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HomeMy WebLinkAbout0065 FRAZIER WAY - Health 65 Frazier Way ;(a.k.a. 86) Marstons Mills CO' . .No. (� S Fee od THE COMMONWEALTH OF MASSACHI in computer: � SETTS Entered --� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABL c`, ASSACHUSETTS Yes N' Application for �Digpogal �§pgtem Con.gtruction Permit Application for a Permit to Construct( ) Repair(iJr Upgrade( ) Abandon( ) ❑.Complete System /individual Components Location Address or Lot No. V� ��e! �� Owner's Name, dre s,and Tel. o. o0.6 ,��n Feld 00 r`" Assessor's Map/Parcel �� Installer's Name,Address,and Tel.No Designer's Name,Address and Tel.No.. -771 Type of Building: Dwelling No.of Bedrooms Lot Size Ti sq. ft. Garbage Grinder (1114� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Z / Design Flow(min.req 'red �3P gpd Design flow provided �.f1 gpd Plan Date Number of sheets Revision Date Title S S/ 466 f�� Size of Septic Tank Type of S.A.S. ye_— Qdt� L� Description of Soil /eq 3�/( Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board ealth 01 ��� Z� Signed � Date Application Approved by Date 2 U' Application Disapproved by: Date for the following reasons Permit No. )0.09—A r Date Issued 2 t �7 �•I. A N. Fee Enter 100 t ed in ggmpute: HIU r v THE COMMONWEALTH OF MASSACSETTS - J w+ •• z PUBLIC HEALTH DIVISION' =ATOM h' OF BARNSTAOLE M_ ASSACHUSETTS. Yes application for Mi5po5al *pztem Con tructton Permit Application for a Permit to Construct O Repairt(/� Upgrade O Abandon O ❑Com lete S stems p y El Individual Components Location Address or Lot No./_9— �//7,re1 Owner's Name,Address,and Tel No. Assessors Map/Parcel 01)6 -010 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Bdr tolv) 7 7/-9 Type of Building: // Dwelling No.of Bedrooms �/� n Lot Size 17k ff71:� sq. ft. Garbage Grinder /�Other Type of Building ,0 No.of Persons Showers( ) Cafeteria'( ) Other Fixtures y, Design Flow(min.required) _ /� gpd Design flow provided gpd Plan Date un `/ Number of sheets Revision Date Title _f y r Size of.Septic Tanl� //>/7�s'/rl/� / �nra�' Type of S.A.S. �i t Description of Soil �- P Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board foo Health. Signed ^ "j X�_i��440 '�"�� Date Application Approved by' F, //i' U1 �(�7,> r/If Date L / 01 9 Application Disapproved by: v Date for the following reasons Permit No. `� d 0�1^a"! Date Issued Ll !2 f/ a ------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIF,rY,that the On-site.Sewage Disposarl System Constructed ( ) Repaired (' ) Upgraded ( ) Abandoned( )by / /� - // / K" ,5 _ at ��/�/./V� // 1 �/ y has been constructed-in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ?OUg�-Q 9 a dated � t Installer Designer #bedrooms 7 Approved design flow r +Q gpd The issuance of this permit shall not be construed as a guarantee that the system will u -Pon as designed: �l Date -�d - Inspector _ i + 1 V ~ ====--------_— .� -- Y No. --)no C1— /1�� Fee r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS =:Mt!5po.5a1 �potem Construction Permit Permission is hereby granted to Construct ( ) Repair ( 1/5""'Upgrade ( ) Abandon ( ) System located at C! / /�/ r 1 y 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: Construction must be completed within three years of the date of this permit. Date ( l �^� {/rl 67 Approved by �--'� r� ,_ 6r I TRANS. NO.: CITY/TOWN: APPLICANT: ADDRESS: DESIGN(FLOW: -3 3v gpd REVIEWED BY: DATE: Y N/A OK NO .St `. exilku+ai'�iill4T�' x ,..x } le. h' '• ? t. iw"X',ia. P�ir{Ji.