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HomeMy WebLinkAbout0147 LEWIS POND ROAD - Health 147 Lewis Pond Road Cotuit --- -- ---- - - - —- - - A= 020- 054 1 FF-J) ru �- I I 71 4 Town of Barnstable Regulatory Services Thomas F: Geiler,Director Pu blic Health Division 039. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 1/14/10 Sewage Permit# Assessor's Map/Parcel 020/054 Installer&Designer Certification Form Designer: Cape & Islands Engineering ° Installers Ron's Excavating Address: 800 Falmouth Road, Ste 301C Address: P 0 Box 809. Mashpee, MA 02649 Mashpee, MA 02649-0809 On /2/ , //)-Cl Ron's Excavating .—, was issued a permit to install a (date) (installer) septic system at 147 Lewis Pond Road, Cotuit based on-a design drawn by+ (address) - Cape & Islands Engineering dated 8/26/03 revised 12/10/09 (designer) X ' I certify that the septic system referenced above was'installed,substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. Y 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 requir s ected and the soils were found satisfactory. CNAglEB,"; (Installer's Signature) SANICKr_: zeoes aA(LAND S� (Designer's Signature) (Affix Desi p Here) ' PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice fonnsWesignemer ification form:doc [� z 's`a r� � �� ` �^ �r�$" �� .� a - x 4 TOWN OF BARNSTABLE D� LOCATION SEWAGE# VILLAGE C-0 tK ASSESSOR'S MAP&PARCEL 0.2 0 - 0� INSTALLERS NAME&PHONE NO. /Zo k) C'.q V A,/I'Vo SEPTIC TANK CAPACITY %6 a O - LEACHING FACILITY:(type) (size) 3 NO.OF BEDROOMS R OWNER `c- ZJ44. • 2 PERMIT DATE: COMPLIANCE DATE: I U 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) f C- Feet Edge of Wetland and Leaching Facility(If any wetlands exist within-300 feet of leaching facility) Feet FURNISHED BY r � 4 � + , r��1 r � 1� "zU �.r '� �� �f,g ,, �9 �- ��16 Z �, TOWN OF BARNS ABLE LOCATION /-0 /j &21 & SEWAGE# VILLAGE 06&�� ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE:- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY i '14 1 o ®�, _ u No. O'-00,7 65 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS• Yes 01pplitatlon for -isposal *pstPrrt Construction i3Prmit Application for a Permit to Construct( ) Repair(V�Upgrade( ) Abandon( ) ❑Complete System Wndividual Components Location Address or Lot No. 'I e-nd Owner's Name,Address,and Tel.No. Assessor's Map/Parcel O Zv 1- `Q('G � 1 )xtstaller' Name,Address,and Tel.No. J'9-lg1_pn-) Designer's Name,Address,and Tel.No. { bY15 uc. n ' o. �c S►L �' .� n J6�ii �116dm. QA MCti 12 ioze, Type of Building: Dwelling No.of Bedrooms Lot Size OI LO WPS sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons C0 Showers( ) Cafeteria( ) Other Fixtures �L -9 Design Flow(min.required) k\ D gpd Design flow provided gP O J d Plan Date - Number of sheets i Revision Date Title fw,c, wyc Sv1J UVCk e � 2��ae,,o Size of Septic Tank 1 56 O Type of S.A.S. Description of Soil 0"- 3" 1� 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 Bo ealth. Signed Date/_-;?. Application Approved by �i> Date I / — Application Disapproved by Date for the following reasons Permit No. 00c) — Date Issued ,'L — 1 — 0 ----------------------------------- M ..,._.._...,„_...�-...,.. -..�..;.e..-�.:��...,,..,.•,:;,,;�.�y..c++K+.s.t:::.xXt,.vv�. ,.: � Rr +�+';xr..*�+:*�+.�...� ..,y„i:.,°1ya" 4"'•'-"""' .,,,,,,.�;,•y,..•.:rt�. rw.�sw.++e.s- N. