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HomeMy WebLinkAbout0016 WASHINGTON BURSLEY WAY - Health 16 Washington Bursley Way Centerville 122-166 I III TOWN OF BARNSTABLE `LOCATION �n �,y� ��SEWAGE# 0 I j- 2 o/� VILLAGE a �^ rV �,P- ASSESSOR'/S MAP&PARCEL a ' b INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /G U O %4 n K LEACHING FACILITY: (type) GL r1 .w6 rc (size) 2,5.� 1.2 23 NO. OF BEDROOMS 3 OWNER ManjZeL c l r PERMIT DATE: COMPLIANCE DATE: 7 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 RA 0 L C. hoo r - a ip I�O A 2 n 133 - 43 �„ No.C;>1n.j 5 Fee /�v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliration for MispoBal 6pstem Construction permit Application for a Permit to Construct( ) Repair(grade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. j A/G 3 11 Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 1-7 7- Y/&& f6 (� frs k Installer's Name,Address,and Tel.No. Designer's Nam ddress,and fel.No. Z e nrd•�► Pi Po /*f-- Zo I fio 5 .2,5/ _01Z&B 6 ram✓ MA Sn4 Z Y --7 %417 Type of Buil ng: 4 k.0 C-0 r- Dwelling No.of Bedrooms Lot Size j:�Ovt) sq.ft. Garbage Grinder( ) Other Type of Building �Z,e�. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �j`3� gpd Design flow provided gpd Plan Date- 1P Zz I Number of sheets ( Revision Date Title cJ $ .,0 Size of Septic Tank 1,000 r A f Type of S.A.S. OQ A Cont-6 C o-Y /f Descri tion of Soil m ri 9' a a !p r v^ 5k 6,0 mev C h n - 6VI A I pco Nature of Repairs r Alterations(Answer when applicable) 3 /Xb Date last inspected: Agreement: The undersigned agrees to ensure the construction and main nance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Cod and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea igne Date Application Approved byAJQ Date Application Disapproved by Date for the following reasons Permit No. ` — Date Issued Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: L ,Yes PUBLIC-HEALTH DIVISION - TO OF.BARNSTABLE MASSACHUSETTS tit �Wiratiou for I8flD8aY ps-tPltt Construction Permit Application for a Permit to Construct( ) `Repair(x pgrade,'� ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Aj C.,i Owner's Name,Address,and Tel.No. i Assessor's Map/Parcel -7 Z�J/4 / DPW �l� Xf✓S �n H / Installer's Name,Address,and Tel.No. ` Designer's Name Address,and Tel.No. 5� /'yl u /�t9fs ��, _ -7 iq7 Type of Buil g: /"t 7 corn Dwelling No.of Bedrooms Lot Size / �000 sq.ft. Garbage Grinder( ) Othe�r Type of Building p S_ No.of Persons Showers( Cafeteria( ) / Other,,ixtures ` N Design Flow(min.required) -gpd Design flow provided gpd Plan Date , Z'Z I Number of sheets l Revision Date y t Title �rn n��s. c d S t�•l rrS,r Dl 5,Aj o l Size of Septic Tank /j 1-700 f 9 P I Type o/f/S.A.S. 5 oQ 6, , Cn c-fc C /�C1►+��✓ 1 Description of Soil f, SU ntY ►�!1 JAG +t�i a a M if J I d v 0^ SG ° _4P_CA ' 600 601l C �A F" &1 1 �4 N ` S; A 1 pia,40 Nature of Repairs or Alterations(Answer when applicable) ,/AlS 4 Date last inspected: Agreement: The undersigned agrees to ensure the construction and main nance of the afore described on-site sewage disposal system in o- accordance with the provisions of Title 5 of the Environmental Cod and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health.. igne t'^ ,.