Loading...
HomeMy WebLinkAbout0325 OLDE HOMESTEAD DRIVE - Health b�iu- do°1- oCR l; I i rrnrn i m o W c o rN o al rq Z —� =29 z ae 1-4 rn f I i F c i �5 TOWN OF BARNSTABLE LOCATION 50 �� ve.s�c�'� ��'`�° SEWAGE # VILLAGE VAa c y -vas UA�5 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. -,-7�. 9L •5 0�+ 771 -3�,,7 SEPTIC TANK CAPACITY i ;600 Lc�,�l� LEACHING FACILITY:(type) � � ��'Z�� (size) (000 1,1((a�,f NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATE BUILDER OR OWNER DATE PERMIT ISSUED: bl Z�r 4f DATE COMPLIANCE ISSUED: G _ d Ale VARIANCE GRANTED: Yes No L/ C% C <s, N - e ` ''`'" Fps..............e............... Z THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 7d,60✓---...-.OF........ar9A.us7196L = Appliratioaa for Bi-qVooal Works Tomuur ion thrmit � Application is hereby made for a Permit to Construct ( ✓) or Repair ( ) an Individual Sewage Disposal ystem at: U ._.../3G--A---.-------------------------------------------•• - Location Address ... • ... . o ............................................. ...... No. _ M....__'e................•----••---•--- W Owner 9 --------------------- ---------------------Inst ---------------------•-------------•-------•- ...... 5 .----------------------------- '�' -Add_-__ress-_---------..._..._------------------ � nstaller d Type of Building Size Lot.._1i .....Sq. feet U Dwelling—No. of Bedrooms______________3___________________..____Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons____________________________ Showers ( ) — Cafeteria ( ) Q' Other fixtures __________________________________ W Design Flow________________________�'�5............gallons per person per day. Total daily flow.......... 30.........................gallons. $4 Septic Tank—Liquid capacity.AP..gallons Length. 7.2••.• Width................ Diameter________________ Depth................ Disposal Trench—No_____________________ Width__....7........... Total Length..... ___y�_.__ Total leaching area___....''_pp_._______sq. ft. Seepage Pit No__________ _____ __ Diameter........ ..... Depth below inlet...... Total leaching area_ 7_.......sq. ft. Z Other Distribution box Dosing tank ) ~' Percolation Test Results Performed b . ...._� � _____________________ .......... Test Y i Test Pit No. 1------z....minutes per inch Depth of Test Pit...... __._____ Depth to ground water_____ _____________ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water________________-__.___- ------------ ................................................................................_.......... O Description of Soil........l�-... �SolLf5C/l3SoiL GGell"-------------- -- ---------------------------------------------------- W -------------------------------------------------------------------•------------•-•••-••-•••-•••---•---•---•-•------------------•-••-•----•••...•-••----••------••-•••-••••-••---••---...••--_•••-•- VNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of p 15 of th to Sanitary Code— The undersigned further agrees not to place the system in operation hntil a ertificate of o Hance has been issued by the board of health. QQ Signed....... =( -e -•-•...........................•--•--•----_--•- ApplicationApproved BY....................................................................