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HomeMy WebLinkAbout0021 BLUE JAY DRIVE - Health 21 BIue'Jay Drive, • t A= 268—009 Hyannis F i t TOWN OF BARNSTABLE i9 LOCATION-XI Vciu,0 SEWAGE# 9QJ0, -M I tUILLAGE; .S r ASSESSOR'S MAP&PARCEL a(,L3 .-QM INSTALLER'S NAME&PHONE NO:—JDWeI,, .l1 Zr'r W ii 'Jouc SEPTIC TANK CAPACITY )"S©p LEACHING FACILITY: (type) A xL 3 c ke 14-a o (size) A,8? NO.OF BEDROOMS 3 OWNER PERMIT DATE: 1 I Z COMPLIANCE DATE: f/"n�- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland 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 Q n �� f�, � O cz v Q �' o ,o � -� � � � � � � �"' � J ���, � N N y � J Town of Barnstable P# Ll 0 `� daTME Department of Regulatory Services Public Health Division Date L! r MA88. � T i6Jy 200 Main Street,Hyannis MA 02601 - Date Scheduled ,l/�/ �( Time // , Fee Pd. 00 "Oo Soil, Suitability Assessment for Sew 'Disposal Performed By: ►G 1�`rMG�h�" E C Witnessed By: 5 LOCATION.&,GENERAti INFORMATION J Location Address. Z S 1 t-e j� 9�`�� Owner's Name V cl`a( r I M O k/ H G VA(\6, 5 Address 8 Ca 5.Q e/ h IJ��S Assessor's Map/Parcel: �cel: k all `,,> E amengineer's, A NEW CONSTRUCTION REPAIR x Telephone# 5 e —7 3 7—t-1 7 (p c Land Use � S� �ztJL Slopes(%) ` Surface Stones Atf�J Distances from: Open Water Body 7 U� ft Possible Wet Area ft Drinking Water Wel L� ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in-proximity to holes) a l -. 1 , is `rE�a :3:,i;: ,W 0 Z� �j Parent material(geologic) (JV� ��V�" Depth to Bedrock 1/4 Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater r' -DETERMINATION°FOR:SEASONAL-HIGH.WATER TABLE Method Used: Depth Observed standing in obs.hole in. Depth to soil mottles: in. M`I Depth to weeping from side of obs.hole _in. Groundwater Adjustment ft. - :nd:x`.Yc!;}! Reading Date- Index Well ievJ` Adj:factor — 'Adj Growid*40 Level PERCOLIkTION.TEST Date Time Observation 1 � 1 Hole# Time at 9" Depth of Perc Time at 6„ Start Pre-soak Time f�M @ Time(9"-6") End Pre-soak g Rate Min./Inch Z. s Site Suitability Assessment: Site Passed Site bailed: 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 o if e(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon SoJ Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel Sol( A DEEP OBSERVATION HOLE LOG Hole* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. r Consistknc °/Gravel -3o c3 SC 0 yw s :G i z0 C C 5.\ A l d (2- 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) 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) Flood Insurance Rate May: Above 500 year flood boundary No_ Yes/ 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 pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yfls If not,what is the depth of naturally occurring p rvious material? Certification I certify that on date)I have passed the soil evaluator examination approved by the Department of Enviro ental Protection and that the above-analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR.15.017. Signature - ,1� / Date Q:\SEPTIC\PERCFORM.DOC i No.Om I LL., Fee 14016 _COMMONWEALTH OF MASSA TS Entered in computer: ..�'� PUBLIC HEA �ISION -TOWN OF BARNST , ; ASSACHUSETTS Yes ltlYlCa for OispdBal *pstem Constr ton Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2.1 -61 yr k y �{ Owner's Name,Address,and Tel.No. 'Nyw" iS Assessor's Map/Parcel 20 —00r Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 50�3-wx_,)­ Type of Building: Dwelling No.of Bedrooms 73 Lot Size 1►170 sq.ft. Garbage Grinder( ) Other Type of Building yw o,,x No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3(9 gpd Design flow provided t J S. �j gpd Plan Date /Z /2=J/! Number of sheets Revision Date Title Size of Septic Tank /fix)&Zt 1 Type of S.A.S.—41C 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 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. Si d Date Application Approved Date .