HomeMy WebLinkAbout0030 LANCES LANE - Health 30 Lance Lane
Marstons Mills ----
- -- A= -124-042-002
Town of Barnstable P#
Department of Regulatory Services
' Public Health Di 1�t MAE& vision Hate 3 ,Z
200 Main Street,Hyannis MA 02601 S
Date Scheduled
Time--t--�-� Fee,Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: C���� e-� Witnessed
LOCATION& GENERAL INFORMATION
Location Address f Owner's Name �v
�@ir(7�Yjt1S iJ('�C Address 3� G1vl-t�s'�-vl M
Assessor's Map/Parcel: Z LJ —B 2 — dQ. Engineer's Name
NEW CONSTRUCTION REPAIR _ Telephone# 7 �� `-7 C
Land Use �S � Slopes(%) Surface Stones N
Distances from: Open Water Body 3� ft Possible Wet Areal 3 ft Drinking Water Well7t ft
Drainage Way N l4 ft Property Line r d ft Other. ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
- � 1
U
cc
/e i �
ta? � C, L`t off.
tea..
t�
0-
CParent material-(geologic) Depth to Bedrock
k E"W
,Depth to Groundwater. Standing Water in Hole: J Weeping from Pit Pace
'Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ,- -..ft. _
'Index Well# Reading Date: Index Well level a Adj.factor— Adj.droundwaterLevel,
PERCOLATION TEST bate, Tlme,�
Observation
Hole# Time at 911
Depth of Pere Time at 6" to• I
i
Start Pre-soak Time @ 18' 1Z q 75me(9"-6")
End Pre-soak l 0 ,Z/ & A
Rate Min./Inch Mt !i kc
Site Suitability Assessment: Site Passed _ Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conservation Division at least one (1) week prior to beginning.
Q:\SEPTICTERCFORM.DOC
.a a
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling '(Structure,Stones;Boulders.
Consistency, Gravel)
0
. .
L
6—13k e-Z M-c Sot" 7 r-Y 7/
DEEP OBSERVATION HOLE LOG Hole# �--
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
Ft_,
/Z- /9 A s L l0 y���Z
101Yar/r
t 0.112. �/y
-M=C SctvkC4 2,i5-Y713
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other.
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, Gravel)
---------------
DEEP OBSERVATION HOLE LOG Hole#
Depth from. Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders.
Consis oncy,
Flood Insurance Rate Man:
'Above 500 year flood boundary No Yes x__
Within 500 year boundary No Yes
Within 100 year flood boundary No A Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious 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 _ , (date)I have passed-the soil evaluator examinafion approve4.by the ;
Department of Environmental Protection and that the above analysis was performed by me consistent with t .
the required training,expertise and experience described in 310 C1vIR 15.017: z
Signature Date Z f Z
Q:\SSPTICVERCFORM.DOC
TOWN OF BARNSTABLE
LOCATION ,�Q (—aN C0 S Cam SEWAGE
`VILLAGE ffin.(V�,t (lS ASS/ESSOR'$MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY /00 0 � s z 14i i
LEACHING FACILITY:.(type) �4- ./ s�'.3(n/� /yZo (size) /ls 4r i
NO.OF BEDROOMS
OWNER ?L1,At�
PERMIT DATE: r7 1e 2.,bt I COMPLIANCE DATE: Ze I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility IVO> l( Feet
Private Water Supply.Well and Leaching Facility(If any wells exist on /
site or within 200 feet of leaching facility) F /t Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility)/ Feet
FURNISHED BY (�/.1��fcJ6�GlR �� Q✓L�3 f✓LC
t
A
x
Az -Ag,
S(O.a
�I 30.o
6Z 3c��
. 3�1
Town of Barnstable P# l v - q
Departiment of Regulatory Services i , ��� F Public Health Division Date ko/v
ea aw
i63A A�� 200 Main Street,Hyannis MA 02601
f0 FAKE l
Date Scheduled �/ O p,
Time Fee Pd. �v e�
Soil Suitability Assessment for Sewage Disposal _
Performed By: (tc�+lae l AqIeAW . E l 1. C Se- Witnessed By:
LOCATION&GENERAL INFORMATION
Location Address 3 a r,4�1c2 Owner's Name
S L�vt� 13-1 Pr�P1 h
S` Address
. 3 ° Lu�G•�S
Assessor's Map/Parcel: Iq/ Engineer's Name C4(2e.-)Z L gy p,`.%-e-1 3G �t,eer[n�
NEW CONSTRUCTION REPAIR Telephone# S-D S-1-t LZ 28 508-273-0 37
Land Use• &Y4e F�i!x c(WCA 4 a Slopes(96) 0 ( Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well 7150
ft
Drainage Way ft Property Line Other
ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands•fn proximity to holes)
Parent material(geologic) Dl1aS�l Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: _ Weeping from Pit Face
e
Estimated Seasonal High Groundwater 7 i -5
DETERMNATION FOR SEASONAL'HIGH WATER TABLE
Method Used: Dt[ecE &5efdct6ov1
Depth Observed standingin obs.hole: 1?a
In. Depth to Boll mottles:
Depth to weeping from side of obs.hole: —in, Groundwater Adjustment � fr.
