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HomeMy WebLinkAbout0027 WEST WAY - Health 27 West Way Centerville A= 246-209 I I I I i I i i 5 M EAD® No.2.153LOR UPC 1204 smeadcom • Made In USA No. FeeL�/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 1 applitation for Bisposal *pstem constCUttion permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (U �$' rh Owner's Name,Address,and Tel.No. �, gS1 ems-�`���� °� A's'�esior s Map/Pat)cel QK * R;� TQ M s Installer's Name,Address,and Tel.No.,1-C ^��a_ C#M Designer's Name,Address,and Tel.No. 17.0-5 94 eR � �f Fiit&4w-LIe- Ccw;i-Cc Type of Building: q Dwelling No.of Bedrooms Lot Size "'I I S IG sq.ft. Garbage Grinder(V Other Type of Building &S , No.of Persons Showers( ) Cafeteria( ) Other Fixtures �/ Design Flow(min.required) Wip gpd Design flow provided ��{ gpd R rt 4 Plan Date �'�-( Number of sheets $� Revision Date 1 i3 Title "��✓ Cc''")a` h e'Y a1 �, C�enP,,,y1 Size of Septic Tank l S O O Type of S.A.S. - G� 3 L 3C 3 '+- Description of Soil "Sr( Nature of Re airs or Alterations(Answej when applicable) ;{ P 1 S \ r''\O f t lwvrl a � Date last inspected: 77 r3 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 alth. S' n _ Date 1 l Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued r � ///� Fee THE COMMONWEALTH"OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ._ ftpliLation for ioi8tlo8aY 60steln (Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(.) Abandon( ) ❑Complete System ❑Individual Components x, Location Address or Lot No. +of />7 - Owner's Name,Address,and Tel.No. .pp -1 �/ A%s§oAVs ap Paecel Q l�{p R " 7Q n'1 t L ' i l n-/ 2.4 S Installer's Name,Address,and Tel.No.2,P6 3 ba (j),y] Designer's Name,Address,and Tel.No. CI��SQ�c�1'r Coh51-C° �► r n^tr r Type of Building: 9 V q Dwelling No.of Bedrooms "/ Lot Size 911 S5 sq.ft. Garbage Grinder 0 F Other Type of Building QnS No.of Persons Showers( `) Cafeteria( ) Other Fixtures Design Flow(min.required) `(No gpd Design flow provided 94- gpd + Plan Date 0 3 51� Number of sheets 8� ,.Revision Date S 114 113 Title /\P,-� Cc "'!a(,r-e r 21 �--D C 4„kryl ll - .. Size of Septic Tank S GG Type of S.A.S. -� "C h Y 11. q 4- _ Description of Soil �P-f Sr, 1,�,( irk` n Ig h NatuKe of Repairs or Alterations(Answer when applicable) t' r Ir q h e/ r-�C p } Q ., -- -— A id n V v i ���� v75 T/ r �. Date last inspected: � Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system'in Y \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 H alth. Sind Date Application Approved by / U Date Application Disapproved by Date for the following reasons fr' r Permit No. / Date Issued L =---------------------------------------------------------------------------------------.---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance f THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by 'J� S 4,.((y � I at a��/pS� UVIA.t has been const cted in accco Te with the provisionsof Title 5 andthe for Diosal System Construction Permit No. d Installer 4 i i� (),{� Designer D. M� r l h �- #bedrooms u- Approved design flow y y Q gpd The issuance of this permits all q6t be construed as a guarantee that the systern will-Iuncti n ae signed. / ( Date I nr 3 f -3 Inspector - - ---------�------------------ --------------- - :- - - - - - r No. Alo Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLI HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Mis'posal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( , Abandon( ) System located at a f i �/�/-�5 C-f r P Y�/�f 1 4 � )/�' 1 Q Q 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:Construct/l*on mus4e completed within three years of the date of this permit. Date / Approved by or`, / v / TOWN OF BARNSTABLE LOCATION a7 A t Q/4 EWAGE# d� VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.Q1115 (3r0V J C04,3$- Ste$ 3Cc�fpa�� SEPTIC TANK CAPACITY LEACHING FACILITY:()pi QvJ1,tk k( 51iwh,1-vj%as(size) I yt NO.OF BEDROOMS OWNER-rkC)�noD.S -pShsi PERMIT DATE: S I I. 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 �s A-1- 57 t3- - 72' -� 05/14/2013 TUB 10:42 FAX 508 588 4662 9001/003 UNITED CURTAIN CO . , INC. 91 WALES AVENUE ' AVON , MA 02322- PHONE 508 588 -4100 FAX 508 588 - 4662 FACSIMILE TRANSMITTAL SHEET TO: ,f FROM.- TOM RESHA ` DAM s FA NUMBER; - 70 OF PAG NCLUDING COvCR PHONE NUMBER SE N REFERENCE NUMBER: RR YOUR REFERENCE NUMBER: I D.URCENT FVAREvtEw PLEASE COMMENT ❑PLEASE REPLY 11 PLEASE RECYCLE j NOTES/CQ MMENT& I v�, �� ���-tom.. • . oo M ' d O N O I e i I i O � � e��/•�(yJ Lx. N t� M an O o o � o � L� f l - tt� N CC - GO OO � N � [ o E i M � ' o �N ' r ��� �d (pny�'�' /�_'n" ^'„n'T — ll_ ��� No. ,�✓_'� V Fee �® THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpprication for ;Di!5poga[ *p,5tem Con!5tructiou Permit Application for a Permit to Constructs( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot `� /�/ 4/� Owner's Name,Address,and Tel.NNo.'