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HomeMy WebLinkAbout0039 ROSEWOOD LANE - Health 39 ROSEWOOD LANE Gotuit �I' - A= 010 - 036 t ' TOWN OF BARNSTABLE 'LOCATION,�J �jS't� SEWAGE# VILLAGE CG'7`lyi ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER �ri br?C� PERMIT DATE: 6.3 COMPLIANCE DATE: 2 w 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 Wwithin 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching acili Feet FURNISHED BY a �7 ' �7' Town of Barnstable P# Department of Regulatory Services Public Health Division Date. S 2� 1t5 sAM - 200 Main Street,Hyannis MA 02601. . Date Scheduled 13-kd Time—It "--- Fee Pd. .E� r Soil Suitability Assessment for Sewage sposal Performed By:_fie 4-c� L }fie' Witnessed By: Vt.✓< <il/ v. LOCATION& GENERAL INFORMATION Location Address � Owner's Name w 00( Care Pe JL. Address 139 Assessor's Map/Parcel: 010 —6 3 fb', �.:� Engineer's Name A A4-r uN NEW CONSTRUCTION REPAIR Telephone# �6g-73-7 `BIZ 67, Land Use �-t G.� Slopes(%) �-- Surface Stones N Distances from: Open Water Body 7 L� ft Possible Wet Area ft Drinking Water Welt rd ft Drainage Way—= - Sa ft Property Line ��7— ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ah- Ncs� Parent material(geologic) V Depth to Bedrock N/A Depth to Groundwater. Standing Water in Hole: �/ Weeping fTom Pit Face ?Estimated Seasonal High Groundwater 132 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: y. Depth Observed standing in obs.hole:. _ _ in, Depth to Sol mottles: Depth to weeping.from side of obs.hole: In, Groundwater Adjustment ft. Index.Well# Reading Date: Index Well level , Adi,factor _ Adj:Oroundwater Level.— PERCOLATION TEST bate . Tite Observation Hole# Time at V Depth of Perc l Time at 6" - n Start Pre-soak Time® L .� M Time(9"-611) - End:Pre-soak / Ls a .� — M'l. (J- 5 . t a�2s�` �. �..c Rate MinJlnch. � ,�ti ,f tI 1--LA Site Suitability Assessment: Site Passed Site Failed* 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 Co'nervation Division at least one(1)week prior to beginning. Q\SEPTICIPERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole#; Depth from Soil Horizon Soil Texture Soil'Color Soil Other ;S.urfhce(in.) (USDA) (Munsell Mottling s(St ucture,'$tones;Boulders:. vl As t ------------ =`132 ti DEEP OBSERVATION HOLE LOG' " Hole# Z' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA)• . (Munsell) Mottling (Structure,Stones,.Boulders. Consistency.%Graven �= q.o DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) • i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell Mottling (Structure,;Stones.Boulders. o --------------- Flood Insurance Rate Map ; 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 th Does at°least four feet of naturally occurring perviou material exist in all areas observetl throughout e. area proposed for the soil absorption system? If not,what.is the depth of naturally occurring perv' us-tnaterial? ....._.. Certification e. .. / - - _ _, - I certify that.on 0A)(date)I.have passed the soil evaluator examination approved-by-the Department of Environ ental'Protection and Ghat the:'7afiove'atialyss was performed by me constst nt wit the required trainin ,expertise and experience described in. 10 CMR 15 017 'Signature Date 6 Q:WEpn0pBRCFORM.DOC D A/ / W /VX 3 � Fee THE COMMONWEALTH OF MASSACHUS TTS Entered in computer: No. Yes V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprtcatiou for Wgpogar *pgtem Cougtruction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.39 R05-10(,441-0 11f Owner's Name,Address,and Tel.No. Assessor's Map/Parcel bf Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. � •,, .Sow y77 oi77 sr i�,eer�� wor sow��7S.