HomeMy WebLinkAbout0038 DENVER STREET - Health 38 DENVER STREET,HYANNIS
A=
f
Town o`',Barnstable P#
Department of Regulatory Services
nRNBrAB M r Public Health Division Date
200 Main Street,Hyannis MA 02601
Date Scheduled J Time---�F-- Fee Pd.
Soil Suitability Assessment for wa�eU_j al
Performed By: � D �jL
y Witnessed BY .
e
LOCATION & GENERAL INFORMATION
Imation Address 38 Denver Street Owner's Name Richard Knowlton.
Hyannis. , - MA 026G7.1 38 Denver Street .
Address
0}� Hyannis:, :MA 026.01
Assessor's Map/Parcel: 2 91/3 0 5. Engineer's Name BSC_ Group, ..Inc
Vi
NEW CONSTRUCTION REPAIR
Telephone# 508-778-8919.
land Use Z-ildt n 0. ' Slopes(96) 6 Spi
Surface Stones N�
Distances from: Open Water Body IV ft possible Wet Area�_R Drinking Water Well _ft ,
Drainage Way Y ft Propertp line Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests;locate wetlands in proximity to holes)
jj .. __.-----
`DA
wry.
Nx
p�N
Parent material(geologic),�l�r4q /i l�'�i't pth to Bed ock `r
Depth to Groundwater. StandingWater in Hole: AIQAI /
Weeping from Pit Face__/✓O
Estimated Seasonal High Groundwater -r
DETERMINATION FOR SEA ANAL HIGH WATER TABLE
Method Used: /—
Depth Observed standing in obs.hole: in. Depth to soli mottles: in.
Depth to weeping from side of obs.hole: �"""" in, Uroundwater Adjustment
Index Well 0—,,__Reading Date: Index Well level,_-,,, ,,�-, Adj.&ctor Adj,droundwater Loyal
PERCOLATION TEST.. nkin
Observation .
Hole M Z at 9" .�
Time
Depth of Pero Time at 6"
Start Pre-soak Time® c�
--�— Time: 19".6")
End Pre-soak 1bh /Z�t
Rate MinJtnch L7�1 GZ�fP� i°l
Site Suitability Assessment: Site Passed Site FailiZd: Additional Testing Needed(Y/N)
Original: Public Health Division Observatl.on Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within•100'of wetland,you must first notify the,
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:\SEPTICIPERCFORM.DOC
DEEP.OBSERVATION H%E LOG Hole# _
Depth from Soil,Horizon Soil Texture a,Soil Color 'Soil
Surface(in.) - Other _
(USDA) (Munselq (Mottling (Structure,Stones;Boulders:
i ecy.1%0—rev 1
d-- • S��D h�e.s 2 b/J� •
Ay_ Jf
lot%
24 6-A L g") l DM h
DEEP OBSERVATION HO E LOG Hole#�_
Depth from Soil Horizon Soil Texture It! Soil Color Soil Other
Surface(In.) (USDA) `3 (Munsell), Mottling (Structure,Stones,Boulders.
C ns en %
AANi
• �v.0 /o'�✓��/� `dui. Pe r-� c��L�
IZo
!�'l.SfJn/D f? /z,1 I Z
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders.
onsistency,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Boll Other
Surface(in.) (USDA) (Munsell) MottlingI(Structure,Stones:Boulders:.,,:.:
i
Flood Insurance Rate Map:
Above 500 year flood boundary No— .Yes .x
Within 500 year boundary No. Yes
Within 100 o Yesyear flood bounds ryN F Depth of Naturally Occurring Pervious Material'
Does at least four feet of naturally occurring perviy �material exist in all erase observed throughout the
area proposed for the soil absorption system? ��((
If not,what is the depth of naturally occurring pervi6us material? ,
,..
Certification .
I certify that on .900 Z- (date)I have passed the soil evaluator examination approved by the
Department of Envi onmental Protection and that the above analysis was performed by me consistent with
the required training,expertise aiA ex erience described in 10 CMR 15.017.
Signature Date T
• r
Q:%SernC%PSRCPORM.DOC .
.............
TOWN OF BARNSTABLE
LOCATION 27-39 0P ie ' S"rr,,t- SEWAGE# aoX- 3,7
VILLAGE ASSESSOR'S MAP&PARCEL oZ y/ 4 3 OS
INSTALLERS NAME&PHONE NO. J, �, � �� �o o�S'Toz c7:t,
SEPTIC TANK CAPACITY /O®o5
• VI-
LEACHING FACILITY:(type) 3 0�®1n r,/,o hw-lo6-5 (size) /o.VX 30,S X a
NO.OF BEDROOMS
OWNER JO417
PERMIT DATE: —/- 11� 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
'�
C� � __
��
9a � � w
` 1 � -� � �
\ �
. .
Z ' �,, R,
�t1 w l;�
NI- �, __
� � � �
`. s
� g
��
���
No. ai s� Fee 1,106
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipphration for � oar 4p5temc Cow5truction Vermtt
Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No.
[9_a RI C�,AALJ iCic�o t fa S�8-�71-tsb,`'
Assessor's Map/Parcel -39 Je-- Z
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel No.
aAJ;7-"P" &)a
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size A4:3'Y1 sq.ft. Garbage Grinder ( )
Other Type of Building AC-SAGr?e',, No.of Persons Showers( ) Cafeteria( )
Other Fixtures v
Design Flow(min.required) S Z?4Q gpd Design flow provided 31 t3 gpd
Plan Date Number of sheets % Revision Date
Title
Size of Septic Tank / Ooo j Type of S.A.S.
Description of Soil .S _ca Ah,L
Nature of Repairs or Alterations(Answer when applicable) /f _1L2-
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 o rd ealth. �y
Date / _ oI
Application Approve Date tt) 1162
Application Disapproved by: 'Date
for the following reasons
Permit No.. �-E' (per !��� Date Issued
+ No. . :�, � � Fee 10 v
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
4. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS eyes
appticatiop lfor Mi m o5o.0 *p5tem Con5truction Permit
Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑ Complete System ❑-Individual Components
3 b'Location Address or Lot No. Owner's Name,Address,and Tel.No l��.v�e�sr.�e��--
"q,j,�J(Sz /�'/A• D a6a �1 Gli+Rf2 t� iC�duJ/'Fob S"a8-���
Assessor's Map/Parcel 3g f�,� � eQ f
flieJe1lS /LO•!J`aC�U/
Installer's Name,Address,and Tel.No. Desig,ascner's Name,Address and Tel.No.
G.Qouro .�/st�D.66
Type of Building:
Dwelling No.of Bedrooms Lot Size IZ),3 J// sq. ft. Garbage Grinder ( )
Other Type of Building �rI j No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 315V gpd
Plan Date 0/06 Number of sheets / Revision Date
Title
Size of Septic Tank /,6QQ Type of S.A.S.