-•-.............. --•-- Date Application Disapproved for the following reasons:----••---------------------•--••--------------•---------------•--------------------------------•-----••••._..._ ...................................•................................................................................................................................................................... Date PermitNo.. .................. Issued....................................................... Date No................-....... Fizs........... .'. THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH ............ f G'f ...... --_:...OF.........5� ,...s!L._!` ........ :._..._... Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (I ) or Repair ( ) an Individual Sewage Disposal System at: •---- ......... ......... .............•---• --...--------.._............•---•-• ----•-•-•-••-----..__..._..---------------........------... Location-Address o Lot No ------------------------•- W s Owner 5 Address- ¢ r---r, a Insta,er Address Type of Building Size Lot..PM 3�......Sq. feet Dwelling—No. of Bedrooms............... .•.._.._..___.._..........Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building ... No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures .r_________________________ _ W Design Flow..........................'... ..........--_.gallons per person per day. Total daily flow__.......f `__.____._._......_____._..gallons. 1:4 Septic Tank—Liquid ca.pacity:j M...gallons Length.'5r e..... Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length..__...._ j�..... Total leaching area________ sq. ft. Seepage Pit No........./----_ __. Diameter.......�z_.._.. Depth-below inlet... 3.._...._ Total leaching areal.... q. s tt. z Other Distribution box ) Dosing tank ( ) '-' Percolation Test Results Performed b} 2c✓/G - �%���'`C. .�__�______________________ Date_>.��._-=Z• '� _.......___. Test Pit No. 1------ -____minutes per inch Depth of Test Pit.... --,--------- Depth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O G� 7�l�5vic./Svc c/Cc�} --------•--------------•.-----.............------------------------------.----- Description of Soil______________�__J_..____..._ M --------------------------------------�:: 1��-- /I�ED!���!1--=�lA/17-----/ IT = !?ik) L2.........................._-.................... W ••-•------------------------•------•--•----•----•••-•-....----------•---•----------•-•------•-•••-•------••••-•--•-----------•••----••••-••---••-••-•----------••-••-•••--••......----•---••---•-----•-- U Nature of Repairs or Alterations—Answer when applicable.._..........................................................:............................... ------------------------------------------------------•------•---•------------------.....-----......••--.....•--•--•-•-••-•-•--•--••---•••--••-•••-•---•-----•-•-••-•-•••--•-----------•-----------•-•-. Agreement: i The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i i t i= ,;of th to Sanitary Code—The undersigned further agrees not to place the system in operation ntii ertincate of fiance has been issued by the board of health. Signed ;✓_ f ------------------- ... ApplicationApproved By...............................:................................................................- Date Application Disapproved for the following reasons-............................................. ..................