HomeMy WebLinkAbout0037 MANOR WAY - Health 3,7Manor Way
Osterville
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TOWN OF BARNSTABLE
LOCATION 3.7 A-940? IA/14Y SEWAGE# o2D/S(-.365
VILLAGE D lG`✓t/ c ASSESSOR'S
/M/AP&PARCEL /ay
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY �ooa,yAi.�„w�ACgrlwtb�/2
.s(x3 LEACHING FACILITY:(type) er� C—SGN etC' (size) D
NO.OF BEDROOMS .3
OWNER �Ck& We4li wC,_VAAQA
PERMIT DATE:a-Q�—f!y COMPLIANCE DATE: OCT. C�Oil/
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
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No. o_G'Lj 3 63 Fee - v
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS► Yes
RppliLAtion for 13ispo8AY 6pstem Construction permit
Application for a Permit to Construct( ) Repair YI Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.3 R M A AI.P,? W y Owner's Name, ddress,a d Tel.No. 6/1- eqq
o sT rNr 11 c �bh.n � we,,, t vQ nnoP $7S,f
Assessor's Map/Parcel 116 la3r 31 j9gJur W � pbl.
Installer's Name,Address,and Tel.N�o. Designer's Name,Address,and Tel.No. SaB_uo
nrt,a Hckc .61-cr Sb8-yd8 Q_CLrrcn Meyer'
8 h 'P.W �. OSTerr<<10 aq ?O. 'Do x Raj, E. !SAIVLCtr
Type of Building: L
Dwelling No.of Bedrooms -3 Lot Size 18i sq.8. Garbage Grinder(h/'j
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33 D gpd Design flow provided gpd
Plan Date--13—L Number of sheets CQ Revision Date
Title
Size of Septic Tank /ODD 6. Gj(t,}(1 R(' Type of S.A.S. G - ?)C f cS TOrI C- ��'X�Oi
Description of Soil f 5 %J�,4/
Nature of Repairs/I or Alterations(Answer when applicable) 15' l5 1 1 OOG -T Ti9 460 �K
pn^ bdE— 3Gt 1.. -9a y
s "Yr - aid 3 Y 57?14C
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date 5,CP7-- @4 o?01Y
Application Approved by c Date
Application Disapproved by Date
for the following reasons
Permit No. 3 6.5 Date Issued j -
-------------------------------- ---------------------- ---- ---- -tr _ -------------------- ------------ ---------------------
No. Fee
THE COMMONWEALTH-OF MASSACHUSETTS Entered incomputer: N-/
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplicatIon for Misposal 6pstem ConBtrUCtion permit
Application for a Permit to Construct( ) Repair Y{ Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.3 7 n Aj-ip,? tiJ h y Owner's Name,Address,arld Tel.No. �,���- 8�'�/-
VSTerville �-cah� Win �) wC"nnoP 975y
Assessor's Map/Parcel 116 -- /,5?y R hAnt,kJ - aST.