Description of Soil /`IA} j
Nature of Repairs or Alterations(Answer when applicable) Ao,A s;Q
Date last inspected:
Agreement:
y,
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 I3/oard of-Health.
Signed ( Date ' ! — ow/
Application Approve Date '�/ �) 62
Application Disapproved by: Date
for the following reasons
Permit No. �- � �4-i 3 Date Issued !� b
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 h IJ Q—S has been constructed in accordance
Jtith the provisions of Title 5 and the for Disposal S stem Construction Permit No. (C 3a dated 1�
Installer Designer 3 S
#bedrooms Approved design flow gpd
The issuance of this permit shall of be construed as a guarantee that the system will function as esig ed.
Date��b Inspector
—————— /———— ——
No. ®V Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
"figpool *p5tem cowAruction permit
Permission is hereby granted t Construct ( Repair (v)--..Upf rade ( ) Abandon ( )
System located at J . 1
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: Constru7-a
n must a completed within three years of the date of this pe
Date e7 0 Approved b
AUG.23.20'04 9:03AM BARNSTABLE BOARD OF HEALTH
' 'own of Barnstable
' Regulatory Service.3
Thomas F.Gefle>c,fredor
► . / Public health Divild.01.1
Thomas Mc,Keaa,Director
200 Main Street,Hy=AbqXAk 0201
Qf.ce: P Zb0�,,�27
Installer&d3esi'znir jerfficatioluLIRM
Date.,
Desiguen X56 ✓� Installer: eat �
Addr,)raos: /�[ov`� �/` 2 Za VAjt0 Address.
On 21 bb ^ Pt4(_Tza ow-,5 was lsst od a pear d 1, `a i zustWl a
(
it (installer)
septar, ;vstera at baaed on>_,c(;a , ;e ;,:f y-1
(address)
dated 7 C, A 6_
(designer)
-72 :[ cortiLfy that-the .eptic system referenced above Was iM3ta11ed ,n;:las :4tia.L1) 1
the desiA whieb may include minor approved char€nu such a s ;fr ; a a�1,:c:a r;i�:a I c►:` : �,::
distribution box aad/or septic tank.
I certify that the septic system referenced above way. hst4led Tiir'I:.r 711i+'rl V;• r;�'• a, ='; =,
—!, greater than 10' lateral relocation of the SAS or any wi7ical rc l x•f:t i)d.
of the septic"cm)but in accordwi6e with State &Lo�'al 1e2u;,,at ,a:as.
oxtBied as built by designer to follow.
,j%OF 1144
2 c
p MARK D. yGN
DIBB
.�
o CIVIL
1 37
*(Ii3tial 459No.
TONAL
17,�Sl,�Ctl3i' E4 S1�Ilat1 }
I.,E PYJBLIC �A�,rE[ 17LE,t ,
PI.+ ��►��lF 1��UR.�T_�) S']['.�S =— - �„�o ' _ I�
�� rEcM[IPINCEVII,II. 1V0'T WE ISa D dr.
�TSTAHL.
Q.Hea1t/Septic/DeAgner CartiEcation Form
Z 7/- 3z3"
V
^,
yz�Z�
` 80
RTOLOTTV CONSTRUCTION INC.
�BIIBB.U"ACL ,:SEWAGE•• DISPOSAL: SYSTEH INSPECTION YOux
Aadr4ss ,of.(propa t.y
Ovnirts: naiizsa: : --
pti' oi��Zsp,act on, -
PART A
CHECKLIST
Check if. the. fol-lowi.ng . have been done
✓ Pumping..iii forma tion was requested of the owner ,, occupant , and
Health.
•Nona.,,of .the. system components have .been pumped. for at least - mac
and the system has been receiving normal flow rates during
period.. :Large. .volumes of water• have: not been introduced into ~.h
system ra'cently�:or:'as: part of this 'inspection .
"a built plans have been obtained and examined . Note i trey
avaiY'able `vith ;N/A.
V Tha f_ecility,•or• dwe111nq was inspected . for signs of se,.,age n1 -
The site was. inspected for signs of breakout .
,Ail a'ystem components , excluding ,; the SAS , , have been locate
/: ,i tQ
L/ The ceptic tank manholes. were uncovered, opened , and the intc ; :
:the septic tank vas inspect:ed . for .Condition of baffles or tees ,
i.atarial,.'ot construction, dimensions , depth of liquid , depth of
saudga, ,dapth. .oi .:scum.
't/. The size =and,.:location- .of. the SAS on .the site has been determir,ee
'Or+ txasting 'information `or_ approviinated by :ion-intrusive metho
The facility• owner•. (:and, occupants , if different from o�-,ner ) -F
provided•-With ;information :on the proper maintenance of SSD ,
SUBSURFACE. SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INYOR?iATION
FLOW CONDITIONS
If residential
number of bedrooms
= number of current residents
garbage. grinder,. yes .or no
. Y _. �aundry connected: to system, yes or no
seasonal use, yes or no
If nonresidential, calculated. flow:
Water meter readings, if available:
Last date of occupancy
GENERAL INFORMATION
Pumping records and. source of information:
_ System. pumped as....part of inspection, yes or no
if yes,-: volume pumped
Reason for pumping : /
Ori //� eE �Dt'
-Tl vh a4=7 l ,JS,7F a�J
Type of system
✓Septic. tank/distribution box/soil absorption system
Single. cesspool
Overfl-ow cesspool
Privy
Shared system (yes or no) (if yes , attach previous inspection
records, if ,any)
Other :(explain)
Approximate .age of . all components. Date installed, if known . Source o
i h f otrAt ion: /
Sewage odors detected when arriving at the site , yes or no
p
S.UBSU.RFACE .S.SWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
/ SYSTEM INFORMATION continued
SEPTIC TANK: .y
(locate on. site .plan)
depth below grade:
material of; construction: concrete metal FRP other (explar.
dimensions: 1')( _1
g!, sludge-.depth
. '_ dstance..from top of sludge to bottom of outlet tee or baffle
scum.:thickness
distance from.from top of scum to top of outlet tee or baffle
y,, distance�. from: bottom of scum to bottom of outlet tee or baffle
Comments
(recommendation for pumping, condition of inlet and outlet tees or bail ,'Ac:. ,
depth of liquid level in relation to outlet invert , structural integrity ,
evidence of .leakage, recommendations for repairs , etc . )
.:.::DI=STRI BUTI,ON ;.BOX:
(iocate ..on''site plan)
'r hiepth of: liquid level above outlet invert
Comments:
(note if level and distribution is equal , evidence of solids carryover ,
e id nce of . eakage into or out of box, recommendation for repairs , etc . ;
PUMP: CHAMBER:
(locate on.. site plan)
pumps in working order, yes-or no
Comments:
(note condition of pump chamber, condition of pumps and appurtenances ,
recommendations. for maintenance or repairs, etc. )
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART
SYSTEM INYORXATION continued
SOIL;ABSORPTION'. SYSTEM ('SAS) : ✓
(locate on site pha, .
