HomeMy WebLinkAbout0152 BETH LANE - Health ol
152 BETH LANE, HYANNIS
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TOWN OF BARN STABLE
LOCATION 4 SEWAGE# �
VILLAGE A�XX iNO Ir ASSESSOR'S MAP&PARCEL 7aZ I jr-3?
INSTALLERS NAME&PHONE NO. lr�nl L�,�'oe6,�X- 1—_®7 07
SEPTIC TANK CAPACITY /s'®® g.!!, -ooV/®
LEACHING FACILITY:(type) /fie---41JI (size) /3 X-X X
NO.OF BEDROOMS
OWNER
PERMIT DATE: -01 COMPLIANCE DATE:
Separation Distance Between the: Aoo,®
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 dr7l /---7
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No. �a r > i Fee f
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftphCation for Misposai 6pstrm (Construction J)ermit
Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) �omplete System ❑Individual Components
Location Address or Lot Now I-X ' 1-� Owner's Name,Address,and Tel.No.
-�Assessor's Map/Parcelo
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building e�e Gr No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided -� y� gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) �F6r��iC'N
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 eal
Signed C' Date �r V`3�
Application Approved by Date ( — d
Application Disapproved by Date
for the following reasons
Permit No. 020o — 7 Date Issued
No.
n 4 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for Nsposal *pstetn Construction Permit
S
' .H Ewa }'•y..:...'...
Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) omplete System ❑Individual Components
Location Address or Lot No:--"' Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel,= I �
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
-77
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building ex No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ,7,01v gpd Design flow provided 3' 0' gpd
Plan Date / -- ty Number of sheets / Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Y'
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, Ieal
Signe 7 Date
Application Approved by �'��''"^ (r Date _
Application Disapproved by Date
for the following reasons
Permit No. S' Date Issued !/` 3 ^O 7
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 s/
at /S`� c�TiS/ Z Jv - �/� has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a'00�—15.'dated r 1- 3 U
Installer C>,W .,�G'���+�lrJ� Designer 4d-441010"/40 Op • o �`'J:
#bedrooms Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system will�fO ction as designed.
Date Inspector f1
No. f- - -------- ------------- --- _ 'Fee
THE COMMONWEALTH OF MASSACHUSETTS v-----{j/]
PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS
Misposal 6psteat Construction J)ertnit
Permission is hereby granted to Construct.( Repair( ) Upgrade Abandon( )
System located at /�c •�t''�`,r� G'� �f�,v�/J"
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.-- C) ri
Date 1 — �j` I Approved b /
PP Y
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APPLICANT:
ADDRESS: kwz ,��{
DESIGN FLOW: `. �0 gPa
REVIEWED BY: DATE: ;
K N/A OK NO
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.2-20 4 (u)
Locus Provided 310 CMR 15.2204 t ,
Plan proper scale?(1"=40' for plot plans, 1" 20'or fewer for
com onents) [310 CMR 15.220(4)] -
Easements shown [310 CMR 15.220(4)(b)] '
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- i not, a variance is required 310 CMR 15.412(4
Location of impervious surfaces (driveways, parking areas etc.)
310 CMR 15.220(4)(d)]
Location all buildings existing and proposed 310 CMR
15.220(4)(c)]
Location and dimensions of system components and reserve areas
(310 CMR 15.220(4)(e)]
System Calculations 310'CMR 15.220(4)(f)]
daily flow
septic tank capacity (required andprovided)
soil absorption system (required andprovided)
whether system designed for arba a grinder
North arrow [310 CMR 15.220(4)( )]
Existing and ro osed contours [310 CMR 15.220(4)( )]
Location and log of deep observation holes (existing grade,el,.on
each test) 310 CMR 15.220(4)(h)
Names of soil evaluator and BOH representative;[310 CMR
15.220(4)(h) and (i)]
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(i)]
Percolation test results match loading rate? [310 CMR 15.242]
Certification statement by Soil Evaluator 310 CMR 15.220(4)0)]
Observed and Adjusted'groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 C-MR
15.220(4)(n)] ,
Location of every water supply,public and private, [310 CMR
15.220(4)(k)] ----
Address 6Z 15KIk t LA�Aj E, �: � She 1 of
4 .