°4�r trG)nl. Legal boundaries denoted [310 CNM 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 / CMR 15.220(4)(u)] ✓ Locus Provided [310 CMR 15.2204(t)] ✓ Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(f)] daily flow septic tank capacity(required and provided) soil absorption system(required and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)(g)] Existing and proposed contours [310 CMR 15.220(4)(g)] 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 CNM 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? [310 CMR 15.2421 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 CNM 15.220(4)(n)] Address Sheet 1 of 7 N/A OK NO Location of every water supply, public and private, [310 CMR v P 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 of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins O located within 50 ft. [310 CN1R 15.220(4)(1)] Water lines and other subsurface utilities located [310 CN1R 15.220(4)(m)] (if water line cross see 310 CN4R 15.211(1)[11) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)1 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)] F[310CNMR equate to demonstrate four feet of suitable material? 5.103(4)] dequate to confirm adequate groundwater separation? 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] Materials specifications noted? [various sections of 310 CMR 15.0001 System components not> 36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] Address �� �a i-I e Sheet 2 of 7 N/A OK NO ryT T�yy A J�1T 7Q�' ,I'll jj i MIAMI 11 AN, ja{ �yi MW WE q ` 1 .h 3 .T'fp• 'ir(lyR'l'lnr1r4 �F 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(1)] 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 described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two for systems>1000 gpd [310 CMR 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)] Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.2111 1dliilfi C�'omp�ar men >hanks f ;.011 Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] Address �� ��Z e� W Sheet 3 of 7 N/A OAK NO BTJILD Iefi lis 1ZAN OI�]EIE iP 11' x ` t'x" Located at least ten feet from any waterline? [310 CMR L15.222(2)] osal piping at least 1.8" below water line (when water and r cross, see 310 CMR 15.21l(1)[1]) nouts required/provided? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphon problem/ (leachfield below pump chamber) Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) ✓ DIS�RIBUT�ONB O�y,. �''�' Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CN M15.232(3)(c)] 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 pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed? Provided? [310 CMR 15.221(8)] Address !� J �7� Gam, Sheet 4 of 7 N/A OK NO Calculations correct? 4 feet of naturally occur ng material demonstrated? [310 CMR 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or / >36" deep) [310 CMR 15.241] . Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole (if>2000 gpd must be to grade) [310 CMR 15.253(2)] Aggregate 1'minimum- 4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)] Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] 100 feet -maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater (3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] Y 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)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] Bottom area used in calculations only [310 CMR 15.252(2)(i)] Address Frail Sheet 5 of 7 N/A ®K NO l )° Plyssure➢osed Systein ? Provided