approximat if possible; excavation not required , but may be
ed '.by: non-intrusive methods)
If-not determined to be present, explain:
Type
leaching, pi_ts,,,and number ><',. r'cI�Z�>,,cii7 � ------_ .
leaching chatters and number
leaching.:galleries and number
leaching .:trenches, number, length
leaching,.fi4lds, .number, dimensions
overflow cesspool , number
Comments:
(note condition of soil , signs of hydraulic failure , level of ponding ,
c ndition :of_,`vegetati n, recommendations for maintenance or repairs , et.c .
d n 3,
CESSPOOLS, ;'(.locate on-site plan) : Ala
number-,:and' configuration _
depth-top ot :aiqu 'd to inlet invert
depth 'of;':solids layer
depth .ol:. scum layer "---
dimensions : ot ;cesspool.
--"
mat;erials;�Of,:oonstruction - -
andication ol .'groundwater
inflow.;`.(casspool ,mutt. be pumped as
part of bispecti -
Comments
(note condition Of 'soil, signs ,of hydraulic failure, level of ponding ,
conditii: .ot•vegetation, recommendations . for maintenance or repairs , etc . ;
PRIVY: /)v
locate �"on: site plan)
=f„Lmaterials of construction
dimensions
depth. of..:sol ids ---
Comments :
(note. condition .of soil; signs of hydraulic failure , level of ponding ,
condition 'of vegetation, recommendations for maintenance or repairs , etc: . '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM.. INFORMATION continued
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarE",,
locate all wells within 100 '
Uw ► OF:`
DEPTH TO GROUNDWATER
2 Z depth to groundwater
method of determination or approximation:
�,k-
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION PORT!
PART C
FAILURE CRITERIA
Indicate yes, no, or. not determined (Y, N, or ND) . Describe basis 01'
.. determination. in all instances. If "not determined" , explain why not )
A/ Backup -of...sewage into facility?
Discharge or ponding of effluent to the surface of .the ground or
surface waters?
n/ Static liquid level in the distribution box above outlet invert'
1,4 Liquid depth in cesspool <6" below invert or available volume<
flow?
/A Required.-pumping 4 times or more in the last year?
number of times pumped
i`/ Septic. tank is .metal? cracked? structurally unsound? substantial
infiltration? substantial exfiltration? tank failure imminent?
Is a:ny portion: of the SAS, ' cesspool .or privy:
Abelow the high groundwater elevation?
within 50. feet-:of a surface water?
wi thin.:l f
00 feet ._of a surface water supply or tributary to a surace
water- s:v..ppiy?
within a :Zone I of a public well?
within 50 feet of a bordering vegetated wetland or salt marsh
(cesspools and privies only, n2j the SAS) ?
within 50 feet of a private water supply well?
Lless than r, 100 feet but
greater than 50 feet from a private water
supply; .wel1 with` no acceptable water quality analysis? If the well.,
has _beenanalyzed to .be acceptable, attach co
PY of wellfor colitorm' bacterial volatile organic compounds, ammoniatnitrogen
and nitrate nitrogen.
SUBSURFACE SEWAGE DI13POSAL- SYSTEK INSPECTION FOPY,
PART D
CERTIFICATION
Name of Inspector� b� '
Company. Name >
Company. Address�7�a� eG�r� UCec`�
to=gilt
I certify ..thit .I have. personally inspected the sewage disposal syste^
this :addr4ss' and that the information reported is true, accurate and
complete as -;o'f .the time of inspection. The inspection was performed ar-"
any::recommendations. rag arding upgrade, maintenance and repair are
consistent/:with. iny.. training and experience in the proper function and
manitenance'of -:on-site sewage disposal systems .
Check one:
I :have:;:not found any information which indicates that the system fti '. :
to:°adequately protect public health or the environment as defines'
3"10. CMR_..15. 3.03 : Any failure criteria not evaluated are as stated
the*1-7AILURE CRITERIA section of this form.
I have.;..determin.ed , that the system fails to protect public health;
the. environment as defined in 310 CMR 15 . 303 . The basis for this
:determination is provided in the FAILURE CRITERIA section of thi ;
form.'-
Inspector l.g. Signature <
Date
original to system owner
Copies> to
Buyer (if :applicable)
Approving authority
rh
C:�.9 ......_ DEC,f 5 �99g
fI -'
BORTOLOTTI CONSTRUCTION, INC. .
765 WAKEBY ROAD,MARSTONS MILLS,MA 02648
509-771-9399 508428-8926 FAX: 508428-9399
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address:
Date of Inspection: Inspector's N me:
orseesName and Address:
CERTa rATION STATEMENT•
I certify that I have personally inspected the sewage disposal system at this address and that the informa-
tion reported below is true,accurate and complete as of the time of inspection. The inspection was per-
formed based on my training and experience in the proper function and maintenance of on-site sewage
disposal stems. The System:.
Passes _
:Conditionally Passes =
Needs Further Ev tion y Local Aproving Authority
Fails
Inspector's Signature: Date:_1 G y�
The System Inspector shall submit a copy of this inspection report to the Approving authority within thir-
ty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional
office of the Department of Environmental Protection. The original should be sent to the system owner
and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARVe
A)SYSXT PASSES:
fit// I have not found any information which indicates that the system violates any of the failure
criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated'
below.
I
B)SYSTEM CONDPTIONALLY PASSES;
One or more system components need to be replaced or repaired. The system,'upon comple-
tion of the replacement or repair,passes inspection.
Indicate yes,nor,or not determined(Y,N,OR ND).Describe basis of determination in all instances. If
"not determined",explain why not.
The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or
exfiitration,or tank failure is imminent. The system will pass inspection`if the'existing sep-
tic tank is replaced with a conforming septic tank as approved by The Board of Health.
Sewage backkup or breakout or high static water.level observed in the distribution box is due
a
Ito broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The.,
- system will pass inspection if(with approval of The Board of Health):
SUBSURFACE SEWAGE D.ISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Broken pipe(s)replaced
Obstruction is removed
Distribution r
d
' ution Box is levelled o replaced
lace
The System required pumping more than four times a year due to broken or obstructed pipe(s).
Y
The system will pass inspection if(with approval of The Board of Health):
Broken pipe(s)are replaced
Obstruction is removed µ
.~
HEALTH:
O ARD O F HE AL
FURTHER EVALUATION IS REQUIRED BY THE B
Conditions exist which require further evaluation by The Board of Health in order to deter
mine if
the system is failing to protect the public health,safety and the environment.
1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE
SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE
PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within SO Feet of a surface water
Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh.
