HomeMy WebLinkAbout0021 SOUTH MAIN STREET - Health 21 South Main Street
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A=228 - 124
SMEAD
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Jul 18 2017 20:17 HP Fax page 18
Commonwealth of Massachusetts
Title 5 OfFicial Inspection Form �w
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
a
21 South Main StreetT,-
Property AddressX.
z-rn
Frances Sullivan s
owner Owner's Name
Information is lei
required for every Centerville MA 02632 7-11-17
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 checkl let at the end of the form.
Important:Whng DUt formsen A. General Information
on l the computer, OF
use only the tab 1. Inspector: .���� '' •• o°
key to move your a pt:
cursor-do not James D.Sears _ JAMES ,m
use the return Name of Inspector =v
key. *: C
Capewide Enterprises
Company Name W: RRTtf�. �¢�_
153 Commercial Street i �iF 5.I N.SPSG` ���
Company Address �irr"irtrltttlN�
Mashpee MA 02649
CIryJTown State Zip Code
508-477-8877 S 1623
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
7-13-17
spector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system 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.
t5im.doc rev.We Title 6 Offwial Insoection Form:Subsurface Sewage Disposal System•Page 1 of 17
�� VS
Jul 18 2017 20:17 HP Fax page 19
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
a
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
Information is required for every Centerville MA 02632 7-11-17
page. CityfTown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E I 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 system is a 1500 Gal. Tank D Sox and three chambers.
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):
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Jul 18 2017 20:18 HP Fax page 20
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
-Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ NO(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
16.303(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
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Jul 18 2017 20:18 HP Fax page 21
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form • Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. CitylTown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, If any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered, A copy of the analysis must
be attached to this form.
3. Other:
DI 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 is less than 6" below invert or available volume is less
than %day flow j F,4C#jA16
t5ine.Coc•rev.e/ie Title$Dificial inspection Form:Subsurface Sewage Disposal system-Page i of 17
Jul 18 2017 20:19 HP Fax page 22
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
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 cotiform 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 11 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.doc-rev.&16 Tllle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Jul 18 2017 20:19 HP Fax page 23
I Commonwealth of Massachusetts
Title 5 Official Inspection Form
a a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
i
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
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); 4
DESIGN flow based on 310 CMR 16.203(for example: 110 gpd x#of bedrooms): 330
t5ins.doc•rev.&IS Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Pape 6 of 17
Jul 18 2017 20:19 HP Fax page 24
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
The system is a 1500 Gal. Tank D Box and three chambers.
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available(last 2 years usage (gpd)); 2015-49,000Gals2015-51,000Gal's
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Present
Date
Commerciallindustrial 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.doc rev.W6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Jul 18 2017 2020 HP Fax page 25
Commonwealth of Massachusetts
r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owners Name
information is required for every Centerville MA 02632 7-11-17
page. City/Town State Zip Code Date of Inspection
D. System Information (coot.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: NA
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):
15ins.doc•rev.6116 Title 5 Official Insoecilon Form:Subsurface Sewage Disposal System•Page a of 17
Jul 18 2017 20:20 HP Fax page 26
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
Information is
required for every Centerville MA 02632 7-11-17
page, Cityfrown state Zip Code Date of Inspection
D. System Information (cont)
Approximate age of all components, date installed (if known)and source of information:
2006 Permit #2006 -466
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 32"
feet
Material of construction:
❑cast iron ®40 PVC ❑other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Pipeing is 4" PVC SCH -40.
Septic Tank(locate on site plan):
Depth below grade: 21
feet
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1500 Gal. Precast H-20
Sludge depth:
1"
t5ins.doc•rev.8116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Jul 18 2017 2020 HP Fax page 27
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
" 21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is -Centerville required
for every MA 02632 7-11-17
page. Citylrown State Zip Code Date of Inspection
D. System Information (cost.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
29"
Scum thickness 1rr
Distance from top of scum to top of outlet tee or baffle
8"
Distance from bottom of scum to bottom of outlet tee or baffle 1
How were dimensions determined? Asbuilt- Plan -Tape
Sludge Judge
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.).-
Tank at working level. Tank at 21" below grade. Inlet cover at 15"w/outlet cover at 4". In and
outlet tees, No sign of leaks a or over loading. Note: H-20 Tank,
Grease Traplocate on site plan):
( P
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
Wns.doc•rev.W6 T@Ie 5 Official In -lion Form;Subsurface Sews Oi S
spe_ ge wal sp ys6em•Page 10 of 17
Jul 18 2017 2021 HP Fax page 28
Commonwealth of Massachusetts
RielmcR Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owners Name
information is required for every Centerville MA 02632 7-11-17
page. Cityfrown 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.doc•rev.61IS Tole 5 Official Inspection form:Subsurface Sewage cisposal Systen•Page i 1 of 57
e
Jul 18 2017 2021 HP Fax page 29
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. CIty/rown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D Box is 16"x2l"w cover at -16" below grade w/two line's out. Box is clean and solid. H-20 D Box.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No'
Alarms in working order: ❑ Yes ❑ No`
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
'If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins.doc-rev.6116 Title 5 Official Irspectlon Form:Substeeoe Sewage Disposal System•Page 12 oW
Jul 18 2017 2021 HP Fax page 30
Commonwealth of Massachusetts
w L, Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 South Main Street
Property address
Frances Sullivan
Owner Owners Name
information is required for every Centerville MA 02632 7-11-17
page_ Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 3
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number.
