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HomeMy WebLinkAbout0097 WHITMAR ROAD - Health t 97 WHITMAR ROAD, COTUIT A= 056 065 WILLIAM LIEBERMAN I 235 TIMBER LANE MARSTONS MILLS. MA 02648 TELEPHONE (508) 428.2592 May 23, 02 Board of Health Town of Barnstable Hyannis, Ma. 02601 Re: 97 Whitmar Road Cotuit, Ma. 02635 , Owner: Crossen, Michael & Joanne K. Gentlemen: When the subject property was constructed in 1994 it had four bedrooms and a playroom which subsequently was classified as a bedroom making a total of five bedrooms. The septic plans prepared by Eagle Surveying and Engineering dated June 13, 1994 set the Title V Design Flow at 440 GPD or four bedrooms. However the design was for an S.A.S. with a 886 GPD capacity and a 1500 Gal septic tank having a Title V, capacity of 1000 GPD. Therefore the installed system was sized for six or more bedrooms ie greater than 660 GPD per 1978 Regulations. In addition, the As Built Card- dated 6-22-94 on file in your office was for a five bedroom house and the subsequent Real Estate Assesment was also for five bedrooms. In view of the foregoing, the existing septic system is sized for five or more bedrooms per 1978. Title V Regulations. Ver my s WL/el it iam Lieberman R.P.E. of ,rss+r WUPAM s U BEWN ENO. �971 y 4�ORA 'S t EP�tt� fsS+'pha r�� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -..... oF.......... Allp iratiou for Dhipasal Works Tuuitrurtiun- ramit Application is hereby made for a Permit to Construct (4 or Repair ( ) an Individual Sewage Disposal S stem at ocati i-Address 7 Lot - • -- �'7'— Owner a dr •---- � ............................... ....... � Installer Address ` � dType of Building Size Lot_._.'_7..�r_���:�Sq. feet. U Dwelling—No. of Bedrooms..._.......____________________________Expansion Attic (A Size Garbage Grinder (Ak-�) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures --------------- --------------- W Design Flow.................... .:.__��__-_�.--e..gallons per person per day. Total dail� flow------��(1.��- � --- lons. WSeptic Tank—Liqu>d capacrty,�.._._._.gallons Length--- Width....�.�.........."Diameter_.__@.----- DeptlS__�..__.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area____..ee_.,,____ sq. ft. 3 Seepage Pit No--------Z-------- Diameter...._:. ____. Depth below inlet...... rJ..... Total leaching ar7- ..sq. ft. Z Other Distribution box (X) Dosing tankk '-' Percolation Test Results Performed by.-_-R.N�)__:_ �:��_�!My__._._..____ Date_..��j��?��`�� a • • ........ ,.a Test Pit No. I....�......minutes per,inch Depth of Test Pit.../102_S.'.. Depth to ground water----- -------- Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ................................................ -----------•---------------------.......•-------------------•-----_--•-- 0 Description of Sail.........................®`: �:... . -- -- -•-----------------------------•--•--.....----------•----- U ----•-•--••-------•...................•-•.... .... _... .._..--•--••••-•-.._...-•--•••-•---....••---•-•--•-••--••-•.....••----------• W -•--•-•.............................................•----•••--------•---•-------------•-•---•-•--------........---------------------•--................................................................ 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the g d by the b and f health. system >n operation until a Certificate of Com liance has � � .......... ✓ �� - Y P P Signed ......... ... ......v Application Approved By --..:.....