pump and piping ulations as required [310 CMR 15.220(4)(r)] ssure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless system -make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year (systems<2000 gpd) or quarterly (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fall -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall? [Guidance Document] Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] .. � . a E 12. Gr :ess ,bs.em 4P5�� a er Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface eri e is S s 00, I/ 'ova e e s: Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenal-ice agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance a arzce °� a Are the variances listed on the plan'! [310 CMR 15.220 (4)(q)] RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address �� ��Zd Sheet 6 of 7 N/A OK NO 'lVztrogen :Se�asitrv�e�Areas � � F ����,.:: Is the system in a Designated Nitrogen Sensitive Area (Zone 11 for a public supply well)? [310 CNM 15.214, 310 CMR 15.215 and 310 CNM 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CNM 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CNM 15 216(1)] r w fp Pumping to septic tank ? [ 310 CMR 15.229] Shared System [310 CNM 15.290] Address 6 F-rQ Z l C \ Sheet 7 of 7 Y , — Town of Barnstable P��4i�E P am® Regulatory Services Thomas F. Geiler, Director * EAMSrnBLE, x MASS. Public Health Division i639• �0 �En�aara' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form J Date: e//LJ/4f Sewage Permit# �� Q Assessor's lea \Parcel g p Designer: G 1/IA` r naslraller: 60pr A�J 6 rS� Address: �r� 1,— (1 Address: On l 1,'7 90r1, ��l was issued a permit to install a (date) (installer) septic system at �j l Z/ C wc-?'y based on a design drawn by (address) &UM 6� A1191, dated L/ (de igner) 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. 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. IN OF 41g8S9�y DANIELA. o (Installer ignature) OJALACIVIL Cn No.46502 GISTE �sS�ONAL 'N-. ) (Designer's Signature) (Affix Designer's Stamp Mere) PLEASE RETURN TO BARNST ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COrvWLIANCE ALL NOT BE ISSUED UNTIL BOTH TIUS FORTH AlelD AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc � WCr,> ® ,/ ON �48�� SEWAGE PERMIT NO. VILLAGE /IfF� F INSTA LLER'S NAME ADDRESS �B UILDER OR OWNER /l-,/lam b✓=�„ DATE PERMIT ISSUED z � � DAT E COMPLIANCE ISSUED /1 ��L �;��_is.� ���2 r ��� t `(�. �" J j� .�{_ .; ;;- `�� ��� ,� �� �: TOWN OF BARNSTABLE LOCATION SEWAGE VILLAGE,: ASSESSOR'S MAP&PARCEL 6 INSTALLER'S NAME&PHONE NO. dg!/j�t' �y�cf//�iGrrs� W 7' SEPTIC TANK CAPACITY��Oo C-� G�CU�snr LEACHING FACILITY:(type) f;y (size) !d` 11 NO.OF BEDROOMS 3 OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet. Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY �..G` � _ � i ., �96� �rG ,, �C�' �� 66 Fmc &p.......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH- ......... .? ..------..OF...................r.....:1. Appliratiou for Disposal Works Tonstrurtiun ramit Applica on,is her made for a Permit to Construct ((/�or Repair ( ) an Individual Sewage DisW�qs�al System at: 1 M _ MAR "� ............................................. 1.s � Location-Address or Lot No. ___.lam- ...... .C.�f?1 Z'-t ..............- ... ..... ...--------••-•- Owner Address Installer Address j QType of Building Size Lot... ' _�6('_..Sq. feet U Dwelling—No. of Bedrooms..............._....................Expansion Attic ( ) Garbage Grinder ( ) ►-+ Other—T e of Building No. of persons...............