2)SYSTEM WILL FAIL UNLESS THE BOARD,OF HEALTH„(AND,PUBLIC WATER
SUPPLIER,t'IF APPROPRIATE:)DETERMINES THAT THE.SYSTEM IS-FUNCTION-
ING IN'AlV1ANNER THAT.PROTECT THE.PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:' n
The system has a septic tank sand soil absorption system and is within 100 Feet to a surface
water supply or tributary to a surface water supply.
The system has a septic tank and soil absorption system and is with a Zone I of a public
water supply well: '
The system has a septic tank and soil absorption system and is within Feet 50 of a private
water supply well. ;
but SO
The system has a septic tank and soil absorption system and is less than 100 Feet
Feet or more from a private water supply well,unless a well water analysis for coliform'
, bacteria and volatile.organic compounds indicates that the well is free from pollution from
the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less
than 5 ppm: -
D)SYSTEM FANS:
I have determined that the system violates one or more of the following failure criteria as defined
in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health
should be contacted to determine what will be necessary to correct the failure.
Backup of sewage into facility or system component due to an overloaded or clogged SAS
orcesspool:
Discharge or ponding of efluent•to the surface of the ground or,surface waters due to an
wkiloaded or;clogged SAS,oroesspool.;,, N ;
Static"liquid level in the.distribution box above.outlet invert duee to an overlaaded'or clog-
k,.'.x • ,. 3.4I? 4f.•.! cesspool: '�f! K. i-. i.;t �. t; .,.a ti 4t,; „,.J• .�4�A«2
gad SAS`or
r Liquid depth in cesspool is less than 6"below-invert or available volume is less than 1/2
day flow: -1-� ,, . . _
Required pumping more than 4,times in the last year NOT due to clogged or obstructed
pipe(s). Number of times pumped
•2_
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
-PART A
CERTIFICATION (continued)
Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater
elevation.
Any portion of a 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 I 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. If the well has been analyzed
to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic
compounds,ammonia nitrogen and nitrate nitrogen.
E)LARGE SYSTEM FAILS:
The following criteria apply to a large system in addition to the criteria above:
The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant
threat to public health and safety and the environment because one or more of.the following
conditions.exist:
The systemr is within 400 Feet of asurface drinking water supply„.,
The systein W—thin 200 Feet of a°tributary to a surface drirdkingwater:supply
tj
The system is located in a nitrogen sensitive area Interim Wellhead.Protectiort Area
(IWPA)or a mapped Zone II of a public water supply well
The owner or operator of any such system shall bring the system and facility into full compliance with the
groundwater treatment program requirements of 314 CMR 5.00 and 6.00; Please consult the local
regional office of the Department for further information. '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Check ifdue following have been done: M '
V Pumping information was requested of the owner,occupant,and Board of Health.'
L7'None of the system components have been pumped for atleast two weeks and the systsm'has
been receiving normal flow rates during that period. Large volumes of water have not been
introduced into the system recently or as part of this inspection.
As-built plans have been obtained and examined. Note if they are not available with N/A.
facility or dwelling was inspected for signs of sewage back-up..
The system does not receive non-sanitary or industrial waste flow.
=The site was inspected for signs of breakout:
✓All system components,excluding the Soil Absorption System,have been located on site.
'c tank mahholes were uncovered,'opened,and the interior of the,septic tank was in-
for condition of baffles or tees,material of construction,dimensions;depth of liquid;
:Of Sludge,depth of scum
The size and location of the Soil Absorption System on the site has,been determined based on,
existing information or approximated by non-intrusive methods.,
-3-
a a,
x� Cv;Art K,;
� ��
S,«�- I�U• , x Y#S�,.y? - r"-,d,-'�itr�t�r +`3 -..?' c"
` Al
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST(continued)
V The facilitY owner(and occupants,if different from owner)were provided with information on
the proper maintenance of Subsurface Disposal System
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
--PART C -
SYSTEM INFORMATION
/ FLOW CONDITIONS
RESID
Design Flow: Ions Number of Bedrooms:_ Number of Current Residents:
Garbage.Grinder: 06 Laundry Connected To System: Seasonal Use:
Water Meter.Readings,if able: •
Last Date.of,Occupancy. '
i'
..Type of Establishment: Y •r.,
Design Flow: aallons/day Grease Trap Present: (yes or no
Industrial Waste Holding Tank Present: rt
Non-Sanitary Waste Discharged To The Title V System:
Water Meter Readings,If Available: Last Date of Occupancy:
OTHER Describe)
Last Date of Occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
System Pumped as part of inspection: A)b . If yes,volume pumped: gallons-
Reason for pumping:
TYP�'OF SYSTEM:
Septic Tank/Distribution Box/Soil Absorption System
Single Cesspool
Overflow Cesspool
Privy , F
Shared System,(If yes,attachprevious inspection records,if any)
Other(explain)'
•
OXIIVIATE,AG=Wqomponents,date installed(if known)and source_of information
Sewage odors detected when arriving at the site:,
:h
. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
"GENERAL INFORMATION (continued)
SEPTIC TANK:
Depth below grade:_./a Material of Construction: concrete metal FRP_Other",
Dimisions:_ —' Sludge Depth: Q " Scum Thickness: —
Distance from top of sludge to bottom of outlet tee or baffle: 36
Distance from bottom of scum to bottom of outlet tee or baffle:
Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid `
level in relation Wgutlet invert,structural integri ,e .deuce of leakage,etc. 106V19.4
• ��
GREASE TRAP: w
Depth Below Grade: Material of Construction:_concrete_metal_FRP_Other
(explain)
Dimensions: Scum Thickness.;
Distance from top of scum to top of outlet tee or baffle:
Comments:(recommendation for pumping,condition of inlet and outlemees'or,baffles�depth.of ligwd''
-level in-relation to outlet invert,structural integrity,evidence of leakage,
TIGHT OR HOLDING TANK:
Depth Below Grade: Material of Construction:_concrete_metal_FRP_Other(explain) ,
Dimensions: Capacity: gallons Design Flow: aallonstday .
Alarm Level:
Comments: (condition of.inlet tee,condition,of alarm and float switches,etc.) _
r
DISTRIBUTION BOX: t�
Depth of liquid level above outlet invert: &xd
Comments:(note if I I and distribution q ual,evt'dencMof solids carryover,evidence of leakage into
or out o box,etc. 4
.-PIIIV _C L4MBER:
,.Pumpts'In,arotidttg•order. x.' - L.. .df. ;iar � 41 '.V :p'o"(Y'�,� ,�;.' "Y
Comments (note condition.of pump,chamber,condition of pumps and appurtenances,etc,)
,i 'd'
gn
� h� r.YF,.'.`-`.{I•S4`+ �'13}}'Ny§.'!+e_f'.r. Yf s+t w53'- fi +:r . - r µr. •..! 151,114;t,n p19i. ''}
p4�p.i,tiN `•r F�f!:, ��+„ti rYr��°�!j','iryf'
r°t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
SOIL ABSORPTION SYSTEM(SAS):
(Locate on site plan,if possible;excavation not required,but maybe approximated by non-intrusive
methods) .If not determined to be present,explain:
TYpe:
Leaching pits,number:Leaching chambers,number: Leaching gall eries,number:
Leaching trenches,number,length:
Leaching fields,number,dimensions:
Overflow cesspool,number:
Co nts:(note oo dition of soil,signs of hydraulic raij4re level of nding,condition of vegetation,
etc
CESSPOOLS: - f
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(cesspool must be pumped as part of inspection)
Comments:(note condition of soilk,signs of hydraulic failure, level of ponding,condition of vegetation ;
etc.)