�, � ,, Date — i c r Application Approved by e r L ( Dateto Application Disapproved by ¢. Date S for the following reasons Permit No. � Date Issued nlp ---------------- --------------- �.r ------------------`----- r- -± - --------h t��`J------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE;IVIA>SSACHUSETTS Certificate of Compliance `� i ..Li THIS IS TO CERTIF tha the On-sit z a e Disposal system Constructed�'(r. )r /Repaired( Upgraded( ) Abandoned( at 41.10110ORW $ has been constructed in accordance ) / with the provisi `s-o/f Ti e 5 d•the for Disposal System Cons ruction Permit N60 5— ZP—,d_a�lted 6/c9-(a / Installer CX�( S Designer Omwn S(Ae, < kjd( C� #bedrooms Approved design flow A gpd The issuance of this perm//it/shall not be construed as a guarantee that the system will fuinc'on��designed. Date V' / Inspector 1 ------------- ---------------------------------------------------------------------------------------------------------- No. (?;�C, (S ceh)-c Fee Q G THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pste Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon System located at FY-S(1,--7 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 •omplete within three years of the date of this ermit. Date (O � Approved b Town of Barnstable WE Regulatory Services Richard V. Scali,Interim Director * ennxsrnat.e, • M^� Public Health Division .639 i � 639 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: j Sewage Permit# �0 4'P 2 Assessor's Map\Parcel ff r Designer: t Installer: it_"' Address: V7 J!70 Address: Ll Lt© On 4hJ11r u L11-1- was issued a permit to install a dat ) (i taller) septic system at I Le hU 1� based on a design drawn by (ad ess) L r nJ,} Pt it& dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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 (i.e. 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 sy ern referenced above was constructed in compliance with the terms of the IAA approva etters (if applicable) `p1�N OF Mq5 LINOA J. ( Yler's igna e) PINTO I (Designer Signature) (Aff NAL Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DI ION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc Town of Barnstable P 0- , Departiinent oPRegtdatory Services ru►wt F Public health blivision Date v7 200 Main Street,Hyannis MA 02601 Date Scheduled Time .' ` /Uv� -�-L� Fee Pd. Soil Suiiability Assessment for Sew e D sposal .Performed-By:. •,t Witnessed By: ( LOCATION&GENERAL INFORMATION Location Address S1t� Owner'eNeme 1711Y Fe-(-(e l rA L r%r1Jt I e, Address Assessor's MRp/Parcel: 1� 11�I `0 Engineer's Name NEW CONSTRUCTION REPAIR / ((�� Telephone/t Land Use�`�le ld Slopes(%) ` l7�ILo Surface Stones 0 OCeonS1G �C,li,M Distances fiom: Open Water Body R_ _p�sib(c Wet Aren N` A� f tt Drinking Witter Well . 01 A ft Dralhago Way. I. Property Line Other SIMETCH:(Street name,dimensions of lot,exact locations of tent holes&Pere tests,locate wetlands in proximity to hales) Scl T?- Z 7 d FS�vi.O t o i.i£5 7;"i1 Parent material(geologic) G LAC.t AI °°II Depth to Bedrock Depth to Groundwater, Standing Water In Hole:JY l A Weeping fl'otn Pit FAce Estimated Seasonal High Oroundwater DETERMINATION FOR SEASONAL•HIG WATER TABLE Method Used: Depth Observed standing In obs.hole: Deilth to weeping from side of obs.(tole: in. Depth to Bull rnottlaBt In. ©rohndwaterAdjustment fig, Index Well Reading Date: Index Well level Ac,J,Actor _ Adj.Ornundwdter Leval,, _ PERCOLATION TESL' >nata,.__ ,xh„m Observation Hole# lad Time at 91, Depth of Pero (G (V V ` 4. v Time at G" Slant Pro-soak Time @1 ��- Time(9"-611) End Pro-soak \ Rete Min./Ittch , V `l Site SuitabIllty Assessment: Site Passed Site Fallcd: Additional Testing Needed(YIN) Original: Public Health Division Obser' tlon Hole Data To Be Completed on Back- ***Y£percOIation test is to be conducted within 100' Of wetland,you must first notify tile. Barnstable Conseirvation Division at least one(1)week prior to beginning. Q:1S EPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Dcpth from Soil Horizon Soil Texture 'Shcl Color Soli• Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. nsisteney.