��= ADDRESS s, 3ZO/7- )UEGK oep C . Z5C-A1/J1 S TELEPHONE NO. (Non-refundable) ENGINEER Lo &J $� GJeZLcx_ Lac TELEPHONE NO. L Z DATE SCHEDULED_ � ZD 3 3 �'NJ_ ` fir — /9G � - (Ap licant' s signature) • . . • • • • e o 0 0 0 0 • o • o 0 0 0 0 • e • • • • • o 0 0 • o • • • • • • • • o • • • • • • • o • • • • o • •.• • • . • • e • o • • • • • o • • • •`• • • • • SOIL LOG SUB-DIVISION NAME DATE_ 6�7-0/�j TIME 3 /7,M . EXPANSION AREA: YES_y NO /�G ENGINEER. ? GO cJ LJ�L L E� , TOWN WATER_/ PRIVATE WELL �/jGs9 c6/ BOARD OF HEALTH tom, 0 'L U UGAlL/AJ WC . EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES : S- 1 ` i i O O VI i j i 1 , 00. o p , i PERCOLATION RATE: C z /-I A TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 1 L s 1. 2 2 3 3 4 4 5 5 6 6 j . 7 7 8 8 9 L 9 10 SPiJ� 10 11 11 12 12 13 ,va f{�o 13 14 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS : -7 / NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E. AND RETURNED TO BOARD OF HEALTH ' COPY: RETAINED BY APPLICANT Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Wllllam F.Weld Trudy Coxe Governor s.r,M.ry Argeo Paul Celluccl David B.Struhs U.Gommor Gornmhelorwr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A - CERTIFICATION Property Address: 39 Warwick Way, Centerville, MA Address ofOwner. Joe Maguire Date of Inspection: , — /7 (If different) 20 Annie St Name of Inspector. W.E. Robinson SR Providence, RI Company Name,Address and Telephone Number. ( 5 0 8 ) 7 7 5-8 7 7 6 02908 W.E. Robinson Septic Service P.O. Box 1089 Centerville MA CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the info 1 / ,accurate and complete as of the time of inspection. The inspection was performed based on my training an enee in the pmp 'i 'on and maintenance of on-sitear disposal systems. The system: _ Passes H krIlw® o _ Conditionally Passes 1 A y _ Needs Further Evaluation By the Local Approving Authority TO ft 7 8 199 _ Fails do yoITH�pSTAB�E Inspector's Signature: Date: C�( Oz The System Inspector shall submit a copy of this inspection report to the Approving Authority within d ce ing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A,B,C,or D: A] SYStIe ASSES: not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. JEM CONDITIONALLY PASSES: ne or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes nspection. s,no,or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a Fonforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX'(617)556-1049 a Telephone(617)292-sm Printed on Recycled Paper I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: 17 Bl SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pips(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 obstruction is removed 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. 9) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: 5 D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the ure. Backup of sewage into facility or system component due to an 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 M 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for ooliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LAR E SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The o r or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program req ' meats of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddrgm 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: q 1-7 Check if the following have been done: — ping information was requested of the owner,occupant,and Board of Health. _VNone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. `'ALs built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. �fhe system does not receive non-sanitary or industrial waste flow _L-�he site was inspected for signs of breakout. system components, excluding the Soil Absorption System, have been located on the site. J_A�e septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. _The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. l'The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design flow: i9 `/ ons Number of bedrooms:3 Number of current residents: Garbage grinder(yes or no):_& O _ Laundry connected to system(yes or no)k' Seasonal use(yea or