- ---------- ---- T� ,7. Dare Application Disapproved for the following reasons ..... ..... .. .................................. ......:..................... ................... ............................. . ......................................................................... .. ................................................................... ........ .... ......-------------------------- Permit )\io. .... .-. 1� �...-�.............�..................... ISSued ............................................-Y--.... ...ce Dace No... ----_- -_. Fps.- "' :......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "76e'-'�.... . ....OF.....Z> .. '...�....� 'Li� Appliration for UWposal Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct (, or Repair ( ) an Individual Sewage Disposal System at: 1��� ............ •-• ......... ..... ... ..................._..... ocati Address .No. C...CC� Owner ess —..: .•. . ......•. -...•--•..................•----•----._.._ .l, .G� h !i /✓i ----- .......................................... Installer Address 1 S q Type of Building Size Lot---- feet V Dwelling—No. of Bedrooms........... .__..Expansion Attic (Ax) Garbage Grinder (4,b) aOther—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) QOther fixtures ----------------------------------------------------------------------------------------- .................................. Design Flow................ ----• - . g P P P y• I v gallons. Jam_. __..______gallons per person per day. Total dail flow p WSeptic Tank—Liquid capacity/`&3.gallons Length--- Width...G_ ..... Diameter__.-.."--_._. Depth45.'8... x Disposal Trench—No..................... Width............ Total Length.................... Total leaching area......�..J. _ __.....sq. ft. Seepage Pit No........7._........ Diameter.......;i----- Depth below inlet.....S J_..... Total leaching area.._.7__�....._sq. ft. Z Other Distribution box (X) Dosing tank C ) '-' Percolation Test Results Performed by.......'� �.... :��_ ... ............. Date... Z a Test Pit No. 1................minutes per inch Depth of Test Pit___, Depth to ground water------ ......I__. Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ F----------•------ O Description of Soil-•--------------------------'..�...-�...---••••�r�........� .�a_..t- U -•---------•--------------------------------------------------------------•-------•------------•--•----------.......-•••-•---••••- W .-•-•-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--•-•--•----......•- Z. 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .................................. ... ... ................. ................................... � Dare Application Approved By .-..b ..C .rJ-------- --------- .... � .? :-. ................................/iG,- -------------------------- ' r Dace Application Disapproved for the following reasons: 1. ......................................................................................................................... . ... ..... ... .................................................. ---....... . .........----........ Permit No. ....� .1............... %��' `.........:.... Issued .............. Da.e. ...'r� ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 'XilPrtifirate Df V antplianre THIS IS TO CERTIFY, The n . ua wage Disposal System constructed ( ) or Repaired ( ) by............. .................................................. ............. 4.-et.......... ..............--............---..................--...-- ......................................... at ...!'e! ..:..` �. �` .. ©. j f .a...�...•= -{�..... ......... ... ......................----------------------------------.....