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliratlon for ]Disposal 6pstem (Construrtio>n i9erllllt Application for a Permit to Construct Repair Upgrade Abandon Windividual PP ( ) p ( pg ( ) ( ) ❑Complete System Components Location Address or Lot No. q j �kvJ 15 P ord (®} Owner's Name,Address,`and`Tel.No. Assessor's Map/Parcel Cj Zv�j 1'`( crr�G, Y U�J�e I staller' Name,Address,and Tel.No. _O n-) Designer's Name,Address,and Tel.No. S(} JCCGtv A- L t tit a�&SO lye VO 12t1) I i�Q Rbu �� m. Q �IGS� eC�� l ULL Type of Building: Dwelling No.of Bedrooms Lot Size 014 q Gict'vS sq.ft. Garbage Grinder( ) Other Type of Building 1 No.of Persons �d Showers( ) Cafeteria( ) Other Fixtures _ f� t 07 Design Flow(min.required) 1 gpd Design flow provided 3,3 Q gpd IE Plan Date _ILir- O'3 Number of sheets 1 Revision Date Title (o� (;�c1. '5p & Ste• L5VCk(-c,& PCiN3. De.� c�aF �!l- D �Gl\ J 1I V a Size of Septic Tank JO 0 Type of S.A.S. Description of Soil 0`- 3" �"W IOU( Z�-Z, ` 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 o ealth. Signed C Date/a Application Approved by �S Date 12 // Application Disapproved by Date for the following reasons Permit No. C� / " 405 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS 9 Certificate of Compliante ;j THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(✓) Upgraded( ) Abandoned( )by at l�� �, 5 Q cn L (•64-, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 900—y6S dated ) '-ri-a Installer 6V1 S `L.X COL Q&-F,f1 C DesignerOAJt t �Ota'JO �'N,4/L-t1erA #bedrooms o -3 Approved design flown 3c:�5 gpd The issuance of this permit shall not be construed as a guarantee that the system wild^c io as designed. r Date �' 13'I D Inspector 1 b/ 1)") � R cl- -----No -LLo5 -----= - --•------ t; - -- -____---____^;- ..� ---�----------. -=_ �._�_- Fee=--=� =� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem ConstrUrtlott permit Permission is hereby granted to Construct( ) Repair( ✓) Upgrade( ) Abandon( ) System located at �- rn.•, p o� p cl c�,� 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. �l Provided:Construction must be completed within three years of the date of this permit. w „ ��� Date 1 A _ 1!•0 °I Approved by �`"'I"�1XiJ f %f t d TRANS.NO.: CITY/TOWN: APPLICANT: K&(L�a 7u,4 1 z L l ADDRESS: L-ncl DESIGN FLOW: J 50 gpd REVIEWED BY: DATE: N/A OK NO GENERAL Legal boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot,tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204(t)] Plan proper scale?(1"=40' for plot plans, 1"=20' or fewer for components) 310 CMR 15.220(4)] Easements shown 310 CMR 15.220(4)(b)] V/ System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if 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)(01 ✓ daily flow v' , septic tank capacity (required andprovided) ✓ soil absorption system (required andprovided) whether system designed for garbage grindei 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)] - f Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] V 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)] J Observed and Adjusted groundwater-(method for adjustment -given or indicated) [310 CMR 15.103(3)and 310 CMR 15.220(4)(n)] Address � � `�wi5 �C�' .c�. (c�1 Sheet 1 of 7 1 N/A OK NO Location of every water supply,public and private, [310 CMR J 15.