PRIVY:,&L
Materials of construction: Dimensions:
Depth of Solids: .
Comments:'(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation
etc.)
6 _.. . . . .
• r
......SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C '
SYSTEM INFORMATION(continued)
SKETCH OF SEWAGE DISPOSAL SYSTEM:
Include ties to atleast two permanent references, landmarks or benchmarks.
Locate all wells within 100 Feet.
1 �
�._ ._ c6 -
a
A
1
�a
DEPTB TO GROUNDWATER
Depth to groundwater: Feet ,
c� on
4' po ' n v: .MetW of or/Ap u ��
s Gam
LOCATION _ SEWAGE PERMIT NO.
VJIF
V FL L'A 6 E
IN.STA LLER'S NAME/ & ADDRESS
8 U K D E R OR OWNER
DATE PERMIT ISSUED �q - 7
DAT E CO-MPLIANCE ISSUED
�f
� G
i
7Z �
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.... .03 ._ ...-- .OF.............-.... r 1.}S- Lam................... w_
Appliratiun -fur Ditipmal Works Cnunitrurtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Location-Address ,� or Lot No.
,a -----•... ------------•--•--- ---- - -------•••----- -•---------•-•----------•----•------. .
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms________________0........
............----Expansion ttic ( ) Garbage Grinder ( )
Other—Type of Building ---------------------------- No. of persons---------_------------------ Showers ( ) — Cafeteria ( )
Q' Other fixtures -------------------------------- -
W Design Flow............... ®.....................gallons per person per day. Total daily flow................e�_ 5.0......._......._..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........1........... Diameter...L ---_ Depth bW 1 f_.._� y _ otal//leaching area------------------sq. ft.
z Other Distribution box ( ) Dosing tank ( ) � — C�
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date-----.---__----------------.--------._..
Test Pit No. 1................minutes per inch Depth of "lest Pit..------------------ Depth to ground water....-----.-_-.__.-__.:_.
G14 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.-.-..----------.-------
P4 ------•-----•------ --------•----------------------------------------------------------------------•----------------------------•-•-•-------_---•--
ODescription of Soil------- vx' -------------------------------------------------------------------- -----------------------------------------------------------------------
x
U -------------------------------------------------------------------------------------------------------------------------------- ----------------•-.......--------...------------------------------. --
-------------................................................ ------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable...----.........................................................................................
---------------------------------------------------------------------------------------------------------------------=------------------------ ----- -------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ssued by the board of hea -la.
- Z. �` ---------- ---------------••---....._------
0� ate
Application Approved By--------��Signe
--- --- •-- --•--•• . . ..� 1/L
Da
7=� .�7.
te
Application Disapproved for the following reasons: 7
-----------------------------------------------------------------------------------
......••----•---------------•--------...---•--...... ..................................................-----------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued..........................................................
Date
No......................... Flns.....,1..5...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Apphrai ltond.for 43W.Vo ttl Workii Tontrurtion Vrrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal
System at ,
ocation Address c� orLot No.
'===- --------•--------¢ j--¢..................
Addr
Installer Address
UType of Building Size Lot............................Sq. feet
�•, Dwelling—No. of Bedrooms----------------! ------------------------Expansionttic ( ) Garbage Grinder ( )
rp.., Other—Type of Building _-___---._---_-•---- ------ No. of persons_-___-_-4............... Showers ( ) — Cafeteria ( )
d Other fixtures --- ------- ---------------- --------------------------------------- - - -- ------------- ---------------------------
Or
W Design Flow_:_. _......*.ems_______________•_____..gallons per person per day. Total daily flow---------------. .'zi ....._.._.. ._ _gallons.
1:4 Septic Tank—Liquid capacity------------gallons Length_............. Width................ Diameter_-.-___.-_ -- Depth----------------
xDisposal Trench No_____________________ Width.................... Total Length __ Total leaching area------------.-------sq. ft.
Seepage Pit No. ..... .:.......... Diameter. Depth b mt__. F! ota1 leaching area.--. - _ --sq. it.
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____-.__-.---.__------
f14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
9 ---------------= ------------------------------------------•--•-------•------------------------•---------------•----------------------------------------
G Description of Soil----• _ -------------------------------------=------------------------
x
VW -------------------------------------- -----------------------------------------------------------------------------------------------------------
Nature of Repairs or Alterations—Answer when applicable-------------_----------------------------------.-------------------__-_-_-_-____--._-___-
----------------------•---•----------------- --••-------------•-----•---••••-••------•----------------------- -•----• -------••---•--•-------------•-----•-------••--•-----•---------•----------._
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be - issued by the boa.= ef-hee*h.
lX -A
Sign ---= -• ------------• --------------------------------
/ • .
�f✓ { r Date
Application Approved By-------- ----�"=---- --/----- -- - ��1r2_Glrcl_/ Date
Application Disapproved for the following reasons:....................................._.__........_...._.._..._..._.._...................._._.___..._._......_...
------•-•--••--•--------------------•-------------------------•-----•-------------•--------•-------------•-----•-----•--••-•-------•---------------------------•----------------------•-•-----.---------
Date
PermitNo......................................................... Issued_-_-_------------- .................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
'l � !
`.j............OF.... ' !. a2..:,:::.. :................................
...
Tntifirtttr of TIMplittnrr
THIS IS TO CERTlfL Th the ,Individual Sewage Disposal System constructed ( - ) or Repaired ( )
by--------.;�'---- = r
r% `l ! ) Installer
at..... " ` -------r---.,C-[�L-r-ram ---- i _-% _ f -1--- .. .......__...... r . -- --••--
Py� ------- - - ..................
has been installed in accordance with the provisions ofr fete XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.L--_-?_L3____k.................... dated.... ....................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............... L ---- v Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O� HEALTH
.' ... � .......�..-:��%���.......... . of...........��e.�f�:z..�................................................
No........ _.?_1....... FEE......'.................