❑ innovativelalternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching is three H-20-500 Gal. Dry well chambers w/3-6' stone on sides. Chamber's at 45"
below grade w/cover at 1'. Chamber's are clean wall's w/6"water. No sign of over loading or solid
carry over.
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.doc•rev.6l16 Title 5 official inspection Form:Subsurface Sewage Disposal System-Pape 13 Of 17
Jul 18 2017 20:22 HP Fax page 31
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. CityfTown 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.):
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Jul 18 2017 20:22 HP Fax page 32
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. Cityfrown Stale Zip Code Date of Inspectlon
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet, Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
J.3-1
3Q' �
A.
13 A-3 = 3 4
2 11 y, s/a
I-Romr
3 �
e C.
-S n T
Olne.doe•rer.6/1s Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 15 of 17
Jul 18 2017 2022 HP Fax page 33
Commonwealth of Massachusetts
x Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 21 South Main Street
Properly Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells jvD
Estimated depth to high ground water: 11+
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: 10- 3-06
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers -(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
T.H.on Design plan 10-3-061 T no G.W.. Bottom of Chambers at 6'below grade. Bottom of
Chambers at 5'+above T.H. Depth.
Before filing this Inspection Report,please see Report Completeness Checklist on next page.
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, P
Commonwealth of Massachusetts
Title 5 Official Inspection Form
A Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
21 South Main Street
Property Address
Frances Sullivan
Owner Owner's Name
information is required for every Centerville MA 02632 7-11-17
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
t5lns.doc•rev.W16 Title 5 Officlal Inspection Form:Subsurface Sewage Disposal System-Page 17 or 17
TOWN OF BARNSTABLE
LOCATION M %v,'4(-fe4 SEWAGE
*VILLAGE CCCtn4cCV ale ASSESSOR'S MAP&PARCEL ZZ�
INSTALLERS NAME&PHONE NO. -6 cOWVi ,v�$, EYCCtiVvt4OrS 7611. 63O 3153
SEPTIC TANK CAPACITY H-20 !r500 9ii llohS
LEACHING FACILITY:(type)()) C64i6(size)
NO.OF BEDROOMS 3
OWNER SU It I J(V
PERMIT DATE: 1(7 `Z NO 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
6
y �IW.s 33'
DSO' 4Ss5
L.01
Y �
Ni Fee
THE COMMONWEALTH OF MAS§ACHUSETTS Entered in computer:
PUBLIC HEALTH ®IVISIO'N e TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplication for TDi.5ponY 4§pgtem Cow5truction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) U Complete System ❑Individual Components
Location Address or Lot No. �-�/�7f� 1"IAA 57 Owner's Name,Address,and Tel.No. 7 7/— 7 f.2,6
Assessor's Map/Parcel "'a 8 /C;L( / �� (/(,� r� /1�I/g/� S 7-
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of u 1 ing:
Dwelling No. of Bedrooms -3 Lot Size 1 a? AK sq. ft. Garbage Grinder
Other Type of Building 14)0Q A >�� No.of Persons Showers( ) Cafeteria( )
Other Fixtures 17-
Design Flow(min.re fired) gpd Design flow provided gpd
Plan Date f /�(;l Number of sheets / Revision Date
Title (f r#- MA IXI Sr
Size of Septic TankOvAt3Type of S.A.S. l �
Description of Soil
Nature of Repairs or Alterations(Answer 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 Ti 5 o teE 'ronmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this oa of
Signe G Date
Application Approved by 4 Date.