-- _ has been installed in accordance with the provisions of TITLE-5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No.�o... .......:r'�.?.. h.. dated .. y! - ..., .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE'CONSTRUED AS A GUA k NA. T E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. - � ........ ..........-. .. .... - .....------------ DATE_............ '' .. '.` Inspecor •. ---------- THE -r COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �� '�,,. .. ....x'� ...............OF.......:.....:......-......:�_.`�.....-...............("'. .............No........:...:.....✓.....<<,f Disposal Vorks Tnnitrurti.on "Vrrmit Permission is hereby granted..............................................------•-----------------------------------------•-----....--•-------........................ . to Construct (_ ) or Repair ( ) an Individual Sewage Disposal System ' as shown on the application for Disposal Works Construction PermiC NoV.._".-7_j_= Dated--___ Z._...._�...;_. ................................................-...................................................... _ Board of Health DATE.................••............................................................ Form 1255 H HOBBS&WARREN TM Publishers w TOWN OF BARRNSTABLE LOCATIONS 9`7 p' ,G /1�rq SEWAGE # 1v VILLAGE � `>'u r ,�� ASSESSOR'S MAP & LOTi5Wd- INSTALLER'S NAME & PHONE NO. PJ fiEU11ACO U �7 2 3 S SEPTIC TANK CAPACITY LEACHING FACILITY:(type) Pou h)D (size) boo NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER// /G BUILDER OR OWNER jl2j*rrooQlo CQa DATE PERMIT ISSUED: Z5, DATE COMPLIANCE ISSUED: �` � " VARIANCE GRANTED: Yes_,_ ..No No ; y A F cod, ' �D A O I TOWN OF BARNSTABLE LOCATION �7 r< ^ Ily Tft% SEWAGE # A t� .VILLAGE. � `�'u t ASSESSOR'S MAP fe LOTdy.-- INSTALLER'S NAME PHONE NO. PaEUI1 ACC U 19 �7 ?,a 2 3 S SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ��Ll�V� (size) ©� NO. OF BEDROOMS PRIVATEOWELL OR PUBLIC WATER)'`TgZ/t /C BUILDER OR OWNER r1C ly .00 Gad" DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No A �L i f )3 F A 0 6 3 � G coo ` Q 6 T Q C ` V -- - 508.428.6191 o evliIA -... esigns _ VM.GLtlfa -- - ------ _ All Ri hI3 Reserved 1(..14 WSUL PI xM0 j CAP.._-_ ('):. ..... w I 'I i —. .._.._:.._ gm CU)A4 CW&OA0.D5 : 8•r14 Ws3A.4L.o.rl. 116 WA TUCTAIRAZI --- FRON'i ILEvn7S Ti Preliminary plans and layouts by DC.D.are for the use of their customers only.Any other use�s str-Ctly PrOhib'le l 7f. y 4i�0� Y�4' 4`4'�- 4'••t" C2'•1" 1Y'�O' " g 1 �E DATE is it - r _I•.rR.►[O.1.CI•fYN.)...._ I �/�Ff6--= 5(SnYT� 0', �•� 1'•'f' .. �',�... y 4�stoei rn rouNn. o I — u Q 508.428.6191 1— N Custom o esigns copyrignt O 1991 I —IAI.MASI�61.__--_ ILLd1' 'I 0 21sL•a0 71CS DItL IIL FO!f__'- _ I ,7 Re (ved �.� Reserves I �f - — - -- .JN1hMAY3:OIf1_i.:07T.110.NlYN71C�:... rr - Preliminary Plans and layouts by OC.O.ary for the Use of their customers Only.Any Other ult IS strictly pron�o�te A 9 i 2a i2••R WIAMAM J _ ,•'XsDl4 j iu lo.�....._. i vo KITCIIFN 44LLTEOCC ... :. 1O , �wnus t Car...'. ._ . .. ._.- � 508.428.6191 0 Qevlin O =i -pv�tL 6,L"fieMr�OC RaunL � � Z• .- Cw� @ustom - a esigns 3 '1• I copyright O 1994 _ All Rr hts --r-Tus4 epue GIf®W/ Y • Restrved ul j; ij i S Q i j U, A D S.o^ t2"o• ..... ..___._ .—.q�(o'..'- .___.tN re'_.._ .Q^A• ..... T'n" .. .: T'•4.. :.. 4.,p_..:...::.-.: _...4�4:._._: ... ..40" !O' A. V1 u O, 9 w � x Preliminary plans and layouts by DC.D.are for the use of their customers only.Any other use ,s strictly Pron,o,te }\ I I IT o -- -- TO- Id•c O 17C''2� �` O I O K!144%IwU Q O' SCALE DATE ..