HomeMy WebLinkAbout0140 PEACH TREE ROAD - Health 140 PEACH TREE`Rpc d --
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No. 15� ` Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: /
PUBLIC HEALTH DIVISION - TOWN OF BARNSTASLE,,MASSACHUSETTS Yes
ZIppricatiou for �Bigo!gal i§p5tem Contructiou Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
TPLocation Address or Lot No. /� Owner's Name,Address,and Tel.No. 44�7— 6A&0,
Assessor's Map/Parcel 5-? AS-) 1��/,el./ 0 / � � I p�S va!"
Installer's Name,Address,and Tel.No. &Z f'V V�� Designer's Name,Address and Tel.No.
AD r'
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min,required) gpd Design flow provided 6-7_.3 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. 4 " Jr0®get C �t fn�Qx�
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mainte nce of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 the End nm d not to place the system in operation until a Certificate of
Compliance has been issued by this B rd f H th.
< -
'gned Date
Application Approved Date t
Application Disapproved by: Date
for the following reasons
Permit No.'=;�W Co Date Issued
.� No. f �• I Fee (}� �•
TH.E�COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTA°B ;iVIASSACHUSETTS Yes
application for Mizpaal �§pgtem CottgtructioH Permit
Application for a Permit to Construct O Repair,(.,,,,) Upgrade( � Abandon O ❑ Complete System ❑Individual Components
Location Address or Lot No. /b 1qW_TR&4 /`V Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel AS-
Installer's / 1ZAIG[L 1,40 �°&ft/ � NnLt����s �u JL
Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
ao 7 Stop UR Mhf2sTt,WS)"jjj 5 CIYL~ l02 t 16-1-6146 NiLL RAO,
Type of Building:
Dwelling No.of Bedrooms Lot Size T sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons # Showers( ) Cafeteria( )
Other Fixtures t
) t� C
Design Flow(min.required) gpd Design flow provided ' ✓ gpd
Plan Date Number of sheets Revision Date
Title '
Size of Septic Tank t Type of S.A.S. 4 — 606 _Ovk d`n C
Description,of Soil 110
IV
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 he Env' onmrtta dry d not to place the system in operation until a Certificate of
Compliance has been issued by this Bo rd f He th.
Signed Date q: 21ra O
Application Approved b, — Date f'
Application Disapproved by: Date
k for the following reasons
` Permit No. �'1- Date Issued
————————— —————————————
THE COMMMO`1�1WEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIF that theOn-site Sewage Disposal System Constructed ( ) Repaired ((/ ) Upgraded ( )
r Abandoned( )by b/ w/g arg 4
at &r, / /r ___has been constructed in accordance
with the provis'onss of Title 55�lz'and
�,the for Disposal System Construction Permit No. A ao�n �w°� dated
�l!N /TL'
Installer Designer����Q.Q
#bedrooms Approv�adesign flow 3 G� gpd
The issuance of this permit shall not be construed as a guarantee that the systeem will functio as de 'gned.
Date / 6 ��P Inspector'.,,,_.
--------------------------------------------
No. � JC.J(p .1 /� Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-B�iIu"•i STABLE, MASS ACHUSETTS
Zigpogal *pgtem Coow9truction Permit
Permission is hereby granted to Construct ( ) Repair Upgrade ( ) Abandon ( )
System located at 77O /06VI96� c1g.
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 this pet t.
Date .21 Q� Approved by� _
1
TOWN OF BARNSTABLE
LOCATION ��� / / SEWAGE# 06—t1
VILLAGE B92�8'� --ASSESSOR'S MAP&PARCEL l
INSTALLERS NAME&PHONE NO. BW/9Yo,y
SEPTIC TANK CAPACITY � mC�
LEACHING FACILITY: e �,�e /
(h'P ) 'L� � � (size)
NO.OF BEDROOMS
OWNER 1`
PERMIT DATE: a COMPLIANCE DATE: 7 G�
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
L6
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Torn of Barnstable
Regulatory Services
Tbomas F.Geller,Director
t Division
NAM Public Health
•ss�
Tbomas McKean,Director
-- - 200 Main Street, ftyannis,MA 02601
Office: 508-862-4644 Fax: 508-740-6304
lnatai�le�.�er,�e� cations or
a '5-- —08
Date- ^ SCW> Permit#:_ .gAssess®r's Map\Parcei�.