within 400'feet of the proposed system location in the case
of surface water supplies and grqyel packed public water supply
within 250 feet of the pioposed system location in the case
within 150 feet of the proposed system location in the case
of private water supply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. 310 CMR 15.220 4)(1
Water lines-and otW- tibsurface utilities located [310 CMR
15.220(4)(m (if water line cross see 310 CMR 15.211(1)[1 ) V
Profile of system showing invert elevations of all system
components and the bottom of the SAS 310 CMR 15.220(4)(o)]
Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2)or as
approved for an upgrade under LUA at 310 CMR 15.405(1)(k
Test hole adequate to demonstrate four feet of suitable material?
310 CMR 15.103(4)] V
Test Holes adequate to confum adequate groundwater separation?
[310 CMR 15.103(3)
Benchmark within 50-75'of system [310 CMR 15.220(4)( )
Materials specifications noted? [various sections of 310 CMR
15.000
System components not> 36" deep(unless Local Upgrade
Approval or LUA.requested) 310 CMR 15.405(l(b
Address
I✓� y' +"'tip/
Sheet 2 of 7
Size OK? '[310 CMR 15.223(1)]
Inlet tee located ten inches below flow- I ine 310 CMR 15.227(6)]
Outlet tee 14" or 14" + 5" per foot for increase ft depth,[310 CMR
15.227(6)
Outlet tee with gas baffle or approved filter 310 CMR 15.227(4))
Note regarding installation on stable compacted base [310 CMR
15.228(1)] {/
Separation between inlet and outlet tees (no less.than liquid
depth) 310 CMR 15.227(2)
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5)) or permitted for
upgrades under LUA 310 CMR 15.405(1)(k)]
Minimum cover 9" (Tanks buried,more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310 '
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be20" or greater) -
middle access at least 8" (b 7/07) [310 CMR 15.228(2)
Access to within 6 " of grade - one port for systems<1000gpd,
two fors stems>1000 gpd 310 CMR 15.228(2
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)]
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done 310 CMR.15.221(8)
H-20 Where appropriate? 310 CMR 15.226(3)
Setbacks from resources 310 CMR 15.2111
Required when other than single=family dwelling or flow>1000
d [3.10 CMR 15.223(1)(b)]
First compartment 200% daily flow; Second compartment 100%
daily flow 310 CMR 15.224(2) and. 3)]
"U pipe through or over.baffle, outlet of each compartment with
as baffle or approved filter 310 CMR 15.224(4)] -
Address v' R a Sheet 3 of 7
�1
Located at least ten feet from any waterline? [310 CMR
15.222(2)
Disposal piping at least 18"below water line (when water and /
sewer cross, see 310 CMR 15.211(1) 1 ) V
Cleanouts required/provided ? 310 CMR 15.222(8)
Thrust blocks specified in force mains? 310 C1VIR. 15.221(6)(c
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
310 CMR 15.222(6)]
Proper pitch on all runs?(.005 within gravity-distributed trenches
and beds) 310 CMR 15.25](9) and 310 CMR 15.252(2)(c)]
Siphonproblem/ leachfield below um chamber)
Endca s or vent manifoldspecified?