� ssor's ap/Parcel """ o Installer's Name,Address,and Tel.No.4--l- Designer's Name,Address Tel.No. CP� r G> *VIOL Type of Building: -S 4/Ld Q Dwelling No. of Bedrooms Lot Siz 4� sq. ft. Garbage Grinder (�J Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures si n Flow(min.required) gpd Design flow provided 4�5 Z gpd Ian Date Number of sheets Revision Date Title xo� Size of Septic Tank Type of S.A.S. y� Description of Soil c— Nature o epairs or Alterations(Apwer when applicable) 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 Health. �y Signed ``�—'� Date Application Approved by Date 3� ,� 3 Application Disapproved by: Date for the following reasons Permit No. -3 ✓ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Construe ed Repaired ( ) Upgraded ( ) Abandoned( )by ( ✓ �.. at C2 has been constructed in accordance with the provisions of Title 5 and the for osal System Co t ction Permit Nq:,CO I dated- h .L Installer �-w '� a Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 1 Inspector t No. 4. Fee Al THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zlpplication for Zioogar * gtem Congtructfon Permit Application for a Permit to Construct )) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot N•. '� /A/ l /� Owner's Name,Address,and Tel.No. rrvvvv 0"7 sor's MaplParcel Installer's Name,Address,and Tel.No.�i3 Z., /V���� Designer's Name,Address anti Tel.No. s Type of Building: �`" � ~ } Dwelling No.of Bedrooms :73 Lot Size / sq. ft. Garbage Grinder (/lfo _ Other - Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures •\ esign Flow(mm.required) gpd Design flow provided C7( � gpd k Ian Date — 3_ Number of sheets `-Revision Date Title Ali✓ 1/ IL Size of Septic Tank Type of S.A.S. r... u Description of Soil - •.�D t Nature oLRepairs or Alterations(An'wer when applicable) �-l/l� I G •1 rf �(/�'J P 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 Health. I'sd Signed Date --/ f12�"lr7 Application Approved by Date �C!� 3 Application Disapproved by: Date for the following reasons Permit"No. P/� 3 ! f Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constntc ed--(— - Repaired ( ) Upgraded ( ) t Abandoned( )by at c:P- 1X 119 ' r AN / has been constructed in accordance with the provisions of Title 5 and the for oral System Con LS ction Permit No,:r/3 — � date /) 3 t// 3 Installer �'�� yl,,p g V Designer � h.� a�'✓t_.�. #bedrooms Approved design flow - gpd a The issuance of this permit shall not be construed as a guarantee that the system will function as designed. � Date- -- - Inspector --- No. rrt� f F Fee ,f `' G, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS I=igpoga[ *p5tem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade j � ) Abandon ( ) System located at d--9'7 w i ,,�/) l/L//, s., lei ti 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`f this permtt.i ` ) �/ J Date bA Approved by, i - i Town of Barnstable �oFVE T°w o Regulatory Services Thomas F. Geiler, Director Mom. Public Health Division 1639. ATeo ��' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: e3_ _ Zo�3 - Designer: Installer: n k Address: /fll.f�d?c' l 7 Address: Z3 4,tl /,/�i �!L't OZ5G 3 E,¢¢�,ori7` G`o�Lr, CS ZG7�' On S-Z�-/3 was issued a permit to install a (date) (installer) septic system at 2 ��P `¢ based on a design drawn by .ev�ir - ddress) dated QZ1�i3 5-24 -i3 (designer) XI certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local tions. Plan revision or certified as-built by designer to follow. \�H of kqc,c moo`' DARR N ti f (ER 1 (Installer's Signature) o. 114Q® GISTS S�1'Pof1Yd�6bQ�� X (Designer's Signature) (Affix Designer's Stamp Here) t PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL; BOTH THIS FORM AND AS- BCI LYCARD ARE RECEIVED BY THE BARNSTABLE P LIC HEALTH DIVISION. THANK YOU. Q: HealthdSeptic/Desiper Certification Form i -N-;sy 2113 09:23a Ellis Brothers Const. 508-362-6266 p.1 FAX FROM US AT ELLIS BROTHERS. CONST. CO. 362-6237 FAX #362-6266 PHONE # I May 21 13 09:23a Ellis Brothers Const. 508-362-6266 p.2 Town of Barnstable P# Department of Reguiatory S r ices MASMPublic Health Division nay os 200 Maia Stmet Hyannis MA 02601 Tate Scheduled , �t ff cry Time FeePd ,S�il`Suitability Assessment for Selvage Disposal ?afamea9y.�_�%�/.l'`r:�.•^. 1,�:Jt�? J /''' - /� .. Wimesscd By: bOCA.(1�.�{bbN,&GENBRAL INFORMA=TIONU t/c7pon Address / } Owner's Name �-r-u.( �F -z-�e, n-a s� aaarcss $�Assessor's Ma - ca •�otrx-3oprParaet: HogineeesNam �J�rl,,1+EWCONSfRUC190Nl' CTelep tan+[Use — d� SlaFes)�) �':5"; �:.•/./ —�•� Surface Slopes .��__ Distances from open Watt'Body =.'" ft Possible Wet.Area � ?; '�' tt Dr)nkingVYaler Wel! ,✓ t} �f.�.{ DrairageWay %",• fr Property lane ?`L t ft Ottsr � SKETCH:(Street name,dimensions of lot,exact laWlam of test holes& `pert tears,lw-—.ad.in proximity to W_) W-'t s� / zap-�q / �+ o Patent material(geotogfe)? it"-•�r. ��, �� . Eadroak Depth to Graaadwater.Staodiag Water in Hole: CL- Weeping fTom Pit Face N: Enimated-Seasonal High Gnaundwater idt%, DETERMINATION FOR SEASONAL IHGH WATER TABLE tir C' Method Used: De�1lt Observed sanding in ohs.We: - in, Depth to still mottex - Depthto weeping fmn side ofobs.hole: In. GmardrtntaAdjustmeat'ft. [odor V6,411?r treading Dare- latex Wdlkvd - Adj.Paa -A4G:»widwnaer Level_,_, PERCOLATION TUT Date 'rim. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Hm•!mn Soil TczLuu .Still Color Soil• Other Surface(in) (USDA) (Mansell) Ma t6ng (Shtueture.Stones;Bociders. �• 'i{.it to. 1::"� + `L� {'mot fl'1 ST DLEP 089ERVATION HOLE LOG Hole# ! Def[hfrom SoilHok" Soil Texture Soil cola Soil Other Surface(in.) (USDA) (Wnsell) Moulin '$ (Slrucwnc,SLtata,Bouldas. DEEP OBSERVATION HOLE LOG Hole# Depthfrorn Soil Horizon Soil Textrae Soil Color Sail Otter Surface(in_) (USDA) (Mwsdq Mottling (Spet:tme.Sloaes.Boulders. . t �1 it DEEP OBSERVATION HOLE LOG Hole# t,,,;N, Depth from Soil Horizon SoilTearare SoilColor Sol Other Surfsce(io.) (USDA) (Munsell) Mottling (Structure,Stones.Booldem. CogskEency.Mim-11 Flood Insurance Rate Men: Above SOt)yearibodboundary No_ Yes 9'd 99Z9-Z9£-909 ISu00 Sley}019 S!113 e17Z:60£l lZ Aeb'd May 21 13 09:24a Ellis Brothers Const. 