�i��u�tt�-: u k,� Chu �tr�trtiu$t rrotit
Permission is hereby granted------- _-_-_ ?.'-_-_- ...............
to Construct ( ) .or Rep, i ( ) an Individual(Sewage' �i�spos7.System /
at No. _ f,',1 .._„- :- �((�1Zrt �� J.
. ...-_ . '� .e r� 1
Y i � {
��
as shown on the application for Disposal Works Construction Permit1 No. -_--___ ated-.� - .............
--- ---------
4-
---------------
'S - � Board of Health `.
DATE--- �...C._.. jg •---------------------• /
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
r r4 r t i
- is � i ��•-
LEV
'PALJL-Muez .� , BAer4. �3U d OfF-44--ri-s w
1� V'. LUJ t�A44r)
_ _9= %1
,ate � -t--�• �.�- � ' ` •.
-� LIQUID LEVELIF
I• J`+-' .-_ - I.. -ter
T Y P t CA L -5 EPT-G C. TI►.A t{L T'y P i CAL-- L-A S T-e-I D 0-r- I O N B cwl-
KAOT- TO nOcA LF_ ►.(OT rp SC./►.LE
1
G i►.1IS►J �{CAp6 �JXS (N1s 41 yLJ.D1.9 �INI`fN yl lLs.OE
T QP oc fr pVw�p fr �l
Pl WNW
►N. Its
149�
I -Mn
e .lono
e �
w
iDlST' GU 3TQwE.
-- - ------� �.,Focc s o c�..c e
E PTn C T,o.►..j "TnR
LLOVEL-
"'A cif P(vu
NOT rO 9C�-L j9:
f
_ 50
s r
�3)
p Parer•Ow�c c_�N GAa,Fc, v I I(D Arm-1, EtEv.
FI reST, FL. ELt.j�AZ t, ala i
�f nn
/ IN+1 1 /
i
Ow�Erg' ��_ , 4 �., �'� ��.�.�..-...'• "� . ' , � 'A, �w�� 1�. !SR��� �y�-r-C''�1. ��
4i
SCALE DATE SWEET � I
201 1`%GI-7 7 1 � � � i�sE i�.rt C�N14t r.-� L'`a. 1G'C7��ti-'1 r�_i �►�.,
DRAWN •r c► KD or er PLAN wo �' t
�
e ' y
SOIL TEST PIT DATA: P#11350
SEPTIC TANK DETAIL: EXISTING 1 ,000 GALLON DISTRIBUTION BOX DETAIL: NOT TO SCALE LEACHING DETAIL.: NOT TO SCALE REVISIONS N 0. DATE DES(,R11111ON
-
NOT TO SCALE NO. OF OUTLETS 5 22'-6„
TES'I_ PIT 1� TEST PIT -#2 NOTES: 1. ADD REPLACE TEES AS REQUIRED FINISHED GRADE o 00 0 0 00 0 0 00 0 0 0 0 0 0 0
° 0 0 0 0 0 0 0 0 0 0 0 °° °O° °O 0 O°0 O °o °p O0 O
GRD. EL. 100.7 GRID. EL. 100.9 TO CONFORM TO TITLE 5. I NOTES: °0 00 1
9O.7 9O.7 COVER ABLE 2" WALLS -__ ._ -- ----__ ---------.- -_--
EST. HIGH GW. EST. HIGH GIN. 2. ADD / REPLACE COVERS AS REQUIRED ° 3 UNITS OBSERVATION
0o i
TO CONFORM TO TITLE 5. .y;;,,+ ;;y+. ;;y+ + 2» 1. DIST. BOX TO WITHSTAND H-10 LOADING ° ( HIGH DENSIT " (o 00, 50" 10'-6 {
A A - T
UNLESS UNDER PAVEMENT, DRIVES OR 4 PVC oo r T P
LOAMY SAND LOAMY SAND 3. PLUG OLD / UNUSED OUTLET. } POLYETHYLENE INFILTRA Or, 3050
TRAVELED WAYS WHEREIN H-20 LOADING PIPE ° - - -- °o{
2-24" DIA CONCRETE MANHOLES ° o o o o 0 0 0 0 o c:
- 10YR5/2 �•• 10YR 2 8„ W/ METAL HANDLES BROUGHT -�- 15" SHALL APPLY. 0 00 00 0 0 000o 0 0 0 0 0 0 0 0 0 0 , GENERAL PLAN
ANNS OR DE_SI(:
- 1 0 00 0 0 0 00 ,� o 00 00 0 00 0
B B TO 6" OF FINISH GRADE a. 8" 2. PROVIDE INLET TEE OR BAFFLE WHERE 30 -6"
LOAMY SAND LOAMY SAND TEE TO BE UNDER 12" MIN. 6" 5,5" OUTLETS ` ' I DIOSPOSAC FACILITY THE Y.1
10YR5/6 10YR6 6 30" M.H. OPENING COVER SLOPE OF PIPE EXCEEDS 0.08 FT./FT OR P N Vi _W - LEACHING CHAMBERS
/ • +o o o 0 0 0 o IN PUMPED SYSTEM. 2. ALL CONSTRUCTION METHODS AN.
'���` Ada�°a a 'a �a J MATERIALS SHALL , -INFORM RA
o� +��A� ��°�
EL = 97.2 42 EL = 98.4 � �' ° L- 2` 3. FIRST TWO FEET OF PIPE OUT OF DIST. D.E.P TITLE 5 ANC LOCAL H(:lr,1D
, RAISE M.H W BOTTOM ON LEVEL LOAM & SEED DISTURBED AREAS
f' 6" MIN. 3 4" TO BOX TO BE LAID LEVEL. OF HEALTH REGUL i"i0".S
± SEWER BRICK STABLE BASE f I T
1 1/2" C USHED 4. ALL PIPE CONNECTIONS AND CONCRETE F 3. ALL PIPES LOCATED UNDEk ; '�'✓EMLNT y
do MORTAR + + �12„ :.> I CROSS-SECTION STONE BASE 3'jMAX. COMPACTED F:�L 36" MAXIMUM, 12"MINIMUM OR TRAVELED wA� SHALr. SHE >U
I NORMAL WATER LEVEL A 0 0 0 0 0 0 00 0 0 o 0 0 o i 40 OR EQUAL.
CONSTRUCTION SHALL BE WATERTIGHT.
" 1 �L o 0 0 0 o'-0 0 o 0 00 0 o 3" LAYER
56 ' 52 gr , L 3" 5. FILL ALL UNUSED KNOCKOUTS WITH MORTAR. I - PEASTONE 4. THERE ARE NO KNOWN PRIVA IE, W� LLS
! ` PRECAST SEPTIC TANK 10" 14" ! I T O � DENSITY HIGH
O OOQ O REMOVE LOCATED WITHIN 150 F T. Or THE
INLET TEES - 30 1/2" 30' 24" O O O O
O O POLYETHYLENE O Q UNSUITABLE PROPOSED LEACHING FACILE i ," NOR
NFILTRATOR 3050 O MATERIAL FOR ANY KNOWN WELLS PROPv"AL) WITHIN
_ DEPTH �0 O O O 5' ALL AROUND 150• OF ANY KNOWN LEACHING FACIL.I T Y.