(aVQ.cL41wE N , O x*. ie �.. 508.428.6191 �° to I Q t— I IYQOOM p ^ rt 0 --.../t�StER"SU]TF.. - p CQevl i n ---- — -- - - a D esigns wY' CK:U4E copyright 01994 ' 4` I' I All Rights }+ '^ Reserved —t;senRoc�M .- A'•41L'YKLT KIUE WAIL s I U Z tU SKQI lA kIDOPI,PIRN - --' - W-O.. _. Preflminar '� Cr o.w y plant and layouts by DC.D.are for the use of their customers only Any other use is strictly Proh,wic 11- 1 D commonwealth of Massachusetts " Executive Office of Environmental Affairs Department of ' Environmental Protection William F.Weld 4 Cox& G°r°^i°' A f BggNc My (T yp , B.Str Arpeo Paul Glluccl El�ld r u.Gowmor h Cam - . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 8 'PART A /, J CERTIFICATION Property Address: �✓ dLca ° Address of Owner. Date of Inspection: a _Gam_ (If different) Name of Inspector. �Lc�^— Com Name,Address an Tele2hone Number. %� wig, Is, �/ a 3 CEATIFICA STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: C"Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: i%'�L�'`" Date: The System Inspector shall) bmit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system ds 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 SUMMARY: Check A,B,C,or D: ti Al SYS ASSES: avvee not found an information which indicates that the m violates an of the failure criteria as defined in 310 CMR 15.303. j y �� Y Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes;no,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 exfiltration,.or tank failure is imminent. The.system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of.Health. I (revised 11 1 ( sed /03 95/ ) One Winter Street • Boston,Massachusetts 02106 • PAX(617)SWI049 • Telephone(617)292-SM t"�primed on aq,,kd P,per SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner. , Date of Inspection: Bl SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout`or�high static water level observed in the distribution bo:is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will peso inspection if(with approval of the Board of Health): brInpipe(&)are replaced obstruction is removed distribution is levelled or replaced _ The system required pumping more than four time&a year due to broken or obstructed pipe(&). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)\are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY TTH BOARD'OF HEALTH: which require further ev ua' tion the Board of Health in order to determine if the system is failing to protect the Conditions exist lu h r'eq � by public health, safety and the environmgnt. 1) SYSTEM WILL PASS UNLES�/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 p ' is within 50 feet of a surface water Cesspool or rivy is within 50 feet of a bordering vegeta\land or a salt marsh. Z) SYSTEM WIL FAIL UNLESS THE BOARD OF HEALTH (ANDS PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMI THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY THE ENVIRONMENT: \1 The system has a septic tank and 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 within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 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 that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or Iwo than 5 ppm. S) OTHER (revised 11/03/95) 2 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner. Date of Inspection: D) SYSTEM FAILS: 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 ide tified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sew in diag to facility or system.component due an overloaded or clogged SAS.or cesspool. Discharge or pon of effluentto the