Index Well# - Reading Date: Index WeII level ter, Adj.t�lCttlr, ,y�_ ,��,gryutldwatet Level
PERCOLATION TEST Dstp &-30-1 ate /o AH
Observation
Hole# Time at 4"
Depth of Perc 3(,•' 3 y ' Time At 6"
Start Pre-soak Time @ /o%a 6 AN - lime(9"•6") _
End Pre-soak I b•:/b A 41
Rate Minllnch G 2-
Site Suitability Assessment: Site Passed ti'e S Site Failed: - Additional Testing Needed(Y/N) All
Original: Public Health Division Observation Hole Data To Be Completed on Back----- ---
***If percolation test is to be conducted within 100' of wetland,you must first notify,the.
Barnstable Conseirvation Division at least one(1) week prior to beginning.
QASEPTICIPERCFORM.DOC
DEEP-OBSERVATION HOLE LOG Hole#=Depth from Soil Horizon Soil Texture .Sdil Color Soil
Surface(in.) (USDA) (Munsell) Mottlln Other
g (Stnucture,Stones;Boulders.
oistencv 96'Orav n
�f O- 2
A L.5 /Dir 3/1 ^ .
jUir -
36 lZO G rt-G S �. Y�l� S% �rave.I
(in.)
OBSERVATION HOLE LOG Hole# 2 Depth . Sail Horizon - Soil Texture Soil Color Soil Surface(in.) _ (USDA) Other
(Munsell) Mottling (Structure,Stones,Boulders.
onsi en ��.m.e
2 A . S /oYr 3/1 —
-3h 6 I- S IUYr S.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil
Surface(in.) (USDA) Other
(Munsell) Mottling (Structure,Stones,Boulders.
1t
DEEP OBSERVATION HOLE LOG Hole#
Depth from .Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
• ons ten '
3
Flood Insurance Rate Man: `
Above 500 year flood boundary No— Yes-__
Within 500 year boundary No—Z, Yes
Within 100 year flood boundary No G"' Yes.,�,,,,_
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? y e-5
If.not,what is the depth of naturally occurring pervious matorial?
� i
Certification .
I certify that on !D'l y-9 (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 training,expertise and ex ience described in 10 CMR 15.017.
Signature Date -7" 1-0
QAREP`1I0PERCFORM.DOC
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS' Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
21pplitation for 33ispo8a.Y 6pstem ConStructiun Permit
Application for a Permit to Construct( ) Repair(✓� Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3r.C, Owner's Name,,Addresss,and Tel.No.