Size and orientation of discharge holes specified?(not smaller /
than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 ✓
CMR 15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed)
A _
1
Stable compacted base [310 CMR 15.22](2) and 310 CMR
15.232(2)(a)
Splash plate or baffle tee required on inlet/provided?(when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323(3)(a))
Riser if deeper than 9" 310 CZAR 15.232(3)(f)]
Inside minimum dimension 12" 310 CMR 15.232(2)(b)
Minimum sum 6" 310 CMR15.232(3)(e)
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
[310 CMR 15.232(3)(d) L
Capacity (emergency storage above working=design flow)?[310
CMR 231(2)
Proper setbacks [310 CMR 15.211 (same as septic tanks)]
Watertight 20-in minium access manhole at least 20"MUST BE
TO GRADE [310 CMR 15.231(5)]
Service components accessible (not too deep.with piping,
disconnects accessible) ✓
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. [310 CMR 15.23](6)and (8)]
------------
Stable Compacted Base [310 CMR 15.221(2)]
Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)]
Address 41 rz- / ta( L'W 6 Sheet 4 of
Calculations correct? _
4 feet of naturally occurring material,,demonstrated?.[3 10 CMR J
15.240(1)] 1/
Required separation togroundwater? 310 CMR 15.212),
Aggregate specified as double washed 3,10 CMR 15247(2)]
System Venting required/provided? (system under driveway or
>36"deep) (310 CMR 15.241] r
Inspection ports specified and within`3",final grade? [310 CMR
15.240(13)] v
Breakout requirements met?(No violation.of breakout elevation
within 15 ft of SAS unless barrier),[310 CMR>15:2 1(1)[4] and
Guidance Document] '
Chambers and Gal. in trench configuration supplied with inlet /
every 20 ft. [310 CMR 15.253(6)] ✓
Each structure with one inspection manhole (if>2000 gpd must
be tograde) 310 CMR 15.253(2))-
Aggregate I'minimum-4' maximum. 310 CMR 15.253(1) b ) _
2'sidewall credit maximum 310 CMR 15.253(1)(a)]`
In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] v -
Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] ;
100 feet maximum length 310 CMR-15.251(1) a
Minimum separation 2x effective depth or width whichever
eater(3x if reserve,between trenches) 310'CMR 251 1)(d
Situated along contours [310 CMR 15.251(2)]
Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document]
s
minimum 2 distribution lines 310 CMR 15.252(2)(a)
Maximum separation between lines 6' 310 CM R15.252(2)(d
Maximum separation between Iines�and outside of bed 4' [310
CMR 15.252(2)(6)]
Aggregate depth below-discharge pipes 6" minimum, 12"
maximum. [310 CMR 15.252(2)( )] V
Se aration between-beds-10' minimum. [310 CMR 15.252(2)(f)]
Bottom area:used in calculations onl 310 CNIR 15.252(2)(i)]
Address -�
l�f Sheet 5 of 7
Pressure Dosed System ? Provided pump and piping~
calculations as re uired. 310 CMR 15:220(4)(r)
Pressure dosing required on all systems>2000gpd or alternative
systems undecrImedial approval [310 CMR 15.254(2) and I/A `
Remedial Use Approvals]
l�
If used in gravelless system - make sure jet is directed as not to
scour soil interface [Guidance Document
V2000gpd)
spections once per year(systems<2000 gpd) or quarterly
good to note on plan 310 CMR 15.254(2)(d))
[Construction in fill - Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ?
Impervious barrier and/or retaining wall ? Guidance Document
Impervious barrier installation must be supervised by
desi ner 310 CMR 15.25 5(2)(b)
Retaining wall must be designed by Registered Professional
Engineer[310 CMR 15.255(2)(a)
Side slope not exceed 3:1 ? 310 CMR 15.255(2)
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended) [3J0 CMR 15.255 (2)(e)J -
.x
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
=X
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has a2elicant submitted a co of a maintenance
Are the variances listed on the plan ? [310 CMR=15.220
(`1)( )
RLS Stamp necessary on plan if a component is within five
-7-
feet of property line [310 CMR 15.412(4)
New construction or increased flow proposed - [Refer to 310
CMR 15.414] EJ
Address -4 V— 9) i"Ii L N(/
Sheet 6 of 7
,.
(t t
Is the system in a Designated Nitrogen Sensitive Area(Zone I1 for
a PP public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy.regarding upgrades of such
existing systems)
Is the system proposed on the same lot as'served by private well ?