508-362-6266 p.3 2 Dy11,.,1 , r— '(/Yl��tnrJt?ri 2 S� AGmcss {L�1 l�of��te,. �` we =e�t Mao?a9a Assrssa'sldapJFarccF t4^eJ '��b^ Z fj � . `� grams�ra,ae C� s NBW CONS"Rmu rrIO�N, RIEP��AEt Telephone ti Land Use sbpcs(%) .•' SarfaceStones �•1,•.':;i Distances Gmm Open Rater Body•'��-'.� fl Possible Wet As.'`- ? � r ;��St Dria;®gNaterlNeB .ID {t �,: } - Dninepe Way fr ProaeAy[.iae ft Other R SKETCH:(Seat name,dimensions of lot,exact localions of test hoses&pc-e tests Wcaze wctl<ads in proxiarity to holes) �) Ii 1r Z � / Z1IG—ZUq t -�,': =i Parent¢ralmiattgaelogic) i.;:- Depth v t 4 1 lo r}Depth to Groundwater,Breading Water in Holc Fu _ Weeping from Pit Face_tv(__. T s Estimated Scasoaal FEgh Greandwata_ iv j t% DETF-RA41NATTON FOR SEASONAL HIGH WATER TABLE Method Used: t . Depth Ohscmd standing ir obs.hole: ta. Depdt to soli mottles: [tt. Depth to weeping fsom tide of obz tot. N. Omtmdwa or AdJnataunt�_,�(t, radcz Well 4 Reading Date. Wez Wrd love!_.,,�,,, Adj,lhclor_.A4j-Groundwata Level...._, PERCOLATION TEST Dale Time Obscrvalioa , Hole N i t1� I TinwatT DepthofPem T.%+—��r,+ 7Yme M 6" StarcPM-soakTime® 1,}�_ 11me(9"•6") End Pro-sank f�' hate MmRnch S:Ic5aitabilityAss=sment: SilaPamcd Site Rd(ed: Additional TmdagNcedod(Y" Original- Public Health Division Observation Hole Data To Be Completed on Back------ ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation D-ivision at least one(1)Week prior to beginning. Q:IS BYiTc�PER CzoRbF.Dx a : � 1JtlPLQ I troy nmo Horizon -Sor771tyo'c Sol]Color So-3 Sndace(iu.) (USDA) (Munsell) Mott"a Other g {5wcturq Stoxs,Bonldozv. i ra t DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Sol)Texture Soil Color Soil Other Stafacc(ia) (MA} . (A'Iuaae7Q Molding (Savaore,Stones,Bouldga. \� Fc I 1 DEEP OBSERVATION HOLE LOG Hole# n Dei;lh F.om Soil liodwn Soil TCUM Soil Coin soil Other Satram(im) (USDA) . (Munseu) Moaling (StnteLnC,S;ottrs.Boulders. j Consisigncy, t F100 d Insurance Rate Man Abaft SOD ymrfloodbuundwy No Ye¢ Within 500 year beUndsry No.f� Yes..�. Within l00yrarfloodbttundw7 No=!� Yes, Depth of Natari lv Occur rim Pervious Material Does at!east four feet of naturally occurring pervious material exist in all mess observed throulithout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pe,-vi6us material? C&Mcation ! .f (date)I have passed the scii evaluator examination approved by the I certifythat on i. -1 Department of.Envimam'enta Protection and that the above analysis was performed by me consistent with . the leguited ftaiam Fexpo tUse and experience described in 10 CMR 15.0M Signature l_----r {.':.,L: -- Date 3 l{ Q:`SFJ n0PMZCF'OaM.DOC ti'd 99Z9 Z9£80S •ISU00 sle410J8 s!113 St Z:60£6 2 ABA oar Town of Barnstable Department of Regulatory Services : .� M Public Health Division Date h 200 Main Street,Hyannis MA 02601 ArEo MA't . CA? Date Scheduled_ Titne /(/ Fee Pd. V)d - �ql Suitability Assessment for Sewage Disposal Performed By: ff _ LQ'. I Witnessed By: CATA N&) GENERAL INFORMATION Location Address ZQ„ I �, Owner's Name �, Z_7rx_e s� Address (� T`{Nd�c1'Le� �e S;-�-90 oL_-kA t'�Cr,Mo90 Assessor's Map/Parcel: 'z,[� ^ 7� Engineer's Name,& S(s NEW CONSTRUCTION RE Telephone# � Land Use Slopes(3'0) � ^� � ,y Surface Stones Distances from: Open Water Body} 2— ft Possible Wet Area 00 ft Drinking Water Well ��� ft Drainage Way ''`� ft Property Line 'C� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) `Z P N a T.Y 1 - 2— V Parent material(geologic) l Depth to Bed�roelt '' Depth to Groundwater. Standing Water in Hole:_ Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE tJ Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: in. Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well#_,-,_ Reading Date:.,, Index Well level _ Adj.factor— Adj.Groundwater level,, PERCOLATION TEST bate Thne Observation Hole# I Time at 9" yy ;p nt Depth of Perc 4o "56 Time at 6" Start Pre-soak Time @ Time(V-6") End Pre-soak Rate Min./lach Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\.SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,Boulders. onsistency.96 Gravel) 0' -7i1 A 6,��� to -gvy - J8 61 Addcaj2 I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsiaten v %Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within t00 year flood boundary No, Z Yes Depth 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? s If not,what is the depth of naturally occurring pervi us material? Certification I certify that on t!� (date)I have passed the soil evaluator examination approved by the /Z-7- Dep_ etlr Environmental Protection and that the above analysis was performed by me consistent with . the requiri in ,expertise and experience described in 3 10 CMR 15.017. Signature Date Q:\S.EPTlCI PERCFORM.DOC �bvv �� � 54� i AsBuilt Page 1 of 1 L0. A710N SEWAGE PERMIT NO. CJ Cil aWG 09 VILLAGE INST LLER'S NAME A ADD E_SS( 2�:� o��-mac • B U It R 0 OWNER a DATE PERMIT ISSUED DATE COMPLIANCE ISSUED =,j .2 �7Rox i d http://issgl2/intranet/propdata/prebuilt.aspx?mappar=246209&seq=1 9/7/2011 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 27 West Way Property Address Rachel Bourque Owner O er' Name, information iseG�/� II� Ma. 02647 2/12/2010 required for every 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. Important:When filling out A. General Information �I �I forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name rQ P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 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 pursuan,.4 . Section 15.34 pf Title 5 (310 CMR 15.000). The system: N, ® Passes ❑ Conditionally Passes ❑ Falls ❑ Needs Further Evaluation by the Local Approving Authority co 2/12/2010 rn Ins tor's Signa ure Date J 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. c � t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments � 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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: The septic system is in proper working order at the present time. 