•-•-•••-------•--•-••••-••-•---...•-------------•------•-••---•-•-•---------...........••-•••••--•-•---••-----•-•---••-----•-----•--•-••-----••••------•---•-•-••••-••--•---•...•-••-- (,, Date PermitNo...........................L...�. �"---------. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CTrriifirate of ToutpliFanrr THIS IS 0 CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by........` `= - f t` ��------•-------------•- w Installer ; NI ...........................................................-......................... has been installed in accordance with the provisions of Tip. —j of The State Sanitary Code/as escr1 ed 'n the application for Disposal Forks Construction Permit No._...__ _�� _..__.1. 3�✓ � S V THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... ...... . ©.—. �S ........................ Inspector............... -D............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH !!%tv/t'/..........OF....... 4)X V ST;.16 as � _/........................... ............................ .....�..I--�10 FEE.__ 7 5--•--- Disposal Works Tonstratrtion rruti# Permission is hereby granted__.__ ::.`..�.._.....� �'.. ............................................................................................. to Construct (V)_or Repair ( ) an Individual Sewage D.'sposal System at \'o.- f� �? s,°>4'�74;19) 3/?. ,/t f),1 s7Clt=S 41/L.�-.5 Street / as shown on the application for Disposal Works Construction Permit No`` �� `�'lla e I, ---------------- _ � T ) ••-----• --------------- Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS �� • LEACHING QASIN SECT/ON NOT TO SCALE 24"C.I MH COVER EARTH FILL BRICK AND MORTAR COURSES AS REOD• To BRING 4„ i4 — COVER TO GRADE B FLOW LINE /PE T _L --.''y'' 2 y TO WASHED PEA STONE FREE.Of IRONS, T. FINES AND DUST IN PLACE II A OPENING W/TH 4%B" ''y . • • •' '/4 TO /%2"WASHED CRUSHED STONE FREE Of OUTER DIAMETER IRONS, FINES AND DUST /N PLACE • AND /3/q„INS/OE .'. DIAMETER • I. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 611x 6° NO. 6 GA. W.W.M. ' •' 3. 21 AND 41 SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS l MIN' �-60 (�� --� 4. NUMBER OF PITS REQUIRED EFFECTIVE DIAMETER NOTE: EXCAVATE TO ELEVATION OR (Nor ro ExcEED i TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED 'TO REMOVE ALL WArER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYP/CAL PROFILE, GRAVEL TO DESIGNED GRADE. /811 STO. IT WGT. C.I.MH COVER Z v E �9 4"C.l.PIPE 4"8/T.FIBER PIPE DWELLING FLOW LINE r/GNr JO/Nr OUTLET LEVEL p TO FIRST ✓O/NT — •,, 14 C.I. TEE 73, 1 10 1 0 0 1 1 " 1 11 000 00 1 1 11 7 D. PRECAST CONC. 7�f.O 1 1 1 1 0 O 00 1 1 1 1 GAL.SEPTIC TANK D/ST. BOX r0 BE 7�j,(� INSTALLED ON LEVEL, 1 1 1 100 00 0 1 1 1 111100 001,111 STABLE BASE 1 too O 0 1 1 1 1 \SEPTIC TANK TO BE I is p 0 O O 0 1 Is I , INSTALLED ON LEVEL, 1 if tool 0 0 1 It 1 ; STABLE BASE. 1 11 100 0 0 1 It 1 111100 001111 LEACH/NG BASIN 1 1( /pQ O 0 0 0 11 1 I BASE TO BE LEVEL 1 11100100 1 11 1 : C SOIL AND fir RC. DATA P S&o-f- 70•o PERC.RATE Z" MIN. /IN. 011 TEST PIT NO. I TEST PIT NO. 2 0 0 TEST BY: . �✓fZyC� (' L� 6► GSA -WITNESSED. BY TGM M G k-E�� A,{ DcUM p TEST PIT GR. EL. - 6 A<Q C) I DATE•.. 5 z3--�� ��` Ti2AzGra(ZAUEL N'D 1.