�2 Application Disapproved by Date for the following reasons Permit No. ,��'" � % Date Issued No., 0 � t Fee 1 �� OMMONWEALTH OF MASS ITS Entered in computer: Yes PUBLIC HEA ISION -TOWN OF BARNST, ASSACHUSETTS l�lYlcati0 forTSJBaY *psteltt c0118tru t1DYCerttlit ;y Application for a Permit to Construct( ) Repair(✓r Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 i -i�)ue kE J _�)f Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 G1' OC)cA Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. >;�S1Gc h T�taW,.j rJC �Ntj1NF�A(1N� ujo( I(5 Type of Building: Dwelling No.of Bedrooms 3 Lot Size l I.ct 70 sq.ft. Garbage Grinder( ) Other Type of Building e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ?j 4/�, y gpd r» Plan Date 9//-7 , Number of sheets ',L-- Revision Date Title Size of Septic Tank /S()r) s1/��Ae Type of S.A.S. Description of Soil i i `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 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. Signed Date tt Application Approved b ( Date "c'-1_ Application Disapproved by Date for the following reasons Permit No. Date Issued f =---------------- - --.- ----_--.: - -- ----- - 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 at 2 ( Blur 1, Dt has been cons ructed in accordance dated 1J�� with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer ,9 j&, A Designer E,v��N t• / ,;t„ G 3 r�✓ 1 r c #bedrooms '3 Approved design flow ��,°^} gpd The issuance of this permit shall not bei construed as a guarantee that the system wiil1'function1s,designed. I / l -` Inspector `�.. �..,_�1 Date -----•--------------------------------------------_--------------------------------------------------------- - ------------------ j �e"l Fee THE COMMONWEALTH OF MASSACHUSETTS _ PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS MispoSal 6pstenl Construction permit Permission is hereby granted to Construct( ) Repair( I)-' Upgrade( ) Abandon( ) System located at f .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 ustbcompleted within three years of the date of this permit.Date � Approved,)y A Town of Barnstable Regulatory Services Thomas.F. Geiler,Director Public Health Division MM Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: I 7 1 Z Sewage Permit# ),Q I'Z-001 Assessor's Map/Parcel 2f� Installer& Designer Certification Form Designer: l✓,.,�,; rt¢ra r.•,„s W a r Lc s, n c . Installer: �' ` `S n rC . Address: )z W. Cc, S s ;e 1CA 1Z#. Address: t a �� 1_4j, t_c M/� az�yy � � 1 U - -3Z On D A �"`�''`; 1"`� ° was issued a permit to install a (date) (installer) septic system at G `-5�Y q, based on a design drawn by (address) nn Wit- Z. dated f Z 'i 2 I'1 (designer) _ ^I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation.of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. Alo1e 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. Stripout (if required) was ' cted and the soils were found satisfactory. H OFM, s � qc PETER T. staller's Signature) C CIVI�EE No.35109 STE (Designer's Signature) (Affix Design ) 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. gAoffice formAdesignercertification form.doc s- LOCATION' SEWAGE PERMIT NO. f VILLAGE IN TA LLER'S NAME i ADDRESS Tel BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED / 7_ ' �� ,�4� _ � G �E ��� z � � �' - Z� � � �. �r w.._ .,� � No... P/�.3 Fss...... THE COMMONWEALTH OF MASSACHUSETTS 6�� BOAR® OF HEALTH -1,0j&n......... d� . ......)--------------------------------- ,� Appliration for R-4posal Works Tnnotrurtiun Vautit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: �� .... . ...... .. . .. Ca? ._.?1 �) ............... --.--•----•-...----•-•-•._-•.............1..o.r..L..o.t •N-•o-.•...-•.•................................tion- .. . dress ..................... .............. ............................ . ner Address .......A Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria dOther fixtures ------------------------------•... W Design Flow............................................gallons per person per day. Total daily flow......................._..............._....gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter..._............ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) 1­4 Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................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........................ ODescription of Soil-----....- __ .. ..-----•--------------------------•---------------------..................................-•-------- x UNature of Repairs or Alterations—Answer when applicable_-___-----7/,e ... > dr%1 -•-- - --------------- 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 bejen issued by the bo rd of he h. Signed•.•• ... -••• - 6 Xf1 ..... ... J D to Application Approved By---•.. • =;�6�' -/1. - -----------------------.................. - ------ Date Application Disapproved for the following reasons------------------------------•----------------•-----•------------------------------------------------......••--- ..........................................................:..............................................-----------------------•--------------------------------------------------------------......... Date PermitNo................................ ._.. Issued----- - -------•---•--••••......J.....-•-------------- Date FEs. ' . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. ................ Appliration for Disposal Works Tonstrurtinn j1prutit Application is hereby made for a Permit to Construct ( ) or Repair (,Y) an Individual Sewage Disposal System at* ! '- ' ----- ' _ fir -•-•r (1` !'l...... Location...............................................ddess .- Ko.......................................... ' f Location-yAddress j)i 11J or Lot No. r Owner'j ?` L.. Address! f ............. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building No. of persons............................ Showers t�•1 YP g ---------------------------- P ( ) — Cafeteria ( ) ar Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow..............................._............gallons. WSeptic Tank-Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ . Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water................... fx, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •---------------------------------------------------------------------------------•------•._.......................................---................... .... ...._!........... ...........................................Description of Soil................... , =-=r ... i / . ---- U ..................•-•......-----•--.................. •-•----•----•--............................................................... .......................................................... U Nature of Repairs or Alterations—Answer when applicable._....__....!_ ..:r_'.._.._ ------------------ -•--------------------------•---------•---------•----------•----------------•-••--•.....-----•----------------•------------------------------------------•............•••••- 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 been issued by the board of health. Signed..::,..... . ....................•--•-....•......-------•.............-----•-- /f /� Date Application Approved BYE`/ .................................... /`.3 ,--------- ate Application Disapproved for the following reasons-------------•--------------•---------------•----------•-------..._..------...-•------------------....._----•-•- -•-•..................•-•-------•---------•--•-••------•--•..............-•--••-•----.......-•-••--------- ••-••---•--•-••••----•••--•---•-••-----••-•-•-•----•-••--................................... Date PermitNo........................................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 .. i.. /... OF....... n.02. ............................................................ Trrtifirate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired bY----......•...•--........_-..--»-`. -'..-..-...............{------------.__-- ------------------------------•-------------.