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 complying septic tank as approved by the Board 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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 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 Y2 day flow 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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- 10,000gpd. ❑ ® 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 l I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for HY P annis ort Ma. 02647 2/12/2010 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of a 1500 gallon tank,D-Box and leaching pit. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2008:60,000 g ( y g (gp ))' 2009:12,000 Detail: 2008:164gpd. 2009:33gpd. Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons 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 Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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-09/08 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 ,M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy P annis ort Ma. 02647 2/12/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 18 Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. feet feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 16"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 Sludge depth: 4" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 3 . Commonwealth of Massachusetts L r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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 28" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. 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 I Date of last pumping: Date t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 27 West Way M Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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 No 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.): Box is Ievel.Box has one outlet Iateral.Bo evidence of solids carryover.no evidence of leakage. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for H annis ort Ma. 02647 2/12/2010 y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ 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.): Sandy dry soil.No signs of hydraulic failure.Pit was dry at time of inspection.Stain line observed 30" below invert. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 f I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °w 27 West Way M Property Address Rachel Bourque Owner Owner's Name information is required for y p H annis ort Ma. 02647 2/12/2010 every page. City/Town 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•09/08 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 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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: Bottom of LP 17' 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: As-Built ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observstion Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 West Way Property Address Rachel Bourque Owner Owner's Name information is required for Hy p annis ort Ma. 02647 2/12/2010 every 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 1 ,44 Fz�s........!J.�............... -� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH -------� ------------ OF.........Z ..................................... Appliration for DiipnsFal Works Tonstratrtiun tirrutit Application is hereby made for a Permit to Construct ( ) or.Repair ( } an Individual Sewage Disposal System at: �' v l L 1.K < w`� - 4 .P.�'C>' . '!.°1-'�-5 - ..................................... R....------......------------......... .... 7Loc , •• a ` .-.Loc -Address �® g�or. Lot No. ..... •.. t.(9. ).. �Ar.........••............... ... S?P_ .. _ -? ---7..... ` Fy 1}�.�V .............--- y Owner G -e Address ai':f C3J -----. c.--------------•---•--................................•.. ......... _ _ !�.1.__!1.._ . � Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..........._ .Expansion Attic ( ) Garbage Grinder (9c) A4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) p•' Other fixtures ________________________ W Design Flow.............41-3 _.__.._______ gallons per person per day. Total daily flow........... _l�......................gallons. WSeptic Tank-�iquid capacity),4___.___gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length......_.__,_ Total leaching area....................sq. ft. Seepage Pit No......I------------- Diameter-------1 ------- Depth below inlet........ Total leaching area.....iZ.-..4.-4-sq. ft. Z Other Distribution box ( ) Dosing tank ( ) O, -/i-'!& - �" Percolation Test Results Performed by....6_/4-_S......6Aaae................................. Date........................................ aTest Pit No. 1..., _minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -;z-- /9�O� I,/ +, escri o S .. .