Assessor's ap/Parcel I Z — ^ O 2 �a QQ 5 ` �9_ � M
Installer's Name,Address,and Tel.No. TW VZP YGa� Designer's Name,Address,and Tel.No. 8 a 79 0 3 7
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size � 00 sq.ft. Garbage Grinder( )
Other Type of Building (2_Q*S No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided gpd
Plan Date 7— 9 — Number of sheets Revision Date
Title
Size of Septic Tank 1060 1.1 Type of S.A.S._ a?U Are 3 Co/&
Description of Soil n—c W 3(" "
� ld�
Nature of Repairs or A-lterations(Answer when applicable) qW4. `Ibb K,
Date last inspected: t C
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 Healt
S' ned Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. // Date Issued
No. Fee
THE COMMONWEALTH OF MASSACHU E Ti S` Entered in computer: Yes
PUBLIC HEALTH DtVIC1 N=-TOWN OF BARNSTABLE, MASSACHUSETTS
i
01pplication for Misposal *p'strm Construction Permit
s
Application for a Permit to Construct( ) Repair(,,)- Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3p (�n e,S en ¢ Owner's Name,Address,and Tel.No.
Assessor's ap/P cel
Installer's Name,Address,and Tel.No. jod, yz P y 6,,z? Designer's Name,Address,and Tel.No. 5o$ ?; o >7
Type of Building: _ L
Dwelling No-of Bedrooms 3 Lot Size F?,00 sq.ft. Garbage Grinder( )
i
Other Type of Building f2 G t No.of Persons Showe Is( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33 y gpd Design flow provided j5 S . a / gpd
.MKty,
Plan Date :2 — 9 — / / Number of sheets Revision Date
Title
Size of Septic Tank /00r) / s', ¢�,�j Type of S.A.S. j G 44„ &/ f
Description of Soil
i
Nature of Repairs or Alterations(Answer when applicable) t✓ S 1 1 r t- A
F{
Date last inspected: 7,0(1
Agreement: W
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
S' a Date -z40
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance �
f THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(v,) Upgraded( )
Abandoned( )bye., C'c i... � �i, �Tr i
j, at �!� has been constructed in accordance
�
with the provisions of Title 5 and the for Disposal System Construction Permit No.2 / -- at
ed
Installer �� 5�/�� DesignerI 4,g e, '
#bedrooms ? / Approved design flow 2Tr 2 gpd
The issuance of this permit shall not be onstrued as a guarantee that the syste ill fun sa ed.
Date Inspector
T
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstrm Construction j9ermit
Permission is hereby granted to Construct( ) Repair( t.4/ Upgrade( ) Abandon( )
System located at �, l,��, / �e , l/J
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 omplet d within three years of the date of this permit.
Date �� Approved
i
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
• sAnxRrABL& Public Health Division
MA69.
&DSO•
r� • 'Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508.962-4644 Fax: 508-790-6304
bate: $-►� (� Sewage Permit# Assessor's Map/i'arcel`. Azy/ 12-02
Installer&Designer Certification Form
Designer: �YG E0stoee(r,nS, Tor, Installer: CaCeLc(& 61Ferer(sLs, LtLG
Address: 285y Cc22, ecry Ij�Htu!y Address:
East wore �+rn H A 02�38
On was issued a permit to irstall a
date
(i
nstaller)
er
septic system at 3o G an ces GQd e_ based on a desibr drawn by
(address)
3G &),gineec(nc) , rL iG. dated 5ii 9 , Zot1
(designer).
I certify that the septic system referenced above was installed substanl;ally according to
the design, which may include minor approved changes such as latera:•relocation of.the
distribution box and/or septic tank. Stripout (if required) was inspc:;.ted and the soils
were found satisfactory.
1 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 Regulation;,. Plan revision or
certified as-built by designer to follow. Stripout (if req °" nsrI cted and the soils
e e Found satisfactory. I„OFVAk c
b
^��.
c CHL'nC"•I•!L
Lj JR.
nstaller's Signature))
No 41507
9 esigner s Signatur (Affix esis le s ' lip; Here)
PLEASE RETURN O BARNSTABLE PUBLIC HEALTH DIVISION. :CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS +`.)RM AND AS-`-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEA:-,CH DIVISION.
THANK YOU.
N Ibnn.duc
rt
L00/1.00 'd P860tt L960ELZBOS 8E:ZZ LLOZ/60/8
LOCATION! ! SEWAGE PERMIT NO.