�i Type of Building: Dwelling No.of Bedrooms 12� Lot Size <9 33, eAW7 sq. ft. Garbage Grinder ( ) Other Type of Building �Ps�j�{.1,T- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of SoilC� e, T,�Q h Nature of Repairs or Alterations(Answer when applicable) lj �< 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 d of Sign B H h. Date �0 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued Al No. � � "" Fee / ' �� � Entered in computer: t THE COMMONWEALTH OF MASSACHUSETTS },- �! PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS t; fori �aYp ten �on5truction er. nit01ppIication Application for a Permit to Construct( ) Repair_( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components — Location Address or Lot No.3f RQs"a�(��y/��y0 � �/1 Owner's Name,Address,and Tel.No. V 1l .J w o M W Assessor's Map/Parcel `oj — 0 3� _ �1 ,, . �. � Installer's Name,Address,and Tel.No. t•Desner's Name,Address and Tel.No. ,�.r�°a �7`•'., SG� �/77 o177 & i �I ePdih Gc% SG,5 (/7-7 Type of Building: Dwelling No.of Bedrooms- ! Lot Size .9 31, tA/7 sq. ft. Garbi ge Grinder,( ) Oiher Type of Building 17e,25/dr'n,T No.of Persons Showers( ) "Cafeteria( ) Other Fixtures F Design Flow(min.required)` gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title i Size of Septic Tank Type-of S.A.S. Description of Soil1 'e- 0A Nature of Repairs or Alterations(Answer when applicable) �j T—)(C Date last inspected: i 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 Boa d of He Signed Date /711 �Q &. Application Approved by ` Date v r Application Disapproved by: Date for the following reasons -' F AAl I' Permit No. /f % Date Issued 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 /?GhX at /f p5�'(�ri0ac'� fh, has been constructed i a ordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer #bedrooms �j Approved design fl� gpd The issuance of thislpermiti shall not be construed as a guarantee that the system(w'ill`funy ti'n as dEn ed. Date Inspector z) Jr i I ;x t_ {n Fee ! �, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Ii!5pogal *p,5tem Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at ��J (CGS E' LlJ GC1( 01 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 conditions. Provided: Cons ruction mLt be completed within three years of the date of thiss.p 't Date ,/� .� I Approved by � / 06/28/2010 07:45 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Service Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 700 Main Street, Hyannis,MA OMI Office: 508-862-4644 Fax: 308-790�304 Date: 2 Sewage Permit# ® Assessor's Map/Parcel " t Desipser: ,-.1*_4 CTv% c AJ%-VY tii In C. • I05taller: S �x �w✓A 'ri Address: ten- (nf. Cr*.1 i l eel C<`� Address: e U d on �>C c /5 was issued a permit to install a te) (ins sepfic�, (2uSC �n w� based on a design drawn by (address) Fe.RfT M C,&t-O—A E dated (ClasiFerT K 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. { I3certify 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 cotnponcat of the septic system) but in accordance with State & Local Regulations. Plan revision or ow tified as-built by designer to follow. Stripout(if required) was inspected and the soils were found satisfactory. 0%OF Mqs PETER T. ler s ignature Mc.ENTEE CIVIL No.35109 iper s Signature) } (A D i8 ) TOBARMAM E01MEM LTH �Y Y 4P ,t ti - J �._ rr�� ,C�,,-Pry _ •. y1 `C1 s 4� �a's1• 1, 1� r l �u�L�/�vG 5 DTP,ACC •EU'f�'�.M��vT� ,i S G A�:.,� .• i •�- 3 B€,p eoc?s— CC�V.�TiQ UG'T�O.v' �f-1A L G C C>Azo-o..�A-t 7'O MA S L O tV �� L GAL.��?,4 y i- I- 'i! r � a.s�c ;-r LEACN 42A7-4 TOP of P2o dc�� a L.EA,--,t-1 T E/�I� Tp ij,v .r��14t15� CQL/� TGa .:'RE t/�mJt1T —1AA,5_--, fA.✓.r'1L 7;e,4 7-1A 6 ( i "AIV1 CN� �~-F'iau�i v.,vF�-�--z-- , ; ,G.vr �' pid. k- /OLL��2��•,/ X li.M11 14. lr.¢ f'rovT /T W � a AJE Al R O U 140 f ( W�iT�-dZT1raN7 1"VVE BoTfGu�r cF ""e 0 T /N vEZr. /,,O GA cq cz TE PT'/G 7—A^.I.4C f �7s�'T.t�e.BuTiO�i �'lG�K ,Fir\lZ7 LE.4C.WIA145 .a/T^ O� TO f'�E OV-- Ei.vFG3,2C Z CG�iSlC.2E7rE 7� sr,+e�.vs7, 300 vs C i�✓G,2 ZO©OU E-)) /V£ W)l N/p 7- TO BE L 0 Y.4 ,eA4OU774)r->Ode7-, AfA - 0V4.e --5-/S7-,ec--iL4 un✓�E ss t�- 2a ' �ES/�N LOALD,t�v� ' 1J5ED. � � 17A T� ,�EAG7T,/ AGE�vT _..; "s i. TRANS. NO.: CITY/TOWN: �crr rn s h y APPLICANT: f4 ft 5 ne, f=s 4?_rA .� ADDRESS: DESIGN FLOW: gpd, REVIEWED BY: DATE: S (a N/A OK NO v- 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? (I"=40'for plot plans, 1"=20' or fewer for /✓ component [310 CMR 15.220 4 Easements shown 31.0 CMR.15.220 4 b 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 /f 15.220(4)(c)] c/ Location and dimensions of system components and reserve areas. 