[310 CMR 15.214(2)
Are the nitrogen loads proposed it compliance? [31,0 CMR
15.216(1)]
r
Pumping to septic tank? 310 CMR 15.229
Shared System 310 CMR 15.290
Address 4 I ' `� y _ Sheet 7 of 7
i
Nov 05 09 03: 26p p, l
_ Town of Barnstable
pFKIiE rr
MwP~ °T Regulatory Services
A.nn E, Thotoas F. Geiler,Director
• J�rnB� =
XA= Public Health Division
e6�q• tb�
Thomas McKean,Director
200 plain Street,Hyannis,MA 02601
Officc: 508-862A644 Fax: 508-790-6304
Tnstaller& Designer Certification Form
Date: "�/ C
Designer: 1 Installer:
A.ddress: . Address: R�-4q)G --
Ozx // — 3—09 ��� �F`�o�l✓/r
(date)
was issued a permit to install a
(i�tallPr)
septic system at. S i ri based on a design drawn'by
(address)
M dated
(designer) "
certify—ZI that the septic system referenced above vcr
eP YS as installed substarxtially according to
--the design, wWch may include minor approved changes such as latcrti: telocation of the
distribution box and/or septic tank
I cerfifyr that the septic system referenced above was installed with°moor changes
greater thou 10' lateral relocation of the SAS or any vertical relocation of any component
of the septiiQgystem)but in accordance with State &Local Regulations. PIan revision or
certified as-Murat by designer to follow.
j ZH 4PMgs
_ z D VID
�Signaturq)
taller's B. '
MASON In
No.1066
'1Nl7ARNT'
- (D er s Signature) (Affix ig—dges Stamp]Iere)
PLEASE RETURN TO BARPNSTAW-'F"PUBLIC IIEAX.TH DIVISION. C RTWICATE
OF COKPILIANCE WR X, NO ME ISSUED•UNTM XiOT)� X#IIS gF0W ANU AS-
BUILT CARD ARE RECEIVED )3Y:THE BARNSTAB-, PUBLIC W&—, ,'l<'H DIVISION.
T14 ANK Y01J.
Q: He11tNScptic/Des4,,ncr Certification Fora,
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-Gown of B i rnstabl .
P# 1274
Department of Regulatory Services
• ' Public Health Division Date_
' i �ARNBTABrB. ` ,..-• J��, t >_1 i t
-20 ,Main S6et Hyannis MA
7� Z�J �b a .';.'�.t`t '"'Ti
Date Scheduled me O U�" Fee Pd. LA-1
Soil Suitability Assessmentfoi,Sewage"Disp sal
Performed �. � Witnessed By ` I
Byr.� ;
i
" LOCATION Sa GENERAL INFORMATION
I n Owner's Name
Location Address
Address
Assessor's Map/P4tcel: 1&V ql i' Engineer's Name
NEW CONSTRUE.' ON REPAI Telephone:#
1
Land Use - Slopes(30) ' ' Surface Stones
Distances from: Open Water Body, ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft. Property Line ft Other ft
SKETCH:(Street name,dimensions%f lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
_
i
Parent material(geologic) Depth t0 Bedrock
Depth to Groundwakdr. Standing Water in Hole:' j Weeping from Pit Face .^
Estimated Seasonal i fth Groundwater i
Dt° ATION FOR SEASONAL HIGH WATER TOLE
Method Used: in. Depth to sell mottles"
!n.
Depth (14erved standing in obs.hole: inn, Depth
mots etttfent
Depth toiweeping from side of obs.hole: , p�,drnundwnter Laval—
Index Well# _ Reading Date Index Well level..:e.�... Adj.factor,,,,_
PERCOLATION TEST Date...-----� l�ne
Observation f Tune at 9" �..._. .._
Hole#
....�.�.._
Depth of Pere
Start Pre-soak Time.@. 1 Time(919•601)� ------
End Pre-soak
Rate MinAnch i
' "Additional Testing Needed(Y/N)
Site Suitability Asse�smeoG ,Stti.P,assed r Site Failed:
i
Origmal:.Public 140lih Division
Observattoti Hole Data To Be Completed on,Back=--------
***If percola#tin test is to be conducted within 100'of wetland,.-YOU must first notify the
.Barnstable C6.4servation Division at least one (1)week prior to beginning.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsis enc %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.%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, o Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
n ist
Flood Insurance Rate May: ' /
Above 500 year flood boundary No— Yes y___
Within 500 year boundary No.� Yes
Within 100 year flood boundary No— Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring perv. terial exist,in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of iaturally occurring pervious material?
Certification
I certify that on 1� (date)I have passed the soil evaluator examination-approved by the
Department of Envirorlmental Protection and that the above analysis was performed by me consistent with
the required training,exp rtis an xperience described in 310 CMR 15.017.