ViLLAGE so
I— -/ -e
IN�SL IER'S NA ADDRESS �
d U LL DI E R 0R OWN ER * ��
0
ob-
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
2 wee ,vKs
cN \
yF'fr O N \
tit
i
1
� o -.....-_._........ � ............
-THE COMMONWEALTH OF MASSACHYSETTS
BOARD OF HEALTH
......................t....::•..............O F.........................---............---..-----------•.---.............................
Appliration for Ui"viial Morks Tonarnrtion ranfit
Application is hereby made for a Permit to Construct o� or Repair ( ) an Individual Sewage Disposal
System at
30 L APJ LL LAND jay-btloZ - eat
.....---•-----------------------••-•--•-•-----...._..........--------••••••-•--•......_••••••...-•t •-•-••-•-._...--•-•-•••---•---•---••••-•--••-••••••----.....--•••-....._....................•••...
Location-Address r�22 or Lot No.
..�101�11N4�_.1.:1.:S NK ..At�Q..► 9H!?A�JSZ:ps ..� ................•----..................----•-••------....--•------.....••••--.........____._...._.
Owner Address
afl.fl� r .---- •---------------------------------- -------------.._..........
Instalrer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms........2.................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons..................--....---. Showers ( ) — Cafeteria ( )
a'' Other fixtures ------------------------------------•-----.....
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
W Septic Tank—Liquid capacity..--........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 ( ) Dosing tank ( )
► Percolation Test Results Performed by.......................................................................... Date........................................
a4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......--................
G� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................---.
----------------------------------------------•------...............---..._......••--....._.._..•.-•-•-•-•••-•-•-......-••--••---•.....-•••-•••---•--•_...--
0 Description of Soil-------------------------------------------- ------------------------------------------------------------------------------•-----•--•---....-•-•-•--•._...........---
x
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 Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance by oar o
Sign •-- --- ------------------ - ..........
Application Approved B .. . �- ........ -•--•.................•------_............................-••----•-•--•• !�.�
- ----------------•------
Date
Application Disapprove for he following reasons----------------------------•------------------------------------------------......-•-••-•-=--••--••--•-••--••--
...............•---•----•............-••-.............-•-•-•--------.....-•••-•---•-•••---....----••...•------•-•-•----.....----...------•--•---•---••------------•-...• •-•••--•-------...••-..__...__
Date
PermitNo....................................................... Issued_.......................................................
Date
-- - - -- --- -------- - -- ��_�------------ - -- --- L..r�
f _
04
o.//.��.. ...' � _. FEs..............................
,THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................... .....................OF.........................................._...........
Ap ira#iun for Uiipuiittl Works Tomitrurtion Urrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage-Disposal
System at:
............................ ;.....
..... ---•....
Location-Address �E or Lot No. f
......................_.---.....---.....................--•---.............................._.... .....................•...................... •••---•...-•--••.............................
W Owner J Address
.................................•-....•••-••. •---... ...._ ...-•--- --- !
Installer {• `' ;"L "+ f Address
UType of Building x r Size Lot.............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder )
Other—Type T e of Building No. of persons............................ Showers
P.I YP g ------------------•-------•• P ( ) — Cafeterias ( )
al Other fixtures -------------------------------- •
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............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 ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................
1:4 ----
------------------------------
------
---...............
-......
-----------
-....
---------------
-...
....
.-..-----•------------------
•-...
••...
.-••••-••...•--
0 Description of Soil........................................................................................................................................................................
x
U ----------------•-------------••----•----...--•--------------•----------------•-----•------------•-•--------•---•------------------•--•-•----••-••-•----------......_........---••••-•-...--•-••........
w
M. 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 T I T U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of Health.
Signo==------•--•....................•-•--------........-•----•--•-•--•---......------
Application Approved B 4".it.L--•....................•---•--•-•----...-------•--••-•-•-•-•---...... ...
Date
Application Disapprove .for he following reasons----------------------------•----•---------------------....----•----------------...--------..._............-•--
... ---•............................•--•....._..............--••-----•--...........................••.....---•-----.....------... ..........••.
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.....................................................................................