_ _ 4'-0" MIN. 90 soap orgy 15 1 2" DEPTH LEACHING O O
MEDIUM SAND MEDIUM SAND - LIQUID DEPTH cis��1
/ 00 CHAMBER O IF APPLICABLE 5. WITHIN LIMIT OF EXCAVATION REMOJ'
10YR7/3 MEDIUM
S3 PRECAST DIST. ALL TOPSOIL, SUBSOIL ANU 0TI.LR
BOX 3/4" - 1 1/2" IMPERVIOUS MATERIAL.
50" 38" WASHED STONE 6. REPLACE ALL EXCAVATED MN iERIAt- WI H,
I INDICATES • :. " ;.
_ _ ESTIMATED �- 10'-6 CLEAN GRANULAR SAND, FREE F ROM ORGANIC
�----------s--� 1 zo" 120 �
EL 90.? EL = 90.9 = SEASONAL HIGH �c BOTTOM ON LEVEL STABLE BASE ek �- -� 20'-6" MATERIAL AND DELETERIOU`_-: SUBSTANCES.
GROUND WATER PLAN VIEW 7 1/2 MIXTURES AND LAYERS OF DIFFERENT CLA'.,`>E
DATE' GATE: ����'�`�� ii�7Z � CROSS-SECTION OF CHAMBER OF SOIL SHALL NOT BE USED ]HE FILL `"+A1
CROSS-SECTION VIEW PLAN VIEW ,
MAY 27 2006 MAY 27, 2006 INDICATES NOT CONTAIN ANY MATERIAL LARGER THA",
EST BY: TEST BY: �_- OBSERVED TWO INCHES. A SIEVE ANALYST'.,, USING A #4
GROUND WATER SIEVE, SHALL BE PERFORMED ON A
THE BSC GROUP, INC. THE BSC GROUP, INC. vv
REPRESENTATIVE SAMPLE OF Fli_L UP TO 4c,%. ,
WITNESSED BY: WITNESSED BY: �� �� � DESIGN CRITERIA: BY WEIGHT OF THE FILL SAMF_E MAY RF
DONALD DESMARAIS R.S. DONALD DESMARAIS R.S. INDICATES i TOWN OF BARNSTABLE NEW REGULATIONS
TEST LOT 87 RETAINED ON THE #4 SIEVE. SIEVE ANALYSES
1 CRAIG A. �' ALSO SHALL BE PERFORMED ON THE FRACTIO
PERC. RATE: PERC. RATE: REQUIRE SOIL EVALUATOR TO INSPECT 4 8 FIELD r jDESIGN FLOW: OF FILL SAMPLE PASSING THE Iy4 SIEVE, Suc*it
? MIN./INCH 2 MIN./INCH N/F J No.38039 -� ANALYSES MUST DEMONSTRA'E= THAT THE
BOTTOM OF EXCAVATION PRIOR TO ANY \ \ _� _ BEDROOMS AT110G.P.B./D 330 G.P.D.
INDICATES THOMAS & IRENE FINAN TR. \ - MATERIAL MEETS EACH OF THE FOLLOWING
SOIL EVALUATOR SOIL EVALUATOR y
N+. DIBB M. DIBB � UNSUITABLE � INSTALLATION AND ALSO PRIOR TO FINAL � � : SPECIFICATIONS:
_ MATERIAL ; ASSESSORS MAP 291 \ , :.� 100 % MUST PASS #4 SIEVE
BACKFILLING. PARCEL 190 , REQUIRED SEPTIC TANK: (4.75 mm EFFECTIVE PARTICLE SIZE)
SOIL CLASS: SOIL CLASS:
\ I 10%-100 % MUST PASS #50 SIEVE
330 X 200% = 600 GAL. (0.30 mm EFFECTIVE PARTICLE SIZE)
L.T.A.R. I .T.A.R. r. \ EXISTING SEPTIC TANK: = 1 ,000 GAL. a 0 0-20 % MUST PASS #100 �-iEVE
0-74 G.P.D./SO.FT. 0,74 G.P.D./SQ.FT. k (0.15 mm EFFECTIVE PARTi 'LE SIZE)
\ \ \ 'e2 V O` 0 0%-5% MUST PASS #200 SIE ✓E
\ -- (0.075 mm EFFECTIVE PAT::fICLE SIZE)
g550. Na1.26'55"E \ \ SIZE OF LEACHING FACILITY REQUIRED:
7. EXISTING UTILITIES WHERE SHOwr:
IN THE DRAWINGS ARE APf ROXIkAA r_
DATUM: \ \ \ DESIGN PERC. RATE: <2 MIN./ INCH THE CONTRACTOR SHALL BE RESPON-
VERTICAL DATUM ASSUMED
SHED \ � \ O \ LONG TERM APPL. RATE 0.74 G.P.D/S.F. steLE FOR PROPERLY LOCATING AND
BENCH MARK r. TOF OF FO�NDATIO^J COORDINATING THE PROPOSED CON-
LE'VATIC)N == 10?_.41 i SSOGKApE FENCE x 100.4 \ \ O �. 330 GPD _ 0.74 GPD/SF = 446 S,F, AND STRTHEAPPLCABLE u uCTIVITY WITH rG-SAFE
E c,r \ COMPANY ANC MAINTAINING THE
N \ \ \ EXISTING UTILITY SYSTEM IN SERVICE. s
LOT 88 X lOO.6 DIG-SAFE SHALL BE NOTIFIED PER P
T x 100.4 N/F OCL \ ISIZL OF LEACHING FACILITY PROVIDED: THE STATE OF MASSACHUSETTS
PROFILE: N O T , 0 SCALE
RICHARD A. KNOWLTON ,\ \ O \ r STATUTE CHAPTER 82, SECTION 409
r TEL. 1-888-344-7233. THE
� \ USE HIGH DENSITY POLYETHYLENE AT
EL.= A FIRS"- PIP LENGTH ASSESSORS MAP 291 �,, \ � r' LEACHING CHAMBERS(3 UNITS) 1O,5�XL2- �X 30.5� EN',INFt � i �_5 NOT CI:ARANTFF
TOP F RICIATION _ CUNCRETE (.07 _RS TO WITHIN -- - 10 FEE SET LEVEL , PARCEL 305 CONC. PATIO �'� \ A. THEik A :ACY OR TIiaT ALL
' 10,341±S.F. J'
- 6' OF �+r�I�riFD GRADE. FOR MIN. 2' `. x lOO.4
\ � UTIL'TIr`� AI'vt) SUtsSURFA(;F STRric Ttj :
_ - FINISH GRADE �J N \ - _ - _ ' - = 1
\ o `WAI 2(1u.5 +30,5 ) X �64 F 26• a fit �._ R
AR,. �r �. LOCATI(%NS Ar�f)
� ` �1 r E 9.6-100.2 ., I f1 / I �� \ \ _ i TOM = 1�. �,55' _. .�2 p Et . )F tIN['ar,;R d[
4` PV SCH 40 L Q
, F
4" P V�'�'`� � `.. � � J
BULKHEAD--� c - -_��% LEACHING CHAMBER -
1 SCH a ? T-- - 4' PVC SCH 40 J' FFRE�' J. H
DECK T LC/�Y� CN AND IN`ic+11 OF L1TII_;
-"- - \ 484 S,F x 0,74 GPD/SF 358GPD
II- l-- L � & MITCr'.ELL MARINEIDE � c^Z \ ", - AND T>?uCzl1RES AS F<EJL�iRED >
I-t3 I y - I=G� ASSES=>ORS MAP 291 x 100.6 \- - - �fiffll \ \ TO TH+=_ S i ART OF t ,TtON
ExIsT1NG �` H PARCEL 306 \ - ---_ --_ --_ -
1 1,O[0 (;A;. I=E �NF
\ � I 18. THIS SYSTEM IS NOT DESK D FOR
- -- I �___- --- -----� i 5 OUTLET I-F KITCHEN
�,� r , __ r, > �I 1 THE USE OF A GARBAGE :i'INDEf?.