--------.......---------••----•-•--•----- -" Installer has been installed in accordance with the provisions of TIT IF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..$0._,/'y.,j................ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NrTCONS RUE® AS A GUARANTEE TI•IAT THE SYSTEM WI FUNCTIONSATISFACTORY. DATE. ............................................... In -• ---•--•- THE COMMONWEALTH OF MASSACHUSETTS - _ BOARD OF HEALTH 1 /..1.l: r...OF....... >ff -..: ..irr`. ` .................. . NoS42-:/.XI T.. FEE..................... i Disposal Works Tuntrwti.an hermit _.�.. Permission is hereby granted.. .....'X......... 1/� (»/ 1 %7,.1 �i ......................: fir:C.•------•--.......-•----...... to Construct ( ) or.Repair (-,X) an Individual Sewage Disposal System at No a 'y �i, 4 � J6 f .^ I it,•1 -t !> j� c .-•:�•- . � ter!; - — .. r f S r t as shown on the application for Disposal Works Construction "Permit No..................... Dated........................................ ? r t ---------------------------------•----....._..... DATE_ and of Health ���� FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 0 . ............_. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1� OF ............... .............................................. Lo J for i vii al Warks Tonotrurtion Prrmit Appli ere rt to Construct ( or Repair ( ) an Individual Sewage Disposal /a. System a Location Address o No. ...��_. �1.5��...._.... �?....QSa� r - 4�............. Owner Address w 111UI - � ........... ue A taller s ss dType of Building Size Lot...fD•v_v..�E...sq. feet Dwelling—No. of Bedrooms-_______.._.z—________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P Other fixtures -----•--------- ----------•--•-------- - ,W Design Flow............/�v........................gallons,per person per day. Total daily flow_-___-..o--------_---------•-----gall ons. W Septic Tank—Liquid'capacity/ __gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `-, Percolation Test Results Performed by.......................................................................... 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-----................... •-------------------------------------------................................................................................................................ 0 Description of Soil......................................................................................................................................................................... U ......................................-........................................................................................................................................................ W ----------------------------------------------------------- --------------------------•----------•------------------------------- •-- ----------------------------------•---------- ----------•----------- UNature 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 TH La: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance sued by t bo r , of health •-•- ........... t ApplicationApproved B •- - -••-- --•- ••----•••------------------•----•-••---•----•----....-•-------•-- Date Application Disapprove or a following reasons:-•------•--•------------------------------------------------------------------------•--•----••--------------•- ...........................................-•----•--•----•--•---•--•----------•-••--••----••-----.._..._.---•--•••-•----••-••--•-•-----............................................................... Date PermitNo---------------------------------------------------------- Issued-------------------•----------------•----•-•---•------. Date J FEZ`L..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... .........................OF.......................................................................................... ,AppfirFanon for Disp o ti al Works Tonstrnrtuan "Pan fit Applo here or a P' it to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ft .... .... .. . .............................................. ........