%'Oravell p-L A -(h SL 3�1 ("IS L ID 3b-bs)- C, ESL 1 0 ` R- Lib �`_c J CL ..J"`. 'v` 1 D �f a..��� 'i T11 L. Jl'� t3��Y'► , �15-12� G3 N1 S^."a o Q S)y DEEP OBSERVATION HOLE LOG Hole# a Depth from Soil Horizon Soil Texture Soil Color Soil Other. Surface(in.) (USDA) (Murfsell) Mottling (Structure,Stones,Boulders. Consistency,%Oa msL Iola SIB Cr mst �Ib Cy 57)y 1 1� S►�learn DEEP OBSERVATION HOLE LOG Hole,# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o I to c O DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling (Structure,Slotre9;Boulders. Consistencv. i flood Insurance Rate Map: Above 500 fl �year ood bound No Yes y Within 500 year boundary No r, Yes _ Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposed for the soil absorption 4ystom4 qes If not,what is the depth of haturally occurring pervious material`s , Certification I•certify that on 0- (date)I have passed the soil evaluator examination approved by the Department of E vironmental Protection and that the above analysis was performed by me consistent with . the required tra ng,expertiso and experience described in�10 CMR 15.017. Signat e e .1 Date )4It5 QASEPTIC\PERCPORM.DOC 42 LO�CATION JJ SEWAGE PERMIT NO." v hlnr u 'A' t INSTA LLER'S NAME & ADDRESS v ev fiv ' I�I^N �� w B U UL D E R OR OWNER DATE PERMIT ISSUED 172 DAT E COMPLIANCE ISSUED Y ' 1 2� 100,C No..---•------------------- Fzms ...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ........ .....OF..... .. .. . ........................... Applirtttion -for Uiiivo.ittl Works Tonotrurtion Prruld Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -_ -_ / ..... ---,��-�L-....'LtJr9 j........... --------------------- --....------------------------------------------------._...------. Lo ' n.Add ss or Lot oo!V 00 Installer Address Q Type of Building Size Loth ---Sq.'feet U Dwelling No. of Bedrooms.............................. ..._.Ex Expansion Attic g— -------.- p ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures --------------- -------•--•------------------•----------------- --------- ---------------------- w Desi n Flow...._.__3._�� � ----_gallons per person per day. Total daily flow_______------------------------- Ix ............ Mons. g g P P P Y Yg Septic Tank—Liquid capacit ,�agallons 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 ) .�/' 9'�'7 q `�' Percolation Test Results Performed by------- 77 a - Test Pit No. 1________________minutes per inch Depth o "Pest Pit..._._....._.._..... Depth to ground water._.._.._.__..____....... fs, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water----------------........ P4 -•----- ---- - ---------------------•---------- O Description of Soil----- 4-�.1 � ---�---�' s _ 5� x �., w x ------------------------------------ U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------- ........................ ---------------------"•---------------------------_-_-...-------------------•--------•--------------------... Agreement: The undersigned agrees to install the aforedescribed Individual Sewa e Disposal System in a rdance with the provisions of Article XI of the State Sanitary Code—The undersigned rther agrees not to pla e he system in operation until a Certificate of Compliance has been by the b�of alth. Si ed----- ------ --•-----•---. ..r. 1 Application Approved B Date PP PP Y � ----------------------------- -� �L-_-1,---�/ e Date Application Disapproved for the following reasons------------------------------•--••------------------------------•-------•--------------------------------------- --•-----•-----------------•------•---•--•-------------------••-----------------------•------------------•---------•--------------------------------•-----•----------------_--•--------------..