Application Disapproved b Date
for the following reasons
Permit No. Date Issued
TOWN OF BARNSTABLE
LOCATION / 50 ®V,41 A, S% SEWAGE#
kILLAGE ENT ASSESSOR'S MAP&PARCEL
/,q,5�oz1C vA
It'd NAME&PHONE NO. /� O ��/1✓�'
SEPTIC TANK CAPACITY /,y Y,,o crC a/V
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS
OWNER r�l A Al Z Ay V
PERMIT DATE: 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
r
�5 ,y.L'
o � o 4
No. Fee
THE COMMONWEALTHOF MASSACHUSETTS Entered in comp ter:
' PUBLIC HEALTH DIVIS164
^TOWN OF BARNSTABLE-MASSACHUSETTS Yes
t
� } ZIpplication for Mir o.5at �& ztem Con.5tru tiott Vermtt 3
Application for a Permit to Construct( ) Repair( ) !Upgrade( ) Abandon( ) Complete System ❑Individual Components
pZ/ ��/( /n17IAI 57 7 7�- -7y z 6
Location Address or Lot No. Owner's Name,Address,and Tel.No.
CFr1r�✓rum fI�c 5 /W rZ_VE _
Assessor's Map/Parcel 8/ /a(/ �f(J/r/ /Yl/�/N S/
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
7
Type of Building:
Dwelling ` No.of Bedrooms _ Lot Size °� sq.ft. Garbage Grinder (r 4
Other Type of Building 4)0Q A fIMOC No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.retired) gpd Design flow provided gpd
,,;Plan Date �/�/�(�`i ' Number of sheets / Revision Date
Title I _�961?h( 57
Size of Septic Tank /5�(r� Type of S.A.S.
M. Description of Soil a-4 lae, r4,q.
Nature of Repairs or Alterations(Answer 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 Ti 5 o the E vironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this a of ealt i �]
Sign Date
Application Approved by Date I
Application Disapproved by: Date /
for the following reasons '
�p� �._lsrs _
Permit No. (�/[/ /ram? (4 Date Issued /1{ r/(,!>
1 12,10 6 - 5-4 S C��c 1 P" 1I" THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS /
Certificate of Compliance ,
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired ( ) Upgraded ( )
Abandoned( )by PIqY C$TACIIJU
at c9-/ 5 A/ C'9A-VA✓ILLI has eeeenn�j construct
/edd ii a/ccordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 1.7�1i'// �`TUJf/� dated
Installer Designer r
#bedrooms Approved design flow. gpd100,
s
The issuance of this permit shall Sot be construed as a guarantee that the systern,411 fu ction as designed. '
Date � /(/( �( -�%C!� Inspector
--- ,'� ----------------------
No.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
�igpo!gal � stem Construction 3dermit
Permission is hereby granted to Construct ( `�) Repair ( ) Upgrade ( ) Abandon ( )
System located at d/ 5,007/r/ /7)4/,l 5 t
C FAITIFAV /L[.- "
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following.local provisions or special conditions.
Provided: Construction must Ne,compitted within three years of the date of this
Date /15) ��/ �(/ Approved by
ft
i
Town of Barnstable -
"�' Regulatory Services
PThomas F.Geiler,Director
,, s�xivsrnBra:.,
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 66 Sewage Permit# Z00(6- Assessor's Map\Parcel 22$ lZIf
Designer: s,;l , P.C. Installer: 2Wy"n-nt &C mUa'1nrS
Address: „�k,- w9u��ra�r a S�r�n�.-� Address: p G•QoK 31C)
P*,W- R5 WIRMIIf3ILJ W ILs, M14 02 057
On 10 °7-7' 0(o BM%J►„ne &C-.,JL4,rr was issued a permit to install a
(date) installer)
septic system at 01 So,,A Insii S - based on a design drawn by
(address)
A- 'l a; dated /olk.,/Zoac
(designer
X 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.
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.
X LYN cn.l
;1 ( stafler's Signature) ��, y<, ;� =-':,tip•
(vc.3t`�tC3 i
e igner s Signature) (Affix Designei s�`t mp Here)
PLEASE RETURN TO' 'BARNSTABLE PUBLIC HEALTH DIVISION. 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:HealtWSeptic/Designer Certification Form 3-26-04.doc
�0_?_0Oee-0V-5-
Town of Barnstable P#
�p 1HE Tpk
Department of Regulatory Services i?4
BARNSrAHLE, Public Health Division Date
y MASS.
t5sq. �e 200 Main Street,Hyannis MA 02601
ArFO MA'1 A l
Date Scheduled Fee Pd.Time�
Soil Suitability Assessment for Sewage Di sal
Performed By: Witnessed I"
LOCATION & GENERAL INFORMATION
Location Address Z 1 S C.114-h Y1'1 e. S f I(c hkr\h Owner's Name F.W, Ifs'►,►
<_c�rhrr a LI SOUHA IMCIWI St,
S�.\�c� y.,ly Address GcvlicrJll�4, YYIA
Assessor's Map/Parcel: Wla to 22e l�: t I Zy "' Engineer's Name Stxr;he., A. LD;Isa4,, t'.6.