310 CMR 15.220(4)(e)] System Calculations 310 CMR 15.220 4 daily flow #/ septic tank capacity(required andprovided) soil absorption system(required andprovided) whether system designed for garbage grinder North arrow 310 CMR 15.220(4)(g)] Existing and ro osed contours [310 CMR 15.220 4 Location and log' of deep observation holes(existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [31.0 CMR 15.242] Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address Sheet 1 of 9 N/A OK NO Location of every water supply, public and private, [310 CMR 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 within 150 feet of the proposed system location in the case , , (�.,Y-A e of private water 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 i V Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] -water-line cross see 310 CMR 15.211 1 1 Profile of system showing invert elevations of all system components and the bottom of the SAS 310 CMR1.5.220(4)(o)] Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)] c/ Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220 3 Test Holes adequate(two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2)or as approved for an upgrade under LUA at 310 CMR 15.405 1 k Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.1 Q3 4 Test Holes adequate to confirm adequate groundwater separation? V [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 i � ,.a Approval or LUA requested) 310 CMR 15.405 1 Va Address Sheet 2 of 9 r N/A OK NO 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)] ` Outlet tee with gas baffle or approved filter[310 CMR 15.227(4)] Note regarding installation on stable compacted base[310 CMR 15.228(l)] �C— Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227 2 Inlet/Outlet elevations at least 12" above high groundwater (except as descried 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 1.5.2228(1) and 310 CMR 15.232 3 Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" 7/07 [310 CMR 15.228 2 Access to within'6 of grade -one port for systems<I 000gpd, two fors stems>1000 gpd 310 C. 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228 2 > 10 ft from building foundation 310 CMR 15.211 1 f Buoyancy calculation Required/Done 310 CMR 15.221 8 H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources 310 CMR 15.211 L Required when gther than single-family dwelling or flow>1000 d 310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% ,, / dailyflow 310 CMR 1.5..224 2 .and .3 ] A "U" pipe througli or over baffle, outlet of each compartment with as baffle or approved filter [310 CMR 15.224(4) Address Sheet 3 of 9 . t N/A OK NO Located at least ten feet from any water line? [310 CMR e� 15.222 2 Disposal piping at least 18"below water line(when water and 11/ 7 sewer cross, see 310 CMR 15.211 1 1 Cleanouts required/provided ? 310 CMR 15.222 8 Thrust blocks s ' et/in force mains? 3-10 CMR 15.221(6)(c)] -� Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 310 CMR 15.222.E ] 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/ eachfieid below pump "chamber Endca s or vent manifolds ified? 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 Materials specified (310 CMR 15.251(5) specifies various pipe / types allowed) ✓ Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] / Splash plate or baffie 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)(0] Inside minimum dimension 12" 310 CMR 15.232(2)(b)] Minimum s 310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232(3)(d)] 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 pumpsspecified? 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)] . Address Sheet 4 of 9 f lBuoyancy calculations needed ?Provided? 310 CMR 15.221(8)] V s Address Sheet 5 of 9 N/A OK NO Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR, 15.240 1 Required separation togroundwater? 