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case J 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 other subsurface utilities located [310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of stem showinginvert elevations of all system system Y 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 structton J 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)] Test Holes adequate to confirm 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 J Approval or LUA requested) 310 CMR 15.405 1 ) Address ,�') U,. Sheet 2 of 7 N/A OK NO SEPTIC TANK Size OK? [310 CMR 15.223(1)] / Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5"per foot for increase ft depth [310 CMR 15.227(6)] V Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] t Note regarding installation on stable compacted base [310 CMR 15.228(1)] f Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] V 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 CUR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" 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<I000gpd, , two fors stems>1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR J 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done 1310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] Multi-Compartment Tanks Required when other than single-family dwelling or flow>1000 d [310 CMR 15.223(1)(b)] f 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 `t� ��� �5 �;h ` ���-, Sheet 3 of 7 N/A OK NO BUILDING SEWER AND OTHER PIPING Located at least ten feet from any water line? [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]) Cleanouts required/provided ? 310 CMR 15.222(8) Thrust blocks specified in force mains? 310 CMR 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 15.251(9) and 310 CMR 15.252(2)(c)] Siphonproblem/(leachfield below pum2 chamber) i 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) DISTRIBUTION BOX Stable compacted base [310 CMR 15.221(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 CMR 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)] ./ PUMP CHAMBERS 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 15.231(6) and (8)] Stable Compacted Base [310 CMR 15.221(2)] Buo ancy calculations needed ?Provided? [310 CMR 15.221(8)] Address ��1 �e�J�.S 1't , C��yL{— Sheet 4 of 7 N/A OK NO SOIL-ABSORPTION SYSTEMS.(SAS) GENERAL Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] Required separation togroundwater? [310 CMR 15.212)] / Aggregate specified as double washed 310 CMR 15.247(2) System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met?(No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document GALLERIES,PITS,CHAMBERS 310 CMR 15.253 Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] j Each structure with one inspection manhole (if>2000 gpd must be tograde) 310 CMR 15.253(2)] f Aggregate 1' 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)] TRENCHES 310 CMR 15.251 Width T 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 greater(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] BED SAS(Maximum size of bed.or field.5000 d) minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" ✓ maximum. 