NEW CONSTRUCTION REPAIR X_ Telephone# Sob 77/-7S07_ e,Cf- /
Land Use V2e z r,rU %fi a 1 Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other tt
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
caioH no 1.,1,.v. �
A WA FRO \\
YYt' Wa.m.o'
V Y �
IL L
-, 1m 1
RC`Lmzfr�`x.-�r�ax�r;.�`ra>., � �'/�_.4,VP \ '�
/ 1 o x e
LOT U. aU 4%9 A
1$857t SO.FT.
0.303 ACRES 'S 5w ""9 .
'" -■ !P_
„A $04 M41126 � WON
mI0H M
� yd
MR Iffy t R
aaa M 1�
ca/a+no s+ax� 5%3 1
Parent material(geologic) a c l21 duo 1,1 Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face v+.
Estimated Seasonal High Groundwater --1
DETERMINATION FOR SEASONAL HIGH WATER TABLE ^'
Method Used: �3
Depth Observed standing in obs.hole: in. Depth to soil mottles: ink t<t
Depth to weeping from side of obs,hole: in. Groundwater Adjustment ft.ly
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater tilOUAtOt-
Observationvel_
PERCOLATION TEST Date 10 ? OG Time
-. Hole# *� Time at 9"
Depth of Perc 100Z, Time at 6"
Start Pre-soak Time a / /3 Time(9%6")
End Pre-soak ;20 (U't. zad J. so-&
Rate Min./Inch 2 v1—I l nC,h
Site Suitability Assessment: Site Passed x Site Failed: Additional Testing Needed(YIN)
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:HEALTH/W P/PERCFORM
ti
;-1_
DEEP OBSERVATION HOLE LOG Hole# 4 _
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistengy.° Gravel)
d—S„ s4�d.� Iorz 2/1 --
�e N.,
5„ I 10 Y K 3/y
A)o Q , Ca/Ydrvr+L+ v'
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.°o Gravel)
G rr See d`S 4,a v" I !0 3/14
b q r2 4/y
/Ny �D y C IY�ao�IdM SaN.r /0 `/I� 54
57�-A"411-.0 /D yle 6/
N, Gbs, rnriacl°cb�`w"
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling . (Structure,Stones,Boulders.
Consistency.% a 1
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
I
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No ✓ Yes
Within 106 year flood boundary No_ Z Yes
Denth 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? e-
If not,what is the depth of naturally occurring p vious material?
Certification
I certify that on �� (date)1 have passed the soil evaluator examination approved by the
Department of Envlrorunental Protection and that the above analysis was performed by the consistent with
the required training,expertise and experience described in 3.10 CMR 15.017.
Signature
Date
Q:HEA.LTH/W P/PERCFORM
ON
n (h')
(C1
lr I(c)
Al
,
Cr
w1 , lr=
i I
FRONT 'ELEVATION
� C
SCALD': 1/4" - V-0" Ln jifd)
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77
4
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---_- L u
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REAR ELEVATION
SCALE: 114" 1'-O"
Al
r JOB: 0610
{' DRAWN.BY: KW
DATE: 9B/06
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,
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ADDITION
Jul
LEFT ELEVATION (ii� girl)
SCALE: 1/4" - V—O" r
-�
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1GH: 0610
DRAWN BY: KW
DATE: 9/5/O6
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---� 4�
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ILJ�
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STUDIO-, o �: o ]n.l
GARAGE
(C)
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EEII /.% NOTE WINDOW DESIGNATIONS ARE t
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/�;�, BEDROQM fig[
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EmsnNG WALL
/ — - --- —: SHEET
34'-0° 1 21'-4, 22'-4' AB
Jag: 0610
DRAWN BY' KW
DATE: 9/5/Ob
! Selo.� O.C. °
2 W6)
—— G 9P PLYWOOD TMING/
— — — —— �....