✓,4 e •�.d . DFS/GN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. ' DISPOSAL- LJd SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL334E GPD. PRECAST REINFORCED CONCRETE UNITS. LGyp GAL. ALL SEPTIC TANK SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL 'AREAL" GAL./SQ•FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING REQUIREDSQ.FT.. ANY CHANGES TO 'THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH, Q.FT. .,. AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 'A" / FT, UNLESS INDICATED OTHERWISE. oF �sq , SEWAGE DISPOSAL SYSTEM o MARTIN BA Lf c3a MORAN H FOR h D v t✓D I IV (� G© 1P234171q�� - T yc-Dt Igo MC s�/A-C� PIZ I\/e a�o�SOIST ��► M A r s-FO A-f S AA �.L.S M ,� S`OlIA4 EN,�+(L V SCALE AS INDICATED DATE- 10 - ZS 8j::, 1 WM. M. WARW/CIY 8 ASSOC., INC. • 80X 80/ - NORTH FAL MOUTH PRZZFESS/ONAL ENO/NEER MASS. 02556 -. (6/7) 563-26.38 vo SITE l°L A N SHEETof z SCALE: l -40. Aa <1 Gr/1L-' G'lvao , I. PI T HZO f'hrcv/s /3679/ 5.1 N,�, O F 'bAssq�y 0 i G 1 ILL W AA ,r v WARWICK in r . Nn. 10771 ,o ��'�f�s�'�fCl$T���'SJ�4, • FOR1' J f REGISTERED LAND SURVEYOR L oT°�.orb� HraM��T�.4'D . DQ•�V� . 76N E M A GZ'S+1'UV 5 M ILLS , :MA PLAN REF,_ ft P �7 Pik tort` pEL l' DATE e& ` BENCH MARK DATUM__107Z ) M SL, ll C.2M WM: M. WARWICK B AS30C ; INC. DOMESTIC. WATER _SOURCE V2 W N WA-1 �� ^ . BOX 80/ - ' NOR TN fA:L MOUTH FLOOD ZONE. A L1�a �G MASS. 02556 - (6/1) 5'6. -.2638 .. t AIlllI,lCATlt)IJ VW: T1-:')T AM) 0IV*,l::IjVATW11 I1'IT.; L_c I,OCATION n J t fjo. E s- VILLAG ' DATE APPLICANT t."ty. FILE Won-refuzidabl�7 ADDRESS�ESS TELE-PlIONE' NO. / --I'll _3 TE'LEP110NE NO.ENGINELI? C�l- DATE SCHEDULED (nf5'plicnnL- s signatuj.L- ) s0l I LQG SUB-DIVISION NAME TA Q DAT L_ 1.:L M E HXPANSION AREA: YES V 1,W) �l , WAV-10101 i A_9k)c- ENGINEER 'DOWN WATER / PRIVATE Wl-:1,1, BOARD OF HEALTH 1 6,cz, EXCAVATOR SKETCH: (S Lreet namp, c,I dimensions of I o t: , exact location of Lest holes and percolation locate wetlawl:-, in proximity to test holes ) NOTES 11 PERCCLATION RATE* V IA }I I^ TEST HOLE 110: PLFWAT10[1 : TEST HOLE 1-10: ELEVATION : 2 2 5 5 6 fI 7 8 9 9 10 1 U 12 12 , 13 -- VU0 13 14 - ro Lk V)Plw 14 15 15 16 16 SUITABLE PO R SUB-SURFACI,; SIMAGE : LEACHIIIG FIELD LEACIUNG PITS LEACHING TRENCHES UNSUlTAIIIA: FOR SUB-SUI%'I`P\(..'E, SEMAGE . REASONS : 140TE : I-AjGIHF'E'.IUNG I'LAIP.; �IUST SHOW, 11UMBE'R AS:IGNED ON PE'RC TI-',ST APPLICATION F�17TRETY IlY 1 . V . 7\111) 1,177111"1171) 'Pn lin7\Pn (-)]:, IIT-.r\T.'Pfl COPY: RETAINED 13Y Al'ILlCANT No. ( WO — Fee O c.v` 'ke THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIpplication for Misposal *pstrm Construction 3pPrmit Application for a Permit to Construct( ) Repair( ) Upgrade(K Abandon( ) ❑Complete System Individual Components Location Address or Lot No.3 Z s O loa-e ka 0,WS$egj P Owner's Name,Address,and Tel.No. Assessor's Ma /Parcel5 eT ` rHes Sp 1 A "3zSQl Aa2 Sf e p crtiy -®®4-cc? NAM Mars-f-&o H- l(s MX QZA$r Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. M�LCe yi���.0 3S C���-tcn�' Lq K^Q �{2✓/t?cFn�e.2 �r+y i,�@.