surface of the'ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the di stub\n box above outlet invert due to an overloaded or clogged SAS or cesspool. _ Liquid depth in cesspool is less thane � 6 below invert or available volume is less than 1/2 day flow. 9 P ►P8 more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System,\cesspool or privy is below the high groundwater elevation. _ Any portion of a cess 1 or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a pool or privy is within a Zone I of a public well. _ Any portion of cesspool or privy is within 50 fee,of a private water supply well. _ Any porti of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well'with no accepts a water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for colifo bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El.LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 go 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 system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking orates PPl3' the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone lI of a public water supply well) \ The owner or operator of any such system shall bring the system and facility into full comphancece 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.. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST . Property Ads 7 Owner. Date of Inspection: Check if the following have been done: pumping information was requested of the owner,occupant, and Board of Health. _None of the system components have been pumped for at least two weeks and the system 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. vAs built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow f The site was inspected for signs of breakout. /All system components,excluding the Soil Absorption System,have been located on the site. Z'The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or /tees,material of construction, dimensions,depth of liquid,depth of sludge,depth of scum. y The size and location of the Soil Absorption System on the site has been determined based on existing information or as pro:imated.by non-intrusive methods. `!The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 9 -7 Owner. Date of Inspection FLOW CONDITIONS RESIDENTIAL• _ Design fiow;-14JL6-'gallo Number of bedrooms. Number of current residents: f� Garbage grinder(yes or no): . Landry connected to system or no): Seasonal use(yes or no): Water meter readings,if available: Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design ilow:_gallons/day Grease trap present::yes or no)_ Industrial Waste Bolding Tank present: (yes or no)_ Non-sanitary w barged to the Title 5 system: (yes or no)_ _ Water meter readings,if available: Last date of occupancy: OTHER(Describe) Last date GENERAL INFORMATION PUMPING RECORDS and source of informaUQD System pumped as part of inspection: (yes or no) If yes,volume pumped: eallons Reason for pumping: TYPE OF SYS ptic tankl6stribution box/soil absorption system Single cesspool Overdow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,.if any) Other(ezplan) APPROXIMATE AGE of all components,date installed(if known)and source of information: Sewage odors detected when arriving at the site:(yea or no)NU (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner. Date of Inspection: SEPTIC TANK:C/ (locate on site plan) Depth below grade:�� Material of construction: onerete_metal_FRP_other(e:plain) Dimensions: Sludge depth: /g ' Distance from top of sludge to bottom of outlet tee or baffle:117 Scum thickness: l �l Distance from top of scum to top