_ Ixs STRAPPING
I/2" GYP. BOARD
- Tw. >✓eva� Lfo)
r—— —————— I z CONTINUOUS VENTING SOFFIT
I :- I MATCH EXISTING TRIM
I : I taxI I N F (c
- I CRAWL SFAGE I ADDITION + w TIM EXTERIOR WALL Il.illl Ilri)
2"GONCREI'E DUST CAP I I = = j ac4 E M STUDS v IV O.c✓VAPOR BARRIER I U 1 9 RIS F.G. INSUL./
b MIL 'Al a I.- I/2" PLYWOOD SHEATHING/ Al
CANTILEVER 2c10e ` <• 05B a I TYVEK WRAP/W.G. SHINGLES f 7 1 = n
R 1q INSUL F
nsTs • IL•O.C. I co
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FOOTING III II T-1 l[ IIII - E I 1ih�Lt,--rr1 II,s-TIrlNf _ aP".>Ta. SILL ANC4IORE wDe 4'i--
O 044 II I -— — —, — —1i GRAN SPAC '_q" CONCRtT
-On DAMP PROOF BELOW GRAD ZME
—2 OCRtfE DUST CAP Io"zb CONTINUOUS FOOTING
E
14' f-A
b MIL VAPOR BARRER I DROP WALL 10°
AT DOOR I�
IcI'I L
� ia
ADDITION SECTIONl,11)
r I rrtt cT
SCALE: 1/4" 1'-0" I i ULJ
EXISTING NEW
CRAWL, I -
CRAWL SPACE rgrzgcrE
4• Cp1CRET'E SLAB
OLD _ PITCH TOWARD DOORS I '_- G
GARAGE
(uD
f
EXISTING
)�, i]
ACCErE+ I -'` I
o I I DROP WALL t0• DROP WALL 10°
' I �AT DOOR AT DOOR
vz,
FOUNDATION PLAN -----------------------
SCALE: 114" s 1'-0"
z _
EXISTING 2'-A°
BASEMENT 1
RIDGE VENT
HOARD > z
2M RIDGE
ASPHALT SHINGLES l
HA
1/2" CZ7X SHEATHING 9 ¢.-
U
1u � ta
z
tu
® �4 TRUE Z
A u -i
e 1 CONT. VENTING DRIP EDGE WE C-
Iza FASCIA
IX4 SECOND MEMBER to }-
v. ALUMINUM GUTTERS AND DOWN SPOUTS
Z FRIEZE BOARD AND MOULDINGS z
GARAGE N 2°4 OCT. STUDS• IV o.c.
tt 1/2° PLYWOOD SHEATHING
J WW FIRE RATED = TYV K WRAP (OR EQUAL) �
I GYP. BOARD
BETWEEN GARAGE F
AND LIVING SPACE a
i 4° C04C. SLAB-, E SHEET
PITCH TO DOORS / L GARAGE SECTION
-,,...-..,._:. ._ _ SCALE: 1/4° e= f'_O°
-11E III IE II t. 11.-111 Ilf III
III-J� III :� Ili III III��If COMPACT FILL =U.!I�I' .
u 11lt:-I -0B: Ob10
22'-4° .;.Ti
DRAWN BY: KW
DATE: q/5/Ob
6
.......... ...... ....... . .
....... ............ .....
SOIL LOGS Ps 1WO DATE 10/03/2006 GENERAL NOTES
' a �' o o �, ••d so • c� -
wFs�°�y• �n BARNSTABLE
• / SOIL EVALUATOR: BOARD OF HEALTH AGENT: 1• PRIMARY BENCHMARK DATUM FROM TOWN OF BARNSTABLE CIS,
P.E. BASEMAP NO. 228. (APPROX. NGVD 1929)
STEPHEN A. WILSON, Fy w DON DESMARAIS
4 '' . •'• O
TEST PIT #1 TEST PIT #2 PROJECT BENCHMARK : NAIL V ABOVE GRADE IN U.P. #39/130
• �' . ,
�. . srrE n G.S.E. = 50.1 G.S.E. = 49.8
EL 51.00'
on on
00
Ap ; 10 YR 2/1; SANDY LOAM Ap ; 10 YR 3/3; SANDY LOAM 2. LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND SHALL
�s 5" ELEV 49.7 6" (ELEV 49.3 BE VERIFIED IN THE FIELD BY THE CONTRACTOR AND APPROPRIATE UTILITY
_ COMPANY PRIOR TO ANY CONSTRUCTION.
:. ;� r •' - :•', C B j D'-i F N ` �` i `f B ; 10 YR 3/4; SANDY LOAM B ; 10 YR 4/4; SANDY LOAM
• 0 3. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE. IF
• f � • v ' - r 0 'Ry<� 16" ELEV 48.8 14" (ELEV 48.6) DETERMINED TO BE NECESSARY A TITLE SEARCH SHALL BE PERFORMED BY
• •. m / • C�� , OTHERS.
z / U T' ' I T Y P(�!E C1; 10 YR 5/6; FINE SAND C 1; 10 YR 5/6; MED. SAND
. �� _ � c- 1�-�� /1 �� 4. THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE
LOCUS MAP Scale. 1 2WO / 30" (ELEV 47.6) 40" (ELEV 46.5) RECORD INFORMATION CONSISTING OF PLANS AND CERTIFICATES. THE EXISTING
4 9'9 R B I D C , 10 YR 6/4 MED. :iAND C , 10 YR 6/4; MED. SAND FEATURES SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD
LOCUS AREA IS COMPRISED OF : ►� 2 STRATIFIED �W/ 2 SURVEY PERFORMED BY BAXTER NYE ENGINEERING do SURVEYING ON 8-18-06.