-•----•--- Date PermitNo.------ .......................................... Issued_- , �............................................. Date ................................................................................................ ........................ THE COMMONWEALTH OF MASSACHUSETTS -� f BOARD OF HEALTH .....................O F..................................................................................... (9rdifirttte of f�omplittnrr THIS T CERT h Individual Sewage Disposal System constructed ( r Repaired b .......................................... ( ) - --------------------- at-----'----. _ /� 1 t - L ----•- --- -- alter r� has been installed in accordance with the provisions ��'6�)I�of The State Sanitary q+ode d scribed in the application for Disposal Works Construction Permit No.-- -- ------ $ �_�----•---- dated.dt���J�` THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................................-•--•-----------•----•--••------- , Inspector--------------------------------------------------- -------------------------------- .............................................................................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �T � S= ........ ^ . ....OF........ ... -t---------_................................... N ............ FEE.../.G............. Bi>-tu�olitt rkii trurtion Prrmit Permission is hereb ed. --------- --••-- •.•-- ------------------------------------"--------------••-•-------------------------------_----- Y grant to Construct r Repair ( )Ian In idu 1 ewage Isposal tem -----All- ........................ Street as shown on the application for Disposal Works Construction Permit No__________ ____ __ d... G. 7............... -------------- DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No......................... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF Applir ttion -for Ditipuiial Evrkii Tonstrurtion Vrrutft Application is hereby'made for. Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No._,_. -Owner Address a = ................ ............................. ddddres' /�--_ -- •-•--- ... � Installer � Aress-----•----------.- Q Type of Building Size Lot '.___.__:t `'._Sq. feet Dwelling—No. of Bedrooms---___-.�------------------------------Expansion Attic ( ) Garbage Grinder aOther—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, nlet------- _. Total leaching area._....___________sq. ft. Z Other Distribution box ( ) Dosing tank ) '� '—' Percolation Test Results Performed b a Y-------s - :.0 - .l ,Date.... +_ " ! Test Pit No. 1................minutes per inch Depth o "Pest Pit_.-._----__--____-. Depth to ground water._______-..-..--.--_- f� Test Pit No. 2________________minutes per inch Depth of Test Pit--------------------- Depth to ground water-----.---__-_.-.-_--.._. } ` frn Description of Soil---- _... `"#- 4G �.. ----- U ••----•-----•-•-------------------------------------•-------•-----•----•-••-•--•---•--•... . 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 Article \I of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. l � , Se -dl ' " r•- -------------------- -------------------------------- I�~I Dale 44 . .APPlication Approved BY (. or, ^.