-- - �&-- � ......1Q--- .....1x--..... ...........................•----------- -------------- 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 iI'L U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee . .u..e._....y t�oard of heal th. Si r ` % ----------------------------•-- Date Application Approved By......... �1._ _... :t....................... �.-.1 a 7..7..... Date Application Disapproved for the following reasons:-------•------------------------------------------------------------------------------------------------------- ............................................•------•------........---------------•------•--•----.............._....................................................................................... Date Permit No......................................................... Issued----- _~. ._ -_7 ................ ..... Date e N ..........ZZ+l�... _ Fus..../.. .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE TH ........... 1 ...OF......... Appliration for lliiponal Works Tonitrurtion ramit Application is hereby"made for a'Permit to Construct ( ) or Repair ( ) an Individual Sewage 'Disposal System at r_rf,Its.-----. y-'-'r..rd..... ................... ' Lo in... NoM.Q.A.. .... 1.... .............•........... ."� _ . .......-�ytl ress4................. Owner iAd !R- Wyw --------------------------------------------------•-•- ---...... '!►.¢►...e..j ?'._...-----------.................-................. . Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...........3............................Expansion Attic ( ) Garbage Grinder ($e aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a4Other fixtures ................................................................................... r w Design Flow............... 1'3 ._.._ gallons per person per day. Total daily flow_.__.__ -3a d.......................gallons. W Septic Tank-14iquid capacity gallons Length:............... Width................ Diameter................ Depth................ x Disposal Trench—No..2.................. Width................... Total Length Total leaching area....................sq. ft. 3 Seepage Pit No._----I_...__; ___. Diameters (...... Depth below inlet .;_� Total leaching area...... _! _l wsq. ft. Z Other Distribution box (' ) Dosing lank Percolation Test Results Performed,by ,.... Date_.. a -•----•• ••••••.....................•-_.... Test Pit No. 1... . _.._._..minutes per inch Depth of Test Pit _________________ Depth to ground water........................ CLI Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ Pd •... _ y Descrip on of Soil "' " ' r'� �. . ' U -- _... . �....._t�_.:.. , :�:........% . ...�. , #� -------------------------•-----------------_------------ w V Nature of Repairs or Alterations—Answer when applicable............................................................................................... -------------•--•--•----------------------------- Agreement f. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System i'n 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 Compliance has bee ued,4y th oard of healt Sign d__ �/��"�^'` Date Application Approved BY 't•` Date Application Disapproved for the following reasons:.......-.............................--------------------------------------------------------------------•---- • ••-----••---------•-•-•-----•----------------------------•••••••••••••••••-•...-• . -- • te PermitNo.........................------ ................. Issued....................................................... j: Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF............ . 6,1Vs44................................................ (9rdifirat e of Toutplittnrr TH IS TWRTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by j .. Installer has been instd in accordance with�tthe provisions of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. ....... ....... dated-..... THE ISSUANCE OF THIS CERTIFICATE,SHALL NOT BE CONSTRUED A GUARANTEE THAT THE SYSTEM Wl FUNCTION SATISFACTORY. ,.r DATE. ° �p, r ./.........................•---- Inspector---. ......-----------........................... --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z� �rOO ............................... (. FEE........................ No......... . Utsvosal . orkt&A �62?- Vnntrurtion antic Permission is. granted------`... .. -- -----" ..... - " " --••--------------------------•-----------•-•-•------ to Cons t ( or pair ( ) an Individ '1 image Disp SysZm_10UW4 at No J�I��,,,,..�� �^��F -r Street as shown on'the application for Disposal Works Construction Prfgt No ..:. ated..... ...+"Z -� ' ............. y, Board o Health DATE.......(//.... .------------•--------•---•........................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS p'l ,z LO AT ION SEWAGE PERMIT NO. CJ � a�G -oa o9 VILLAGE , INS T/4 ILER�Sh NAME ��A� DDJRE� • B U I l MR 0 OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 0- 7 � • . �s Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel.Viewer Custom Map Abutters Map Size ■^� Zoom Out j I M M I J I M l In t52 *' s d 51 v °Sc4 ST�r r ,y i .. a x fib. .y r 3r (o,3 {Y l' TiS K $) .v t!. } F 4 3M+ 1. 3 20 Feet Set Scale 1" = 20 I Aerial Photos I MAP DISCLAIMER f—,,inht )r)nr_,)oln Tnum of R.r—fT hln RAA 611 rinhfc rcecnn rG. G c� , SU3- q9 9? W'9 25 q7 47 Ct�•.�,✓ � � •`ems/ Q` �? qG r 7b,. 4Z /o.v. By/Z_T rTNi� / 9 • ,r o.