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. S08.360
Bruce Hc.,cc.11',STrr So$•yd8 isle er ` 3311
B 7 1Q;�} S'i . OSTer ssaq r,0. 'bot L, SArb1t,,1iCtr
Type of Building: l
Dwelling No.of Bedrooms Lot Size 181 d �(y sq.ft. Garbage Grinder(Allp
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
YDesign Flow(min.required) 33 gpd Design flow provided gpd
Plan Date—G Number of sheets Revision Date k
j Title
Size of Septic Tank l/000 6,41 1r=X() 7,1r Type of S.A.S. l96-r
Description of Soil
,SE'r
r Nature of Repairs or Alterations(Answer when applicable) 5 i` S! 00 G41 i15Ti�/ GYf G H1
D�rVD C'HAm 1�- lis �• Bob Inqrtl 1� t,,; 1S ,(3G�
41s = �r.�P�i1� ' /�cd / 't 3�y-l�t -57-me
Date last inspected: "
Agreement: '
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. 11
!i Signed c� Date Sepro)6.0?0/,
Application Approved by ` /7 - Date
Application Disapproved by Date
for the following reasons
Permit No. gG l Ll 3 6 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 O by S r1 o r et,el t Co A S-
at 3^1 MANUR- W19 i OS/Fr vi1 r has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.ao l q-365 dated q ' 6 rr�
Installer ice hCLGr-���� Designer �Arrex1 McY�R
i #bedrooms Approved design-flow gpd
The issuance of this permit shall not be ons ed as a guarantee that the system will cti, as e7ined' ✓'Date j Inspector1,�/�. - t.� ,
/ f
------------------------------- -- -- --- -------
'_
No. G I `I 1 J Fee (`'v
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
misposal *pstem Construction Vermit
Permission is hereby granted to Construct( ) //� 'Repair(►15 Upgrade( ) Abandon( )
System located at / ///>'1C/G? /Ni�i - 05
I
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be co leted within three ears of the date of this permit.__-,
^ 26 - /C P Y p /
Date Approved by � f
Town of Barnstable
�TK�E'O'�tio Regulatory Services
Richard V. Scali,Interim Director
MASS. g Public Health Division
i639•
or f p Mpr A Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304 .
Installer & Designer Certification Form P
Date: Sewage Permit#' _Assessor's Map\Parcel
Designer: ���, i ' ✓i L .Installer:
Address: P .6 /�V,C, 1D Address: 7 �00,
)� l Vk S �G'r�Gflc
E
On 'orb `�� C-C� ! ;le� was issued a permit to install a 3
9 ,ice
(date) (installer)
septic system at 33 ® � ) L 1,k based on'a design drawn by
(address)'
[)qe--
dated'
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. .Strip out (if required) was inspected and the soils
were found satisfactory.
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. Strip out (if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in compliance with the terms
of the l\A approval letters(if applicable)
OF Mqs
l
( taller s lg ER
nature) l I —"
J� No, -1140
RFGl51
I
(Designers Signature
PLEASE RETURN TO ARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE'
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FOR1yt AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification Form Rev 8-14-13.doc.
� , r
Town of$a' -;-nstable. P#
, � Department of Regulatory Services.S
` =• Publiciealth I2ivision Date
. �xnrtsresre .
ie3q. �e 200 Main Street,Ryan is MA 02601 w. .
�rfnµAtt` ` '' I•° Arj
S �s
Date Scheduled / Time Fee Pd.
Soil Suitability Assess `merit fop:Sew Dig ' osa ' � �,
,/� �,
Performed By: l 1�1��`�L # �e�"" Witnessed Dy
LOCATION &-GEN ERAL INFORMA . ON
Owner's Name o�i(7'�';
Location Address .�� 1/e{ V L%12. ' w' i(`�
I Address �}
Lr—Or'Ix)S�j-6
Assessor's Ma /P rcel: f Engineer's Name
y' I
NEW CONSIRU�'fiON REPAIR �\ Telephone# ✓ 31
qLLand Use CiS iJGI� Slopes(9'0) U �• M Surface Stones
Distances from: Open Water Body .2—®0 ft Possible Wee Area�ft Drinking Water Well -
t�reinage Way l ft Property Linc >�� , ft Other ft
SKETCH:(street name,+dimensioiis`of lot,exact locations of test holes&perc tests,locate wetlands"in.proxitnity to holes)
���(� PCB °�� c�� ��.� •�.��� J -_. • . , . . .
E`er "+�•r,CIV
. l �. . ,� .. • ..
Parent material(geologic) �t' (w.4`• ` Depth t0 Bedrock _
Depth to Groundwa.Fer. Standing Water in Hole:*- t q � i Weeping from Pit Face
e
Estimated Seasonal Righ Groundwater y i —
Dtni ATION FOR SEASONAL HIGH'WATER T"L E. �
Method Used: `(7 1 � �. 1 i b�. 123< : .._
Depth Clbserved standing ut abs.hole: 1® �l Z± in. Depth to Soil mottles: In.