� - Date Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------•--•------- -----------------•-----•-•---•-••-----------••---.....---------------•--...------------------•-----..........•....-•-------------•-••-- ---•---•--..._..-------•--------•---•----------••-- ------------ Date Permit No.. Issued -------------- ----- ••-•..----•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD TOSHEALTH ......................OF....................... ........................................ Trrti$iratr of WnMphatcrr THIS S T CERT h Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........ = --------- {/ taller )�� , at -------------- r-•---� .. • •--�.... .. 41----- •- has been installed in accordance with the rovisions e i'of he State Sanitary d r'p of S y e 'described ibed in the application for Disposal Works Construction Permit No... _ _.__ 'N......__... dated.t.i_¢'�jL ! __-e P.`1. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A•GUARANTEE THAT TIME SYSTEM WI&L FUNCTION SATISFACTORY. DATE.----- -.C/. ............---`..... ---------••---••--•--••------- Inspector--------.......... ------.. ----- THE COMMONWEALTH OF MASSACHUSETTS BOARD 04� HEALTH ............. ..... ..OF.........' -r............................................. .. ............No. ' t FEE. Bitiv>a,itt rkg- ru rtion Vrrmit Permission is hereby granted------.. — -- ' to Construct_ r Repair ( ) n In tdu ewage isposal tem �J at Nor- f av Street 0 as shown on the application for Disposal Works Construction Permit No-----------'._. __ d__- � ._..__ .._.._..... Board of Health DATE............... ----------------------------- - ............................... FORM 1255 HOBSS..& WARREN. INC.. PUBLISHERS 6.P. 4C-- k (-7)C)CI-) A L AkF_ I/ 100 S67Y To-r,&L Df_- LjE6<,. X Gi oo N y f WAY Fel Cc Iwy. 09 M 'Boy A 5 OA3 60 L_ INV. loon GAL_ r, VI/ u Ao cns-1. L L E, KX A!...l T 71m_ 7 E=V711 C!C-=- V,/Q oj-_7 7-4- C� C� J ti'i7=- IL _C _ -'-)L)I! T t- I-�S, V)I A I I"S. L-1 OT Cl I c lt-4 f-j 0'�,'T E Q_V k L k f �_.1i 1�.1_i- t"'!a,'.r:tt_`�-,r- 3 �'�•r.:ULSG�/+�C . ,/DU.�'ta .. t_�C� C-,l�f•'i.�V.r (:r:tLJC>i.ft --- •— — - ' f 4 U 5 :_ t c��C��, A c_ . �Do, o � Gr 8�i �X; '..l j'alyC--A - (rjC> �•�..�......... , QUX ('"•:� �'t= p 6NL i 1 TOTAL T7E-��(C�til = .�'�S L.F'•t.�. � ► � ,C i Tz-?TA 1- -C),a{L-•( DWEtt,J►J! � C'r=•f�'GVl.QT1C.>1_{ fZdI"L- (� It.f 'L�+ttt,I O� ��,5, i ,e titH OF A. Wlt LIAM lie C- N Y E D FG- ck TUK �kllt> . IC>C.>.o Cl 7' "i a --ACC .�Ti is C"��/%,%t�✓�.''i ) $vd45U'�- 114V. f jOX 'XA �iE'?TIC 1G1 A•• T A+�IK 4 ivOv t}Jv -���►J__ GIN FIT p• � W 1 l%!, EL — _ L cr G A_I,(c t ( CEt J i^�'�/1 L.C.E I C_( I�'C1 {=ter T!-I,/aT' �1-lt= � C .QO�1. E1� `�l1, /►J 4�'-- AS i?i yC'G-:rzC_ GC r t-I W IT1- T t-1 AID I_tt--1 r�.l.ii.� '-C."I"t?>/�C1: is{=C�;.3i�.:C�/rtc._►..1'} bF= Ti-it �•.-. Q�T � �..) •i n w�: ot== �, 4t?I,y,ST-�� t,c- PC.A 1J C3 UrJtC �UC� PAGE 24- R r.��l`S {'C tt'.t�G t._/a l•-t C�J �U�Li i=Y ca c�:S i l t_10'1, C1. .1 1-Its U�'�G�'�/11..t_i= c) lt_d ( .';J;.�i ..t.l �' %.cJ.:./�-_� •r- 'llll:. < .(_c_••,i:1'.� .�,.11::.Ji..T� ! , , , �,r 1'1�_; I � t .��� rr-• i'.�•.� . }_.._._v. ___.__._ rr-• l•••/1,� � J1,/`.�11,1.. (U{� o ' r I. LEGEND TIE DIMENSIONS — w— WATER SERVICE LINE /i, I A B Elevations — G— GAS SERVICE LINE ST SEPTIC TANK DB DISTRIBUTION BOX 2 50.7' 55.�' 45.7 D-Box Ilnvert IOut ,�� SAS SOIL ABSORPTION SYSTEM 3 GO.O' G3.G' 45. 1 Invert In Chamber I C INSPECTION PORT �'� 4 G3.5' 58.2' 45. 1 Invert in Chamber 2 © ELECTRIC BOX I hereby certify that all work has been completed In substantial compliance with \ a�\ the terms of the permit and approved �'),0 \ �\ 2` design plans. The work conforms with `\�\ � \ Massachusetts Title 5 and Barnstable �� Board of Health regulations. 