of outlet tee or,baffle: y Distance from bottom of scum to bottom of outlet tee or baffle: _5 Comments: (recommendation for Pumping, of inlet and outlet tees or bafA ,depth of li 'd level in relation to outlet invert,st aural integrity, evidence of leakage,etc.) a GREASE TRAP:_ _ (locate on site lan) Depth below grade: Material of construction: _con metal_FRP_other(ezplain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffler -- Distance from bottom of scum to bottom of outlet o "bailie: Comments: (recommendation for condition of inlet and outlet tees or baffles,depth of liquid level-- 9ation to outlet invert,structural integrity, evidence o ) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Adde eaa Q Owner. Date of Inspection: .1- TIGHT OR HOLDING TANK_ (locate on site plant Depth below grade: Material of construction:_concrete_metal_FRP_other(eplain) _ S _ Dimensions: 3 Capacity: ¢allons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: '`� (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level distribution is equal,evidence of qolids carryover vid ce of leakage_into orcutjqf box, etc.) d PUMP CHAMBER:_ (locate on site plan) , Pumps in working or?en(yes`or no) Comments: (note condition of pump chamber,condition-of pumps and appurtenances,etc•`` (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Y`-� Owner. Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits, number:_ ��v leaching chambers, number:_ leaching galleries,number: leaching trenches,number,length: leaching fields, number, dimensions: overflow•cesspool, number: Comments: (note ndition of soil, signs of hydra 'c failure, level of ponding,con tion f veptation etc.) 19 CESSPOOLS:_ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: y 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 ins ion) Comments: (note condition of soil, signs of hydraulic failure,' level of pon • ,condition of vegetation,etc.) PRIVY:_ (locate on site plan) Materials of I. - Depthcoon: Dimensions: of soliComments: ( ndition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) (revised 11/03/95) 8 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION (continued) Property Address: .0, Owner: Date of Inspection: .2_ SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' p e c l� 3` DEPTH TO GROUNDWATER Depth to groundwatec,/�feet —� method of determination or approximation: (revised S/1S/9S) 9 z. 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SURRWtD TO CE7LINE>-DE516N �KAIN NEW FOYER KOtIDOWS TO BE PEl-LA ARCHITECT do TO BE DETERMINED O ILEPHONB(TERVELLA MA oMSS SERIFS WOOD FIX®OVAL WIIIDOW WITH SIMULATED _ TBLEPHONE(508)428-3999 DNIDED LUTE.INSULATED 43-A95.LOW V WATIN& i. Y—NEW B'-b'CAA OPEPONS AND ARGON FIWNB ` - FYI FOYER WINDOW PAmN PM,RY CONSULTANTS SCALE:1/4"=I'-0" ___ - - - MEW B'CASED OPENINGS EXISTING GARAGH EXISTING LIVING ROOM EXISI7N0 DINING ROOM /- . HALLWAY PORTIONOF N5 4 FLOOR TO BE OAK�• (, L�= TO MATC+f ADJACENT DININSS TRIP ROOM AID WIN& ROOM-WOOD SELECTION COULD CHANGE FACE OF EXISTING FOUNDATION — 12L 05 RE-BAR DOWELS EPDXY INTO IN 4"REFORCED .• •- I NEW FRENCH DOORS FOUNDATION WALL-UY OL. I' I C.