� ! • / //SN�o c5epc� c 9G !� '•D O/TCN ���c> , , G/;rCN�S/'�.c7- �/o, _- _ • ,.vaFer' e'o, o /moo a 9G,v,�' 95 ..E : . I �•�; /Nl�Ert1" D/ST o..: r1C-7-19AVI ZO ��!-- � I Y o TTOrN ,,•o .�. � � � •� ALE ,� Af 5 za Z� SEPTIC S'X'S T�fyf C'O,c/�TieUC T/on/ O .S�C�•/ G a�cJ ��,��— C7 i9L/0�9 y ✓G i92�"9 8 S ,8.z'9iH2_.l- 7 4,S `_�' �f/©�` /'/<.fC.G.Fi'I.�!�; •� ��!'.�i9 J h��AG�'� ��G�UGA7'/Ones SITE PLAN SHOWING PROPOSED CONSTRU:CTI ON L O C AT I ON: APPROVED 1977 SCALE : 61^ DATE: BOARD OF HEALTH R E F E R E N C E ,8��,c,�c, ,�oT B,53 r� 4:5 DATE A G E N T ���1H Of M�`�s 11 �kA OF �s BVEREIT s � y H. JOSEPH M. lSiNCELI3Y C M S ASSOCIATES , I N C . b MX)NAHAK tR y 1p 13230 O Fp� ��� REGISTERED ENGINEERS a LAND SURVEYORS " 13660 C TV MID -CAPE OFFICE BUILDING - 12r55 ROUTE 28 STS��a� SOUTH YARM OUTH, MASS. 02664 su1N� Y { LLE - CENTERVI A.M. 246/005 ` 156g4 L.G•C _ _ RpA�_ CRAIGVILLE BEACH A.M. 246/213 190 00� 1 =` — — ROAD LOCUS W z „E ST �z� I N00`56 40 ` cFi�lT R 0 o 0 24 — — "p _ 19.8' 30.6' — 1O"P 10' TWIN \ \ 2� LOCUS MAP 1�0"0 25 6"0 1 �ti° 2 / LOCUS INFORMATION �4 \ PLAN REF: 15694D (SH.2) 10"0 F,S O O 26 _ — TITLE REF: CTF#191002 i V ' PARCEL ID: MAP 246 PAR. 209. ZONING: "RD-1" NOT IN ZONE II 2 2 PRpp, W PLK / FLOOD ZONE: "C„ 14"P v 3�2, �— — — _ — COMMUNITY PANEL: 250001-0008-D OATED:07/02/92 y SEPTIC SYSTEM 00 28. �� O //.:::;••�• I ASPHALT DRIVEWAY REPAIR PLAN LOCATED AT: 27 WEST WAY I m ROA oar .. TOF=27.28 — '- — f PUMP, CRUSH & FILL 1 Aq�oSFo ��� CEN TER VI LLE, MA. LEACH PIT O ::.: %% I �� PREPARED FOR W THOMAS M . & LYNNE M . oN #27 W RESHA APRIL 1, 2013 REMOVE TANK AND �,p W DISTRIBUTION BOX \ REV: 5/17/13 REV: 5/24/13- RESERVE p P „ ,,,,, JAC. ROPOSED „ POOL �tN OF� Ss j TWIN 10"0 / :; :� -o ! A.M. 246/209 �NOF�asSa c R � LOT 38 r 0�� EDWARD �� , 0 AREA=29,159f S.F. a`r A. � g? w rLFj i i _ STONE cn . 1140 No 2898 OHW ssi A J Sq. 1TAR� A.M. 246/171 215.91 E. A.. S. SURVEY, INC. i 27 � _ NO3°01�55"E 141 ROUTE 6A GRAPHIC SCALE SALT POND BUILDING P.O. BOX 1729 A.M. 246/210 20 0 10 20 40 so SANDWICH, MA. 02563 ( IN FEET ) BUS:(508)888-3619 CELL:(508)527-3600 1 inch = 20 ft. SHEET 1 OF 2 J 1521 B TOP OF FOUNDATION r EL-27 28 45' CLEANOUT SWEEP , W/SCREWCAP 4" SCHEDULE 40 P.V.C. 2 OBSERVATION PORTS (10' MIN.) TO GRADE MIN. PITCH 1/8" PER FOOT W%SCREWCAPS TO GRADE EL=26.4 _ 24.0 .................. EL 3 8 : : . .,�..,, ..... . - 6" MAX. � Ti�1��:.. .,..,,,.; ,.,,.,. ,. EL 23 2 6 MAX.'....... .: ......... ..:......,.... ........................ . 9" MIN. .................. .............. .......................� RISER COVER RISER CONC. CLEAN SAND FILL """ NEEDE A NEEDE RISER & 36 PER 310 CMR 15.255 36 EL= 23.25 LEVEL INVERT BETWEEN AND TO A MIN. OF 6" COVJR �OR 2' LONGEST RUN EL= 19.86 OVER UNITS 52' ® S=.03 11.2 S= .17 -� 8' S=.01 EL= 20.2 FLOW LINE -' INVERT 110" 14" INVERT INVERT INVERT 12" (TO VEMAiN) EL=22.25 MIN. EL= 22.0 EL= 20.11 6" SUEL=19.94 8" INVERT 4' GAS 6" BASE OF MECHANICALLY L EL= 19.2 BAFFLE COMPACTED SAND 32.0' PROP. D135 32-QUICK 4 STANDARD PLUS INFILTRATORS 6" BASE OF MECHANICALLY DISTRIBUTION (34"W X 48"L X 12"H) EACH COMPACTED SAND BOX W/"T" SOIL ABSORBTION SYSTEM (S.A.S.)(BED FORMATION) PROPOSED 11.33' X 32' 1 ,500 GALLON TANK o PROFILE OF 34 No CLEAN SAND FILL EL= 20.2 00 ui SEWAGE DISPOSAL SYSTEM EL= 19.86 $ N (NOT TO SCALE) EL 19.2 11.33' GENERAL NOTES END VIEW BOTTOM OF TH #2 ELEV.= 11.1 (NO GROUND WATER) 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATIONS- AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE DESIGN DATA: ACCESSIBLE WITHIN 3" OF FINISH GRADE, WITH ANY REMAINING BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE ACCESS PORTS BROUGHT TO WITHIN 3" OF FINISH GRADE. DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, NUMBER OF BEDROOMS........._ 4 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE ARE U TE AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. GARBAGE DISPOSAL................. NO _- UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. W - X 4 BR.)GAL./BR./DAY / 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION ( ) __440440 OF ALL UTILITIES PRIOR TO ANY EXCAVATION. DARREN M. MEYER, CERTIFIED SOIL YVALUATOR 440GPD X 200% = 880 GAL 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE USE NEW 1500 GAL. TANK OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. INSTALL: 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE � TES PIT RESULTS. 32 QUICK4 STANDARD PLUS INFILTRATORS (34"W X 48"L X 12"H) OVER THE S.A.S. AND DISTRIBUTION BOX. AND BACKFILL WITH CLEAN SAND FILL 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL TEST DATE: MARCH 21, 2013 R 310 CMR 15.255 11.33' X 32' SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6' ABOVE PER ( ) THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND B.O.H. AGENT: DON DESMARAIS, R.S. SOIL CLASSIFICATION................ LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. SOIL EVALUATOR: DARREN MEYER, R.S. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN DESIGN PERCOLATION RATE..... <2_t&bL/N- 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT BACKHOE: ELLIS BROTHERS EFFLUENT LOADING RATE.........__74___ ELEVATION of THE OUTLET PIPE. REQUIRED LEACHING CAPACITY.....440 GAUDAY 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. TH#1 E L.=2 3.2 P E R C RATE<2 M I N./I N. @40-5 6" L/ 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS LEACHING CAPACITY PROVIDED.....447 GAL DAY BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER (4) ROWS OF (8)INFILTRATORS X 4.73 S.F./L.F. 