------------ Showers — Cafeteria P4 Other fixtures ............................ . w Design Flow........... .......................gallons per person periday." Total d41y flow............... ............gallons.. WSeptic Tank—Liquid capacity/OVCkallons Length... Diameter________________ Depth.._ :- " Disposal Trench—No. ........... ..... Width......-_............ Total Length.................... Total leaching area....................so. ft. Seepage Pit No---------/-------- ameter....../0_-jO._`_/Depth below inlet-... Total leaching area_-_15V_. VPt. Z Other Distribution box ( Dosing tank ( ) '-' Percolation Test Results Performed b ._.: _// Y Cc: = - Date �f��C P. ,aa Test Pit No. 1......d .....minutes per inch Depth of Test Pit.. .......... Depth to ground water.i4ffJeP.� Test Pit No. 2................minutes per inch Depth of Test Pit............>_...... Depth to ground water........................ a ......................•------------------------------••-••-...•..._... - Description of Soils �' i' ..... -� ��`fi ..........��--------------- .......................... ---------------------------------------- ------------------------------------------------------------------ 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 iIT1..L 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Co li ce has b en issued b the boar of h. Signe - . ------------- ••-•-•-----------..._.....- Daatf Application Approved Y .... _ -------------•-------•• -•----jl Lam/ Date Application Disapproved for t e following reasons-...............................................---------------•------------.....----------------......._.._.._ ------•----------------------------------------•=-•-•--••-----------------•-----•••..._..-----------••••----------------_-----•---------•------•--•-•-------•--------•................................. Date PermitNo.....••-•......--ram- -------.- � -•-•--------- Issued-....................................................... . ....------- Date .r No.6h- ".LQ10 Fps. .......... THE COMMONWEALTH OF MASSACHUSETTS i ,, � BOARD OF HEALTH .. -a. . ....OF............................................... ,✓i is ApplirFation for Disposal 10orkii Tomitrnrtion ramit _ Application is hereby made for a Permit to Construct ( Vor Repair ( ) an Individual Sewage Disposal System at: 7 to Location-Address or Lot No. a ,4:.W� Owner Address �` Installer.......... ........................................................... Address b U Type of Building Size Lot..... � .Sq. feet a Dwelling—No. of Bedrooms............... ...................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow............ ........................gallons per person per*ay. Total fd�i�y flow....._........... _..........gall s. WSeptic Tank—Liquid'capacity/�i` Qallons Length-__-t).'�?Width.._I- `���Diameter................ Depth__ C x Disposal Trench—No. .................... Width_.._.Pe----------- Total Length........... Total leaching area_._........_..__..s . ft. y� :� Seepage Pit No..........1.--_...... a meter....../�Q__l!_ Depth below inlet...... _ .... Total leaching area._5. z Other Distribution box ( Dosing t pk '—' Percolation Test Results Performed b ....... � iia/f.. • W Y .. . -••---• Date Test Pit No. I.....� /..._minutes per inch Depth of Test Pit-__- 2•......... Depth to ground water_- ��__. r14 Test Pit No. 2................minutes per inch Depth of Test Pit............_....... Depth to ground water........................ O Description of Soil. �"�°'_C.i f;,Srr��4...._&-':����--/f.....&S .....�... ..-.�................. 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Co Ilia ce has been�isue �sd by the boar Al .� Signed�' %' •� �1 --------------- AA -- Date Application Approved Y --- ................................................... ---•--- •-� Date Application Disapproved for the following reasons----------------•---•-----------------•-------------.....------...--•--------•----------•--•-•••--••---•-------•- ...-•-------------------------------------•----.....-----•--•-------------------••----.......-----...-----••-•-•-•---••....--•--•••••-• •-•--••-•---•-•-••••-•--••••••-•----•••---•••----••••---•----- Date Permit No.------........... .......13*13............ Issued. . ...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �/� ............OF...............Tntifirate of Tantp'litanre THIS IS TO CERTIFY,nT the, Individual Sewage Disposal System constructed (" ) or Repaired ( ) by ------------------------------------------------------------------------------------------------------------------------------------------•--_----- Installer at -�-------------•---•--a....Z..e=3--•--•..�G C` .............M ---------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code�as d scribed in the application for Disposal Works Construction Permit No.__.__.___�r.__._.!vd (2r � ----•----------. dated---....l.(- ---- --------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION $ATIAFACTORY. DATE......................... -... -- � ----------•------ Inspector................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �� .......................OF...... ....... 's.........---......................................No..... .....ly d FEE....... �i���a� 1 rk� �nn�trnrtirrn erntit Permissionis hereby granted.....~•---•.Z�. •.....-•-•---••---•-•---•••---••-•--•••-••-•••••---•-•••••-•••-•••-•--••••-•-•-•....•-••.........................•--• to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo................4-.=._J._.......Lp........... �yy� k,4 Street ge—,IvM i as shown on the application for Disposal Works Construction Permit o... Dated.._..!! ?��-- ................ �� --------------------------�----•--••• ......-----•----••••- "^ Board of Health DATE.----••... •.._.. •=.................................................... Tom. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS,, pe;( -lZ -� A T-ION S I W A C:E PEAMIT. N:Q: VI.tLAG- TA LLER"S NAME L ADDAESS 7�1 r .RAJ ILDE R QR -OWNER DATE PERMIT ISSUED DATE C0:14PLIANCE ISSUED �rj SYSTEM PROFILE MALL ARKED W COMPONENTS APE O BE NOTES (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 20" MIN. WATERTIGHT 1. DATUM IS ASSUMED ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE f 2" PEASTONE OR GEOTEXTILE 2. MUNICIPAL WATER IS EXISTINGTOP FOUND, EL r 70.2' FILTER FABRIC OVER STONE / R a \ 68.5' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. PF&CASrRISIOM �-� DESIGN4. LOADING R PROPOSED PRECAST 8" MIN. COVER BLOCKS OR UNITS TO BE AASHO H 2'0 Z67.1' 4"OSCH40 PVC MORTAR ALL PRECAST RISERS COMPONENTS H-105. PIPE JOINTS TO BE MADE WATERTIGHT.PIPES LEVEL 1ST 2 4 (�) INVS EL QJ Pie \0CUS A- ENDS SIDES NSTRUCTION DETAILS TO BE IN ACCORDANCE EXISTING " ,° ; °e:::` ° ' 'l .. ° e� T10"EE 1000 GAL H-10 TEE y * °°°°°°°° ®®®® ®®®® °°3goo;° ®®®® O ®�® ;og00000a WITH SEPTIC TANK** \�6579t ° ° ° ®®®®®®®®®®® o°o°� . ®®®®®®®®®®® 310 CMR 15.000 (TITLE V.) o 0 4 ° ° ° ° ° ° o > 0090, ° ®®®®®®®®®®® ° °� ®®®®�®®®®®® ; ° ° ° ° GAS BAFFLE: °°°°°°°°°°°° °°°°' °°°°°° °°o„o ° °_ cv ,°°°°°°°° ° °100000000° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND )°°°°°°°° ®®®®®®®®®®® s�Up; ®®®®®®I�®®I�® . O ° ODO O + + °°°°°°°° °°°°� °°°o°o°o EL. 61.5 NOT TO BE USED FOR LOT LINE STAKING OR ANY N, 4' LIQ. LEVEL (ACME OR EQUAL) ": 64.31 64.14 ° ° ° ° ° OTHER PURPOSE. A Boxter Neck R 0 3/4"-1-1/2" DOUBLE WASHED STONE LH-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. a DEPTH OF FLOW = 4 OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30.00' X 9.83 (2) UNITS REQUIRED TEE SIZES: 6" CRUSHED STONE OR MECHANICAL 9. COMPONENTS NOT TO BE BACKFlLLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF INLET DEPTH = 10" COMPACTION.COMPACTION. (15.221 [21) HEALTH AND PERMISSION OBTAINED FROM BOARD OUTLET DEPTH = 14.E 5.5 OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP MIN. CALLING DIGSAFE VERIFYING THE LOCATION2 OF ALL UNDERGROUND & NOT TO SCALE SCALE 1"=2000't ( 3.2 x SLOPE) ( 1 x SLOPE) 56.0' BOTTOM TH-2 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NO GROUNDWATER FOUND WORK. FOUNDATION EXIST. SEPTIC TANK 43' D' BOX 16, LEACHING ASSESSORS MAP 57 PARCEL 6 FACILITY 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE EXISTING 3 BR DWELLING; NO NEW CONSTRUCTION *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT PROPOSED LEACHING FACILITY. SITE IS WITHIN ESTUARINE PROTECTION DISTRICT & UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE -12. EXISTING LEACHING FACILITY SHALL BE PUMPED AP DISTRICT PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. AND REMOVED OR PUMPED AND FILLED WITH CLEAN LE G E N D .00 SAND. 99- EXISTING CONTOUR X 99•1 EXIST. SPOT ELEV. 99 PROPOSED CONTOUR (98.4] PROPOSED SPOT EL. TTH1} TEST HOLE (51 x 66.59 7.72 y SYSTEM DESIGN" Y x 65.36 HCF 2� SLOPE OF GROUND 188241 GARBAGE DISPOSER IS NOT ALLOWED c� UTILITY POLE 6 x 6 9 DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD .91 / o 68 - FIRE HYDRANT X 65.31 x 6 2 SHED x6 0 \\ 67.71 USE A 330 GPD DESIGN FLOW 67 26 N07L NOT ALL SYMBOLS MAY APPEAR IN DRAWING � .93 , x 6p.19 SEPTIC TANK: 330 GPD (2) = 660 " x 66.2 / X / LPIT x 68.54 RE-USE 1000 GAL. SEPTIC TANK** TEST HOLE LOGS x 64.38 TH1 BOX 118 7.36 BENCHMARK: USE TOP OF LEACHING: 49 x 68.7 FOUNDATION THIS AREA AT SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD ENGINEER: ARNE H. OJALA, PE 65 V66 1 / ' ST; ELEVATION 70.2' ��; 70.16 � 4.97 , o BOTTOM 30 x 9.83 (.74) = 218 GPD DONNA MIORANDI, RS 66 0 � 8.58 O WITNESS: 6, / TH2 ,l6 .10 TOTAL: 454 S.F. 336 GPD 68.96 DATE: APRIL 6, 2009 �` x 66.09 x 6 . 3 ' x 67.68 a PERC. RATE < 2 MIN/INCH �- x ExlsnlvG s7-� USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) = Z ' DECK DWELLING WITH 2.5' STONE AT SIDES, 4' AT ENDS CLASS I SOILS P# 12524 x 66.68 TOP FNDN. AND 5' BETWEEN UNITS � 'w 8.05 ELEV. = 70.2' ' " � ELEV. " n ELEV. LOT 10 1 - `O `n ,�' MA 0 67.3' 0 67.0' 26,966 SFt / �s.a3 ��.� s�.1o � s7.1a APPROVED DATE BOARD OF HEALTH A A i SL SL x 67.15 x\66. 9 1" 10YR 3/1 1" 10YR 3/1 �� \\ b28j 22 6 79 WATERLINE TITLE 5 SITE PLAN E E FS a �2�� PAVED 70 66 FS OF 2" 10YR 5/2 3" 10YR 5/2 6.96 DRIVE /V 65 FRAZIER WAY BW Bw 1 ��� MARSTONS MILLS SL SL 9�'66' _ " 2.5Y 5/6 ++ 2. s7.11 PREPARED FOR 32 64.s 34 5Y 5/6 64.2 CC)* BORTOLOTTI CONSTRUCTION/ 67.27 6.8Q92 HILDEBRANDT PM � 2009 C C UTILITY 66.83 APRIL 6, RISERS off 508-362-4541 MCS MCS NOFMgss9 �NOFrfq y fax 508-362-9880 DANIELA. cyG�� �o` DANIEL 9pyG�c� ELEC. 6 .34 65.37 downcope.com OJVIL o A down cope en ineerin inc. 2.5Y 6/6 2.5Y 6/6 � CIVIL N � OJALA N PAD � 8 8, 132" 56.3' 132" 56.0' No.a6502Q o No.4 P civil engineers Scale: 1"= 20' sr IST? �'� ssk°o land surveyors NO GROUNDWATER ENCOUNTERED -a"Zoc� L S 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., .L P .S. 64.71 YARMOUTHPORT MA 02675 0n_O 6 1 0 10 20 30 40 50 FEET e7 09-061.DWG(SBO) GENERA L IVO TES O a ��--�� =�� 2. PITCH A/.4, LINE-0 A rL1/N/MU1I't OF %8 lFT. C O U O (3 (1) G /)vZESS OTHERWISE SPEC/FIEO. V `���i _!