�SLAB I —'h A EXI IDSTN6 DOORWAY I I ?' AND CASE P.T.2'xb'LA66ED THOU P.T. B�CIP�CONCRETE FLUNDATON �. r I Y MALL-0 ALL SPACER AINST NEW LA6 BOLTS GI B'OLO.M C WALL WITH SHELF TO 4SGENE — 4-CONCRET SLAB-SEE 5ECT014 I— 4,-I POSTS 10Y zlF AVATFD Iry STAND OFF BASE GALVANIZED - P.T.45.4-POST — S Q Q f¢YER A S J TOII��FLOCi2 p N PR.P.T.2'xe'RIM JOIST ABOVE-SHOWN DASHED �b'-D• b P.T.2',S'J05TS O W OL. - LINE DRESSEDSEED ON&ALVANIZED JOIST HANSERS — MANO&ANY DECK B'•FR,P,COLUMON 10' SQUARE BASE PLINTH PORTICO FO NDATION PLAN FN2KnC,0 FLOOR FRAMING . P.T.4 OLE POSTS INSIDE FRP COLUl1N PORTICO PLAN FIRST FLOOR PLAN sCAL&1/4^=1'4Y SCALE:1/4'=P-0" i a U 3' O-3•J LL . EGOAL 8'-O° ECEIAL - '- PROPOSED ADDITION REVISED: ADDT!'ION&RENOVATIONS TO TfiE CROSSEN RESIDENCE LLu ® v LJ - LIn n wrarnzAR ROAD COTUrr.MASSACHUSErrs a a LI UnE _ - (. �— ❑®❑ ❑&j PROPOSED FLOOR PLAN AND EXTERIOR ELEVATION: fiqT llim ® rff� InI SCALE:AS NOTED®� ®® DATE:JAMAIRY 15.2003-FOR PERMIT DRAWN:GJ a oa DRAWINGNUMEER INSTALL FLPSHINB AT NEW FOYER A-01 SIDE ELEVATION FRONT ELEVATION ADDITION PATCH B YK CLAPBOARDS PROPOSED NEW PORTICO/ENTRY FOYER SCAT R.1A.a 1..0. A5 NECf�vSARY REFER TO SNET A-02 FOR DETAILS SCALE:u4"=I'-OT - (� PERMIT SET ISSUE 0 WISE-SURMA-JONPS-ARCHTIECJS GENERAL NOTES : DESIGN CR I TER I A : INVERT ELEVATIONS : DESIGN FLOW: INVERT AT BUILDING: 96. 65 l . THIS PLAN IS FOR THE DESIGN AND ACCESS COVERS MUST BE WITHIN 4 BEDROOMS AT 110 G. P. D. PER INVERT IN SEPTIC TANK: 96. 25 CONSTRUCTION OF THE SEWAGE DISPOSAL l00.5 I2' OF FINISH GRADE FIRST 2' TO BEDROOM EQUALS 440 G. P. D. INVERT OUT SEPTIC TANK: 96. 00 SYSTEM ONLY. BE LEVEL INVERT IN DIST. BOX: 95. 90 , 4' PVC MIN. 2' of NO GARBAGE GRINDER 2. ALL CONSTRUCTION METHODS AND scHEDULE 40 :44 roNE INVERT OUT DIST. BOX: 95. 7 7-96.0 INVERT IN LEACH PI T: 95. 5 MATERIALS FOR THE SEPTIC SYSTEM 65SEPTIC TANK REQUIRED: SHALL CONFORM TO MASS. D. E. P. 995,9 13.51 3/4' - l I/2' DIA. 440 BOTTOM OF LEACH PI T: 92. 0 3 ourcer 92.0 WASHED STONE G. P. D. X l 50x - 660 GAL •TITLE 5 AND LOCAL BOARD OF HEALTH /0' MIN. 1500 GAL D-Box SEPTIC TANK PROVIDED: 1500 ADJUSTED GROUND WATER REGULATIONS. GAL . OBSERVED GROUND WATER: SEPTIC TANK LEACH PIT SIZE OF LEACHING FACIL I TY REQUIRED: BOTTOM OF TEST HOLE: 88. 0 J. ALL SEPTIC SYSTEM COMPONENTS LOCATED PROFILE : NOT TO SCALE 440 G. P. D. UNDER AREAS SUBJECT TO VEHICULAR TRAFFIC CATCH BASIN DESIGN PERC RATE 2 MIN/INCH OR GREATER THAN 3 ' IN DEPTH SHALL BE ZONE : RF CAPABLE OF WITHSTANDING H-20 WHEEL LOADS. PROVIDED: 2 4 'P/ T l S 1 W/ 3 -STN. SETBACKS: FRONT - 30 ' 4', ALL SEWER PIPE SHALL BE SCHEDULE 40 SIDEWALL : 264 S. F. X 2. 5 _ 660 Gpp SIDE - 15 ' OR APPROVED EQUAL , BOTTOM: 226 S. F.X l . 0 - 226 GPD REAR - 15 ' TOTAL : 490 S. F. 886 GPD 5. BEFORE CONSTRUCTION CALL 'D I G-SAFE'. ®WA ER GATE I -800-322-4844 FOR LOCATION OF SOIL TEST PIT DA TA UNDERGROUND UTILITIES. ` w I ND I CA TES _� I ND I CA TES PERCOLATION OBSER VED I I j v TEST - GROUNDWATER 6. VERTICAL DATUM IS: ASSUMED L Tp P-5049 TP#_ 7. FOR BENCH MARKS SET. SEE S l TE PLAN. - I i a� • \ GRND EL.98•5 GRND EL.- - / � \° � G. W.EL. N/A G. W.EL. TOPSOIL l�" , -\' c\ 2�2 io I \\\ i Z SUBSOIL 2 . G y 96. 5 > .E i \ ► e 0.53 CO T U l T \\ ` I500 GAL ; z o `\ v'CE •I SAND I \ 1 1 SEPTIC TANK \ I 1 1 1 1 RESERVE 1 -+ m k° 2o. " O NO WATER 12-4' PITS ' res� Hoc \ 10. 5 ' 88. 0 d D-BOX k(/3' STONE N 1\ \\\ b \\ I \\ \ \\ \ \ 29 `�\ ► I I \ °\ \ \\ `\ °° \ DATE: DECEMBER 17. 1965 TEST BY: PETER SULLIVAN �\ 1 \ \ �.': •,, Y . TOP CB/DH W I TNESSED B Y: JAMES CONL ON RES RVE \ pRoPos�o HAND/TEL/CATV N EL. - 100. 14 PERC RA TE: 2 MIN/INCH 0. kc P T / C S S T.EM E- S I G/V 28 X 2% 68°29 -,,%L o 0 T T S.F\\\ \`\ s`� \`� R N T < CO T U / T O O-- �� °\ � �� `\ � \`� P R EPA R E-C,) F O R MARK WOO o C, 0RP . _\\ S CA L E : / 3 O .J U/VE / 3 . / 9 9 4 I \ \ O \ �, f & r'', .A m a U •� E'14 CL, E' 'Y I NG' 8t E'NG I N I NG I NC . \ ® a Z. - - � Ma ® 2aor I �S ® �� 432 - 5333 0 15 30 60 JOB NO: 94-277 FIELD:CFW/R VB CAL C: SAH/CFW L.CHECK: CFW DRN: SAH