--------------...... .�:..••-•••••---•••-••--•-...•-•-•.......................--- Location-Address or Lot o. .... ----- -- ..... ....--•••••_.. ..... ............... - ........... Owner Address a ........................... ..C-A) ............................................... ----------•---- 5 4-r .... e_.. ....l _... .._........ (LAtaller Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms...............Z........................Expansion Attic () Garbage Grinder (--) p, Other—Type of Building ...................... No. of persons...........".............. Showers ( ) — Cafeteria ( o) aOther fixtures ............................................................... Design Flow............ .....................gallons per person per day. Total daily flow__._.....AA.®.......................gallons. WSeptic Tank—Liquid capacityYAA0.gallons Length................ Width................ Diameter-_--_. Depth...fi_°...... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................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........................ ------------------------------•-----------------------•---...............-------•--....-----................_..............------•-•-•---...........-----•- 0 Description of Soil-------------•---.....-•--------•---•-•-------------..........-•--•---•---------------------•----------------------•.......----------------------...-•-----•••-..-•-•- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------•----------------...........------. 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 TiTI. . 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been issued by he bo d of hea ? 1Z ApplicationApproved --•-•------------- ------------------------------•--••--------•--............... Application Disapproves the following reasons------------------------•-----------------------------------------------------•--••-••---•• Date-----------•-- ...............••••••--•----•••-•••----------•---•-•••-•-•--•.....•••-•••--•--•••------------•-•---•......---••••-•-•--•--•---•--------------•-•-•••------•------••••--••-••---•-•••---•••••••••--------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................1........OF..............................................................I...................... Marrtifi.ratr of Tompli anrr o-- TIS�S T CERI-FY That the dividual Sewage Disposa ystem constructed ( ) or Repaired ( ) at st has been installed in accordance with the provisions of T * a,`>sf Ile State Sanitary, 0 . a s�ibed in the application for Disposal Works Construction Permit No.---............ ......................... dated........... .................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST E AS A GUARANTEE THAT THE SYSTEM WII L TION SATISFACTORY. DATE.-- ...4°... . 7---------------------------- -•--------------- ----- Inspector- nspector -------------------------------------...._....... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... FEE........................ g ar otr ion rrmtt Permissio>isgre by ed - ; to Construct ( ) an osal System < ✓.i2GY.Ti Street ` as shown on"the pplication for Disposal Works Construction Peiinit �`................ Dated.......................................... if �7 Board of Health DATE �j FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I LEGEND N e 1`\ A { -a- - •� .---, , x 100.98' EXISTING ,SPOT GRADE -- 98 -- EXISTING CONTOUR aG�o c P°Poi —O.-H.-W.— OVERHEAD WIRES G EXISTING GAS SERVICE "a m PG 141 W EXISTING WATER SERVICE a/ LOCUST PB 173 TEST PIT a S I o BENCHMARK �a rown P DDT 3 Ra S BENCHMARK SET t TOP COR./DECK BENCH Y EL.=103.92 (Assumed) Tobey Way STOCKADE FENCE S 11�1230 W 91 100, x 120.00; VENT X LOCUS MAP x 100,91 100,7� NOT TO SCALE i � � � GENERAL NOTES: 6�, r SSs _ TP— i SHED ^�i 1. ALL CHANGES TO THIS PLAN MUST BE APPROVE D BY THE LOCAL Z ' p� �Qs_ o BOARD OF HEALTH AND THE DESIGN ENGINEER. z 'I ,.L--- `���_ .