Designer: � �� — Inats!ler: -Y—
Address: �!U S � "Address:
OJIVN
On q--; Y0 6 _ Efl,_Y e-1--1 zi-76- was issued a permit to install a
(date) (installer)
septic system at C` 1_ `Vll\ based on a design drawn by
(address) qq
�- � `T 4� dated 1 k l o �
(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,
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
y certified as-built by designer to follow.
xV
TIN TrZAS1701__J
._ Llezet WNTRE
(Installer's Sigt90
CIVIL �+
kill �
(Designer's Signature) (Affix Designer's Stamp Here)
CL AS & UTUJW a® I; UN'JABLE ,E]JILLC HEALIH ,21VISI!2N. _CMIFICATE OE
f,Ml.L ILL 1111 ' UO _r�IL WIN r�0
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0:He-JtWSeptic/Desipa Certiftc*tian Foam 3-26-04.doc
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O4j lGy Barnstable .
Town of Barnstable
MASS.am Board of Health �� � ►
1639.
200 Main Street, Hyannis MA 02601
2007
Office: 508-862-4644 Wayne Miller,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
November 30, 2015
Mr. Robert Greer
140 Peach Tree Road
Marstons Mills, MA
RE: 140 Peach Tree lane, Marstons Mills
Dear Mr. Greer,
During the public meeting of the Board of Health held on June 14, 2011, the Board voted
unanimously to permit five (5) bedrooms maximum at your property, located at 140
Peach Tree Road, Marstons Mills, Massachusetts.
Although only a three bedroom disposal works construction permit was originally
obtained, the septic system was designed to accommodate five bedrooms. It has a design
capacity of 573 gallons per day. On May 4, 2006, the owner applied for a building
permit to add a family room. The floor plan showed four bedrooms plus the proposed
family room over the garage, which would/could have been considered as a"bedroom"
due to its design and location. At that time, the issue regarding the number of bedrooms
was discussed at the Public Health Division Office. It was noted at that time, that this
property was located outside of the Saltwater Estuary District as well as any zones of
contribution to public water supply wells. Therefore the Health Agent had no objection
to allowing five bedrooms at this property.
The Board voted to permit five (5)bedrooms maximum at this property.
Sincer yours,
v
Wayne Jiller, M.D.
Chairman
BOARD OF HEALTH
TOWN OF BARNSTABLE
Q:\WPFILES\Greerl4OPeachTreeRoad2Olf.doc
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Excerpt from the Board of Health Meeting Minutes on 6/14/11:
B. Robert Greer, owner— 140 Peach Tree Road, Marstons Mills, of
interpretation of septic permit dated 4/26/2006 with the number of
bedrooms —Section 360-45 variance of salt water estuary.
Robert Greer said the septic permit taken out in 2006 was for a five bedroom.
Thomas McKean said the staff commented that in 2006 a three bedroom permit
was obtained and the septic system is designed adequately for five bedrooms — at
573 gallon. The inspector noted on 05/04/06 in the bottom right corner of the floor
plan that the applicant came in to add the family room, the inspector consulted with
Tom McKean and with it outside of restrictive zones and designed for five, he had
no issue with it. In the staff meeting, they said they have no issue with the
enclosed rooms becoming bedrooms and the Saltwater Estuary Restriction does
have a provision in it to allow variances.
Dr. Miller asked if there was any reason back in 2006, for it to be denied as a five
bedroom: Mr. McKean said "no". Dr. Miller said he has no problem accepting it as
a five bedroom. Dr. Miller acknowledged the inspector did note the records in
2006.
The Board had a floor plan (even though it was not that clear, they all agreed they
could see four bedrooms up and the family room over garage qualified as a
bedroom — making five bedrooms.
Dr. Miller inquired whether the Board even needs to do a variance because the
issue was settled before the estuary regulation. Dr. Canniff said it would prevent
confusion and Dr. Miller agreed.
Mr. McKean said Inspector David Stanton distinctly remembered the situation and
accepting it as a five bedroom and Dr. Miller said he remembered it too.
Upon a motion duly made by Dr. Canniff, seconded by Junichi Sawayanagi, the
Board voted to approve a variance to the estuary to permit the 5 bedroom design
flow to be used for the 5 bedroom house. (Unanimously, voted in favor.)
C:\cache\Temporary Internet Files\OLKFE\Excerpt BOH Jun 2011 Ful Minutes 140 Peachtree Rd MM.doc
So g-yz
Excerpt from the Board of Health Meeting Minutes on 6/14/11:
B. Robert Greer, owner— 140 Peach Tree Road, Marstons Mills, of
interpretation of septic permit dated 4/26/2006 with the number of
bedrooms —Section 360-45 variance of salt water estuary.
Robert Greer said the septic permit taken out in 2006 was for a five bedroom.