Depth to' from side of obs.holes itt. .t7C0unditter Adjustment {k
I [ Adj.aroundwater Level.
Index Well# Reading Date index Well level - __ Act ffetoC,,,,.__�-
PERCOLATION:TEST Date �rini�:
Observation I Time,et 9"
Hole#
Depth of j °t• Timeat+6"a _
Start Pre-soak Time.@ Time 611) y .
End Pre-soak
Rite MinJlnch
b Site Suitability Assessment: Site Passed; Sit41
e Failed:
Additional Testing Needed(YIN)
Original::Public k e$ith Division # Observation Hole Data To Be Completed on Back--
***If pereolalibn test is to be conducted within 100' of wetland,you must first notify the
Barnstable C4#servation Division at least one (1) week prior to beginning.
i
t DEEP OBSERVATION HOLE LOG Hole# -
D'epth from Soil Horizon Soil.Texture Soil Color Soil ' j Other
.Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
z b'r
j DEEP OBSERVATION HOLE LOG Hole# �
Depth from Soil Horizon Soil Texture Soil Color Soil `Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc %Gra el
W1 ��
� ����- ►� � ,� � �J� 3 Sty �v ,�
DEEP OBSERVATION HOLE LOG Hole# "
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) DA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel
I• I _ i I T
DEEP OBSERVATION HOLE LOG Hole# ITM
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders.
Consistency, ra I
.t
Flood Insurance Rate Map: -
Above 500 year flood boundary No— • Yes
Within 500 year boundary No Yes
Within 100 yearflood boundary No .Yes
Depth of Naturally'Oecurring Pervious Material
Does at least four feet of naturally occurring pervi us material exist.in all areas observed throughout the
area proposed for the soil absorption-system?
If not,what is the depth of naturally occurring pervious material?
Certification �,
I certify that on l (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the, above analysis•was performed by me consistent with
the required'tr int , p&rtise and experience described in 3,10 CUR 15.017.
Signature ; — Date
Q:ISEPTIC\PERCFORM.DOC
Certified Mail#7003 1680 0004 5458 4296
�opWE rawer Town of Barnstable
Regulatory Services
BARNSrABLE,
9 MASS. Thomas F. Geiler,Director
3.639. -
ArfDMAtA Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
June 1, 2007
John & Wendy Wannop
2246 Deer Ridge Way
Woodstock, VT 05091
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II— MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE CODE CHAPTER 170.
The property owned by you located at 37 Manor Way, Osterville, was inspected
on May 23, 2007 by Meredith Morgan, Health Inspector for the Town of Barnstable.
This inspection was conducted on the basis of the rental registration in accordance with
Chapter 170 of the Town of Barnstable Code.
The following violations of the Town of Barnstable Code were observed:
070-10—Smoke Detectors and Carbon Monoxide Alarms. No smoke detector
provided in basement.
You are directed to correct the violations listed above within twenty-four (24) hours
of your receipt of this notice by providing smoke detector for basement.
You may request a hearing before the Board of Health if written petition requesting same
is received within ten (10) days after the date the order is served.
Non-compliance will result in a fine of $100.00 per violation. Each day's failure to
comply with an order shall constitute a separate violation.
QAOrder letters\Housing violations\Rental ordinance\37 Manor Way.doc
Should you have any questions regarding the above violations, please contact the Town
Health Division and ask to speak with the inspector who performed the inspection.
PER ORDER OFZTE BOARD OF HEALTH
Thomas A.McKean, R.S., CHO
Director of Public Health
Town of Barnstable
Cc: Meredith Morgan, Health Inspector
QAOrder letters\Housing violations\Rental ordinance\37 Manor Way.doc
FORM30 C&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS
t _ BO . D OF HEALTH
, b'ej
Y/TO d
o MAM)O(S
ARTMENT
®C
ADD S woo
G1.y svey`0�. �(
' //OO�1 I TELEPHONE
Address 0 V ' 9�fe, Occupant 9 QAIY,�t 1,
Floor Apartment o. No. ofOccupants�
No. of Habitable Rooms No.Sleeping Rooms 73
No. dwelling or rooming units_ o.Stories �""""���� ��,,��jj��
Name and address of owner , K O �,lG(,?�S� &-
Remarkks" Rig. Vio. (/4f"
YARD Out Bld s.: Fences: G�j (
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress: and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Li htin :
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.: '
11110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
—Living Room
Bedroom 1 ,
Bedroom 2 Q
Bedroom(3) 0M
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.:
Stacks, Flues,Vents,Safeties.-
Kitchen Facilities Sink
11,!51-
Stove - --
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECT PORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALT IRS PEjF3JURy.",
INSPECTOR TITLE
A.M.