�n1..5,f1�s,�.1 MA 4Zc- .5ue_:5 , I-9S87 ci-� k Type of Building: .S Fr-9�7.7—S3( z�6y4 1)welling No of Bedromso Lot Size s ;.ft: Garbage Grinder( ' OtherShowers( } Type of Building es i kn4--�g( No.of Persons Showers( ) ) Other Fixtures Design Flow(min.required) gpd Design flow provided 77o gpd Plan . Date t+ 21 Number of sheets -7— Revision Date Title P��e �Pirc Sx���w� Upgcw-kk ('1��.F.:3ZS 8 f 1>! I"�w+s s Nhrl Size of Septic Tank 16-Q6 c ck l Type of S.A.S. '���41 VP X 3 k,3 t Description of Soil T�-1 0-49 Fcc '0.57 Yj° r q-L , FZ-J4q Cz'• 6i cc Ai,; LS 5:a-- y $.' F—L SLR �Y- iv q C r- Nature of Repairs or Alterations(Answer when applicable) JUkw D—T3a A o+%4 d SA s fl• (fqe a ci to H—Zee I.,in, I�-r143-c,s�J 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 t system in operation until a Certificate of Compliance has been issued by this Board of Healt �--- Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. t - ..�"""" s , Fee /0-0 k THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH:�DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application �ltl Dri for Mi8tlD8aY *p8tettt COTCBtCULtI01I Permit- Application for a Permit to Construct( ) Repair( ) Upgrade(A Abandon( .) ❑Complete System Individual Components ham* :: Location Address or Lot No..3 Z S" t9 id-e (-[a".s+kcid P, Owner's Name,�Address,and Tel.No. Ales Assessor'sMap/Parcel a q 4 -009 O© M:it 5, MA QZea'-(Y ' Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. � •/y�4e LS I3aor a 3S' mar�-c h-i- (.y��`E pefe�•Mc.�ntee ���g 2 nc-e�':.�cJ!/�ksr{� 6:: Puif MA ozc,3S- "95;E7 I tw Crxws_p`•�_{d gal Type of Building: - Dwelling No.of Bedrooms �3 Lot Size 19,34 sq.ft. Garbage Grinder( ) Other Type of Building �''e3, ck eO--g No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ' gpd Design flow provided L/ -70 gpd Plan Date III fs jZ! Number of sheets 'Z- Revision Date Title Preen s� St p t-,c 5ysi-gv- U ec%oA,_ o,. t�1c ti.,-3Z5- 6 S ,4- tAq 66-S - (tom Size of Septic Tank 16 Q e: Gj Type of S.A.S.Ark`c1d 1-7' X 31.3 ` Description of Soil T00-1 O-tf? Fu 4R-S'ZAIi l S , Z--8Z tg'F Ca 5t. { 2�--1 y t� Cz �-Z 4)-..r4 oci-cc Sy-"5,3 Ab. LS . 5 9y Iii'.F 4y- /99 Cz ' F- C...-5 ..i Nature of Repairs or Alterations(Answer when applicable) /Jkw D-13a aC .-cowl $A _';r ~ ti. ta�S o i` C 40ck L; -j-rq-�,of J 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 Signed Date •' Application Approved by 'f4 i�/1�1'ie ��..^� /' ; �� Date Application Disapproved by". �� �. Date for the following reasons a � Permit No. f� .f Date Issued � t THE COMMONWEALTH OF MASSACHUSETTS SE 1 _ 1e BARNSTABLE MASSACHUSETTS f 1 cQ13/.)I ertificate of Compliance ;THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(W Abandoned( )by at 32 s' 014 140me-s4eg Pam'/ u,�fm�.r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.._ .�q ( ated Installer Designer �. #bedrooms Approved design flown ^-3 gpd The issuance of this permit shall not be construed as a guarantee that the system will func io l as gdesigned. (� Date Inspector ` ��/ 1J ( T^ (z s No. ' .,� �.. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstrm Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(,A* Abandon( ) System located at 32,5 oIc,kk Morcae.51,cJl V�- ar 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 completed within three years of the date of this permit. �i11(,t,t dtt l Date Approved by _:yk�t( 9 v - 7 Town of Barnstable `NE'O` T Regulatory Services Richard V. Scali, Interim Director + BABNSTABLFo ' 16`9. � Public Health Division rFD1Ai`�' Thomas McKean,Director 200 Main Street;)Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Z �Slewage.Permit##, ` �� '�Assessor's Map\.Parcel 6 `� _t' -OT6 Designer: ��� ;,�Q,��,,�� t � � ,C S 1nC Installer: ,Vl�,- Address: )Z. Wi Crtoisr:n I d /Zt4 Address: h�r^es h da Ito M A. 6-z ..r; A On was issued a permit to install a (date) (installer) septic system at e J� ��. \A S'1- -C Ck V/ based on a design drawn by (address) ��cl;'et ter r15� 6'ya:�LCs I�� 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 with the terms of the I\A approval let cable) `M P""Nee (Installer's Signature) No J%p8 P- -9 c esigner's Signature) (Affix Designe ere) .PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU. QPSeptic•.liesigner Certification Form Rev 8-14-13.doe Engineers note:This certification is limited to an as-built inspection of system components as installed prior to backfill.The engineer did not supervise construction of the system.The installer assumes responsibility for all materials,workmanship,backfilling to specified grades with proper compaction and setting risersfcovers as shown on the design plan. Town of Barnstable z, ram, Regulatory Services ti °s Richard V. Scali,Interim Director r BARNSAB Public Health Division 9 RAW. eg `bAJFo 3 �� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office- 508-862-4644 Fax: 508-790-6304 Homeowner Certification Form for Alternative Systems Property Address: 2� Ql�e G Y S t� -- 19 r'S I'Un.1 i 1� Assessor's Map\Parcel: 044 — On of - Property Owners Name: aw12 S S ^+ r► C\ In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of record must place an 'Y' in the applicable box next to each line certifying the information. Yes N\A P ❑ I have been provided a copy of the Title 5 I%A technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) ❑ "I ve been provided with the Owner's Manual ElE4 1 have been provided with the Operation and Maintenance Manual El tom' For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) �,�and.the Approval ElL1 For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5) P ❑ If the design does not provide for the use of garbage grinders,the restriction is understood / and accepted L� ❑ Whether or not covered by a warranty, I understand the requirement to repair,replace, modify or take any other action as required by the Department or the LAA,if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 I S -11 rl G agree to comply with all terms and conditions above. o erty Owners rented name rope y` ers Signature Date Note This form must be submitted along with the septic system disposal works permit application for all I\A systems including new construction, repairs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. Q-\Septic\IA homeowner certi fi cati on.doc t 14 LEGEND CONVENTIONAL S.A.S. FOOTPRINT x , \ FOR ILLUSTRATION ONLY-DO NOT INSTALL N - 100 -- EXISTING CONTOUR j 4-500 GAL PRECAST CONCRETE CHAMBERS !i' 101.41 PROPOSED S.A.S. 06 PROPOSED CONTOUR - C H HAVING 4 OF STONE ON ALL SIDES . 6 ROWS OF 5 H-20 HI o r' �� •68 BOTTOM SIDEWALL TOTAL x 100.98 EXISTING SPOT GRADE �'✓1"" � ------ CAP INFILTRATOR UNITS AREA `= 537.E SF 219 2 SF 756 8 SF W EXISTING WATER SERVICEo3Y501destons Homestead ( Or Mnr M'lls_ y 101.7 102.20 TOTAL CAPACITY = 0.53 GPD SF 756.8 SF = 401.1 GPD G EXISTING GAS SERVICE UGVV'-UNDERGROUND WIRES �'�. _. , 'CJ + 1 40 x / E 7 TEST PIT 1N, w E,r 9lail` 1 21 y 100,69 BENCHMARK NT 05.86 1816 Award 6, Tr a. .