Signature
—Z�
t Date tt�
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Q:ISEFTICIPERCFORM.DOC
LIVCATION SEWI E PERMIT NO.
l5-4 J 4&-o"e —15-1,
VruLAGE
INSTALLER'S NAME ADDRESS
JOHN A. AALTO .BACKHOE SERVICE
Tvalnut Street
West Barnstable, Mass. 02668
l N UILDE R OR OWNER
OAT E P E R M I T ISSUED S —7y
- DATE COMPLIANCE ISSUED
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No...........144......... ..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................ ...................................................................
Appliration for Uhiposal Works Tottarurtion Prratit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
...... ..... ...4_��3............................ . .... ............
-
Location...-Address ........ ........... Lot N
. �.. ............... .......................... ... .............9.el:-_4�- .....
wner
..... ................. .....................................
.....................................................
....................
Installer Address
Type of Building Size Lot............... feet
Dwelling—No. of Bedrooms........ ..................................Expansion Attic Garbage-Grinder ( )
'_l _ ,".. , -
Pk Other—Type of Building ............................ No. of persons............................ Showers f—" "C�feteria, ( )
Other fixtures ............................................................................................................................./
.........................
.................. ..............
Design Flow.....Im S-s— 1.........gallons.
W .................................gallons per person per day. Total daily flow._._.....:2.aC)........IL.
1:4 Septic Tank—Liquid capacity./A.00gallons Length--P.......... Width-_---_-_-__-- Diameter................ Depth.1111/111
Disposal Trench—No. .................... Width_......_.._.__._._.. Total Length......._.__...._.... Total leaching area..- .1 _'0.......sq. f t.
Seepage Pit No.....I-------------- Diameter...._&.(----(- Depth below inlet_.........._._. Total leaching area....2-Rd7sq. ft.
Z Other Distribution box ()<) Dosing tank ( —Percolation Test Results - Performed by._.- ------------------------ ...........
Test Pit No. I....!4t-:2__minutes per inch Depth of Test Pit.__.Z........._. Depth to ground water..---A....
Test Pit No. 2......Lk......minutes per inch Depth of Test Pit___..._.`- ......... Depth to ground water..........11..........
.............. ...................f----------e---------------------
0 . ............2_._.J.4n....... ------ /2
Descriptionof Soil..............10-—-_I... ...... .......XV
*---------*-------------*---------*-----"----------------*---------------------------------------------------------------------------------------------------------------- ----------
...................... .................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when -applicable.........w.................................................... ................................
.........................................................................................=...................................................... .....................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ued by W1h goa*d 1 4;4 ..........
S*gne....
Date
Application Approved By_._.... .......... ..... .......
Date
bee s ue,...eD
Application Disapproved for the following reasons______________________________________...........................................................................
........................................................................................................................................................................................................
7 Date
-
Permit No.......................................................... IssuedL... /�_�...............
.....................
Date
No...........1 ....... FEs.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
44 ,
... ...........OF........ � 'a��..................................................................
,���lir��ion fnx �i��o��al orko C�oo��r�r�ion rruti#
Application is hereby made for'a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
1
clen
-�i `t :f$ °t il/ ti•y 4 a.. ..............................
ate.* ..........i � �•�; ...�F............................................
�..... .�......c.......
wner ,may A r
W 4 -r� w,f�L
a .... ••••.............................................. ........................ ......... ....... a
U Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.........��'.................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
a'' Other fixtures
W Design Flow...... ._.._.._?isz-~:..............gallons per person�paer day. Total daily flow...........................................gallons.
Ra Septic Tank—Liquid*capacity_A g4gallons Length- .......... Width.... ....... Diameter________________ Depth....Y.......
Disposal Trench—No..................... Width.................... Total Length ..... Total leaching area..........:.........sq. ft.
Seepage Pit No------�------------- Diameter....... .-.:....... Depth below inlet......k.......... Total leaching area...:*:_`.:.sq. ft.
Z Other Distribution box ( .) Dosing tank ) '`
aPercolation Test Results Performed by - .................................... Date...................................._..