no):_ Water meter readings,if available: 1995 — 101 , 000 gals 996 — 107 , 000 gals Last date of occupancy:, y ql l COMMERCIALANDUSTRIAL: Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non4anitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING'RECORDS and gource of information: System pumped/as part of inspection: (yes or no)_ If yes,`volume pumped: gallons Reason for pumping: TYPE SYSTEM t/ 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) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: Sewage odors detected when arriving at the site: (yes or no) de d (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: -.,Z-—Q SEPTIC TANK- (locate on site plan) Depth below grade: Material of construction:z/concrete_metal_FRP_other(esplain) Dimensions: Sludge depth: C Distance from top of sludge to bottom of outlet tee or baffle: z)3 Scum thickness: 0 , Distance from top of scum to top of outlet tee or baffle: 7- )y Distance from bottom of scum to bottom of outlet tee or baffle;,: Comments: (recommendation for pumping, co dition inlet and outlet tees or baffl ,depth of liquid level in rela1on to outlet invert,at integrity, evidence of leakage,etc.) .+Ac r� .%� Giz, Ty z7 G E TRAP:_ .--- r (locate n site plan) Depth low grade: Material of construction:_concrete_metal_F"_other(e:plain) Dimens' ns: Scum ess: from top of scum to top of outlet tee or baffle: ce from bottom of scum to bottom of outlet tee or baffle: Comm ts: (rem ends 'n for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, eviden of leakage,etc.) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe ma quire Date of Inspection: TIGHT OR HOLDING TANK:_ ( on site plan) Depth low grads: Material f construction:_concrete_metal_FRP_other(explain) Dime ns: Ca ¢allons flow gallons/day level: Cc nts: (oo ion of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX:✓ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and tion is egpal, evidence of solids carryover,evidence of leakage into or out of box,etc.) �C;'g A- t t(note CHAMBER:_ n site plan) n working order:(yes or no) ts: edition of pump chamber,condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe lelaguire Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_ (loc:ate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits,number. leaehiag chambers, number. leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Comments: (note condition of soil signs of hydraulic failure, level of ponding,condition of vegetation,etc.) A, Z�-1-1tf L e A C %- — C POOLS:_ (loco on site plan) Numbs and configuration: Depth- of liquid to inlet invert: Depth o an layer: Depth of scum layer: of oesspool: Mate ' of construction: Indicati of groundwater: inflow(cesspool moat be pumped ee part of inspection) Commen : (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.) PRIVY: (locate on ite plan) Mate ' of construction: Dimensions: Depth solids: Co :(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) (revised 11/03/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 39 Warwick Way, Centerville, MA Owner. Joe Maguire Date of Inspection: S' _ - SIUMH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' G iL ' 1 36 p . G r� !o s f J \ g ,��° _0 , DEPTH TO GROUNDWATER Depth to groundwater:/2---- feet method of determination or approximation: 4 (revised 11/03/95) 9 No. 49 !11- +r Fee$5 0 . 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 3pprication for Migpogar bpgtem Congtruction permit Application for a Permit to Construct Abandon( ) 11 Complete System ❑Individual Components Location Address or Lot No. 3 9 Warwick Dd a y �- Owner's Name,Address and Tel.No. 4 01 —4 5(_1 7 3$ As es or's Map/Parcel Centerville, MA Joe Maguire, 20 Annie Street Providence, RI 02908 Inst ler's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Win E Robinson Sr Sept Sry PO Box 1089 , Centerville, MA Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( nq Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil gravel Nature of Repairs or Alterations(Answer when applicable) Title 5 Leaching system consisting of a D-Box and three stone acked° -1 h--capacity.,. heavy :.duty infiltrators. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this.1!loaz0cf Health. _ Signed o Date Application Approved by Dated Application Disapproved for the following reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION ;� L�''��/�. V )c• SEWAGE # VILLAGE -2-- �� ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. Gt� SEPTIC.TANK CAPACITY LEACHING FACILITY: (type) /( h a , 1 (size) _ �CA�r2� NO.OP.BEDROOMS 3 BUILDER OR OWNER PERMITDATE: "/— / 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 t No: / '~�1�� Fee$50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS { 01pprication for Migogar *potent Construction Vermit Application for a Permit to Construct( )Re air X pya )Abandon( ) ❑Complete System 0 Individual Components Location Address or Lot No. 3 9 Warwick Way Owner's Name,Address and Tel.No. 4 01 —4 6 6—1 7 3 8 Assessor's ap/Parcel Centerville, MA Joe Maguire, 20 Annie Stfeet Providence, RI 02908 . Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr Sept Sry *O Box 1089, Centerville, MA Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(ng Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil gravel Nature of Repairs or Alterations(Answer when applicable) Title 5 Leaching system consisting of a D—Box and three stonepacked, high capacity, heavy duty infiltrators. 01 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has Signed issued by this oar of Health. g ._.. /"'f 8 g ; � Date L Application Approved by Date Application Disapproved for the following reasons f I` �- .- Permit No. Date Issued / ----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS Maguire BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Abandoned( )by at 39 Warwick Way, Centerville, MA has been constructed in'accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. '7"f dated Installer Wm E Robinson Sr Sept Sry Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Maguire ligogaf *pztem Construction Vermit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 39 Warwick Way, Centerville, MA by Wed E Robinson Sr Septic Service and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this it. Date: Y / 9;z Approved by V NOTICE: This form is to be used for the repair of failed septic systems only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I,William E. Robinson, Sr. ,hereby certify/that the application for disposal works construction permit signed by me dated ��T S`- concerning the property located at 39 Warwick Way, Centerville, MA meets all of the following criteria: * There are no wetlands within 300 feet of the proposed septic system. * There are no private wells within 150 feet of the proposed septic system. * The obseved groundwater table is 14 feet or greater below the bottom of the leaching facility. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. SIGNED: w 1 l DATE L 9 LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). 0jcA T.O.F. EL.= 57.5'± FINISH GRADE OVER D-BOX = 54.9 ± FINISH GRADE OVER CHAMBERS = 54.5' - 54.9' 3/4"TO 1-1/2" DOUBLE WASHED SLOPE GENERAL NOTES PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER @ 2% MIN. OVER SYSTEM STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6" OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS BOX OUTLET TO WITHIN 6"OF F.G. 0 2"OF 1/8"TO 1/2" DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE , F.G. OVER TANK EL. = 55j.7�± 5" DIA. OUTLET(S) MIN SLOPE 1 /o TO F.G. (SEE GENERAL NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.= 56.0 ± STONE OR GEOTEXTILE FILTER FABRIC - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE TOP OF SAS = rj2.$3� PLACE RISERS ON ALL DESIGN ENGINEER. PROPOSED 4" 9., MIN. CHAMBERS WITH EXISTING 4" 36" MAX. , 9" MIN. 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE T SCH. 40 PVC 52.00 36 MAX. BREAKOUT EL= 52A .50' INLET PIPES TO 6 OF SYSTEM UNLESS OTHERWISE NOTED. -' SEWER PIPE FINISHED GRADE 3" DROP MAX L-25'+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" _ 2" DROP MIN 3 9 MIN.SLOPE@ 1% PROVIDE WATERTIGHT o ELEVATION = 52.