ASSESSOR'S MAP 228 PARCEL. 124 PLAN BOOK 118 PAGE 151, LOT 14 / - 5 1 , C, i SMALL COBBLES STRATIFIED 5. SEPTIC SYSTEM LOCATION PER SKETCH PROVIDED BY CLIENT, DATED 14 JULY
/ ��', �__ ,. 140" (ELEV 38.4) 132" (ELEV 38.8)
DEED BOOK 9378 PAGE 132 N A I I_. I N POLE � o TE`� I '! � ! � NO WATER AT 140" (ELEV38.4) 2004
OWNER: FRANCES W. MILNE SEE GENERAL NOTE #1. �3
21 SOUTH MAIN STREET �, �O� � �;- PERC 060" (ELEV 45.1) NO WATER AT 132" (ELEV 38.8) 6. WATER LINE PER SKETCH PROVIDED BY WATER DEPT., DATED 25 APRIL 1950.
CENTERVILLE, MA., 02632 •o f?A >2 MIN/IN 7. BUILDING LOCATION, DIMENSIONS AND OFFSETS FROM TRIM BOARDS.
ZONING INFORMATION �\ •�' CLASS
SS I SOIL
\�
-� o �'ti9 EXIST; G
ZONING DISTRICTS: RD-1 & RIC g� n i� DRY'�r��E L L �'�, coNSTRucnoN NOTEs
RPOD RESOURCE PROTECTION OVERLAY DISTRICT --� 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH
AP AQUIFER PROTECTION OVERLAY DISTRICT V ' �l \ TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995, AS AMENDED
`� ��•, �, �' \ THROUGH THE DATE OF THIS PLAN, & ANY LOCAL RULES & REGULATIONS
MINIMUM CURRENT ZONING REQUIREMENTS - ZONE RD-1
\, G � � � � � f APPLICABLE.
MIN. LOT AREA = 2 ACRES - WITHIN RPOD �' ,.5 0,_P \ T r ^'
� �_ , 2. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY THE
MIN. LOT FRONTAGE = 20' MIN. LOT WIDTH = 125' \ I ` /""`> ` i
.• � � , ` ✓ r-L 1� • ENGINEER. ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN
FRONT YARD = 30' SIDE & REAR YARD = 10'
�" ` � ,� •��- PRIOR APPROVAL BY THE ENGINEER.
1__
0.
MINIMUM CURRENT ZONING REQUIREMENTS N ZONE RC CONTRACTOR SHALL vERIFINcoo WAIF B FIELD
-Y \\ ���.��' \ TIE IN OF EXISTNG PLUMBING IN RT IN BASEMENT
0 PRIOR TO THE COMMENCEMENT 0 ANY 3. WHEN CONSTRUCTION IS COMPLETED NOTIFY THE BOARD OF HEALTH AGENT
MIN. LOT AREA = 2 ACRES - WITHIN RPOD 0�5 'tU J ?$• `' ;j�� CONSTRUCTION. PLUMBING WILL R UIRE AND DESIGN ENGINEER FOR INSPECTION AT LEAST 48 HOURS PRIOR TO
�j �, MODIFICATION TO RELOCATE INVERT uT of BACKFIWNG. THE SYSTEM SHALL NOT BE 13ACKFILL ED UNTIL INSPECTED AND
MIN. LOT FRONTAGE = 20 MIN. LOT WIDTH = 100 / E�- N� t `� BUILDING. THE CONTRACTOR SHALL140TIFY THE
ENGINEER IMMEDIATELY IF THE INVERN NEED TO BE r- APPROVED.
FRONT YARD = 20 SIDE & REAR YARD = 10
Q r REDESIGNED.
DBOx
COMMUNITY PANEL NUMBER: 250001 0005 C DEFINES �� rL •' 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" SCHED 40 PVC. UNLESS
THIS AREA AS FLOOD ZONE C, A NON-HAZARD AREA a. s s �Q� . \;t \ OTHERWISE NOTED HEREIN.
O !off 1 ��,�' 5. IF UNSUITABLE MATERIAL IS ENCOUNTERED BELOW THE TOP OF SAS
Z O N '� T - 1 I \ (PEASTONE ELEV),
, EXCAVATE AS NOTED TO THE "C HORIZON", FOR A HORIZ.