310 CUR 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 ChambersV and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253 6 Each structure v�rith one inspection manhole(if>2000 gpd must be tograde) 310 CMR 15.253 2 Aggregate I minimum-"4'maximum: 310 CUR 15.253 1 2' sidewall credit maximum [310 CMR 15.253 1 a In bed configuration, inlet evEg 40 sq. ft. 310 CMR i 5.253 6 Width 2'minimum 3' maximum 310 CMR 15.251 1 100 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 /v Situated along contours 310 CMR 15.251(2)] Breakout OK? 10 CMR 15.211 1)[41 and Guidance Document r i 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 Separation between beds 10'minimum. 310 CMR 15.252 2 Bottom area used in calculations only 310 CMR 15.252(2)(i)] Address Sheet 6 of 9 r N/A OK NO VORMz. MM ri Pressure Dosed System ? Provided pump and piping calculations as required 310 CNiR 15.220(4)(r)] Pressure dosing Tequired on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use ovals If used in gravelless-system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd)or quarterly >2000 dgood to note on plan 310 CNIR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the s ecification of 310 CNIR 15.255 3 ? 1 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 15.25 5 2 a Side slope not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met?[310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended 10 CMR 15.255 2 e k' Check DEP Approval letters for credits and design conditions It/ If used with pressure dosing do not allow pressure discharge f to scour soil interface -j 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#ote on the plan regarding the requirement for perpetual maintenance eement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has!Zeficant submitted a coRX of a maintenance agreement? Are the variances listed on the plan? [310 CMR 15.220 4 RLS Stamp:necessary on plan if a component is within five / feet of property dine 310 CMR 15.412(4)] Address Sheet 7 of 9 V__ 0 New construction or increased flow proposed - [Refer to 310 CMR 15.414 t k _ Address Sheet 8 of 9 N/A OK NO Is the system in a Designated Nitrogen Sensitive Area(Zone H for a public supply-.yell)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing s stems 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(l)]. rr. Pumping to septic tank ? 310 CMR i 5.229 Shared System [ 1-O-CMR 15.290] Address Sheet of 9 i LOCATION SEWAGE PERMIT NO. . y VILLAGE �� � �• - ��„�� wo D I N S T A LLER'S NAME & ADDRESS B UILDE R OR OWNER OAT E PERMIT ISSUED DATE ",.:;COMPLIANCE ISSUED/� � ' �� .� i ._. ��� ti .� �� n -� �. ?` � ._ -�� �. �2 r- 7 / T• No------------------------- _ _ ............._ T-.,vs COMMONWEA_L'TH-OF MASSACHUSETTS ` BOARD OF H ALTH ApplirFation fur Uhipoii al Works C omarurtion Vanift Application is hereby`made for a Permit to Construct (4 or Repair ( ) an Individual Sewage Disposal System at: d..............................................4.......... 9 Location-Addres zr Logo ;_._ '�-------------- fl- Ow,,prT/ .................................. .. Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms----------/-------�-_----__-._.-_--.-._Expansion Attic ( ) Garbage Grinder #2d) Other—Type of Building No. of persons--------4--------------- Showers ( ) — Cafeteria ( ) 0.' Other fixture_s -----------•-•--------------�f- -------------------------------------------- -- 'W; Design Flow_________________ _-.-__-._.__..gallons per person per day. Total daily flow_____%_.__......_...___________._..___..gallons. 04 Septic Tank— x Disposal Trench igtNocapacity_J jg bons LengthTotal Lengthidth--------------Total leaching area--Deptli-------sq. ft. Seepage Pit No........__.l______- Diameter_.&------ Depth below inlet_________ ________ Total leachin area-_ .--.---_--.sq. It. z Other Distribution box Dosing Xtk � /Percolation Test Results Performed by.. i�1-s_.:.._ _;_�pC��_e ........................... Date......_...._.__.__._._....________._.... a Test Pit No. 1_-_Z-,I--___minutes per inch Depth of Test Pit______________---_. Depth to ground water...--_.__--__..__.----- fi Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water_--.____---_.---_._... 0 -•--•----...=:-<-------------- �. 