7bsrk sign Engineer Date a d � I too' . i,, De i, STD ! p rJ� , < ox n a4 Q i a a , A y� �i, Prepared for: , �S $ / �` \go�0 Manuel Ferreira, Trs. oo I G Washington Bursley Way, Centerville, MA 0 9 LOT 10 IzH oFty, s -o Area= 15,000 S.f.± o� goy Sewage Disposal System As-Built G6� �� _ • ' �PINO G I G Washin ton Bui-51CY Way, Centerville, MA BENCHMARK I G E c + Top Corner Concrete I 4 Prepared b DEL=50.00(Assumed Datum) ?�- Q p Y: 51TE PLAN o 20 40 Go SCALE: 1 " = 20' SCALE I "=20' P.O.Bos201, Brewster,AM 02631 Phone:(508)896-1513 CA0ceanside\05-Washington Bursley\OS-Washington Bursley-SDS Plan.dwg Date: 07/07/15 Scale:As Shown By: UP Check: MIA Project No. 0515 143 F i .t f LEGEND f TIE DIMENSIONS — w— WATER SERVICE LINE i �i.— G— GAS A B Elevations re SERVICE LINE � '� ST SEPTIC TANK 'i, � ''�,, 1 22.3' 53.8' 4G.3 S-Tank Invert Out DB DISTRIBUTION BOX ii/� /� 2 50.7 55.5' 45.7 D-Box Invert In SAS SOIL ABSORPTION SYSTEM ' 3 GO.0' G3.0 45. 1 Invert In Chamber I C INSPECTION PORT 4 G3.5' 1 58.2' 45. 1 1 Invert In Chamber 2 © ELECTRIC BOX 00 $o I hereby certify that all work has been completed 1n substantial compliance with 4 ��� the terms of the permit and approved design plans. The work conforms with 3.\ . 2 Massachusetts Title 5 and Barnstable Board of Health regulations. sign Engineer Date ii/ Ga �eAt ;i ST�n I// o sira00 �" rJ� �� fix, < 1 i A aG Qa�� cif �d2�v� a f A Prepared for: i o '�i, eg $ P. Manuel Ferreira, Try. 00 1 G Washington Burnley Way, Centerville, MA LOT 1 O I OG 9� Area= 15,000 5.F.± l ���j,ZHOFMa Sewage DIsFoSal System As-Built LINDA-I: - �, I G Washington Burnley Way, Centerville, MA El c BENCHMARK PINTO � '' Top Corner Concrete I� Prep ared by' EEI 50.00um) L NAL 51TE PLAN 0 20 40 GO SCALE: 1 " = 20' SCALE I "=20' P.O.Box201, Brewster,MA 02631 Phone:(508)896-1513 C:\Ocean5ide\05-Wa5hington Bur5ley\05-Washington Bursley-51)5 Pian.dwg Date:07/07/1 5 5cale: As 51hown By: UP Check: MIA Project No. 0515143 i I TOP OF FOUNDATION 24"D/AMfT5RCONCRtTECOVtR5 CENTERVILLE, EL=50.0± 9415ED TO WITHIN 6'OF FINISH MA GRADE(OR A5 NOW) 4' 8.5' 8.5' 4' � m /J 0 -� / U � EL=49.0± EL=4B.8+ tL=48.4� EL=4B.4f 5 m all e e#" I Old Stage Rd U o p� LOCUS a 0 hambet < cn m 47.4� p ro � Washington Burnley Q 36.8a 46.0. � �- p� p ,lJ o p N _ GEOTEXTlLt FABRIC (IN PLACE OF 1/4"-1/2"P5ASTONE) N 36.25 a 46.2D ° p __/ 45.95 :4::5:5:07 45.33 45.20 N P 3/4 - !-l/2 STONE v v (DOUBLE WA51/ED) . Henry F, Loring Rd GA5 BAFFLE m 43.30 TWO(2)5HORtYPRECA.5T 500 PLAN VIEW HAMBER5 WITH '5 '� GALLON LEACH C 12' --4 }----45' Lor�ge�tRun 4'OF,5TO (f ALL AROUND SCALE: I" = 10' ° SITE LOCUS (END V/EW) EX15T1NG 1000 GALLON D0-3 1-1-20 Rated � tL=37.B+Bottom of Test Ho% LAC! / NOT TO SCALE SEPT/C TANS D-15ox CHAM25fR.5 SY,5TEM DESIGN CALCULATIONS I .) Map 172 Parcel IGG 2.) Deed 2588 Page 1 14 FLOW P R0 F I LE SEWAGEDE5/GN FLOW REQUIRED-3 BEDROOM DWELLING @ J/O GPD/BEDROOM 3.) PI Bk 30G Pg 24 Lot 101 =330 GPD REQUIRED 4.) This property 15 not In a Zone 11 of a Public 5tWAGEDE5/GNFLOWPROV/DED.• 7WO(2)500GALLONLEACHCHAMBER5WlTH Water Supply CON5TRUCTION NOTES NOT TO SCALE 5.) Flood Zone: C TEST HOLE LOGS 4 OFSTONEALL AROUND 1,)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE,TITLE 5 (3 10 CMR 15.000): STANDARD W=j(25.0x /2.63)+2(25.0* /2.63)x 21 x.74 REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION,UPGRADE,AND EXPANSION OF ON-SITE SEWAGE Test Hole#I (EL=48.3±) =340 3 GPD PROV1DtD TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT AND DISPOSAL OF 5EPTAGE,AND THE LOCAL BOARD LEGEND OF HEALTH REGULATIONS. 