� TP-10 ' n 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 11 --T �r� m OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Q ,��'� P P. EXISTING CESSPOOLS LOCAL RULES AND REGULATIONS. v PROP TIC (RECORD AS-BUILT) 3" THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR D-BOX TANK x 100.93 TO BE PUMPED, FILLED TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ' x 100,98 /^ 000 0 WITH SAND & ABANDONED DESIGN ENGINEER. w 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING DECK '70, 100.86 100,84 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN O I- x x ENGINEER BEFORE CONSTRUCTION CONTINUES. i rn �\\01,0 1 1. GAS 100.90 100,89 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. 6 � EXIST" SEWER STOCKADE FENCE, Q0 I rn -1 x Z 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 100.51 v THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF N i I co 00 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. EX/STING CARZo I HOUSE (#21) PORT --! 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. � T.O.F.=101.8E -,! p 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS �• i AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE (LOT 2) DIRECTED BY THE APPROVING AUTHORITIES. 100.87 101.00 x 100,72 APN 268-009 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 71 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 11,97OfSF i CONSTRUCTION. 100,63 100,79 �� �� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS ca.- PAVED IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND DRII/EWAY + REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 120.00 ° 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 100.28 INSPECTED BY A CERTIFIED SOIL EVALUATOR PRIOR TO BACKFILL.. N 11*12'30" E 100.20 tx 100�,00 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND UP up IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. edge of pavement 14. ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED EXISTING 100.29 9 P 100.30 100,23 100,08 pF Mgss9� SEPTIC SYSTEM COMPONENTS THAT MAY EXIST ON THE PROPERTY. T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN BLUE CIVIL PETER E JA Y DRIVE Mc VIL 21 BLUE JAY DRIVE, HYANNISPORT, MA o "' No 35109 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD .,1 � �9 EG/STE��' ��� •Engineering by: SCALE DRAWN JOB. N0. KELLARD, TIMOTHY J & MARY T TRS FS L \ Engineering Works, Inc. 1"=20' P.T.M. 256-11 8 CARRIAGE WAY fe. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DANVERS, MA 01923 j2 IZ ,1 (508) 477-5313 12/12/1 1 P.T.M. 1 of 2 t NOTE: ,TO PREVENT BREAKOUT, THE PROPOSED • FINISH GRADE SHALL NOT BE < EL.98.3 FOR A DISTANCE OF 15' AROUND THE ' PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-80 I INSTALL RISERS & COVERS OVER INLET & PROPOSED S.A.S, 0 .-- OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT CHARCOAL Q' ' COVER SET TO 6" OF GRADE INSTALL INSPECTION PORT OVER END UNIT VENT 6SHED T.O.F.=101.8t Q� 4+ F.G. EL.=,101.3(MAX.) EXISTING 87 F.G. EL.=100.9t F.G. EL.=100.9t 4 9 —' MAINTAIN 27. GRADE (MIN.) OVER S.A.S. LO S=1%1(MIN.) j L = 22' L = 2' 4"SCH40 PVC ® S=1% (MIN.) 0 S=1% (MIN.) 6 4"SCH40 PVC 4"SCH40 PVC TOP LOADED F INSPECTION PORTLLP �• 4 D„I s• 14" 19" TO INV.=99.25 48" LIQUID INVERT 6fflffifflkftj1 LEVEL INV.=98.78 PROPOSED INV.=98.61 I I BACK OF HOUSE ADD r• --I CAR INV.=99.00 D-BO INV.=98.59 1 TRENCH W/12 ADS,Arc 36HC UNITS ® 5'/UNIT = 60' PORT SOIL ABSORPTION SYSTEM (PROFILE) PROPOSED SEPTIC TANK UNITS MUST BE STAMPED H-20 TIE IN TO EXISTING SEWER ESTABLISH VEGETATIVE COVER S.A.S. LAYOUT AT OR ABOVE INV.=99.36 BACKFILL WITH CLEAN NATIVE OR NOTES: PERC SAND TO TOP OF CHAMBERS (-F-15 5'=•-•� �--15.5"--��2" 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=98.59 ' INVERTS, PRIOR TO INSTALLATION. TOP ELEV.