� 101.12 x 1 I_L1J /� LOCUS MAP 1 1 1 F INSP. 10,6/,68 DECK 1 I 1 I Fti PORT I I 1-1-4-4V °� 100.20 i �1 1 1 101 "o x 101,24 -11-ttt i_ GENERAL NOTES: x `� I I �I X I T-1� / 107.03 ALL ANGES PLAN 100 00 I I �1 I I LOT 153 1 BOA DH OF HEALTTH TO TAND THE DESIGN BENGIINE APPROVED BY THE LOCAL PK SET t-T \ 1 20 19,345±S.F. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS f OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Q 12 x LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: 3,19 co I I Tp o2 Jl / 0 ,29 -310 CMR 15.405(1)(b): LOCAL UPGRADE APPROVAL a �0 - 1) A 2' variance to the 3' maximum cover requirement, for up to rl� t x L G 5' of max. cover. S.A.S. shall be H-20 and vented. EX/STING 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR \ �\ 1 8.57 HOUSE(J325) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 5.43 'T.O.F.=108.7f DESIGN ENGINEER. DIFFERING BENCHMARK �G/ \ sI�FL 4 FROM ANYCTTHOSEONS SH SHOWN ENCOUNTERED HEREON SHALRLI NG BE CREPORT DTI ON TO THE DESIGN CATCH BASIN 3 48 ENGINEER BEFORE CONSTRUCTION CONTINUES. RIM = 99.52 % �- s j�� + 07.70 4 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF O-�� �� 45 0� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 0 99,94 \ x 105\0 GARAGE ^o� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. o \ 10A9 N 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. (1 QL _ 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS \ 1:;PAVED•` ,' AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE cod \ 5.91 DIRECTED BY THE APPROVING AUTHORITIES. \ :', '• •. .. 10. IT SHALL BE THE RESPONSIBILITY OF THE .CONTRACTOR TO VERIFY 100.56 \ ' '' 107.3 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING WOODED CONSTRUCTION. -� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS •'.'' ' • '�• �`• • " "' • + IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND EXISTING SEPTIC TANIf :. .4 .; : : `�• ''.:••. :"'.,.`" A REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). TOP OF TANK, EL.=104.78 101,23 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INV.(OUT)=103.45f .�._ r rDApT �_ + �-8� INSPECTED BY T�. ,�-� «�NT PRIOR TO BACKFILL. r� ef t ' :Yb3':8Q \ ,�\ 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES +ONLY ND 101.80 \ 105.98 \ / \ IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. of Mgss 0 ` �� `�> PARCEL ID: 044-009-008 o PETER T. � S '2'06'44„ PROPOSED SEPTIC SYSTEM UPGRADE PLAN Mc So oo1 CIVIL 103,16 E 325 OLDE HOMESTED DRIVE, MARSTONS MILLS, MA "' ��� No. 35109 EXISTING LEACH PIT Prepared for: Dibuono Sewer & Drain, 35 Content Ln, Cotuit, MA 02635 st TO BE PUMPED, FILLED W/ 103.93 SAND & ABANDONED. PK SET , Engineering by: SCALE DRAWN JOB. NO. 104,82 OWNER OF RECORD SPINA, MAUREEN M & JAMES R Engineering Works,orks, Inc. 1"=20' P.T.M. 274-21 325 OLDE HOMESTEAD DRIVE 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. MARSTONS MILLS, MA 02648 (508) 477-5313 11/8/21 P.T.M. 1 Of 2 j NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL: 100.33 SEPTIC TANK PROPOSED D—BOX PERIMETER TOFCTHEFS.A.S,AROUND THE INSTALL RISERS & COVERS OVER INLET & INSTALL RISER AND COVER PROPOSED S.A.S. OUTLET AND SET TO 6" OF FINISH GRADE SET TO WITHIN 6" OF FINISH GRADE INSTALL INSPECTION PORT OVER EACH ROW T.O.F.