349 GPD PROVIDED>330 GPD REQUIRED Depth Layer Sod Class Sod Color Comments 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE 15 POTENTIAL FOR VEHICLES OR HEAVY 0"-G" A Fine-Medium Sandy Loam I OYR 3/1 SEPTIC TANK CAPACITYREQUIRED: 330 GPDX 200%=C60 GPD REQUIRED EXISTING SPOT GRADE EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO WITHSTAND AN H-20 LOADING. IF UNDER AN IMPERVIOUS G"-30" B Medium Sandy Loam I OYR 5/G 24x5 PROPOSED SPOT GRADE SURFACE, SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. 30"-82" C I Medium Sandy Loam I OYR GIG 50'W TANK CAPAC/7YPROVIDED: EXl5T1NG 1000GALLONPROVIOED -- EXISTING CONTOUR 3.)TO MINIMIZE UNEVEN SETTLING, SEPTIC TANKS SHALL BE INSTALLED ON A STABLE MECHANICALLY-COMPACTED BASE 82"-95" C2 Medium Sand 1 OYR 5/4 w/small pockets of Silt Loam A GARBA6E015PO5AL 15 NOT PERMITTED 1*777i TH/5 DESIGN FLOW 24-"` PROPOSED CONTOUR ON SIX INCHES OF CRUSHED STONE. 95"-1 2G" C3 Medium Sand I OYR 5/4 50%Gravel, little Sandy Loam W WATER SERVICE LINE Test Hale 42 (EL=4g.5±) o OVERHEAD UTILITY LINES 4.) COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE DISTRIBUTION BOX,AND THE SOIL 48 U UNDERGROUND UTILITY LINES ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN G"OF FINAL GRADE. LEACHING FIELDS,`TRENCHE5,AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALL HAVE AT I FAST ONE(1) INSPECTION PORT CONS15TING OF Depth Layer Sod Class Sod Color Comments i'�re� FENCE G GAS SERVICE LINE PERFORATED 4"PVC PIPE PLACED VERTICALLY TO THE BOTTOM OF THE 501L ABSORPTION SYSTEM WITH A CAP,TIED i EDGE OF CLEARING WITH MAGNETIC MARKING TAPE,ACCESSIBLE TO WITHIN 3"OF FINAL GRADE. " O"G" A Fine-Medium Sandy Loam I OYR 3/I 48.2 i/ G"-I G" B Medium Sandy Loam I OYR 5/G -'-'-Tp I G"-58" C I Medium Sandy Loam I OYR GIG TEST HOLE LOCATION 5.j PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A MINIMUM CONTINUOUS ediu 58"-80" C2 Mm Sand I OYR 5/4 w/small pockets of Silt Loam O �` 32 SEPTIC TANK, GRADE OF NOT LESS THAN 2% FROM THE BUILDING TO THE SEPTIC TANK,AND NOT LE55 THAN I%OTHERWISE. �' / ST 80"-1 2G" C3 I Medium Sand I OYR 5/4 50%Gravel, little Sandy Loam 515wtRemoua/ DB DISTRIBUTION BOX G.)DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4"DIAMETER SCHEDULE 40 PVC(OR DATE OF TESTING: OG/1 G/15 P#14721 (fie Note#2 450 5A5 501L ADSORPTION SYSTEM EQUIVALENT) LAID AT 0.005 FT/F7. UNLESS OTHERWISE NOTED. LINES SHALL BE CAPPED AT END OR AS NOTED. SOIL EVALUATOR: LINDA J. PINTO, P.E., OCEANS{DE SEPTIC, INC, 00p BOARD OF HEALTH AGENT: DAVID STANTON, 13ARNSTABIF HEALTH DEPARTMENT 7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2) FEET BEFORE PITCHING TO THE SOIL PERCOLATION RATE: ,,LE5 THAN 2 MIN INCH IN "C"LAYER ��p 49 7 f i ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO A55UU EVEN DISTRIBUTION. (PERC AL t� 4 8.)GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES IN ORDER TO s PROVIDE A WATERTIGHT SEAL. NO GROUNDWATER ENCOUNTERED Plant /� 49.8 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE DISP05AL FIELD DURING I z - THE COURSE OF CONSTRUCTION OF THE SYSTEM. I CERTIFY THAT I AM CURRENTLY APPROVED BY THE P DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO 10.) IN ACCORDANCE WITH 3 10 CMR 15.22 1. ALL 5Y5TEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING 3 10 CMR 15.017 TO CONDUCT 501L EVALUATIONS AND THAT TAPE. THE SOIL ANALYSIS HAS BEEN PERFORMED BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE / 1 1.)THERE ARE NO KNOWN WELLS WITHIN 100'OF THE PROPOSED SOIL ABSORPTION SYSTEM. DESCRIBED IN 3 10 CMR 1 5.017. 