Trrtif iratr of faoutpliatta
TH•`I '"CERTIFY, That the Individual Sewage Di o System constructed ( or Repaired ( )
by... ;"� ^.....--�..... '`..... �. -••----•..•...... --e-..-••--• -------------••-•-----------•--••--•-------------------------------•--•----•---..--•-------
f Installer
at.. f._ , /.,knee.
e_ . ...............^........- s�_........_.._..__._•-•--•----------•----••--'---•-••---••-------•_.._............._.........._............._ r..------•----••-
has been installed in accordance with the provisions of TIT, 5 of The State Sanitary Code a.,do�s gibed in the
application for Disposal Works Construction Permit No. ....."�'�._/` ?............... dated'.zf, �`` .
...............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
o
DATE...................................... �� ............ Inspector.......
�`== ......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....................O F............----........... ....
...................... FEE—)
Diu laku 24-TPermission
ishereby—grant - - -� ••-• ..............................................
to Construct ` '�
p 'r (� n Individuals. gage Disposal System
G�
Street
as shown on the application for Disposal Works Construction Per rt^No!................... Dated..........................................
s-- ......................
-
Board of Health
DATE..................................................•------•------.............. ,r
FORM 1255 A. M. SULKIN, INC., BOSTON
• TOP OF FOUNDATION s'
CONCRETE.COVER c
y o;� CONCRETE COVERS -
e:o .4'-CAST IRON'.12"MAX. r.
PLPE,.(OR 12"MAX. •
EQUIV)-.MIN° f 4°ORANGEBURG(OR EQUIV.)
PIPE:- MIN. .
PITCH 1/4,,PER. LEACH
.PITCH `I/4"PER.FT,
o.o PIT 'PRECAST
o' NVERT • a �EACHING
EL,,48t2b INVERT INVERT , P - R PIT'O.R•
SEPTIC TANK: DIIST. w '4 , EQUIV.
o INVERT E 77 HON E q7,S.. '.' _ d
L �!7 L
/.QO,D.. GAL`. INVERT • INVERT .,.
EL}7.d ww p• '• 3/4'T01.1/2
•''° _ EL..4'7 a LL� �: WASHED
STONE
/O41,4
' 01Ar
: PROFILE' OF GROUND-WATER,TABLE
_ SEWAGE. :-DISPOSAL.' SYSTEM
'. NO SCALE ' .
'SOILLOG WITNESSED BY :
DATE ,. //;/A/r9,3:. TIME. <.3.4Arr1_ ' A '� ��: 4 'T BOARD OF,'HEALTH.
TEST HOLE I TEST HOLE 2 .�S"�,eT�t'c ✓_. <1 '//.rJLC� ENGINEER
w
DESIGN DATA
1. NUMBER OF BEDROOMS Z: . . . .
Caw,4E TOTAL ESTIMATED FLOW ?2Q . GALLONS/DAY
r �5-.givp BOTTOM LEACHING AREA ?8...5:SQ.FT. /PIT
SIDE LEACHING AREA .'. . . !86.„$ . SQ.FT./ IT.
D' GARBAGE DISPOSAL . .. :NP. .(50% AREA INCREASE:)
>. Cn,e'�SE TOTAL LEACHING AREA . . 6:? SO.FT
n//pp PERCOLATION. RATE : . . . . :4 .. MIN/INCH
LEACHING AREA PER PERCOLATION RATE . �t'9aZSQ.FT.G>16
.!YOWATER ENCOUNTERED
NUMBER OF LEACHING PITS
APPROVED . . . . BOARD, OF HEALTH �'✓ir/.�. 2.".PF.�r�C�r✓F , On! �LL.s��� . . .
� DATE.. . . . . . . . . . . . . . . . . . . . 3
` AGENT OR INSPECTOR
OF ly�As
S SO
LOTS HAL
. o.5 ti
/STS
Nlr �,n .
' PETITIONER :
i
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w
n�( r
L O \ --
Z /.966 ACRES' ' ELS�S
i0o� 4j i 4rYrrjUC
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' 6L�/. 77'
V4sr .$Ox_. v 1
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_ 7a.57r /OOD GRL
NG+Lv _ ,�` .sCOTit isli✓� ��`�O��`I
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S I T E PLAN • fY .a-o, s f ��
6s ` o.