DATE TIME P.M.
A.M.
THE NEXT SCHEDULED REINSPECTION P.M.
L
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or
impair the health, or safety and we of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to
include affect the legal obligation of the person to whom the order is issued to comply with such order.
(A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary
needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer.
(B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as
prohibited by 105 CMR 410.200(B) and 410.202.
(C) Shutoff and/or failure to restore electricity or gas.
(D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com-
mon area required by 105 CMR 410.254.
(E) Failure to provide a safe supply of water.
(F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR
410.150(A)(1)and 410.300.
(G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object,
including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452.
(H) Failure to comply with the security requirements of 105 CMR 410.480(D).
(1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar-
bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests
or otherwise contribute to accidents or to the creation or spread of disease.
(J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public
Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.)
(K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,
so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety.
(M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release
of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105
CMR 410.353.
(N) Failure to provide a smoke detector required by 105 CMR 410.482.
(0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or
knowledge of the owner of said condition or conditions:
(1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven
or any defect that renders either inoperable.
(2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any
defect which renders them inoperable.
(3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of
generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard.
(4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as
required by 105 CMR 410.503(A)and 410.503(B).
(5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550.
(P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con-
dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner
to remedy said condition within the time so ordered by the Board of Health.
�wv`
� ra��
Town of Barnstable
oFY�
y�P o� Regulatory Services
* BARNSrAQLE. = Thomas F. Geiler,Director
y MASS.
ib39. Public Health Division
plFO MAC a
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
May 24, 2007
Attn: COMM Fire
Health Inspector Meredith E. Morgan conducted a rental inspection in accordance with
Chapter 170 of the Town of Barnstable Code. In accordance with the State Sanitary
Code, 105 CMR 410.482, the Health Department is required to notify the Fire
Department if there is a smoke detector violation, or possible smoke detector violation.
The following property had possible smoke detector(and\or CO detector) violation(s):
37 Manor Way Osterville Assessors Map-Parcel: (116-124):
Smoke detector lacking in basement.
Meredith E. Morgan -Health Inspector
Q:\Order letters\Housing violations\Rental ordinance\\Fire ViolationsT RE TEMPLATE.doc
..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTj4__
71� ......
........ ... ....OF............. d-V444-1C.
Appliration for Disposal Works Tonfitrurtion Vrrmit
Application is hereby made for a Permit to Construct or Repair Individual Sewage Disposal
r 4mepa r
Syst af�
- -•.... .... . . . .. . .. ....................
---------- .. .. ................. .........................................
ocati n•Address or Lot No.
..... ......................................... ...............................................
. . ..... Owner Address
a .. ...... .. ..... ........... ..................................................................................................
Installer Address 1
Type of Building..- Size Lot----------------------------Sq. feet
U
Dwelling' No. of Bedrooms...........................................Expansion Attic Garbage Grinder (
Other—Type of Building ......................,...... No. of persons............................ Showers Cafeteria (
Other fixtures
Design Flow........................& V_ 'r"a"1 lo"n"s...per...person----per i-,d"a"y.......Total ot,-a'I----daily_' '----flow___..._._....'---''................ ----------------__.gallons.
9 Septic Tank—Liquid capacit�Po?!Olallons Length................ Width--_----_-.--._-_ Diameter__:-._ ;-------- epth....
Disposal Trench—No. .................... Width......._.._......... Total Length....._....._........ Total leaching area.i4l.......sq. f t.