/ Q (D O O O O (1) @ O C. 4LI, PIPES TO ANO /N THE SYSTEA4 S1-IA4,L 6E CAST IRON OR SCHEOU,LE 40 PVC. (D O O O 3 00 4. 444 SEPTIC TANKS, a/STR/BUT/ON BOXES, f J^ O O O O 0) @ 0 ' A.NO �.EACH/NG PITS SHA,GJC. 8E OES/GNED `q Q FOR h/--20 WHEE,G 4 OARING 5 WAWIV o (D (D (D O'OO O (D (a) O UN©ER PAYING. °a ® O © O ,5. REMOVE Akl, UNSU/TABk6' AfATER/A4, m o rn BENE,4 Thy TyE /NYEfr'T EL EYAT/ONS ,Z" 'ZO ,z" ,2" /O ,Z" C.A AN/TARY TEE l: O O O O OA HE PIFFI/s4RS FOR A R/STANCE OF ' 0 /d ANO BACKFILL W/TH CkAY-FREE CD O O0 (DO P a SANG ANP 6RAVEk 114V/NG A PERCOJGAT/ON TYPICAL D/STR/BIMON BOX RATE OF Z hf/NOTES PER INCH OR 4,655 ' `^-''- 6. THE T� BOARO OF HEAD.TH MUST NOT TO soxi-E �- TYP/CAC, ,GEgC�//NG P/T /VOTE= 01S7-1?19V776N BOX ANON GAS,. NOT TO 60,41-H BE NOT/F/EP WHEN THE SYSTEM/S NEAR 05SER04T/ON PITS REINFORCED SE'PT/C TANK BY C01YPkET✓ONANO PR101? TO BACffF/41./NG. TYP/C�4.�, /G� G.4�.. SEPTIC TANK' PERCO�AT/D/V RATE = 2 ►.� rJ !►.iG A�GfER/CAN 1mRFCAST OR EQUAL- 7 UN,(,ESS OTHERW/SE NOTED,A1L4 SY-5reAf NOT TO %5"I-E COMPONENT5 SHA,f„CJ BE /N,57-44LED IN OBSEF�'YATIONS BY- .Joy+�.t ��ot3; NOTE: TANKS !PE/NFORCEO THROUG//QUT ACCOri'OANCE" t�Y/TH T/T�JE Jt OF✓HESTAT� Pt-L-MOUTH BOAh'P OF HEALTH W/TH El-ECTR✓C PY6- ,PEO lkyM " `Y/TH Z4- %z" SANITARY CODE ANO ANY 4,OCA4, R4/4,9L3 ENG//VEER 12!►C t,d A.tc'.L7 $ 2't '. Jo EiIIBEOG�EO STEEk RODS /N TOP F 00TTOW WHICH 1Y.4 Y APP1L Y. OATS:l-�PE t t... �►, lg8�- Gam' / CONCRETE lS 000 f'S./. TEST. iVOTE.'ACCESS MA/V/-IOLFS TO SE,oT/C TANK _.8 c,� F,F� AND / EACH/NG P1T5 TO f3� BU/,C.T UP TD � E�„E-y= ad-+-a �,Z" Q�Lor✓ F/N�SN G,QAoJE. - F/N/SH GRAPE I FINISH GRAPE OVER TANK F/N H GRADE F/q/15f/ 0,2ADE OV,EJQ E,GEV. = EEC EY. - OYE "O'BOX J 32+�. 31+8 E�GEt! = 3 i+- LEACN/NG = /7- .r '/Bg %4"PEA5 TON E' \9 t7 °00 ©< G3� /NY Q N ,� J oo°o 0 o° o o° m $�a of 3l4`"�12 /Goo GA,C,. = OIST. BOX o ® O 0 O m °°0 00 CJQUSHED STONE CO C E?EE PTO BE,LEXC4 00 0 O m 44 f STABGE) $ - ,�� o ° l8x0O UO CD S ° -� EPTIC TANK P , k /NV= of 5 oa 8 BOT L_.O ( I I (T4 B ' �.EYE�, 3'TAB,CE) Env = 23+45 �--� 1! ,LEACHING PIT ( -0 AE ,LEVEL 4 5TAO4E) _ v A C ^v w NOT TO SCAt.JE . a y, ;Qj 2�� �` �-- SECT/ON PARCEL koT _ APP96SS LOT o f-�' � -- r` o f �. J .COINING ©1,57R/CT r400P H,4.ZARP ZONE G� T j c 1 � p- SE© LOC4TiON OF RPEZZING P fJ�'SIGN CR/TEh'/A PROPO �.EG'�"NG7 NU.rfBE'R of BEDROOMS ExiST coIYTOUR -- -- —e 'er SE!lY.4GE h/SPOS�.G cYT /l�I PERSdNs fE 1aLDi�'aUrN _ 'oRapourp cONT,04//? ROBERT '�' — 10 F24"t t3A�t. .ONtiS P'ER,FEJPSON PER RAY S 4'XIST. SPOT Ek47YAT/ON/ 6*0 r� E, 2 PROPOSED SI'DT E�(,EV4 ION 8�O .� ,C,Ei4C /ING Rf QU/Rt�G 33t� . -, �,.EAC"f!/NG f'I'�4V/L'�'!� �` ,� ��'Df'�'h"CO',L�4T/ON fi�€'ST ,-r r /' / . 4/C,4 7 : ENGINEER : 0,a'SERl/,4T✓o 4p �. N L0?,GrfI N-tc� O 4RROI�YENG/N ERING INC. aliN OF s � rr c C2O E �,44M,04YTH - t , _ S,Et�I''EREiS'IG14/ E. E. FQ�GOTi�/,r6l�.O53� R Y C t �, No,2 . - . � SG'A�GE: DATE v`'HEET 2 ,y /+, . JA\ear. . o rTo t� - `rr e a N E oc7. !� r OF t _.. As oT v TO TA 1. 5 .. t Y tr ORAYYN SY' jc#6nmp BY ARP©. BY: P�C,AN NO.