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 22.6 0"-7" A LOAMY SAND 10YR3/2 --- ----- L.F. X 4.73 S.F. L.F.= 605 S.F. FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 128 L / BE LEVEL. 20.1 7"-37" B SANDY LOAM 10YR5/8 --- ----- 605 S.F. X .74 GPD./S.F.= 447 GPD 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 15.1 37"-96" Cl MED. SAND 2.5Y6/4 --- ----- TO EAS SURVEY, INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW AND APPROVAL. 11.2 1 96"-144" C2 F/M SAND 2.5Y6/6 I --- ----- 447 GPD PROVIDED - 440 GPD REQUIRED = 7 GPD RESERVE NO GROUNDWATER/NO MOTTLES ; -�N OF MgSS9 �-\N.OF MA CONSTRUCTION NOTES: TH#2 EL.=23.1 o= EDVVARD ��, A yG SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER A. 27 WEST WAY ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING STONE �" , 22.5 0 -7' A LOAMY SAND 10YR3/2 --- ----- I n. , ER CENTERVILLE MA. WORK ON THE SITE. N0• 28980 0 1Vu. 1140 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 20.0 7"-37" B SANDY LOAM 10YR5/8 --- ----- �P - ' WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT " ___ �F G� TE '� APRIL 1, 2013 14.9 37"-98 Cl MED. SAND 2.5Y6/4 -PERC J� F IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. i NA LA LISTER REVISED: MAY 17, 2013 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING 11.1 98"-144" C2 F/M SAND 2.5Y6/6 I --- ----- S'QNiTAR\ SHEET 2 OF 2 J# 1521E TAPE OR A COMPARABLE MEANS. NO GROUNDWATER/NO MOTTLES L CENTERVILLE A.M. 246/005 ______---- ---------- A.M. 246/213ROAp -- --------- CRAIGVILLE BEACH 19000 -__--_ -- --_ ROAD ,ao"E FEE --TREET - _ ___ -- - Locus W Z _ _ ___ -------- ----- - Npp�56 ------------ __----�- CFjVre Er 0 0 DIRT ---------------- 10"P TWIN 04 � ; � --_� 10"0 �/ 25 -- LOCUS MAP 1r1\�` IdB 6' � 32D i Q LOCUS INFORMATION PARTS � .___ � � W, /' ,L6 _ 4 - PLAN REF: 156940 (SH.2) - n TITLE REF: CTF#191002 PARCEL ID: MAP 246 PAR. 209 10"0 '' W , O ' Wp,�K /� ZONING: "RD-1" /� LA ,� i�PROP FLOOD ZONE: "C" TP#2 ,-' (n 23.1 ' `S� 70 ��' ��� ' �� `` • / COMMUNITY PANEL: 250001-0008-D DATED:07/02/92 14„P , ,�' W.�..-�� ,,,,;;;;,,,� � ,\\ ---------------- I" SEPTIC SYSTEM P ' �T`' % ���'���� DRIVEWAY ASPHALT REPAIR PLAN PUMP, CRUSH & FILL „ ' �; LEACH PIT /� AR \ Q•oJ T��- (( _ 27 WEST WAY LOCATED A Op o a %% TOF=27.28 --- ----- -- ------ A OS _ --- / CEN TER VI LLE, MA. . f W o PREPARED FOR _ -=N #27 I W 0 THOMAS M . & LYNNE M. REMOVE TANK AND 2 ii. :i ° W RESHA DISTRIBUTION BOX � ROPOSED I P P�10 %% �' f APRIL 1, 2013 TWIN 10•10 I •- POOL'' o A.M. 246/209 Of � LOT 38 ASs9 �Ztl Of ,� 00 ;; = AREA=29,159t S.F. o���DAR, ���� Sys �ti ,7E� EOlNAF3D b No. 1140 // /• i i i i ' — - _ - - . - offal No 28 ci51 Z6 , - _ ------- �NITAR\a� 1.13 NAL LAfl� ( V3 A.M. 246/171 215.91' E. A. S . 27 SURVEY, INC. NO3°01'55' - 141 ROUTE 6A ` GRAPHIC SCALE SALT POND BUILDING A.M. 246/210 1 729 20 0 10 20 40 80 SANDWICH, MA. 02563 t ( IN FEET ) BUS:(508)888-3619 CELL:(508)527-3600 1 inch = 20 ft. j SHEET 1 OF 2 J#1521 TOP OF FOUNDATION 45' CLEANOUT SWEEP �'`• EL=27.28 W/SCREWCAP LE 40 P.V.C. ` �- (10' MIN.) TO GRADE MIN. PITCH U/8" PER FOOT 1 (2) OBSERVATION PORTS W EL=26.4 EL= 25.0 EL= 24.5 r O SGRA GRADE tee EL= 23.8 EL= 23.2 EL- 23.2 MAX. "b 1vtX' 6" MAX.' ....., RISER COVER RISER CONC. CLEAN :;::SAND :;::FILL ::,..,... ...............% A NEEDE NEEDE 36" PER 310 CMR 15.255 EL= 23.25 RISER & LEVEL ' INVERT BETWEEN AND TO A MIN. OF 6" 36' COVER EL= 19.86 OVER UNITS 39' ® S=.04 11.5 S= .16 FOR 2' LONGEST RUN EL= 20.2 EL=23.85 �� FLOW LINE 8' S=.01 10 INVERT INVERT INVERT t (TO REMAIN)INVERT EL=22.25 1 MIN. 14 EL= 22.0 EL= 20.11 6" SUMP INVERT 94 8"� 12" INVERT EL= 19.2 VUHUTv 4' GAS 6' BASE OF MECHANICALLY BAFFLE COMPACTED SAND 32.0' PROP. D85 32-QUICK 4 STANDARD PLUS INFILTRATORS DISTRIBUTION 6" BASE OF MECHANICALLY (34"W X 48"L X 12"H) EACH COMPACTED SAND BOX W/ T PROPOSED SOIL ABSORBTION SYSTEM (S.A.S.)(BED FORMATION) 11.33' X 32' . 1 ,500 GALLON TANK _ o PROFILE OF 34" CLEAN SAND FILL EL= 20.2 00in SEWAGE DISPOSAL SYSTEM 7EL= 19.86 (NOT TO SCALE) ARL= 19 2 8" N 11.33 GENERAL NOTES END VIEW BOTTOM OF TH #2 ELEV.= 11.1 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. (NO GROUND WATER) TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF FOR SUBSURFACE DISPOSAL OF SEWERAGE. ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED ACCESSIBLE WITHIN 3" OF FINISH GRADE, WITH ANY REMAINING BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE DESIGN DATA ACCESS PORTS BROUGHT TO WITHIN 3" OF FINISH GRADE. DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, NUMBER OF BEDROOMS........._3 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE ARFAOCCURATE AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. GARBAGE DISPOSAL................. NO UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY ` TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION (110 GAL./BR./DAY X 3 BR.) __330 OF ALL UTILITIES PRIOR TO ANY EXCAVATION. DARREN M. MEYER, CERTIF D SOIL EVALUATOR 330GPD X 200% = 660 GAL 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE USE NEW 1500 GAL. TANK OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. INSTALL. 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE TEST PIT RESULTS: 32 QUICK4 STANDARD PLUS INFILTRATORS (34"W X 48"L X 12"H) OVER THE S.A.S. AND DISTRIBUTION BOX. AND BACKFILL WITH CLEAN SAND FILL 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL TEST DATE: MARCH 21, 2013 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE PER 310 CMR 115.255 (11.33' X 32') THE FLOW UNE AND SHALL BE ON THE CENTERLINE AND B.O.H. AGENT: DON DESMARAIS, R.S. SOIL CLASSIFICATION................__ LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. SOIL EVALUATOR: DARREN MEYER, R.S. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN DESIGN PERCOLATION RATE..... <2 MIN-_/IN. 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT BACKHOE: (ELLIS BROTHERS) EFFLUENT LOADING RATE.........___74 ELEVATION OF THE OUTLET PIPE. 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. TH#1 EL.=23.2 PERC RATE<2MIN./IN. @40-56 30fD " REQUIRED LEACHING CAPACITY.....3 GAAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS LEACHING CAPACITY PROVIDED.....447 GAj=/DAY BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER 4 ROWS OF (8)INFILTRATORS X 4.73 S.F. L.F. 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND ( ) ( ) / FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 22.6 0"-7" A LOAMY SAND 10YR3/2 --- ----- 128 L.F. X 4.73 S.F./L.F.= 605 S.F. BE LEVEL. 20.1 7"-37" B SANDY LOAM 1OYR5/8 --- ----- 605 S.F. X .74 GPD./S.F.= 447 GPD 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 15.1 37"-96" ClMED. SAND 2.5Y6 4 TO EAS-SURVEY, INC.-FOR-B.O.H. AND DESIGN / --- ----- ENGINEERS REVIEW AND APPROVAL. 11.2 96"-144" C2 F/M SAND 2.5Y6/6 I --- ----- 447 GPD PROVIDED - 330 GPD REQUIRED = 117 GPD RESERVE NO GROUNDWATER/NO MOTTLES CONSTRUCTION NOTES: TH#2 EL.=23. 1 10 �F MAS�9� ��� Uf Slq��gc SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR_ MOTTLING OTHER ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING DARRE I ,M� . ✓+ g ED AP.D J' 27 WEST WAY WORK ON THE SITE. 22.5 0"-7" A LOAMY SAND 10YR3/2 --- ----- '� a 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 20.0 7"-37" B SANDY LOAM 10YR5/8 --- ----- 140 � N CENTERVILLE, MA. WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT NO 8 Q APRIL 1, 2013 -� 14.9 37"-98" Cl MED. SAND 2.5Y6/4 --- -PERC IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. RfGI$TE� ERA 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING 11.1 98"-144" C2 F/M SAND 2.5Y6/6 --- ----- SgNITAR�P� roNAL LANDS ,�� SHEET 2 OF 2 J# 1521 TAPE OR A COMPARABLE MEANS. NO GROUNDWATER/NO MOTTLES ,l:�j CENTERVILLE A.M. 246/005 _ C•C•C• ' — CRAIGVIL.L BEACH A.M. 246/213 — f FZ°AD` � — — � ROAD 190.00 z vn _ _ T — LOCUS w z�! -5614011EFAIRv1E T Rai p <<F 10"P R oR�E 1 <<S 19.8' � 30.6' _ 1011p — 10' TWIN 2CPI LOCUS MAP 10'0 25 � 6"0 1AL� 0 '2 / P LOCUS INFORMATION 91002 > �4- — _ � �(� PLAN REF: 15694D (SH.2) 10"0 ��5� 026 ` — ( ' PARCELTITLE S D: MAP 246 PAR. 209 ZONING: "RD-1" NOT IN ZONE II 2 FLOOD ZONE: "C" 2 �? PROP• z COMMUNITY PANEL: 250001-0008—D DATED:07/02/92 14"P00 • SEPTIC SYSTEM 00 o 28. �� O ����;;; '�' " �� ASPHALT DRIVEWAY �� REPAIR PLAN`OA - LOCATED AT: 0 0. N A • _ _ _ _ _ - - - - - - - - - - 27 WEST WAY rn ' RpA o�� TOF=27.28 " ` — — PUMP, CRUSH FILL .�1 Aq ps' ��� �. "%�� CENTERVILLE, IVIA. LEACH PIT �/O v' ;:.: %% �� PREPARED FOR y� W W 0. THOMAS M . & LYNNE M . #27 RESHA O20' ;; APRIL 1, 2013 / REMOVE TA K AND ��• " DISTRIBUTIO Box ROPOSED PPT10 W� REV: 5/17/13 REV: 5/24/13— RESERVE JAC. POOL ';, :. ��x of MqsOF ALQ`�s�C TWIN 10"o �. -o A.M. 246/209 AFT S9c A �� LOT 38 �o� EDWARD p � / i; ii n AREA=29,159f S.F. o A. t R p �Fj S STONE N No 2898 or •6. 1141J -a GISTS �... — OHW Fss� QST �' s1NITARk� 2 i A.M. 246/171 ' 215.91 E . A. S. SURVEY, INC. 27 �— — NO3'01'S5"E 141 ROUTE 6A GRAPHIC SCALE SALT POND BUILDING P.O. BOX 1729 A.M. 246/210 20 o to 20 40 8 L SANDWICH, MA. 02563 cS ( IN FEET ) BUS: (508)888-3619 CELL:(508)527-3600 a ® � ����'� ✓b i� aLkAl i (�- 5 4- 5 I 1 inch = 20 ft. SHEET 1 OF 2 J 1521 B az i 6'.8• 10'-8"24'-0" ®' • -+r-t at 8'-0" TFa. 8'-0" 8'-0" ` d�7 \ •\ _ I'�pII I�I I�II' IpI� RIDGE I VENT T . __ 2XIO RIDGE2X 8 RAFTERS•16.O.C. I ROOF STEA SHEATHING -- --- --- --- --- -- 6-0 �ASPN� PPER I -------- D ASPHALT SHI GLESHANGRS 3-X10..PT : O STORAGE �' KITCHEN BATH n _ I n U (j AREA �•:. - MI Z iv O i.' p • _.__ _ e o• \I U X ,p �� ,r-2XI0 RIDGE e-Dfe'•ro 1/Y WALLBOARD u X3 STRAPPING 2XI0 PT n e v Q Q r o H 16"O.G.-� -;Q X • I. m �_ �. n m POOL 1/2'WALLBOARD :r U •° O Q n �O!� \ n :� HOUSE 2X4'e•Ib'O.C. LIVING m ° O Z 4 —M1+ �� 1/2'WALL SHEATHING - v AREA • - R k d W W I 1{,/ •� — .� ,u: 3/OUSEL PLY WRAP OR-SIDING EQUAL NG / ¢ F ZXB'e•16'O.G. F 2XI0'e•Ib"O.G. O '• 2446-2 2446-2 ./-TYP.HANGERS 3-2X10'e PT J m O I +� I� NAILED a GLUED. It r✓ _ m i 4. Q "I 24'-O" --- --- -- � � 4 -----'-'=L=J xass__ae_ L^r•- --.._--. --- - -_--------------- - ----._-_-_-'---- - - - ,'-IOI4" 1 ,'-10" l ,'-10w" `� .- -- ROOF FRAMING PLAN FLOOR PLAN FLOOR FRAMING PLAN GROSS SECTION DETAILS ASPHALT ROOFING_ ASPHALT ROOFING . ASP_HALT ROOFING IS•ASPHALT PAPER \ : r— --- -IR"SHEATHING - -- - - - — _ \�TYP.H2.5A TIES - - �3-2X10'e PT _ _ 5"GUTTER 2XI0'e �TYP.IX5/IX4 ._._ s - I G IL:•L _ NR.BRDS q t �-_---.—_— -I i .WALL LENGTH" -0' I 'rr -IXB FACIA i CsRADE LEFT ELEVATION /C SHINGLES FULL HEIGHT SHEATHING• -2I I �` ` �`r-IXB SOFFIT v ACTUAL 5HEATHING•�L% 1 2-1/4"VENT - --�� I /, f,1,•''J,'d /TYP.CB68 BASE / (MI,Required '�%) I. �1-3/4'BED MLDG. / / /, /•,-- NPLIFT 4200 EACH)RATI j EDGE NA NCg�O.C_ I r TO REGFRIEZ.EIDING // /,% 1'•JQ•,J° /�j� /�// �. FRONT ELEVATION FIELD NAILINCnJZO.G /r --- _ - az SHEAR EA _ HEA SHEAR / _ ...._. .._ .. .. ... 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