01 Description of Soil �� --- . �'J V ....:� . x = x �.......-----l 'G �1! ------------------------------------------------------ W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable........... ----------------------------------------------------------- --------------_-------- --------------------------------------------------------------------=-------- ------------•----------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI 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. 7 Application Approved B r _,� .. � � - �1-�f ...._.. - Y-- IWte 1`7 Application Disapproved for the following.reasons:--------•-----------------------------------------------------------------------------------------•--•-• ..... --------------------------------------------------------------------•....•--•••-••----•--•-------•------------••---•-•-----------••-•----......-•-•--.-------------------------------------------­--- Date PermitNo._.................................................... Issued........................................................ Date ------------------------------------------------------- ----- —---- -- - -:� No......................... Fiziic .r...n................ TH.,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _.._j6v-n_ --------------OF......./L ?:�.✓�..5...�. .. .......... ... ....... Apphrtt#ion -for :41-4poiittl Works Tvtt.�#rurfton Vrrnift Application is hereby'made for a Permit to Construct, (4 or Repair ( ) an Individual Sewage Disposal System at Location-Addres r Lot /f = --------- .' Ow Address ..._..._._�� � .-1.__.._.GC, ......._ :`:.�. ..................... Alm !._ -4................................. Installer Address Q Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms___________________ ____________________Expansion Attic (�y,o) Garbage Grinder O Other—Type of Building _ _4� 1'1.:...�.!_4.. No. of persons...-____ Showers ( ) — Cafeteria ( ) Other fixtures f W Design Flow--------------------- 45.............gallons per person per day. Total daily flow----------------------------------------.---gallons. WSeptic "funk—Liquid capacity_/V-_ 1lons Length---------------- Width................ Diameter------.--------- Depth.__._-_-.-...- x Disposal Trench—No..................... Width.................... Total Length..--_--_-_---__-.- Total leaching area--------------......sq. ft. Seepage Pit No.........../--__-___ Diameter..`ti'.`7----__- Depth below inlet_ Total leaching1. tre�t__________________sc it. z Other Distribution box (, ) DosingXtk ( ) + '� 77 r a Percolation Test Results Performed by._ .�___ __/.2-�___________________________ Date.__.._____..._..__.________._..._._..--. Test Pit No. 1....4 -___minutes per inch Depth ofr Pest Pit-------------------- Depth to ground water.._.___.-_------.-...- ' 1:14 Test Pit No. 2...........:....minutes per inch Depth of Test Pit.................... Depth to ground water_-.-.--..---_-.--_---__ -------------- ...... .• r -- Description of Soil_..____ M✓ "* "'✓�• _ L W ------------------------- U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ?.�a.. r.. y. is- Agreement: 1 The undersigned agrees toy 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 p p by-,the t- ." .. e' * g e cre�" 'c,�r s operation until a Certificate o om liance has been issued b the board of heal A. Application Approved BY.--------- •,- jk`,�p : Application Disapproved for the following reasons:------------------------------------------------------------------------------------------- --_--------------- -• . . -------------------------- ------ j------........................................... ------------------------------------- ------ Date PermitNo........................................... .............. Issued......................................... Date THE COMMONWEALTH OF MASSACHUSETTS JJ .BOA.R.. .... OF HEA.. LTH �.-�� ..OF A..................... .... . . .... ..... ' err#ifirtt#r of 0,omplittnrr THIS Irr��0 �CERTIFY, That—the Individual Sewage Disposal System constructed O or Repaired ( ) by......................I r' ...... --:...........