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM JOINTS (TYP.) ��� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" �*53.9'+ SEPTIC TANK 4" PVC OUT TO 0 0 O 0 0 0 0 0 00 0 O 0 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE © LEACHING FACILITY po 00 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN o 0 INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 52 667' M N. 6 52.50' 2' op o 0 C) o pop 00- 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF 00 0 0 0o 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK EAND XISTING CONDITION O opF AND REPLACE AS GAS BAFFLE 6" CRUSHED STONE p FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS OVER MECHANICALLY 00 p NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 4 0 ( ) 4 8.5' TYP AND DESIGN ENGINEER. _I 5 OUTLET DISTRIBUTION BOX 4.0 4.0' (" " ,) .0, 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 56.39, TO BE INSTALLED ON A LEVEL STABLE 25.0' ESTABLISHED ON THE CORNER OF THE BULKHEAD AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 1r50.00' GROUND WATER ELEV= < 43.7' TP 2 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS 5' MIN. 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES *CONTRCROSS SECTION VIEW CHAMBER END VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. ELEVATION i RI .I R VERIFY EXISTING C I RO I L �P n 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. ELEVATION PRIOR TO ANY WORK & ' � � DISTRIBUTION BOX DETAIL CHAMB TAILS NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE -- 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING �� ♦ * • ' ' • . TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM �M �# • ♦ ♦ PERC NO. TPT-19-117 APPROPRIATE AUTHORITY. } ♦♦ ♦ ~ ♦ INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED ♦ UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR /" >` � ; • ; �' • A EVALUATOR-.John L. Churchill, Jr., PE, PLS TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. .�I0 / �, err: • • ♦ ♦ Fall 1997 ♦ ♦ ♦ ♦ C.S.E. APPROVAL DATE. /�I '�\ ♦♦ 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. _A,P`� ,� / �� �"��\,\�r ♦' ♦i` ♦♦ ♦ 4 DATE: August 20, 2019 `L v ' �� ///i • ♦ ♦ ^�► TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE A,��'j`� 0��� P j II ♦ ♦ i ♦ . OF i MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. i • t� '� ♦ ELEV TOP= 54.80 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, V" FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). l 0 �► ELEV WATER = <43.80 �, �� o �p O ,i ♦ �� 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN , } I PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. ' MAP 148 `� ♦ + ♦ ,� 16. PROPOSED PROJECT IS LOCATED WITHIN: � � � +' DEPTH OF PERC = 30 -48' W �` ♦ • i /� ASSESSOR'S MAP 148 LOT 56 ( ,� = ,63' 0 I PARCEL 55 ;� 1 TEXTURAL CLASS: 1 - -54 �120 0 J \ Q ��� ♦ '; OWNER OF RECORD: STETSON R. &JANE G. HALL lik�rJ, / \ c- d'o�oC5 erry ADDRESS: 28 RAMBLER ROAD Cl)� 0" 54.80' OSTERVILLE, MA 02655 Aso r'o. Benchmark Y �\ LOCUS Loam Sand cMAP 148 \ o0 00 Corner of Bulkhead O A y AP 14 �� 9s PARCEL 56 �` Elevation = 56.39' z q Sri. 6„ 10Yr 3/1 54.30' FEMA FLOOD ZONE X M 8 - .h 15,320±S.F. Approx. M.S.L. g I ♦ f 3 COMMUNITY PANEL# 25001CO561J PARCEL 68 B Loamy Sand \ GRAVEL - - 56- - J ' a iNE .- ' 10Yr 5/6 17. DEED REFERENCE: DEED BOOK 11161, PAGE 160 \ DRIVEWAY 9s 30" -- 52.30' 18. PLAN REFERENCE: PLAN BOOK 350, PAGE 55 APPROX. LOCATION OF EXISTING S.A.S. TO BE FILLED WITH CLEAN �" t. 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. \ 9s COARSE SAND & ABANDONED f 4 I 30.80' �� 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY \ 43 ,. \ #39 �i - ' r �' �/ FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY PROPOSED rJ FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. \ `\ EXISTING DISTRIBUTION BOX -,, ,v~ M Fine-Med. Sand \ \ 3-BEDROOM �� I \, C 2.5Y 7/4 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A \ DWELLING mber't .,... DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A 1 TOF = 57.5'± '' ...