1 FURTHER CERTIFY THAT THE � 49.2 48.0 RESULTS OF MY SOIL EVALUATION AS INDICATED ON THE 12.) FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF THE CERTIFICATE OF ATTACHED SOIL EVALUATION FORM, ARE ACCURATE AND IN i� a�� 6\ I Plants COMPLIANCE,THE PERIMETER SHALL BE 5TAKED AND FLAGGED TO PREVENT USE OF THE AREA THAT MAY CAUSE ACCORD NCE WITH 3 10 CMR 15.100 THROUGH 1 5.107o DAMAGE TO THE SYSTEM. 4 . 13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLE55 CONSTRUCTED A5 SHOWN ON !� ¢_1W e ° ��� �� �� pie ov�� x� i C r ,'48 8 PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY THE DESIGNER. Linda J. Pinto, Certified Soil Evaluator �Zr �� `'00 OF 14.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE BOARD OF HEALTH pQOsea ° ° a �� 47.8 'tµ AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE 15 � "�' Z REQUESTED. 40 15.) LOCATION OF UTILITIES 15 APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR DETERMINING THE ` 505ting.5eytit Components to LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, .1� �/ l� be Abandoned(see Note#23) BUT 15 NOT LIMITED TO, REQUESTS TO DIG5AFE,ANY PRIVATE UTILITY COMPANIES,AND THE LOCAL WATER / O Fxistmg.Septic Tank to be DEPARTMENT. � ©fl � Utilized(See Note#22) CO),G.) CONTRACTOR SHALL VERIFY THAT ALL WASTELINES ARE CONNECTED BY WATER TESTING WITHIN THE DWELLING }7 �/� PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. 048,I O I 48 48 Area= 15,000 5.F.i- 17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY 5EPTiC 5Y5TEM G6/ d� Prepared for: COMPONENTS. �� --- --- BENCHMARK Manuel Ferreira, Trs. 18.) INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL NOT BE USED FOR STAKING,OR �G El c Top Corner Concrete I G Wa5hm9ton Bursley Way, Centerville, MA ANY OTHER PURPOSES. Kitchen Dmmg Bth EL-50.00(Assumed Datum) Family Bdrm 19.)THIS PLAN DOES NOT CERTIFY, GUARANTEE OR WARRANTY COMPLIANCE WITH DEEDED OR ZONING BYLAWS, Bth /Q Proposed Sewage Disposal System SPECIFICALLY, BUT NOT LIMITED TO, SIDELINE SETBACKS AND BUILDING HEIGHT RE5TKICTIONS. OWNER IS RESPONSIBLE ,L 1 C Washington Bumley Way, Centerville, MA FOR OBTAINING SUCH A DETERMINATION FROM THE APPROPRIATE AUTHORITY. 20.)TEST HOLES COMPLETED PER STATE ENVIRONMENTAL CODE,TITLE 5. SOILS CAN BE VARIABLE AND TEST HOLE Living Bdrm Bdrm Prepared by: C� p DATA 15 NO GUARANTEE OF SOIL CONDITIONS IN OTHER AREAS. IF SOILS DIFFER FROM THOSE SHOWN IN THE SOILS Garage ✓ITE PLAN LOGS, DESIGN ENGINEER 15 TO INSPECT THE SOILS PRIOR TO PROCEEDING WITH INSTALLATION OF ANY SEPTIC COMPONENTS. " = 2 1.) SOIL REMOVAL• ALL TOPSOIL("A"LAYER), SUBSOIL("B"LAYER), AND C I LAYERS SHALL BE REMOVED FORA SCALE: I 20' DISTANCE Of FIVE(5) FEET LATERALLY FROM THE SOIL ABSORPTION SYSTEM DOWN TO THE C]FAN SAND LAYER kQaN 0 (EL=4 1.8±). AREA TO BE BACKFILL 1`LOOK FLAN ED WITH CLEAN SAND AND COMPACTED TO MINIMIZE SETTLING. INSPECTION NOTE: ��� 22.)EXISTING 1000 GALLON SEPTIC TANK TO BE UTILIZED. PVC TEES TO BE INSTALLED ON INLET AND OUTLET PIPES IF 0 20 40 (SOPRIOR TO FINAL INSPECTION BY THE ENGINEER,SYSTEM NECESSARY,AND A GAS BAFFLE INSTALLED IN THE OUTLET TEE. NOT TO SCALE NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS. ENGMTERING.DIVISION 23.)EXISTING SEPTIC COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN SAND AND ABANDONED IN SCALE 1 "=20' P.O.Box201, Brewster,MR 02631 Phone:(508)896-1513 PLACE. AREA TO BE COMPACTED TO MINIMIZE SETTLING. C:\Ocean5ide\O5-Wa5hington Bursley\OS Washington Burnley-51)5 Plan.dwg Date:OG/22/15 Scale: As Shown I By: LJP I Check:MLA i Project No.0515143