=98.33 2) SEPTIC TANK & D—BOX SHALL BE SET LEVEL AND �� 12" TRUE TO GRADE ON A MECHANICALLY COMPACTED `' 15.5 SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=97.00 6" �` 8�, 310 CMR 15.221(2). it 2.83' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE BOTTOM OF } p T • 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE T.P. EXCAVATION OR G.W. 3 OUTLETS — H-10 LOADING' 2„ AS MANUFACTURED BY TUF—TITE, ZABEL OR EQUAL. EXISTING SUITABLE D-BOX NO G.W., EL=90.8 4 t MATERIAL �+ SEPTIC SYSTEM PROFILE ADS Arc 36HC UNITS TO BE INSTALLED IN TRENCH CONFIGURATION WITH NO STONE —63.25" N.T.S. TYPICAL SECTION 16" DESIGN CRITERIA SOIL LOG 34.5" NUMBER OF BEDROOMS: 3 BEDROOMS DATE: NOVEMBER130, 2011 (REF. P#13,482) SOIL EVALUATOR: PETER McENTEE PE, (SE#1542) SOIL TEXTURAL CLASS: CLASS I WITNESS: DONALD D.ESMARAIS R.S. HEALTH AGENT TOP VIEW DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. no TP— 1 DEPTH ELEV• TP-2 DEPTH 60'= DAILY FLOW: 330 G.P.D. 100.8 A 100.9 A 0" END CAP END CAP SANDY LOAM SANDY LOAM FRONT VIEW SIDE VIEW DESIGN FLOW: 330 G.P.D. END CAP 100.3 10YR 4/2 100.2 10YR 4/2 REAR/TOP VIEW GARBAGE GRINDER: NO 6' 8" LEACHING AREA REQUIRED: 330 e 1' NOTE:NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW ( ) = 445.9 S.F. SANDY LOAM f SANDY LOAM TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY .74 10YR 5/8 ! 10YR 5/8 DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY 98.8 24," 98.4 30" MINI 4640 TRUEMAN BLVD HILLIARD, OHIO 43026 Are 36HC DETAIL PROPOSED D—BOX:: 1 INLET, 3 OUTLETS, H-10 RATED PERC ADVANCED DRAINAGE SYSTEMS, INC.• UNITS MUST BE STAMPED H-20 36''48" w SOIL ABSORPTION SYSTEM PROPOSED SEPTIC SYSTEM UPGRADE PLAN - e COARSE SAND COARSE SAND 21 BLUE JAY DRIVE HYANNISPORT MA ° USE ADS Arc 36HC UNITS IN STONELESS TRENCH CONFIGURATION 10YR 5/4 10YR 5/4 � � } (GENERAL USE APPROVAL FOR 7.79 SF/LF IN TRENCH CONFIGURATION) Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 4'" 12 UNITS = 60.0 FT Engineering by: SCALE DRAWN JOB. NO. 90.8 120" 90.9 120" Engineering Works, Inc. NTS P.T.M. 256-11 • ,� - 60' x 7.79 SF/LF = 467.4 SF # 9 g NO GROUNDWATER 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW- PROVIDED: 0.74(467.4 S.F.) = 345.9 G.P.D. PERC RATE: <2 MIN./IN. (508) 477-5313 12/12/11 P.T.M. 2 Of 2 SOIL L0G L NO. 1 NO . 2 SITE PLAN /S - SAWo`( 0 1 97 LOAM Asiay 2 _ 3 r 4 93 -- ---- — TOP OF FOUNDATION El.: 5 e ° 1 MAN. Ca4C-. � 2 �/D ~Corr OJi=t� I_�NLlilAis - r1 � ° • a r�1A C.@h�1��T l../S`/'. 1� 91 `f 7 - e., DIN EL. — • --- 10 l rWEL EL 87 • WEL __- s.� _z_a •.. __ 2' COVER 1/8 3/8 WASHED STONE e D/ B W/ 6�� SUMP IN El. l�� �om� moo •, ° :: 3/4 1 1/2 WASHED STONE -- `�':` 13 • 4' LIQUID LEVEL :� a bi• ° o° O C 1� o a s o 14 ailJ• , ° g FF. DEPTH: r _ - -` —r 1 5 � s�_ __ T ° . • c:�.. __= 1, C, . y 03 PERC TEST RESULTS � ooD ^,y • PRECAST SEPTIC TANK WITH -©°sue o PRECAST LEACHING PITS PERC RATE : _� rvui CAST IN PLACE INLET AND °" ° ; � ` WHITNESSEO BY: _�R EL. . ' OUTLET T "S PER TITLE g _ B0AR0 OF HEALTH 6 "� Lo�rG- -ilxlo. �r,�_ xStf3 }-i,4 f,�_ DIA . SIZE : z 1��o Gv,1rs DATE : ___.s-3- S3 ___ - 1 - - a— DIA . - p- )Sot PROFILE OF PROPOSED SEWAGE SYSTEM -� L � SYSTEM DESIGNED BY THE TOWN OF REGULATIONS AND STATE TITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE 1/4"= 1 " 0 "' t t�s , N . B O 3o ' I2 I 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE o1 2. ALL PIPES SHALL BE SLOPED 1/4 " PER FOOT EXCEPT FOR ► i -� - - ` THE FIRST 2 FEET OUT OF THE O / B WHICH SHALL BE LEVEL 3. DESIGN FLOW BEDROOMS AT 110 GALDAY PER BR . ____ _ GAL/ DAY SEPTIC TAN K SIZE X GAL . USE __ GAL. W/ GARBAGE DISPOSAL LEACHING SYSTEM : USE -Tif — oNL FLAT Lr EFFECTIVE AREA : SIDE - BOTTOM TOTAL FLOW__...._ TOTAL REQ 'O FLOW X �',- - W/ . GARBAGE DISPOSAL i RESERVE FLOW G¢ -, = 14-4 GAL/ DAY REFERENCE PLANS _ 5u13D�1/l�tL�rl 1'Lrr e�`= t�ra to T(7) ---- -----b D P L NO Z4 APPROVED BY : - - - . �.,, _ BOARD OF HEALTH DATE PROPERTY OWNER : __ ____ _ _ K = _ _-- - _ _-- _- S/ TE AND SEWAGE PLAN 1 N - Ow'EL i �Z41 OF h'Q� S GLC � �`{ t N G LcT- fs ,ST��: W ILL ►AtA LtE_C3tt2MHN -- 23 5 T )Mere_V— want V -- — ---- -- -- -- 02�,G _ GJ7 -$28