__ Q n. DISTANCE OF 5' SURROUNDING THE LEACHING FIELD, AND REPLACE WITH
,. t r�1 ��► 1500 GAL \C��
� .
Z O N � „�m.,� �. y P I SEPTIC TANK � CLEAN SAND PER 310 CMR 15.255 TO THE TOP ELEVATION OF THE SAS.
N 6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN 3
•.! iea...<e ,4caa a.�i:.'d..x.e - p i O� .
OF COVER.
\ DOES NOT INCLUDE GARBAGE GRINDER
'+ 7. THE SEPTIC SYSTEM DESIGN
7
5 0,0 S 3 s s � � DISPOSALS.
{ • :- . { f 8. 1TIOIy; THE CONTRACTOR SHALL CONTACT DIG SAFE (AT
-� R� 24L.F-4 PVC O S-2.OX ,
PLAN BOOK 11 PAGE 1 51 o� N �� `` 4,. ., a . h ' - - IG-SAFE AND,UTILITY COMPANIES TO LOCATE ALL EXISTING UTILITIES
..,..^
12 ) 857 ± C' T �� P o• '\� i ^�� 9� =_ ..��, ^��.. 2yr �....� A 88LEAST
O T 72 HOURS BEFORE THE START OF CONSTRUCTION. THE CONTRACTOR
., .... : SHALL DETERMINE--.THF. EXA"T t C1rATin� p�rN Una)��nlre�I,Y AAIn v�RT11 v
R
J cJ GON P-\\0 S �p,� � j 01`' ALL EXISTING UTILITIES BETORE THE START OF ANY WORK. THE LOCATION
o. 30 ACES j 0 3 ,
G J Q y O i OF EXISTING UNDERGROUND UTILITIES ARE SHOWN IN AN APPROXIMATE WAY
'0 PG n 495 9 ' ONLY, MAY NOT BE LIMITED TO THOSE SHOWN HEREON AND HAVE NOT BEEN
INDEPENDENTLY VERIFIED BY THE OWNER OR ITS REPRESENTATIVE. THE
r�� �� G P •Z 50,5 c�r1EL L X 4 9' CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR ANY AND ALL DAMAGES
50,7
�, �- '' �.�V P ,- , WHICH MIGHT BE OCCASIONED BY THE CONTRACTORS FAILURE TO LOCATE THE
UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS'FROM PLAN
C,Fy�� �Ao �y_ INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR
&-Top0 J o 5O \ POSSIBLE REDESIGN. AT UTILITY CROSSINGS, VERIFY IN FIELD THE LOCATION /
5 0,0 *,N50.4A P P R 0 X A P P R O X. INVERTS OF ELECTRIC, GAS, TELEPHONE & DATA/COMM AND RELOCATE IF
�1 5����
LEACHING AREA REQUIREMENTS as 5 0'4 1 , 0 0 0 GAL. �asT. oIAN AND LUSHEACH 50,1 L E A C H PIT CONTRACTOR SHALL PRESERVE ALL UNDERGROUND ENGINEERS
UTIUTIES DIRECTION.
DS REQUIRED.
NITROGEN LOADING UMITA71ON: NIA 1N /F H A Y E S 50.0 SEPTIC TANK BASIN IN PLACE
RESIDENTIAL- 3 x BEDROOMS ?�
x 110 GPDf BEDROOM 50,8
CK
TOTAL DESIGN FLOW =GARBAGE GRINDER (NOT 30 GPD INCLUDED)NCLUDED) = N/A __ R E A R E T A C B /D H F P J
_
PERC RATE _ <5 MIN. f INCH (CLASS 1) _ O
LIAR = 0.74 GPD/S.F. 502 0 - _-{, IN I� p� r-�r
a 7 .8 3 S 1.2 ' 'MA
MIN. LEACHING AREA OF S.A.S. REQUIRED: 5 0,3
330 GPD/ 0.74 GPD/S.F. = 446 S.F. MIN. 50.2
0
TEM: 5 O.3PROPOSED -0 S
B 3°1 C I O rf I N 9
WITH 3 6C OF SRETE TONE ION SIDE &NG CHAMBERS OF STONE AT ENDS C B/D H F N D
, _ E . FENCE 50,3 21 SOUTH MAIN STREET `�`�'�=��`���
SIDEWALL AREA: (27.5 + 12)2 x 2 DEPTH - 158 SF -f 0 CK A I �Y �• r /�
BOTTOM AREA: (27.5' x 12'� = 330 SF ' 50,4 s Centerville, Massachusetts
TOTAL EFFECTIVE LEACHING AREA = 480 SF /
SYSTEM DESIGN CAPACITY = 480 SF x 0.74 GPD/SF = 355 GPD 1 Ba side Building nc.