Seepage Pit No----------------I-------- Diameter....__..__..._..._. Depth below inlet.................... Total leaching area------------------sq. ft.
Z Other Distribution Dosing tank
Percolation Test Results Performed by......................................................................... Date----------------------------------------
Test Pit No. 1................minutes per inch Depth of Test Pit..____..._...-_..... Depth to ground water----___--________-_--.-.
04 Test Pit No. 2................minutesper inch Depth of Test Pit.................... Depth to ground water__-__-_-_--_________---.
.........................." -------- ---- ..................................................................
0 Description of Soil..................... ... .. `
_ I-----------------------------------
U ........................................................................Z................................................................................................... -----------------------------
........................................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable.____............................................... ------------------------------------------
.............................................................................................................................................. ........Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
.the provisions of Article XI of the State Sanitary C The undersigned further agrees not to place the system in
e
operation until a Certificate of Compliance has tied by the bQar & alth.
Signgn --- ........ ...... --------- ..........................
Date
at,
Application Approved BY--- WJ_,01 ._e -
....
Application Disapproved for the following reasons:----..........................................................................................................
......................................................................I..................4--------------------------------------------------------------------------___............................
Date
Permit No......................................................... Issued._'a3//` .......................
-------------------------------------------------------------------------------------------------------------------------------
No...�:... .... ...................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF H E�A,�L�! -
------..OF..... "�.. .. G..?G.'
Appliration for Disposal Worko Cnonstrurtion Pumil
Application is hereby made for a Permit to Construct ( ) or Repair ( ) Individual Sewage Disposal
y J
S st 1 at:
F, -...._ ..._%._ t4. 1 �, -CrL ----------------�.. .
Y ocati n-Address
or Lot 1\0.
W / 0 nner� ♦ v Address
-- "�P ----.--f�_=""'r--iset.. .-' - ............
Installer Address
Type of Buildi,n,�i• t Size Lot............................Sq. feet
U Dwelling« No. of Bedrooms........... .....................•.._---Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ___-_-____________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Otherfixtures -----•-------------•-------------------------------------------------------------------------------------------
W Design Flow........................v_ .._._._sgallons per person per day. Total daily flow.............. __ _------------gallons.
WSeptic Tank—Liquid capacit/_d'_/ ..gallons Length................ Width---------------- Diameter--__--..----____ Depth-.-------.----_
x Disposal Trench—No................ .... Width.................... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area------------------sq. ft.
Z Other Distribution box (I ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date----------------------------------------
Test Pit No. 1................minutes per inch Depth of Test Pit--_______--------__. Depth to ground water..--_----_---__-__---.-.
f-T., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--____---_--..-.____----
a --'-' .. -'•'---
tom' ..........
----------------
•--------------------------------------------------
O Description of _____________________
U •-----•---••-'-•---------------•---------------•--••-••'-'•'---•--•-••-•-••-•-••----••••••-•••------"--••--•--'•-••-'--'--•-•--••-"--•-'-----------------------------•-------------------------------
W
UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the,aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary n The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bued by the boarder lth.
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Slgne
----- ----
' r Date y
A lication A roved B r'�' "� `''. r
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Date
Application Disapproved for the following reasons:.................................................................•_______
----•---•------- -----------•--
---------------------------------------------------•------------------------------------=--------------- •-•----•--•------_..--• -••-•---•-•------------------•......-•-••-•--•
Date
PermitNo........................................................ Issued--C '�`•_
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF _!�-IEALTH
T...............O F............• ..,� . ;r?T °°gig, ......." ....
Ir if ira y of ToutpfiiYYtrp
T TO CERT; Y, Th e Individ 1 Sewage Disposal System constructed ( ) or Repaired
( )
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......
has been installed in accordance with the provisions of Ar cle XI of The State Sanitary Code as:described in the
application for Disposal Works Construction Permit No.-!........................ --- dated.---:i-A ``f e_ �_.._-__: ----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
�
DATE ��t
---•----------------•---•"-•'--•-••••-----.... Inspector-'------ �,,`� = �
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTH rr
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No........:.... ... FE>.