•••...... . Installer has been installed in accordance with the provisions of : Li I of The State`Sanitary Code as described in the application for Disposal Works Construction Permit No dated fr✓"`:�` TIDE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT .THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................................................. Inspector- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........OF............ ! - ..�. 'r .. - FEE.—••-------............ �i>n�o�ttl rk� Cn �#r�tr�z .t �>ermit Permission is hereby granted............... ` ........•----!'...------. o-C............................................................... to Construct=( ) or Re air ( an Individual Sewage isposal Syste at No-------_---------- �fj. .... ...................�r..J�� = Street as shown on the application for Disposal Works Construction Permit Na ..............•-__ .Dated -�_... 1f"' `-77..---•..... Board of Health DATE............... ?--------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS n .Es ,� ) a�0d C. . 'Qf•F 1 S f'. $.-1. r / • i - tf' E e-, t J v 1 f Af x 2> �-€.�.✓ 'mow`. �, to 0. Vl 9. 1t : �� -• gyp;;�' .. � =� 4 S�eraACA;j-- E mvfQ _ - • P�eo FAO SAD SE P T/C Sys TEM COA/.5 TI�:UG�'l-ON , 3HA[_L. COS/FQ M rt) GAL I17.4 Y -'2 A-fZ- /77, T/t4..4 ]Z Y4A4Tiy T.�L6v4- 1 T/ONE l 3 p TOP of _ FP20 'toS T� L EACH I %41�_6,� A a ,co uNDAT/OA/ 6 Q C .. AA/f!©L.E Co✓E,p 7'O 5aC TE,J27O Jn W�`;>`,�a/�v A/15_ t- OZ'A /2c> inr .a iAAs `t f�.k 1.FrF c ,a• FNZ� GO✓� "'-` .S�oru� ;. i ../ e G= Ir t T�f✓. FLdlx/ 'Liw�� r sr _ MrN .�i"7t�� Y" - - P!T ._ $ Y4- 7- /4 4'/Fool ^91nr rrc�v -►r ` �' Aa� - �Z { l l3 � Y Z;O o E f'.. `., a ., ST nl ' AL�.UA, n /A/vE2T 1 (r!AlATE�T/� 7� $C3TT[ OF ,,1✓tea c7- / '1 P1T' /k /iV-V I�T4. # S u J E/�E.J� g .77 r-� r-,niv� �>s z`<r�/: riov 80 ►?'4 ET a .AND L .4G All A10 .F�/T icO,e . T OF EiNFa /^ CO.VCI2ETL� 4-4—7 '4 �0 LOAD/NG /iE �� v °' , P)eiVE WAY A,10T rC.BE LQC TED s 57 r `O G/T / ' / !i -� n 4C�F ,r U V' 2 S yS TE!�✓I Uri/[,:E s S h�-- ZO' . DE:S/GA1 L OQ l�/.vG� /S U.S�D: LEA TE. IIEAL77-1 ,ttGut/T DST :C: f A p t PLO t/ L IA s N ——100 ——EXISTING CONTOUR _ o x 100.98 EXISTING SPOT GRADE- , N 54'54 09" W 0�3 ose ° W EXISTING WATER SERVICE 65.00' n fence a ' wo hoc °a - .H.W—OVERHEAD WIRES Locus TEST PIT x 101.19 GJ�\Je y1r e 3 0 BENCHMARK O zLEGEND °7,.� 100.91 x .w \ �O`�@ OC X 101.17 \1 1 o CO ♦ . 1 Route 28 1 X 101.00 LOCUS MAP NOT TO SCALE i / / / J 01. 0 �� O r�♦ // j A / 101.23 �,-o� 101.10 y r'w `�'1', ;�Q, x 101, 6 I n I 1' 84 y — \, I x 101.14 ' + 101,0 EXISTING LEACH PIT(opprox.) A �_- 1 W NOT FOUND—CONTRACTOR SHALL LOCATE, PUMP & FILL WITH hh + 106 88 ! WITH SAND AND ABANDONED N o of �� -�� CV' M 4 ry Cl) co x°F -i• 101.42 0 o� 4- 101,55 shrubs EXISTING SEPTIC TANK O -`0 1.69 TOP OF TANK, EL.=99.46 101,52 edge of lawn 101.77 fieldstone 101.71 . INV. (OUT)=98.13f + ... . shrubs ....+ patio .. �11,74 Y DECK 10 1i 10I $OL80 SUN RM. +14bi 86. HOUSE(#39) T.O.F.=102.12 101.85 walk 101.94 Benchmark + 101.8-6 shrubs 101.94 OUTSIDE CORNER OF Cb walk CONC. AT BULKHEAD "+ 101.76 EL.=102.12 (Assumed) 0 1094 PA VED 101.78 DRIVE �+ 101,16 101,Q9 (LOT 27) b x 10iJ7 APN 010-036 1 23,047±S.F. \ 125.00' WSO 0.95 101.07 S 63'40'1 4„ E 101.40 edge of pavement 99.91 101.48 of k4 ROSEW0,.f 4D LANE o� PETER T. P PROPOSED SEPTIC SYSTEM UPGRADE PLAN M EN E CIVIL 39 ROSEWOOD LANE, COTUIT, MA No. 35109 Prepared for: Jerome Friedman, 39 Rosewood Lane, Cotuit, MA 02635 o REGISIF�\� �� Engineering by: SCALE DRAWN JOB. NO. F Engineering Works, Inc. 1 —20' P.T.M. 162-10 I p 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 6/7/10 P.T.M. 1 of 2 l•1 - \ r` rFrt NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:97.3 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL INSPECTION PORT OVER END UNIT T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE (SHALL BE WATERTIGHT) F.G. EL: 101.3(MAX.) CHARCOAL EXISTING F.G. EL.=101.7t F.G. EL: 101.0t VENT MAINTAIN 2% GRADE (MIN.) OVER S.A.S. i L = 55' L = 6'(MAX) IN PO TTION ® S=1% (MIN.) @ S=1% (MIN.) 4'SCH40 PVC 4"SCH40 PVC 6" io l s 11.3" TO t4� INVERT EXISTING 48' U0JID �, I LEVEL AD INV.