Test Pit No. 1.._.'... ____minutes per inch Depth of Test Pit.................. Depth to ground water.__. R .. ..
Test Pit No. 2.......°`......minutes per inch Depth of Test Pit.................... Depth to ground water.......................
..............A....._ j �r 1 .._E.... ....-...... ...................._.
/........
O Description of Soil...............0..... . .... •... .....-=--��`•----- �� .�s�r�( i
x
W ••---•-•---•.............•-•------•----•--......•--••-•---•----•-••--•-••---•-•••-•--•-------••-•----••-•------••-••--------••-•---•--••-•--------•-•------•------•--•-••••••--•----..................--
VNature 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 TITI,w. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
S>gn 00-; Dat
Application Approved By-•••-•/r ', ..44
...... .» `".. ��'...._..
Date
Application Disapproved for the following reasons:.....................................................................................•..__.___._._____......•._
........................................;....---•-••---•••--••-••--•-•---••..............................................................................................................................
\ Date
PermitNo.......................................................... Issued.........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........OF............ .......`............................................
Trtifiratr of Tamlilianir
T S S TOOPTI
Y That the Individual Sewage Disposal System constructed (�) or Repairedb ?17 : --•-•--•---------•---------------------------•_---•-••••-•----
Y
Installer
has been installed in accordance with the provis ns of T � 5 of.The State Sanitary Code described in the
application for Disposal Works Construction Permit No, s'_...._ ................ dated.__... :. ."...__ ____...._._........
THE-'ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION,,:SATISFACTORY.
� Inspor � 1'"iDATE._ ..... :------------------••-•-•-- � -----.-. - __-- -C ---••-----•--------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
tom'.........:O F.---........ � .// .....
No.........16.......... FEE .
�to�ro 1 ork ,��o�ion rrmtt
Permission is ereby granted.... _ p. �. ......................................................................................
to Con
or R i t)ry n I idual rage°Disposal System
�� Street Olt
as shown on the application for Disposal Works Construction . it N .:' '
•---• --•--. Dated.... �--� ................
Board of a th
DATE................/-a ? ..................-------•-.-...----..:
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS -
- F. F. 53. 00 I TYPICAL SYSTEM PROFILE
AREA PLAN — FINISH GRADE= 1.00
FDN TOP NOT TO SCALE
SCALE : I ' = 'q0 52'VO} / FINISH GRADE OVER TANK= J�1 .44 FINISH -51 , 00�
GRADE OVER PIT-
LOT # 32 BE TH 'S LANE
-49.00 I PVC OR 0 O e • ° °
�C. I . TEES\ 107' 73--15, 00 0 S• F . � v • . o • • • o • o 0
BSMT 1000
FLR45-00 GAL. 4" o 4$, 25 • e ° e • • • o . e a
REINFORCED DIST. BOX e e e • • • e ° ° a
TO BE INSTALLED ON
CONCRETE 8 , ° ° e • j , • ° °
A LEVEL STABLE BASE e ° • • • I • ° ° • ° e
SEPTIC TANK I '
TO BE INSTALLED ON A • • j • • • ° ' a
LEVEL STABLE BASE
2"-I/8" 1/2 "WASHED PEASTONE ALL ' ' ' ' • ' ' ' �' ° ° .,
BRICK 81 MORTAR COURSES AS AROUND FREE OF IRONS, FINES ' • ! • ° ° ' ° ° -
REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE
oc
\ 24 "C.I . MANHOLE COVER a 3/4 "TO 1 -1/2 "WASHED CRUSHED LEACHING PIT
\ FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL
IRONS, FINES AND DUST IN
\ PLACE � I RF-QD.)
�- FOR FIN. GRADE
SEE SYSTEM PROFILE SOIL AND PERCOLATION
4" Z., DATA
1
s" - - - PERC. RATE : 7 2. MIN./IN.