T. BOX SEPARATION TI{ 0> \ \ \ O I+ A GARBAGE GRINDER IS NCT
SEPTI : TANK
16'$' gA 1 STORY GE \ RECOMMENDED DUE TO RE OGNIZED
EST. HIGH GROUNDWATER RA \
BR WOOD FRAME � GA \ \ ADVERSE IMPACTS TO THE LF.ACHINC;
HOUSE #38 O FACILITY. __-
- 1 FF=103.50 \ n' \ LOCUS i N F 0 R M A TI O N 9. EXITING INVERTS ARE TO BE: CHECKED `Hy
-- o TOF=102.41 \ THE CONTRACTOR PRIOR TO CONSTR •."+_
it `✓ERT ELEVATIONS. INV=99.21 ❑HW--- 10. THE ENGINEER IS TO BE NOiIFiED Of
rn ❑HW HW\\ ❑ \ CURRENT OWNER: RICHARD A. KNOWLTON ANY FIELD CHANGES THAT M� RE
�n tN R00►� � � t � \ HW-----_ ❑HW---�. ❑HW� REQUIRED. _.....,.,._.._,
13R LlV G \ TITLE REFERENCE: CERT. 152134
w TOF OF FOUNDATION 10 2.41 A
4" INVERT AT BUILDING 99.21 B EXISTING o � ^ BR GAS ' \ \
\ PLAN REFERENCE: L.C. 14034-M `� x
EXISTING ~:: w METER I x 100.8 \ \ :
4 NVERT /A SEPTIC TANK (IN) 98.25 C � o ' \ ASSESSORS MAP: 291
v' \ \ PARCEL: 305 349 N11lin Strcct, ({:"I '_j► unit 1) i
4" INVERT AT S ��PT!t I ANK (OUT) 98.00 D EXISTING \
W. Yau-n1�>utll ;Vlass�l�ilrl ��tts
4" INVERT AT DIST. BOX (IN) 97.94 E o STOOP
° \ ZONING DISTRICT: RB
4" !NVt R ( AT DIST BOX OUT` 97.77 F x 100.4 � No 1 '� SETBACKS: FRONT 20' (l2(,;3
i Z - -`�- " \ \ SIDE 10 -_
I ➢ N TWIN 10 OAK \ \ \ REAR 10' S0� ^ 4 r�`` °4
Z APPROXIMATE _
a f PROJECT `1 TLC
!N �FRTS AT LEACHING FACILITY: X o L. PIT LOCATION O BITUMINOUS ' o, \ \
MINIMUM LOT SIZE: 43,560 S.F.
DRIVEWAY 1 �^,
12" OAK �� \ \ t EXISTING LOT AREA: 10,341fS.F. DE,ZiIGN I•- h�
4" INV=RT AT BEGINNING ` \
LEACHING CI IAMRE l 97.70 C BREAKOUT 98.20 1 TP 1 ` `
} X _ _ 1 k 1 12, OAK
OVERLAY DISTRICT: NOT IN A ZONE II
z - S # o► °- � \ \ SEWAGE DISP �.:� .
m �. BARN. OVERLAY DISTRICT: AP
E LE v'A _ION A T BOTTOM ' 1 K , . o_
_ I!
PROPOSED LIMITS OF 1 OBS TV.IN 1 "' `OAK �'� �` -E I P SSTEIV!
C)F LF_ 1CH!NG CH AMC R 95_70 _ H 10" TWIN OAK �_ l ' M rn.._._. I t ,
EXCAVATION. SEE NOTES 5 & 6. X / L J.- _ CONFIRM PRIVATE / � � � FEMA FLOOD
013 _R 4,rC GROUND AI/A _!.�R " ° / �� 30.5 'T LAMP POST WIRE 1 ,-�
ZONL DISTRICT: ZONE "C" AS SHOWN ON
PROPOSED 4' HIGH 40 MIL. ' 10 PINE _
BCC i ��M OF HOLE 90. , 0 J - =� - _- nor LAMP10
PANEL #250001 0005 C
POLY LINER - 60' LONG. �,'', t �OST ANU R`�1` ENCE / I DATED 8/19/85
TOP 98.2, BOT. 94.2 x / �, •-CB/DH 199
- 99 4 FN D _ E I ti` R
PROPOSED 10.5x30.5 _ -- I //�� p
LEACHING AREA. 1 NOFM4 LOCUS LAN : N❑ SCALE
PUMP AND REMOVE EXISTING 98 WO
LEACHING PIT(S) FROM SITE IN-- _ - �� MAR
AEIAS ', `
ACCORDANCE WITH TITLE 5. 97 _ -- 0 CIVIL c w S
OO RELOCATE WATER UNE No.45937REQUESTED:
(ALSO OLD D BOX)
\ _ SHOWN �O' ,9FoistEQ'�`��`�``Q r I}Nt ( �F - _- OO ARL', r f;
00
ONAL U Ar w.
r
N `� `'1 1/0 --� RINK
FOCUS '
s
VER 1�
--
j OEN �-
PI AN VIEW
SCALE: 1" _. zO FEET
sj USN R �.
0 5 ;� 20 FT MITCHELLS WAY
�W 7-
M
,.,.r„n w r. .... ...... .u, ..n -....w. ,,:,su+.«•. w:, ,.,.� .....a r,x ..,.:. sr'ar„ +w.G•.,