L.00,97-/4N: /YIfJRSTOn/1 /✓14,4%' /7 7.q EC 49.0 I. o
• FG Sp.•zS
PLAn/ REiEREn/CE.' gEiw Lo T r/9 ~- ,. .- B2 .0.4 Qv w6L L_
t-$y./Qr.✓n/ C>n/ /7 PL,�i✓ OF L;nn/p Fpt? -
L/Jn�CE A. /YIA�E/✓ER/✓E�' AN!-� ��CO,PdE� ��p�ZH OF P:)q � ,. �J,F,q�.�14 Of Rs�J^ , cc so.7'
/✓OTc: - 6LE✓/�j iC i+LS" Ei 'f p Oi✓ /Ji✓ �p� ti /gip �O
ARD
ED
36/ YJ
ET g E. Ex iST n�G !•✓ELL
R. y v ELLE •
No 5 61� h ELf✓, T o D� SELL n1w,✓G
C/STS flio,
! �G/STEA
q �%
SWARM E
T.O.F. EL.= 60.6'± 'INISH GRADE OVER D-BOX= 58.8' 4"SCHEDULE 40 PVC MIN. SLOPE 1 % FINISHED GRADE:OVER BIODIFFUSERS= 58,4' - 58,7' GENERAL NOTES
PROVIDE EXTENSION RISER SLOPE @ 2%MINI.
WITH COVER OVER INLET& REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH ACCESS BOX TO WITHIN 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISH GRADE OUTLET TO WITHIN 6"OF F.G. RISER TO WITHIN 6"OF FINISHED GRADE 3"OF F.G. (ONE PER ROW) METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
@ FND. EL.= 59•8± F.G. OVER TANK EL. = 59,2± 5"DIA. OUTLET(S)
CODE AND ANY APPLICABLE LOCAL RULES.
} 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER.
PROPOSED 4" 9"MIN. 9"MIN.
/B.O. = 55.73' 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
EXISTING 4" PVC SEWER PIPE 36"MAX. 36"MAX. TOP OF SAS
SEWER PIPE
SYSTEM UNLESS OTHERWISE NOTED.
61 3" 3"DROP MAX 9„ _ � PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
2 DROP MIN ----
3 MIN.SLOPE 01°r6 L" 4 -+ JOINTS (TYP.) ELEVATION =55.73' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
10" 4 PVC IN FROM 1.33 16" 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
14" \*56,5'± a SEPTIC TANK 4"PVC OUT TO 0. of (TYP.) 10.7j7(TYP THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
CONTRACTOR TO PROVIDE . LEACHING FACILITY )
SPECIFIED DROP BETWEEN � 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL 12" 6" , 55,30' --54.40' laid flat 2,$75'(34. ")---I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 55.67 MIN. 55.50 (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
AND CONDITION OF EXISTING TEES 5.01 FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
GAS BAFFLE 6"CRUSHED STONE (TYP.) 5'MIN. 11.5'
EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY REQ'D NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
TANK NECESSARY COMPACTED BASE
25.0' AND DESIGN ENGINEER.
5 OUTLET DISTRIBUTION BOX (TYP-) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 60.09 ESTABLISHED
TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 48.30' BIODIFFUSERS (END VIEW) ON A NAIL SET IN AN OAK TREE AS SHOWN ON PLAN. j
BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
EXISTING 1,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. BIODIFFUSERS (PROFILE) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT I
(BY ADVANCED DRAINAGE SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
SEPTIC TANK PROFILE cRoss SECTION vlEw
*CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR S DISTRIBUTION BOX DETAIL ARC 36HC (#3616BD) BIODIFFUSERS (H-20) TO THE DESIGN ENGINEER.
10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT.
TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE �+ �
TEST PIT DATA 11 REGULATIONS.TOWNER/APPLICANT IS O OBTAIN SUCH DETERMINATION FROMNING
* APPROPRIATE AUTHORITY.
f' R
MAP 124 r . PERC No. 1334
PARCEL 17 07 �� + INSPECTOR: Donald Desmarais,R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
4' LOCATED UNDER PAVEMENT DRIVES OR TRAVELED WAYS IN WHICH CASE
EVALUATOR: Michael Pimentel E.I.T.
` THEY SHALL WITHSTAND H-20 LOADING.
PROPOSED INSPECTION PORT �1°�� �1` C.S.E.APPROVAL DATE: Oct. 1999
WITH ACCESS BOX(TYP OF 4) June 30,2011 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
DATE
NHESP 2008 PRIORITY HABITATS OF „#ZONE 2
1
PROPOSED TOTAL 20 ARC 36HC(#3616BD) �0 58xT RARE SPECIES AND ALSO ESTIMATED---, . ._. !t TEST PIT# 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
BIODIFFUSERS H-20 IN A FIELD CONFIGURATION \ HABITATS OF RARE WILDLIFE ' + MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
( ) ELEV TOP= 58.30
\ �' .�r, REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
\S f3y� f ELEV WATER= <48.30' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
LOCUS
15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
PROPOSED DISTRIBUTION BOX N ! PERC RATE_ <2,min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
_ " „
58x5' DEPTH OF PERC- 36 - 16. PROPOSED PROJECT IS LOCATED WITHIN:
a EXISTING LEACHING PIT(approx. loc.)TO BE PUMPED, TP 1 TP 2 a �s� �' TEXTURAL CLASS: 1 ASSESSOR'S MAP 124 PARCEL 42-02
FILLED WITH CLEAN COARSE SAND &ABANDONED 5g ! 150` �� • `` &2- 3fl \ -_^ - *° 1 j', '` �t P
Icl f *� OWNER OF RECORD: BOHDAN R. &DONNA M. PRYPIN
CIDass` �' 58.3 `✓ pp 124,PA - =' // Qi3 % it"8 a rry 0„
ADDRESS: 30 LANCES LANE
d y NHESP 2008 PRIORITY HABITATS OF a S Litter 58 30� MARSTONS MILLS, MA 02648
1 / XIST. D-BOX TO BE ABANDONED RARE SPECIES AND ALSO ESTIMATED` I'P ••�► Q ti 2" 58.13
LP a . II q� A Loamy Sand
MAP 124 / / i HABITATS OF RARE WILDLIFE , 6" 57.$0'
(APPROX. LINE) ,, 10Yr 3/1
FEMA FLOOD ZONE C
PARCEL 17-08 \ ; ,� ' Loamy Sand COMMUNITY PANEL# 250001 0015 C
F, \
� 58x5' II r , „ � B
Sg TREE (TYP) h 1 10Yr 5/6
51 \ t" 17. DEED REFERENCE: BOOK 5112 PAGE 2
LSA EXIST. 1,000 GALLON SEPTIC TANK 1 36" -� 55.30' 1
18. PLAN REFERENCE: P.B.361, PG. 11
o TO BE UTILIZED IN THIS DESIGN # Perc ,
54" 53.80' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
;>
\ \ °' p___ ZONE 2 r-�: 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
--�, _ Med.to Coa rse Sand FOR SEPTIC SYSTEM UPGRADE.---JG ENGINEERING WILL NOT ASSUME ANY LIABILITY
MAP 124 C 2.5Y 6/6
FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
( o
-,. ,-...� � -• ; £ ��. , �'� � `^� 5/o gravel) �
.� Benchmark PARCEL 42-02 p
\ #30 1.986±Acres \ . •
EXISTING Nail in Oak Tree
Elev. =60.00' •
3-BEDROOM LOCUS PLAN +
DWELLING Approx. M.S.L.
TOF -60.6'±
/ SCALE: 1"= 1000'
SHED 120" 48.30'
i f
l DRIVEWAY � / No Mottling,Weeping or Standing Observed '
DECK O, DECK DESIGN DATA TEST PIT DATA LEGEND
SWING-TIES SCALE: 1"=20' PERC NO. 13334
INSPECTOR: Donald Desmarais, R.S.