/4 FOR I N V. ELEV SEE °
LANE INLET ° SYSTEM PROFILE 6 ° TAKEN BY : C. D SPOHRR�A�
BET H S - "LINE o � � WITNESSED BY: $�'R�ST.�-Ba-E E�s�, ua^ �+>�tiL.�t1
40% _'� ° ° _ o o OPENINGS W/4-1/8" 110 .5 DEC , I g-7a
N I �� 2 5 S OUTER DIA. 81 1 -3/4 m , , DATE :
1 25.00, 7 INSIDE DIA . _ ° TEST PIT -GND.ELEV. + 51 . 05
�. ...... o g ' a s TOTAL u o o . y, `
0D AREA o O
Houk t 52 - 0 0 0 0 0 3_ LOAM S S Nv R��Sr, ti•.Ec�G�
31 2 o • ° L A 1
LOT -* 33 40` w Td�N v�rATE� LO -- � � �• � � � ' o 0 0 0 2���.F. o 0 0 ;�"; � -�=, _ o`" k� OR wAT
� (�txetT� � �_ •', : '_ , � ,° � � u o 0 0 0 0 0 0 • � o <. .'.� c�ARsE SAND
°
a� pQOPGSf-_u —
3 p•- _ 2' 6 ' 6 " DIA.
!![
0 25� LOT"* 32 0 � •t BOT. PERC. HOLE
� ip (o EFFECTIVE DIA.►o 1000 aAl., PQECa.�eT " cglVktl� 5, 000 5•F o� DOWN 3�sir t C- TANK ^- aatza��l � 56 ( r LEACHING PIT SECTIONPRIECAST COW i?f�TR1BU -— (itE�.rz1 NO SCALE
!•I4.E •.,� � DESIGN DATA
PIT � AREA FOR �' NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM N0. OF BEDROOMS 3
PRECAST COW.R L E LC'AC►-1 t M C- ... :R P �p jE PIT
SEE DETAILS MOF161t .10 DISPOSAL
LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT '�� GALS.
I . CONC. TO BE 4000 P.S.1 a 28 DAYS . SEPTIC TANK 5:2 O GAL.
OWER S 13� 2 5 rJ�� W 2. REINF W 6 " " �x 6 6 GA. W. W. M.
N S BUILDER
3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES
GREATER DEPTH REQUIREMENTS
CI-ARK 4 FI-Y NW i5L)I i. DERS 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
8(�X EE NOTE : EXCAVATE TO ELEV.�Q0O0R LOWER AS ACCORDANCE WITH TITLE 5OF THE STATE SANITARY CODE
FAL.f�it�t��!"`l MASS, S� DATED JULY 1,1977 & ANY LOCAL RULES APPLICABLE. �
s REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPRD. BY THE
MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD- OF HEALTH, AND CHARLES D. SPOHR.
WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
B. N0 T E E AREA = S. F.0_S.F./GAL 495 GALS
[� BOTTOM AREA g S. F.��S. F./GAL GALS NOTIFY THE ENGINEER FOR INSPECTION.
SIDE
4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.
_ �—
TOTAL AREA =� 5S. F. TOTAL 582- GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
AL.L.. _'ELF , BASED014 PAVSIUI�"[�tT iiD�IE APPROVAL BY CHARLES D. SPOHR. j
Y-0T I& ASSIL EL PE V. +50-00• LEGEND 6. FOUNDATION INSPECTION READ. WHEN EXCAVATED.
♦ 50.01 EXIST. GROUND ELEV.
A P EA , PLAN' 50.0' FINISH GROUND ELE V.2'UNDERLINED"
4750 P� . cic PIPE INVERT. ELEV. REv. DATE DESCRIPTION
Ur�zwY C�
FOZ C` F,• IIU �..bEUS SC/fit.- V A� • TEST PIT LOCATION
pEC . '78, 5Y J P. us7YLV=- W. , L. S ° SEWAGE DISPOSAL SYSTEM
FOR
o O SEPTIC TANK LARK FLYNN BU I LDERS
To�nr4� YVATER 4 C. I . PIPE LOT # 32 BETH'S LANE
-t ttt+i-r}— 4"�BIT. FIBER PIPE 'TIGHT JOINTS Sp0liR
(P I TCHERS WAY), HYAN N IS
p p No. 7468 p w
- -- - PROPERTY LINE v e49'57 a�l r DESIGNED: C.D.SPOHR DATE:5 DF-C, 'TIR DRAWING No.