310 CMR 15.252(2)( )] Se aration between beds 10' minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address Sheet 5 of 7 N/A OK NO DID THE PLAN INVOLVE: Pressure Dosed System ? Provided pump and piping / calculations as required [310 CMR 15.220(4)(r)] •/ Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2)and I/A Remedial Use Approvals] If used in gavelless system - make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd) or quarterly (>2000 d)good to note on plan 310 CMR 15.254(2)(d)] v Construction in rll -f Did the lan specify that the fill shall meet P the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? Guidance Document] Impervious barrier installation must be supervised by ✓ designer 310 CMR 15.255(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 I ] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] `✓ Gravelless System[UA Approval Letters] Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface v Alternative Septic System[I/A Approval Letters] 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 applicant submitted a copy of a maintenance Are the variances listed on the plan ? [310 CMR 15.220 (4)( )] RLS Stamp necessary on plan if a component is within five J feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed - [Refer to 310 CMR 15.414] Address 1 LO La,,��5 96 - Sheet 6 of 7 N/A -OK NO Nitro en Sensitive Areas Is the system in a Designated Nitrogen Sensitive Area(Zone II for a 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 in compliance? [310 CMR 15.216(1)] Miscellaneous Pumping to septic tank? [310 CMR 15.229] Shared System [310 CMR 15.2901 Address I�(� v=�S �CV��� �+ Sheet 7 of 7 c� n vyusLA 4 } Ysa No. 3 Fee �© s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OFF BARNSTABLE, MASSACHUSETTS Z(pprication for Mi5pooal *patent Construction Permit Application for a Permit to Construct( , )Repair( )Upgrade ).Abandon( 1 ❑Complete System ❑Individual Components , po e ._Location Address or Lot No. et Owner's Name,Address and Tel.No. 1y� L5 �rn.a �-tw . Assessor's Map/Parcel6 O 5(f L o 1(/t q,y u at P,tl Installer' Name,Address,and Tel.No. �asoM itf •'I.T oV ti¢ Designer's Name,Address and Tel.No. o 13o t'3a3 4"VfY, Art., v.2C 5 J- �A{!t Z's I oo ds -74y- F36- as/6 4117- 721 Q_ Type of Building: Dwelling No.of Bedrooms 7J Lot Size q.ft. Garbage Grinder Other Type of Building VaA&J- No.of Persons Z Showers(✓) Cafeteria( ) Other Fixtures Design Flow J'3 o gallons per day. Calculated daily flow 3-3o gallons. Plan Date If ia-G 1,13 Number of sheets I Revision Date Title Size of Septic Tank 1'�W / S 00 Type of S.A.S. �. Description of Soil; 5A nA Nature of Repairs or Alterations(Answer when applicable) I '} K C 9*l h C. 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 Certifi- cate of Compliance h issued by this Board of Health, Sig ed Date 0 a Application Approved by _�!� �._ Date LO�� Application Disapproved for the following reasons Permit No. 3 I 5 Date Issued ld o 3 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 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer �U4 S tM A . .Sow Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector A� —y— ----------------------------------- ' No. � "' 3 �v *�.- •:..,�.