=108.70f CHARCOAL fF.G. EL.=107.5t F.G. EL.=106.5t F.G. EL.=104.3t F.G. EL.=101.9t VENT DECK EXISTING f NECT MAINTAIN 27 GRADE MIN.to 10 OVER(SAS) ALL ON ROWS IN PORT ION EXISTING-, L = 57' L = 10't 6. 04'SCH 0 PVC) ®'SCH40(PVC) a HOUSE&J25) LL11"I 14a a 11 TO `L$- T.O.F.=108.7f EXISTING as• LIQUID �INV.=1073.45± INERT �LEVELINV.=100.20 r / ` 0 (VERIF PROPOSED 6 ROWS OF 5 UNITS AT 6.25'/UNIT = 31.3' ^� �� i'64,]' GAS BAFFLE INV.=99.92 �. INV.=100.37 �� / ' H-20 RATED SOIL ABSORPTION SYSTEM (PROFILES f'� a" 73 7� EXISTING SEPTIC TANK "`��� ` �\ 39.0 ESTABLISH VEGETATIVE COVER ro BACKFILL WITH"aEAN NATIVE OR �� PERC SAND TO TOP OF CHAMBERS �J2 TOP ELEV.=100.33 f':'' '; 3 �` PROPOSED S.A.S. NOTES: BREAKOUT=TOP "• ,:.....�....'' �` 6 ROWS OF .5 H-20 HI ?ry?1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.= 99.92 CAP INFILTRATOR UNITS INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.= 99.00 2) D-BOX SHALL BE SET LEVEL AND TRUE TO S.A.S. LAYOUT GRADE ON A MECHANICALLY COMPACTED SIX 4' OF NATURALLY OCCURRING �283 INCH CRUSHED STONE BASE, AS SPECIFIED IN PERVIOUS MATERIAL EFFECTIVE WIDTH=17.0' 310 CMR 15.221(2). 4' (MIN.) ABOVE G.W. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE EL=92.0 _ MATERIAL 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE NO G.W., AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL., USE 6 ROWS OF 5-HIGH CAPACITY H-20 INFILTRATOR UNITS o 0 0 0 0 0 0 0 0 0 0 0 0 0 SEPTIC SYSTEM PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TYPICAL SECTION 28' F-- 28"--I N.T.S. Closed End Plate Open End Plate DESIGN CRITERIA SOIL LOG DATE: NOVEMBER 1, 2021 (PERC# 21-282) NUMBER OF BEDROOMS: 3 BEDROOMS (AS PERMITTED) SOIL EVALUATOR: PETER McENTEE SE#1542 Z--- - WITNESS: DAVID STANTON R.S. HEALTH AGENT SOIL TEXTURAL CLASS: CLASS II IA 16" ELEV. TP— 1 DEPTH ELEV. TP—2 DEPTH 1 11 + DESIGN PERCOLATION RATE: 17 MIN/IN 0" 0.. II DAILY FLOW: 330 GPD 104.0 104.4 -iF- 75" --i 34" DESIGN FLOW: 330 GPD FILL FILL 1.25" 100.0 - Side View End View CARBACE GRINDER: NO—NOT ALLOW WITH THIS DESIGN ✓ A !'" 48 00'3 A 54' IF ONE EXISTS, OWNER IS RESPONSIBLE TO REMOVE LOAMY SAND LOAMY SAND HIGH CAPACITY INFILTRATORS, H-20 LOADING LEACHING AREA REQUIRED: 330 GPD) = 622.6 SF 10YR 4/2 1OYR 4/2 ( 99.7 B 52" 99.6 B 58" INFILTRATOR CHAMBERS .53 GPD/SF F-C SANDY F-C SANDY PERC EXISTING SEPTIC TANK: 1000 GALLON (RECORD) LOAM LOAM 48"/66" N.T.S. 10YR 5/8 10YR 5/8 DISTRIBUTION BOX: 6OUTLETS (MINIMUM) 97.2 82" 96.6 C 94" PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 6 ROWS OF 5 HIGH CAPACITY INFILTRATOR C H-20 UNITS WITH NO STONE ALIGNED AS SHOWN - F-C SANDY F-C SANDY 325 OLDE HOMESTED DRIVE, MARSTONS MILLS, MA SIDEWALL AREA: NOT APPLICABLE LOAM LOAM Prepared for: Dibuono Sewer & Drain,5Y 6/4 5Y 6/4 2 35 Content Ln, Cotuit, MA 02635 . . Pre BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF) 2 P (INFILTRATORS) 30 UNITS x 6.25 LF x 4.73 , SF/LF = 886.88 SF 92.0 144" 92.4 144" Engineering by: SCALE DRAWN JOB. NO. DESIGN FLOW PROVIDED: 0.53 GPD/SF x 886.9 SF= 470.0 GPD PERC RATE 17 MIN/IN. +"B" HORIZON Engineering Works, Inc. N.T.S. P.T.M. 274-21 NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. NOMINAL BED AREA: 17.0' x 63 . SF (400 SF REQ'D) (508) 477-5313 11/8/21 P.T.M. 2 Of 2 31-3' ��'� � S� r ulC , fal3p