• \FESS�ONA�
MIN. CODE DISTANCE "- DRAWN: C. S. SCALE:4SSHOWN 5128 E
MAP SEC PCL LOT �� CHECKED' C. D. S .
14
AssEssoRs MAP : 2-7Z.- _.- __ _- TEST HOLE !._OGS �'� :
` PARCEL : .
1�� � Y-� `� � SOIL EVALUATOR : 7A/1 f ''rt � 1 The installation shall comply with Title V and Town of Barnstable Board of
FLOOD ZONE_ ) P y
.w/ n LL WITNESS : 1k' 1 �j rt�( Health Regulations.
REFERENCE �1 L1 ,( - ^-�� C•✓ l DATE : � ��?' �t-�Z G�IC)' verify P
�� - � _�.� 2) The installer shall very the location of utilities sewer inverts and septic
,-� _.. _.__. _.__ ___._ ._ PERCOLATION RATE : G�14 ! components prior to installation and setting base elevations.
VT) chi I C °f 3 All gravityseptic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first
TM- I TH-2 two feet out of the d-box to the leaching shall be level.
L�*-lxJt� IXM 4) This plan is not to be utilized for property line determination nor any other
� L-Iq � - purpose other than the proposed system installation.
� 5) All septic components must meet Title V specifications.
� t"DwM . Y0- 6) Parking shall not be constructed over H10 septic components.
�7 10 ��} 7) The property is bounded by property corners and property lines.
a b Y / t S The property owner shall review design considerations to approve of total
LOCAT 10N MAP �___..______..__..__ c0t � � �.-___.__.._._..__....... .�1 ) P P y g PP
�O i design flow and number of bedrooms to be considered for design. Receipt
j � � y of payment for the plan and installation based on the plan shall be deemed
.lrJ' �14'0P approval of the design flow by the owner.
C �6 e7 ' 9) The existing leaching or cesspools shall be pumped and filled with material
1/ I f per Title V abandonment procedures. Those within the proposed SAS shall
be removed along with contaminated soil and replaced with clean sand per
- _ Title V specs.
h10tRlAa(� �1��' �, w0 �,W° 1 10)System components to be 10 feet from water line. Sewer lines crossing the
_ water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if
applicable. The proposed SAS is being installed below the water service
SEPTIC SYSTEM DESIGN line. The line is to be sleeved as aforementioned and maintained in place.
11) If a garbage grinder exists it is to be removed and is the responsibility of the
FLOW ESTIMATE owner to ensure such.
12)The installer is to take caution in excavation around the gas line if such
__..__T__ _ __
-z _.._""-------�_J— � �BEDROOMS AT � �� GAL/DAY/BEDROOM - GAL/DAY 13)The exists.
installer shall verify the location, quantity and elevation of the sewer
i3 vz3 ,
` t� 'jr-' �� .` & .'_� lines exiting the dwelling prior to the installation.
EFT I C TANK
'5�f)GAL/DAY x 2 DAYS - GAL
a 1D 19 - \
lu _ Via- USE GALLON SEPT I C TANK e�Mwf- -
I
SOIL ABSORPTION SYSTEM VA
rr
NJ
-
S I DE AREA: Z`� 4
BOTTOM AREA: 45
S-EPT 1 C SYSTEM SECTION
�� = �-
<<.���11-1 Wald__ U
'�i� � f � ------ —---
h�
XP=iL
1 _—_- ----_-_. ._.._-. _-_
Box
- v ' ��- � - .C � 'ICI Z
SEPTIC TANK
:.
� off•. �.�e�-()�'( �.1�. l� � �-
6` 6C_b _ �t _ _�-- r SITE AND SEWAGE PLAN
LOCAT I ON : IZ �"(�� [✓ ,�
PREPARED FOR : :j 1�j I—E�Df::�UF7 S �
0
SCALE: -' ,�;
DAV I D B . MASONRj �DATE:IU 60i
DBC ENVIRONMEN`>-AL DESIGNS
J
z EAST SANDWICH . MA
3 DATE HEALTH AGENT ( 508 ) 833- 2 177
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