Permission ip,>ereby granted........
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to Constrtuef (/6T or Rep •r* ) an Individual Sewage Disposal System
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as shown on the application for Disposal Works Constructing, mit N,p-�'4� _ Dated_•-.,`==,l�d� "'
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------' Board of xealth
DA FORM 1255 HO S & WARREN. INC.. PUBLISHERS'
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OSTERVILLE
PROP. 1 ,000 GALLON LEGEND
PUMP CHAMBER PROPOSED CONTOUR LOCUS or
_ PARCEL ID: P z a
116/125 09-81 PROPOSED SPOT GRADE <
co F EX15T. 1 ,000 GALLON -- 98 -- EXISTING CONTOUR
ENE _ SEPTIC TANK (re-use) i + 96.52 EXISTING SPOT GRADE
PARCEL ID:
116/021 S84'31'30"E, _ _ W— EXISTING WATER SERVICE
1 -' 133. 5 ~ - - _ TEST PIT WEST BAY o
PARCEL ID: o
I. 116/124 6'
f� AREA=16,644f S.F. \ � y v�
N p P
-----= G - ----------=----
LOCUS MAP
1 1 i i Ln
---OTH-1 i 1 W n
TH-2
LOCUS INFORMATION
K CEDE\ �' '
I N G;
PLAN REF: 249/73
i TITLE REF: 3726/019
Y G3 7 PARCEL ID: MAP 116 PAR. 124
w 1 i i i I ZONING: "RC"
FLOOD ZONE: "AE" EL=12
TOF=10.86 i A\ �� COMMUNITY PANEL: 25001CO757J DATED:07/16/14
N ! 25' SEPTIC SYSTEM
CO jl � REPAIR PLAN
- + ' LOCATED AT:
17' 1 1 I O TBM: COR BLHD �, / , O %00
DAR L ID: 1 >> ; ; EL=10.00 -�w 37 MANOR WAY
116 022 1 ; , \, I OSTERVILLE, MA.
J MAPLE \ 1 1
PREPARED FOR
►'� --I s.0O, I ;; GARAGE ; i py~~ -T -----~~~---___f__--=4 GENERAL NOTES: J O H N W. 8� WE N D Y S.
_ ems\
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
i i ; BOARD OF HEALTH AND THE DESIGN ENGINEER. W A N N O P
\ 1 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS bRivEwgy SEPTEMBER 23, 2014
TREES __ I \ ; ¢ OF THE STATE ENVIRONMENTAL CODE, TITLE 5, AND ANY APPLICABLE
- 1, Q LOCAL RULES AND REGULATIONS.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER. �40 OF MgsJ'
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �P 9CyG
\ y FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
_ Y t ENGINEER BEFORE CONSTRUCTION CONTINUES. { D IEI�}/M'
5. ALL ELEVATIONS BASED ON ASSUMED DATUM. ��\
1140
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ���NNNO:
-�_1-I THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
S84"31.30"E T „ \ i HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. SjER��
132 \ 7.WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
76 i\ uP 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. l G
PARCEL ID. ` 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION
116/123 tI AND/OR PRESENCE OF ALL EXISTING SEWER OUTLET PIPES AND UNDERGROUND QQ��
I UTILITIES PRIOR TO BEGINNING CONSTRUCTION. MEYER UC, SONS INC.
10. EXISTING LEACHING TO BE PUMPED, CRUSHED, AND REMOVED PER TITLE 5.
REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5.11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION P. 0. BOX 981
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY E. SANDWICH , M A 02537
GRAPHIC SCALE AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13 REMOVE UNSUITABLE
20 0 10 20 40 80 TOPOF 'CC" SOILS AROUND" LAYER AND REPLACE WITHC LEACHING
LEAN MEDIUM SAND PER .69 OR TITLE PH: (508) 360-3311
TITLE 5.
14. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING FAX: (774) 413-9468
15. ALL PIPING TO BE 4" SCH 40 ® 1/8-/FT (UNLESS SPECIFIED) meyerandsonsinc@gmail.com
( IN FEET )
1 inch = 20 ft.
SHEET 1 OF 2 J#1688
NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
PROPOSED TANK PUMP CHAMBER D-BOx FINISH GRADE SHALL NOT BE < EL:7.90
INSTALL RISERS W/IN 6" OF FINISH GRADE INSTALL RISERS to FINISH GRADE INSTALL RISERS W/IN 6" OF FINISH GRADE FOR A DISTANCE OF 15' AROUND THE
TOP OF 1 PERIMETER OF THE S.A.S.
FOUNDATION I
EL. = 10.86 EL.9.5t EL9.50t EL.9.00t EL.9.00t F.G. EL: 9.20f F.G. EL: 9.50(MAX.)
A
:b 6" INSPECTION PORT TO BOTTOM OF STONE
sA►arARr TEE W/IN 6" OF FINISH GRADE (USE PERF. PIPE)
EL. 8.70 '
EL.8.35t 2 SCN 40 �C 8• 6
• 4" SCH 40 PVC
a CS=2% io• .• a 1 1$ (MIN.) io• FORCE MA,N
a• ) TEEMS ARE TO BE INV.=7.70
4• SCH 4o PvC INV.= 7.90 �� INV.= 7.57
:c GA5 INV.= 7.40 23"
BAFFLE TEE SHALL NOT EXTEND
Exist. Invert w/ FILTER INV.=7.30 PUMP OFF 17• _ BELOW 'FLOW LINE
INV.= 7.86 12" (USE DO-&W/BAFFLE)
INV.= 7.65 . .. ,. INV.=7.55
t EXIST. 1,000 GALLON MONOLITHIC SEPTIC TANK
PROPOSED 1.000 GALLON PUMP CHAMBER j0'
` NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING (installalltion of pump chamber to be reversed) P
PIPE INVERTS PRIOR TO CONSTRUCTION.
2) PUMP CHAMBER AND D-BOX SHALL «n ">Fc Na 4,o 507L 9 .
PER Tl TL MIN 5
BE SET TRUE TO GRADE ON A MECHANICALLY rTL>Fa vAerxc
COMPACTED SIX INCH CRUSHED STONE BASE AS
SPECIFIED IN 310 CMR 15.221(2). BREAKOUT EL = 7.90
3) INSTALL INLET & OUTLET TEES AS REQUIRED. INV. ELEV.=7.57
SEPTIC SYSTEM PROFILEEND ELI1/-7L4E2ASNens�avE
4) GAS BAFFLE W/ FILTER TO BE INSTALLED ON OUTLET TEE J,q•_
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL
5) INSTALL SANITARY TEE IN D-BOX N.T.S.
INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING BOTTOM EL.= 6.92
WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM PROVIDE WATERTIGHT CONCRETE RISER 2.5 5'
FLOAT TO GP 2000 HIGH WATER ALARM PANAL ON WITH SECURED COVER TO GRADE �5 -
SEPARATION 5.05FT.
CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. NEMA 4 JUNCTION BOX CORROSION RESISTANT
& LIQUID-TIGHT CABLE CONNECTORS SUPPORTED SOIL ABSORPTION SYSTEM (SECTION)
HOISTING CABLE 7x19 STAINLESS STEEL BY 1-1/4" PVC CONDUIT. JOINTS TO BE MADE ti ADJUSTED GROUNDWATER EL. 1.87�-
1/8" DIAMETER. / 1,760 LB. STRENGTH. WATERTIGHT
2"BALL VALVE w/ UNIONS SCH. 80 PVC SOIL LOG S
PC INV.(IN)=7.30 GEORGE FISHER CO. MODEL NO. 560 OR EQUAL Elev. TP-1 Depth Elev. TP-2 Depth
2"SCH. 40 DISCHARGE TO D-BOX 8.95 0"
ALARM ON EL: 5.13 2"SCH. 40 TEE w/ CLEAN-OUT CAP A 8.85 A 0"
L: 4.63 DATE: SEPTEMBER 3, 2014 LOAMY SAND LOAMY SAND
PUMP ON E
PROVIDE 1/4" WEEP HOLE IN DISCHARGE 7.95 10YR 3/2 12" 7 85 10YR 3/2 12"
PUMP OFF EL: 4.30 22'1 PIPE FOR SELF-DRAINING FORCE MAIN SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1 614 B B
WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH
re•112" 2" BALL CHECK VALVE SCH. 80 PVC 10YR LOAMY SAND LOAMY SAND
BOTTOM OF INT. P.C. EL. 3.30 100 P.S.I. FLOWMATIC MODEL No. 208S 6/8 1OYR 6/8
P#:14457 5.70 39"
PROVIDE 2- WIDE ANGLE FLOATS: 2" SCH. 40 PVC DISCHARGE PIPE C 5.69 C 38"
FLOAT NOA: PUMP ON/OFF (BARNES 073618 OR EQUAL)
FLOAT N0.2: ALARM ACTIVATION (BARNES 073612 OR EQUAL) 2ARNES SEV412 PUMP .4 DISCHARGE PASSING 2""soups OR EQUAL BUOYANCY CALCULATIONS
ple"C<_ 9 MEDIUM SAND MEDIUM SAND
t NOTE: PUMP CHAMBER TO BE FACTORY WATERPROOFED AND SEALED WITH THOROSEAL OR EQUAL s 4 ,w is 2.5Y 7/3 25Y 7/3
PUMP & ACCESSORIES AVAILABLE AS A UNIT
THROUGH WIGGEN PRECAST CORP., BOURNE MA. (800) 564-6774 1.000 GALLON SEPTIC TANK
PUMP & ACCESSORIES AVAILABLE THROUGH WIWAMSON ELECTRIC (781) 444-6800 1.12 94"
PUMP DETAIL EXISTING SEPTIC TANK NOT IN GROUNDWATER 1.02 94"
FOR TESTHOLE #I, FOR TESTHOLE W2-.°
N.T.S. GROUNDWATER OBSERVED AT 92" EL 1.28 GROUNDWATER OBSERVED AT 90" EL. 1.35
MOTTLING OBSERVED AT 85' EL 1.87 MOTTLING OBSERVED AT 84" EL. 1.85
DOSING & STORAGE REQUIREMENTS
' ••AOJ GW BASED ON MOTTLING: EL 1.87•• ••ADJ GW BASED ON MOTTLING: EL. 1.85••
of Mqs DAILY FLOW: 330 GPD PROPOSED SEPTIC SYSTEM UPGRADE PLAN
`r9�, DOSING REQUIRED: 4 CYCLES/DAY (SAND)
o� 'R N M. 9� 330 - 4 = 82.5 GALLONS/CYCLE PUMP CHAMBER
I1 ` R DISTANCE REQUIRED BETWEEN PUMP PROPOSED PUMP CHAMBER NOT IN GROUNDWATER 37
MANOR DRIVE, OSTERVILLE,MA
441 o. 1140 "' ON AND PUMP OFF FLOATS:
82.5 GAL/CYCLE=-250 GAL/FT = 0.33 FT/CYCLE (4") Prepared for: Wanno
RfC/$TER�� STORAGE REQUIRED ABOVE WORKING LEVEL: 330 GALLONS System Design and Topography Plan by: SCALE DRAWN DATE
STORAGE PROVIDED: MEYER&SONS,INC. N.T.S. DMM 09/23/14
N I TAR�a� PO BOX 981
INV.(IN) EL:7.30 - ALARM ON EL: 5.13 =2.17' E4STSANDWICH,MA02537 REV. DATE CHECKED SHEET NO.
STORAGE PROVIDED = 2.17' X 250 GAL/FT 542.5 GALLONS 508-362--2922 DMM 2 Of 2