��� -Fee == THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -T01N4&ijBARNSTABLE"MASSACHUSETTS Yes 2ppltcatton for �Dtopozar *pgtem Construction Vermit Application for a Permit to Construct( )Repair( )Upgrade(,)Abandon( ) O Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel (j 4 e,r e. A c4.V C.e G t eJ(6cr :f r Installer's Name,Address,and Tel.No. _r4.5-r." 4 • S w e'o4- Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size /t 0 v-6 sq.ft. Garbage Grinder Other Type of Building No.of Persons ' .Z- Showers(✓) Cafeteria( ) Other Fixtures y Design Flow_`f 3 O } '4gallons per day. Calculated daily flow gallons. Plan Date J Number of sheets Revision Date Title Size of Septic Tank 15 w Type of S.A.S. Description of Soil, j Nature of Repairs or Alterations(Answer when applicable) C., Date last inspected: , Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewagedisposal system . in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance h n issued by this,Board of Health. Si , ed Date w I b :Application Ad-b.pprove ,. - - - - Date - Application Disapproved for the following reasons R Permit No. � �'y Date Issued 3 --------------------------------------t — THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certiftrate of Comphance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by at i has been constructed in accordance with the provisions of Title 5 and the for Disposal.Sysfem Construction Permit No, dated r Installer J'q s cri A . SOU z h' Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. .+ Date Inspector i =- �o i7 —No. Fee 5© THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Itopoar *p5tem' Con5tructton vermit Permission is hereby granted to Constfuct( )Repair�U `f) pgr de )Abandon System located at `Q 5 } and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special cGnditions. Provided:Construction must be completed w;thin three years of the date -t-bis pe Date: /0 /27)©3- F Approved by L SYSTEM PROFILE I NOT TO SCALE j TOP OF ,c,- .► /- FOUNDATION FINISH GRADE FINISH GRADE OVER FINISH GRADE OVER EL. EL.. 3 a -7 SEPTIC TANK/PUMP CHAMBER r. WEEP HOLE DISTRIBUTION BOX FINISH GRADE — -- _ FOR B CK DRAINAGE t CONT'ROL�; �� :'p •�� - "g, RISERS TO h" I3o, .� C.I. FRAM ' OVER TRENCHES Z-s a \—"—OF FINISH GRADE Y-- &COVE O �'. t , _ '�10' _ �' ' �; '' ' I° ''� '•.C I Q.I'I_`o,, 2" DIAN1. o PRECAST CONCRETE 4.• ,• Pv,.sCHD.4o RISERS TO 6 _�' ° OUTLET PIPES LEVEL H-20 REINFORCED LOADING 3"MIN. " 500 GALLON DRYWELLS OF FINISH GRADE ( ) 3" f LEVEL ` ° FOR 2 MIN.1 /o SLOPE \ ,- MIN.SLOPE 1% _ ALARM _� '( ° TRENCH LENGTH = 25'-0"' ,� O P. SE I OND �r 13"MIN. I • DRYWELL LENGTH= 8'-6" •� �.: /71 i/ C• '�, •P / F6'Sump ,:., `,,, is 'y•Q,0:1• �` L'` i •ItI�;O:1' �('r' y• `� �' �,'� '' •. �' ' �• `� '�' PUMP ..] p F 71 - / °1�,,,,c� PVC OR CAST IRON TEESMALFUNC�'i02i 5"0 ,. ,�,,o ,o �" ,, or „ •a 1 �; =C=�� 0 6 / O '' .fib t �� b�, �', '.1 GAS BAFFLE:y DISTRIBUTION BOX z , 2 ' - .° =,at.is \°- \_ G" =,j H-20 LOADING 3/4"- 1-1/2" DOUBLE 3/4"- 1-1/2" DOUBLE , WASHED CRUSHED 4 PRECAST CONCRETE �o o- MINIMUM INSIDE DIMENSION 12" STONE WASHED CRUSHED 1_ •' OUTLET INVERTS 2" BELOW INLET INVERT STONE �sMT.FLR. : H-10 REINFORCED ELEV,z�./ '°' !16 =A= MINIMUM CONCRETE WALL THICKNESS 2" lo;• INSTALL ON COMPACTED LEVEL BASE ,,{ TRENCH SECTION •� h.l , .:�r ,, .•,=,, •—.,``i •..- ..../ L•.• l,,r I ., ,' .°„ i•;R• U ;: V�. U i�,n ,A,. -n.q., 6i - ,,'1• °� `I.• p,0• �••-,'n o/..� Oh..,I, .,0 G ., • •/ Y:•lO / Id• - - NOTE: EXCAVATE TO =C= STRATUM IN ORDER TO REMOVE ALL =A= & =B= IMPERVIOUS MATERIAL r o c/s-o o _ 2__ c P r m �` tiy,� o +► Jai s 4 / WITHIN 5' OF THE SAS. REPLACE WITH CLEAN, 9" MIN. 3"OF 1/8"- 1/2" s pso ~ r r CLAY-FREE SAND 4" DIAM. 36" MAX.