=97.57 PROPOSED INV.=97.40 (3 ROWS OF 5 UNITS AT 6.25'/UNIT) + 0.7' WEDGE = 32.0' GAS FLE INEXIST NG t D-BOX INV.=96.94 SOIL ABSORPTION SYSTEM (PROFILE) 3 OUTLETS (MIN.) EXISTING SEPTIC TANK ESTABLISH VEGETATIVE COVER BACKFlLL WITH"ftEAN NATIVE OR , PERC SAND TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP ELEV.=97 33 INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=96.94 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM ELEV.=96.00 ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 2.83' 5' MIN. ABOVE BOTTOM OF 3) INSTALL INLET & OUTLET TEES AS REQUIRED. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=8.5' { 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE EXISTING SUITABLE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W., EL=89.8 - MATERIAL USE 3 ROWS OF 5-16"(H-20) ADS BIODUFUSER UNITS + WEDGE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE SEPTIC SYSTEM PROFILE . TYPICAL SECTION N.T.S. SOIL LOG GENERAL NOTES: DATE: JUNE 3, 2010 (REF. P#12958) 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL EVALUATOR: PETER McENTEE PE, (SE#1542) BOARD OF HEALTH AND THE DESIGN ENGINEER. WITNESS: DAVID STANTON R.S. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS HEALTH AGENT OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: Elev. TP- 1 Depth Elev. TP-2 Depth -310 CMR 15.405(1)(b): 100.8 100.8 1) A 1' variance to the 3' maximum cover requirement, for 4' of A O„ A 0" max. cover. S.A.S. shall be H-20 and vented. SANDY LOAM SANDY LOAM 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 100.3 10YR 4/2 6" 100.1 1OYR 4/2. 8„ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE B B DESIGN ENGINEER_. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING SANDY LOAM SANDY LOAM FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 10YR 5/8 10YR 5/8 ENGINEER BEFORE CONSTRUCTION CONTINUES. 97.3 C1 42" 97.5 C1 40" 5. ALL ELEVATIONS BASED ON ASSUMED DATUM: 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF M-C SAND M-C SAND THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 2.5Y 6/4 2.5Y 6/4 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION: fi 7. WATER SUPPLY PROVIDED BY .TOWN WATER SERVICE. 89.8 132" 89.8 132" 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED-S.A.S. NO GROUNDWATER, PERC RATE: <2 MIN./IN.(RECORD) 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE ' 0-1 DIRECTED BY THE APPROVING AUTHORITIES. 75" 10. IT' SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE,S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE _) INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFlLL 76 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND PROFILE IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. ; 11.3" TO INVERT 16" DESIGN CRITERIA �-� 34" i NUMBER OF BEDROOMS: 3 BEDROOMS SECTION END CAP SOIL TEXTURAL CLASS: CLASS 1 16" HIGH CAPACITY (H-20) BIODIFFUSER UNIT DESIGN PERCOLATION RATE: <2 MIN/IN MODEL 16" HICAP DAILY FLOW: 330 G.P.D. LENGTH 76" DESIGN FLOW: 330 G.P.D. NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY GARBAGE GRINDER: NO DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. SIDE WALL HEIGHT 11.2" LEACHING AREA REQUIRED: (330) = 445.9 S.F. OVERALL HEIGHT 16" .74 OVERALL WIDTH 34" 4640 TRUEMAN BLVD EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 13.6 CF ® HILLIARD, OHIO 43026 PROPOSED D-BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSTEMS, INC. USE 3 ROWS OF 5-16" (H-20) ADS eIODIFUSER UNITS PROPOSED SEPTIC SYSTEM UPGRADE PLAN W/NO STONE AND EXTENED 0.7' W/ CONTOURED WEDGE 39 ROSEWOOD LANE, COTUIT, MA BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF UNIT) (BIODIFFUSERS) 15 UNITS x 6.25 LF x 4.70 SF/LF = 440.6 SF Prepared for: Jerome Friedman, 39 Rosewood Lane, Cotuit, MA 02635 (CONTOURED WEDGE) 3 ROWS x 0.7' x 4.70 SF/LF = 9.9 SF Engineering by: SCALE - DRAWN JOB. NO. TOTAL AREA = 450.5 SF Engineering Works, Inc. NTS P.T.M. 162-10 DESIGN FLOW PROVIDED: 0.74(450.5 S.F.) = 333.4 G.P.D. 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 617/10 P.T.M. 2 Of 2