Thomas McKean said the staff commented that in 2006 a three bedroom permit
was obtained and the septic system is designed adequately for five bedrooms — at
573 gallon. The inspector noted on 05/04/06 in the bottom right corner of the floor
plan that the applicant came in to add the family room, the inspector consulted with
Tom McKean and with it outside of restrictive zones and designed for five, he had
no issue with it. In the staff meeting, they said they have no issue with the
enclosed rooms becoming bedrooms and the Saltwater Estuary Restriction does
have a provision in it to allow variances.
Dr. Miller asked if there was any reason back in 2006, for it to be denied as a five
bedroom. Mr. McKean said "no". Dr. Miller said he has no problem accepting it as
a five bedroom. Dr. Miller acknowledged the,inspector did note the records in
.2006.
The Board had a floor plan (even though it was not that clear, they all agreed they
could see four bedrooms up and the family room over garage qualified as a
bedroom — making five bedrooms.
Dr. Miller inquired whether the Board even needs to do a variance because the
issue was settled before the estuary regulation. Dr. Canniff said it would prevent
confusion and Dr. Miller agreed.
Mr. McKean said Inspector David Stanton distinctly remembered the situation and
accepting it as a five bedroom and Dr. Miller said he remembered it too.
Upon a motion duly made by Dr. Canniff, seconded by Junichi Sawayanagi, the
Board voted to approve a variance to the estuary to permit the 5 bedroom design
flow to be used for the 5 bedroom house. (Unanimously, voted in favor.)
Q:\MINUTES\EXCERPT OF MINUTES\Excerpt BOH Jun 2011 Ful Minutes 140 Peachtree Rd MM.doc
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BORTOLOTTI CONSTRUCTION, INC.
46
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Address Prop , .�o�o
Date of Inspec} ./ _ Map arcel Owne"�_ -�
PART A — CHECKLIST
CHECK IF THE FOLLOWING HAVE BEEN DONE:
✓PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH
NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND T &SYSTEM H
RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE OT'BEEJI t4{VTR 4%WTO,
THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. � �
AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE IT N/A.
THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. ''Uy
HE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. 8
ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. s
THE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK WAS INSPECTED
FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE,
DEPTH OF SCUM.
THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR
APPROXIMATED BY NON-INTRUSIVE METHODS.
&--rHE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER
MAINTENANCE OF SSDS.
PART B — SYSTEM INFORMATION
FLOW CONDITIONS
RESIDENTIAL �
No of Bedrooms Y—No of Current Residents Garbage Grinder
Laundry Connected to System / _Seasonal Use
NON RESIDENTIAL:
Calculated flow
WATER METER READINGS,IF AVAILABLE:
Pumping Records and Source of Information: GALLONS
SYSTEM PUMPED AS PART OF INSPECTION? IF YES,VOLUME PUMPED= GALS
Reason for Pumping:
TYPE OF S TEM:
Septic tank/distribution box/soil absorption system
Single Cesspool Overflow Cesspool Privy
Shared system (if yes,attach previous inspection records, if any)
Other(explain)
Appr imate age of all components. Date in Iled,if known. Source of information.
SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
E' PART B — SYSTEM INFORMATION (Continued)
SEPTIC
Depth below grade: S" Dimensions:
Material of construction: oncrete Metal FRP Other}
Sludge Depth i Distance from top of sludge3p bottom of outlet tee or baffle
Scum Thickness If Distance from Top of Scum)p top of outlet tee or baffle
Z
Distance from bottom of Scum to bottom of outlet tee or baffle
Comments:
Gv/' r
DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT
Comments:
ZX.S.2�_-Z& i
Q
PUMP CHAMBER: 0 Pumps in working order?
Comments:
SOIL 011,143ORPTI N YYTEM (SAS):
IF NOT PRESENT,EXPLAIN:
TYPE:
Comments: �
CESSPOOLS: Number and configuration
Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer
Dimension of cesspool Materials of construction
Indication of groundwater inflow(cesspool must be pumped)
Comments:
PRIVY:
Materials of construction
Dimensions Depth of solids
Comments:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
' PART B — SYSTEM INFORMATION (Continued)
SKETCH OF SEWAGE DISPOSAL SYSTEM:
INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS.
LOCATE ALL WELLS WITHIN 100'
).(9 i
O
DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER
METHOD OF DETERMINATION OR APPROXIMATION:
/'a.Yi o �✓ /am &/, 5. ems ® Z tiI-Jc,--)' r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C — FAILURE CRITERIA
J
(Indicate Y—yes N—no ND—not determined.Describe basis of determination.If'not determined",explain why not.)