- DOUBLE WASHED e' h T A �� PEASTONE INSTALL ON COMPACTED LEVEL EASE - ' : '' 2'�' � ' I.PUMPTO BE INSTALLED IN STRICT CONFORMANCE ° L°N'1° �`�'f �r•f: WITH MANUI.ACCURER'S SPEC"i"C:A i'ION:-. ��. tC 5� '' <�,,L jje ., � _ _ ''4 11 ,, ��; - �•' ;1. / 2.PUMP CONTROLS SHALL BE MOISTURE PROOF �"� '� � �h i' "''4'`"°°°"' °_:-- _3/4" 1-1/2" DOUBLE d� �. � i.l ..t16°reh 1 " .1 Lam..-. i 3.CONTROL SEQUENCE: r 1 '' 1 fir'• " ��` i 4 " 5-2 " WASHED CRUSHED A.PUMP OFF TRENCH WIDTH >.'` STONE B.PUMP ON � •� , ublt - 1 11 C.ALARiM ON AT PUMP MALFUNCTION � � � � ��F ;jo4� ' �.v�� 4ndtn1 D.ALARM ON AT HIGH WATER LEVEL . ` y'=�/.c1`' Cj , ^ Cotait NUMBER OF TRENCHES 1 , 4.ALARM CIRCUIT SHALL BE SEPARATE FROM THE y NUMBER OF DRYWELLS 2 PUMP POWER CIRCUIT , j •sue' 1 G� 5.PUtifP CHAMBER SHALL BE EQUIPPED WITH 1 RISERS AND A MANHOLE COVER U9TI III;6•• /� a ' rI',y,1„h r OF GRADE 1. K a CF t"�k �-r' GENERAL NOTES: I 1. ELEVATIONS SHOWN ARE BASED ON NGVD [ 2. ALL PIPES IN THE SYSTEM MUST BE CAST IRON ,,, M \•o ' • OR SCHEDULE 40 PVC: 3. HEALTH AGENT/CAPE & ISLANDS ENGINEERING ,o I MUST BE NOTIFIED WHEN CONSTRUCTION IS L .-w.J �� � ci. >9 y 24 zo 1 COMPLETE PRIOR TO BACKFILLING. -- _.__ ..... _. ..__.. . __ ... ....._. ... w 4. ANY CHANGES IN THIS PLAN MU"T BE APPROVED �� zz r3' ya•.. f 41 ND ENGINEERING AND THE- BOARD BY CAPE & ISLANDS ENGI EE AR a c' OF HEALTH S COMPLIANCE WITIALS AND H THELN SHALL BE IN, STATOE SANITARY CODE [TITLE Vj AND LOCAL APPLICABLE RULES AND REGULATIONS. i / i Win'`' r 6. NORTH ARROW IS FROM RECORE, PLANS AND IS - - - _. — -- -- - Ir I, ( �' o �-� \ ''ti . NOT INTENDED FOR SOLAR ENERSY PURPOSES. \ �. ! :� z `�� ' =� • - 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. w fK, ,� „�, �� w/ u .� r .8. FLOOD ZONE All [ELA 1] & C OBSERVATION PIT . / 3I 9. FLOOD PANEL: 250001 0021 D DATED: JULY 2,1992 \ N, PERCOLATION RATE: < 2 MIN./IN , I '`Y o 0\1�, �y�f, �. • ` ,� WITNESSED BY: G:DUNNING z - t\ `•R �, w BARNSTABLE BOARD OF HEALTH o DATE. MAY 8,1998 lit V ♦Or D li' n R y =A= LOAM DESIGN DATA 10 YR 2/2 I 31f 3 �\ \ - \ '' �� =B= LOAMY SAND NUMBER OF BEDROOMS 3 l 0YR 4/6 GARBAGE DISPOSAL NO \ \ n :. v,ti'9 .•fie v J ` � 32" Z � " DAILY FLOW 330 GPD. 1 w �•,, \ \ �, '' -4- _ SEPTIC TANK REQUIRED 1500 GAL. w SEPTIC TANK PROVIDED 1500 GAL. r, h• \ �- \.X, �, LEACHING REQUIRED 330 GPD. i \ -C= MED-FINE SAND , 10�(R his SOIL ABSORP i�ION SYSTEM CALCULH!IONS: SIDEWALL AREA = 152 SF. 152 SF. X .74 G/SF. = 112 GPD. NO GROUNDWATER i z o " BOTTOM AREA = 329 SF. Ito" 329 SF. X 0.74 G/SF. = 243 GPD, . . �J y ; h %.� .• \ .�- � \ `�-' ;. . ;. LEACHING PROVIDED = 355 GPD. Ci"o `}•I i Yip / ryp \� �- \AN, t LEGEND 52 PROPOSED CONTOUR PROPOSED ADDITION & SEPTIC SYSTEM UPGRADE ---52--- EXISTING CONTOUR PROPOSED SEWAGE DISPOSAL SYSTEM OBSERVATION PITa'� GF � ��. PREPARED FOR ri CHAI ja+? 1rm,-S ❑ DISTRIBUTION BOX 4 �i 6EP9s�NL �- MARCIA DUDLEY ��.. �,._ �•. HSE.N0. 147 LEWIS POND ROAD SEPTIC TANK n 'r•'�°�s ti°`/�` COTUIT,MASS. SOIL ABSORPTION SYSTEM PLAN NO. �r �� G c �^ SCALE: AS NOTED A j `�HOF : RESERVE RESERVE 'yass9c;�. FILE NO. 3 5 ' 8,4 s yG c C. DATE: .l.: .. ... . ,• 2 C, a rJ,3 DPVfD G y - � SEPTIC FILE NO. 7,3 PCS FILE: 22.26 PIPE INVERT ELEVATION �6, Cf-I,a CKI M' � SANICKI ��� PLOT PLAN ` 2208. CAPE & ISLANDS ENGINEERING SCALE: 1"= 201 z z z ' . � FcISTER M��¢�i 20 54 147 41. o g �'��s�'tiu JNfls�jf 800 FALMOUTH ROAD, SUITE 301C MAP SEC PCL LOT HSE MASHPEE,MA 02649 (508)477-7272 `3 i