- fi� �,. / REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. FFE = 58.3'± / 22. CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL REQUIRED PERMITS AND 12' �� DECK // l PROPOSED TWO (2) 500 GALLON APPROVALS FOR THIS PROJECT. / 18" H-10 LEACHING CHAMBERS W/ LOCUS P LA N 10" O hb SURROUNDING AGGREGATE MAP 148 20�o s O LP // \ 20" SCALE: 1"= 1000' PARCEL 57 ,0- `01 �� 0 s" 132" 43.80' A o, \ No Mottling, Standing or Weeping Observed TP 2 $,. \ EXISTING 1,000GALLuN 20" �-- - ,' 54x7' 22 \ TEST PIT DATA LEGEND SWING-TIES TANK TO BE UTILIZED AS 04 / 54z8' I� a ( _55- / DESIGN DATA PERC NO. TPT-19-117 50x0' EXISTING SPOT GRADE DESCRIPTION DC HC PART OF THIS DESIGN 16" INSPECTOR: David W. Stanton, R.S. 50 EXISTING CONTOUR K,, 14" NUMBER OF BEDROOMS (EXISTING) 3 (3)4^ ; EVALUATOR:John L. Churchill, Jr., PE, CSE CORNER OF STONE (1) 31.8' 47.6' NUMBER OF BEDROOMS (DESIGN) 3 r5� PROPOSED CONTOUR CORNER OF STONE 2 38.2' 29.1' u 1s "' I C.S.E. APPROVAL DATE: Fall 1997 ( ) J MAP 171 DESIGN FLOW 110 GAL/DAY/BEDROOM DATE: August 20, 2019 r-5-0-1 PROPOSED SPOT GRADE CORNER OF STONE (3) 49.3' 40.4' PARCEL 82 TOTAL DESIGN FLOW 330 GAUDAY TEST PIT#: 2 APPROX. LOCATION OF 1s° 00� DESIGN FLOW x 200 % = 660 - GAS - EXISTING UNDERGROUND GAS CORNER OF STONE (4) 44.6' 55.3' PROPOSED GAUDAY ELEV TOP= 54.70 EXISTING S.A.S. TO BE o p,0 O/H/W EXISTING OVER HEAD WIRES 5� � INSPECTION PORT USE EXISTING 1,000 GALLON SEPTIC TANK � < ABANDONED S. ,�0 ELEV WATER = 43.70' -W -W EXISTING WATER LINE PERC RATE = -54 - - TEST PIT LOCATION INSTALL 2 - 500 GAL. CHAMBERS w/ AGGREGATE DEPTH OF PERC = TEXTURAL CLASS: 1 O SIDEWALL CAPACITY O O EXISTING 1,000 GALLON H-10 SEPTIC TANK \1PG Oo�l (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAL/DAY� - PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE ��`" ��� (25.0' + 12.83') ( 2 ) (2' ) ( 0.74 GPD/S.F.) = 112.0 GAUDAY EXISTING (P l�0 A 0 Loamy Sand 11 54.70' 13 PROPOSED DISTRIBUTION BOX 3-BEDROOM a BOTTOM CAPACITY 10Yr 3/1 y s 6" 54.20' �O PROPOSED 500 GALLON LEACHING CHAMBER DWELLING HC p o (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY TOF = 57.5'± , (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY B Loamy Sand FFE = 58.3'± c, 10Yr 5/6 0 DECK TOTALS: 30" 52.20' REV. DATE BY APP'D. DESCRIPTION (2) 7 I TOTAL NUMBER OF CHAMBERS 2 - O ?8• �6D� TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE DC O O (3) TOTAL LEACHING CAPACITY 349.4 GAL./DAY Fine-Med. Sand PREPARED FOR: C 2.5Y 7/4 CAPEWIDE ENTERPRISES ° NOTES. (1) 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF LOCATED AT MAP 148 (4) EACH SEPTIC SYSTEM COMPONENT. 39 WARWICK WAY PARCEL 56 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE CENTERVILLE, MA 02632 15,320±S.F. '' PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF SCALE: 1 INCH = 20 FT. DATE: AUGUST 21, 2019 HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 132" 1 1 43.70' �H OF ly,% 0 10 20 40 80 FEET No Mottling, Standing or Weeping Observed �' 'cy .� 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE GRDUNDWATER - OO JOHN L. PREPARED BY: �p o PROTECTION OVERLAY DISTRICT AND THE ESTUARINE WATERSHEDS. RESERVED FOR BOARD OF HEALTH USE CHURcHILL JR. JC ENGINEERING INC. S50 1000 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY NO. 41807 2854 CRANBERRY HIGHWAY FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS ci EAST WAREHAM, MA 02538 IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL SWING-TIES PLAN SITE PLAN NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO 9E INCORRECT. 508.273.0377 SCALE: 1" = 20' SCALE: 1"=20' Drawn By: BSM Designed By:BSM 1Chedced By:JLC JOB No.4779 EM / OF— -__ too — / --r -- - --- /o4 --- - -- -- - ----------- 44 --- -- ----_ _ --- ---- - -- - ---- - - ---=--- ----- --- -- ------ ----- - - _ - -- - Al O TE• EXTEA1D F4L L A PPLiCA BL_E V E )2 T" S G f9 L Er / ' = /O' /"1ANHOL E. G O V E_,e5 TO !.�/THI/V 9ravnd Prof; le 5 C HE D. 4 O p V C. OAR> -- f EOU,49L 7-0 SEPTrC Cm,n,rnurn X4- F:,,--r foo+� 2 of �e ` �2 washed sfone -� / ter//, �- �_-� ��T • ° O Q O D/ST BOX os ° (v'dia. 0 e c i \\ /OOO G,9L_SEPT/C T,9,VK o � wQ S/n e d s-t o rre ° ° •, i ° ° a \\� � 3 q 5 I S c A E / L E "9 c f-4 -T- /4 S Q\ U. r, Q ° - DES / Gn./ -- - T� 5T OL. 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O44L�N�: 000 Pr-o,00sed e /evalion �EQU/A2 C= 4,/TS �►vrA� YAK rIO vTH �7F� Ss. - - - -- -- - - e X /S f•i n C O n f O U�s 100 r O /"-)� _ O •P7F 9 S r de voof f9>c>P,2 0 V E D — - -°— - P�o�osed con-f-our-s reQr- _ , e to BoAQD OF HEALTH