DESCRIPTION HC-1 HC-2 EVALUATOR: Michael Pimentel E.I.T. 50xO EXISTING SPOT GRADE
ks
� NUMBER OF BEDROOMS (DESIGN) 3 '• Oct. 1999 - - - -
f BIODIFFUSER CORNER(1) 61.5 71.7 C.S.E.APPROVAL DATE. 50 EXISTING CONTOUR
DESIGN FLOW 110 GAUDAY/BEDROOM
DATE: June 30,2011
BIODIFFUSER CORNER(2) 69.9' 83.0' TOTAL DESIGN FLOW 330 GAUDAY 2 50 PROPOSED SPOT GRADE
BIODIFFUSER CORNER 3 88.0' 90.3' o TEST PIT#:
I \ O DESIGN FLOW X 200 /o = 660 GAUDAY � 0 PROPOSED CONTOUR
ELEV TOP= 58.30'
�? ao BIODIFFUSER CORNER(4) 81.5 80.0 USE EXISTING 1,000 GALLON SEPTIC TANK <48.30' D/H/W EXISTING OVERHEAD UTILITIES
Q� ELEV WATER= �
PERC RATE= W W EXISTING WATER LINE
/ `� DEPTH OF PERC-
"� (3 INSTALL 20 -ARC 36HC (#3616BD) BIODIFFUSERS (H-210) TEST PIT LOCATION
EXIST. WELL TEXTURAL CLASS: 1
/ U.P.#824/2a j0%
EXISTING 1,000 GALLON SEPTIC TANK
SYSTEM CAPACITY
(2 4) (TOTAL L.F. OF BIOS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 0" 58.30' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE
MAP 124 (100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING/DAY " Litter ,
PARCEL 42-03 'Lys A Loamy Sand 5$.13 PROPOSED DISTRIBUTION BOX
6" 10Yr 311 57.80' j
TOTALS:
NUMBER OF BIODIFFUSERS: 20 g Loamy Sand 0 PROPOSED ARC 36HC(#3616BD)BIODIFFUSER(H-20)
TOTAL NUMBER OF COUPLINGS: 0 10Yr 5/6
TOTAL LEACHING AREA: 480.0
TOTAL LEACHING CAPACITY: 355.2 36" 55.30' REV DATE BY APP'D. DESCRIPTION
I O !
PROPOSED SEPTIC SYSTEM UPGRADE
N NOTE:. !
L=97.22' EXIST. WELL °' PREPARED FOR:
NOTES: EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE Med.to Coarse Sand
O R=52.50 DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LE17EIR C 2.5Y 6/6 CAPEWIDE ENTERPRISES
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO ADVANCIED (5%gravel)
SEPTIC SYSTEM COMPONENT. JANUARYE SYSTEMS,TRANSMNTTAL NUMBER OCTOBER 003(LAST W0 0052MODIFIED LOCATED AT
2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE
) LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA 3O LANCES LANE
PROPOSED C
SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF HiC-1 MARSTONS MILLS, MA 02648
SOILS ARE NOT CONSISTENT WITH TEST PIT DATA.
/ C-2 120 48.30'
SCALE: 1 INCH = 20 FT. DATE: JULY 9, 2011
3.) ENTIRE PROPERTY IS LOCATED WITHIN THE WELLHEAD PROTECTION OVERLAY 0 10 20 40 80 FEET
No Mottling,Weeping or Standing Observed
AVELL�D �`� DISTRICT AND THE ESTUARINE WATERSHED. EXISTING
p g g PL�n OF migssgc�
PREPARED BY:
MW
RESERVED FOR BOARD OF HEALTH USE JOHN JC ENGINEERING, INC.
_ ®Ge OF TRW 3-BEDROOM G
.�•t /-.-------- -' DWELLING � CHURCHILL JR.
�- TOF=60.6'± 41IL
8 2854 CRANBERRY HIGHWAY
\ o crsT N EAST WAREHAM, MA 02538
� � R 508.273.0377
'69 \ SITE PLAN
SCALE: 1 =20 DECK Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.2021