��J �F WINGREN , Y g Co.,�
SEPTIC TANK SIZING: 330 GPD x 200% = 660 GAL 1 > > P.O. BOX 95
•SSE 1500' GALLON TANK ( INM IMUM)
0 03.6' o 0 o CENTERVILLE, MA 02632
TYPIC TE PROFILE 1 CR ME
Q \ '2' 8.5' 4•83' 3CI-CIAINBEIS Proposed Septic System Upgrade
NOTES:
p P Y P9
W EXISTING TOP OF FINISH FLOOR 1. ALL MATERIALS SHALL MEET H-20 LOADING REQUIREMENTS. 3 6' 3 4"-1.v WASHEl'
ELEV = 5z.13 SET AT LEAST ONE MANHOLE FRAME BAXTER NYE ENGINEERING & SURVEYING
EXIST GRADE = 50.4 do COVER TO WITHIN 6' OF FINISH
GRADE
�. . ,. : :. 27.5'
a nmsHED GRADE OVER TANK = 50 3 Registered Professional
N FINISHED GRADE OVER D. Box = 50.3 � � PLAN OF SOL ABSORPTION S)LQTEM WITH
� Engineers and Land Surveyors
`i: NEW INVERT OUT OF 4" SCH 40 PVC 600 GALLON PRECAST LEACI•RN(1 CHAMBERS (H2O1 78 North Street- 3rd Floor, Hyannis, Massachusetts 02601
r -
BUILDING TO BE CREATED. L= 24' S=2 OX (1.0% LAIN ALLOWED) :Y _ 3" MIN. AAAXIAIUAI GRADE OVER LEACHING S1"5TEA1 : 50.3
INV OUT = 47.s5 Phone - 508 771-7502 Fax - 508 771-7622
o 6 MIN.CONTRACTOR TO 10 LF-4 SCH 40 PVC OS= 1.OX
9" min Cover
c� COORDINATE IN FIELD 10' 1MN. 21 LF (FIRST 2' TO BE LEVEL.) , , 36' ((max; Cover "
cw THIS INVERT TO WORK INV IN- 47.37 INV OUT= 47.12 r 2 OF � % DOUBLE 100
o WITH EXISTING PLUMBING. R• PVC ' 4" SCH. 40 PVC O S-0.5OX WASHED PEASTON ELEV=1429 NSTALL ONE INSPECTION PORT TO 10 0 10 20
EXISTING PLUMBING WILL 7 2 WITHIN 6" OF FINISH GRADE ,. „
REQUIRE MODIFICATION TO _ GAS � INV IN- 47.02 :. CwWeER TOP CONCRETE LEACHING CWUII3ERS CONNECTION 4 (8 H-20)
RELOCATE INVERT OUT OF 14• + `= 6' � ' • �- 48.85 _ M �- SCALE IN FEET
FRONT OF BUILDING. REINFORCED CONNCRETE 6` CRUSHED _ ELEV= 47.50 ��r•Y'':�• �I 2O DIA�--
n STONE BASE Jw • - - - --- - -- ----- -- - -
Cl) ;.:•r ;,:. ;; --�r -� INv 46.75 '- -' SCALE:' DATE: 10/11/06
N L= O CM0 O ®� ® ® O
: :•.;- 6' CRUSHED BOTTOM OF „ ® ® ® ® ® ® ® ro
a• 44.75 3
STONE BASE v UNSUITABLE SOILS, IF ENCOUNTERED BELOW CHAMBER do STONE sto
THE PEASTONE ELEV (TOP OF SAS), SWILL BE 5' MIN
DOUBLE WASHED STONE REMOVED TO THE "C HORIZON" AS REQUIRED cV
p - SEE CONSTRUCTION NOTE #5 HEREON. No Groundwater Observed O Elev. 39.75 - -® ®® ®-- -® -
a 1
102"
NO. BY DATE REMARKS DRAWING NUMBER
U
1.500 GALLON ONE-COWARTNENT SEPTIC TANG DISTRIBUTION BOX LEACFIND CHAWER
9 ED ROTONDO ST15W OR EQUAL TO BE INSTALL ON A LEVEL STABLE BASE 0: 2006 06-045 SURVEY wrksht 2006-045s .dw
o TO BE INSTALLED ON A LEVEL STABLE BASE 2 OUTLETS REQUIRED
C) SEPTIC TANK TO BE INSPECTED CLEANED AW&ML.Y
2 - 4
0
0
N