Backup of Sewage into Facility?
Discharge or ponding of effluent to the surface of the ground or surface waters?
Al Static liquid level in the districution box above outlet invert?
Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow?
All Required pumping 4 times or more in the last year? Number of times pumped
Al Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiftration?
tank failure imminent?
Is any portion of the SAS,cesspool or privy, below the high groundwater elevation?
Al Within 50 feet of a surface water?
Within 100 feet of a surface water supply or tributary to a surface water supply?
Within a Zone I of a public well?
Within 50 feet of a private water supply well?
i--- -- Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)?
Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water
quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for
cofrform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen.
i
PART D — CERTIFICATION
INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS
COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399
CERTIFICATION STATEMENT
I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION
REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY
RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE
IN THE PROPER FUNCTION AND MAINTENANCE OF ON—SrrE SEWAGE DISPOSAL SYSTEMS.
CHECK ONE:
1/ I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT TH
E HE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC
HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS
STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM.
I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN
310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS
FORM.
INSPECTOR'S SIGNATURE:
DATE: 714
ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY
9/t i�3
Tbb Is To Be Used F®r tth® - fr ®l lM
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.aMIR perrtLit will bested ter
Dips Sudmnd m Ow Alum antl�t', oa
TOWN OF BARNSTABLE `
rLOCATIUN ��IU� /`el- Qd SEWAGE#
V%LLAGE/A rsyi2a/YI A ASSESSS 'S MAP&LOT
�Risazvs,&IA �s AME&PHONE NO. /�'�/0�C O''>'/cSl�
.0/
SEPTIC TANK CAPACITY Me Q Q J�n V QQ OQ0C
LEACHING FACILITY: (type) ;Z)/ C /� (size) /D 6 G�
NO.OF BEDROOMS
BUILDER O OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
i
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility ea? Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) /V w Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 eet of le chi f lity) Feet
Furnished by {)���'ipYl4
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L-0 C A`fi IQr S E AGE=P4NO.
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VILLAGE ,Y
INSTA LER'S ��NAME A ADDRESS
BUILDER OR OWNER
ki�
,DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
I�
f bao �l�
ono.
—X7. Fxa......T: ............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................O F...................:......................................................................
AVV tra tun for Dispiial Works Tonstrurttun ramit
�`•'t Application is hereby made for a Permit to Construct (( o�/or Repair ( ) an Individual SewageV Disposal
System at:
............ �..7" j� ..................................... ...........................14..�.--- ---C-��-r��T....?.........-..
Loca bn-4Uress or Lot No.
----------------—
...� ..._.......,... .._ usr.....� ... y �
n Ow(yePrqyr d,tr s
Installer Address
d Type of Building Size �q fee
Dwelling—No. of Bedrooms........... ---•-•-----------------------Expansion Attic ( ) Garbage Grinder
PL4 Other—Type of Building 4No. of persons...........2........... Showers ( 2�, — Cafeteria ( )
a
d Other fixtures -`---------------------------------------------------•--------------------------------------..._...-•------........•--•... ...---.......--...-.
W Design Flow.............................1.§Qb....gallons per person per day. Total daily flow......3-1 Q....__..._.............gallons.
WSeptic Tank—Liquid capacity- gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—�.................... Wid�.�-�._--De t Total
below let_._..._..:�� � Total leaching area _.......s ft.
Seepage Pit No_______ ____ _______ Diameter... ' .. p Length �....... leaching q.
Z Other Distribution box ( Dosing tank ( )
'-• Percolation Test Results_ .... Performed by.......................................................................... Date........................................
W
Test Pit No. 1......�. minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. '2......5?Z....minutes per inch Depth of Test Pit.................... Depth to ground water.-......................
..........................................................-+.......................................................... ........................................
0 Description of Soil..... . -• , �� - =lY'
V ----••... �'...........- t.
W
U Nature of Repairs or Alterations—Answer when applicable �{i ..'` `�1
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 has been issued by the board of health.
-- -�-- ................................ .........
i ..... l.!...i5 f
Application Approved—B ---- • •---- .............. . ................... .........•••. -- ...... •----
...... Date
Application Disapprov r he following reasons:........... . .......... ..•.-•-------------------.•------•----------_ .............
...........................•.... •-•---•-••------....-•-•-•----••................................ •-----•---•--•--..............•--••---••-•--•---••---•--•-••-----•--•--•-•--.' ......-••---•---
Date
PermitNo........................................................ Issued.......................................................
Date___________ --------- ,
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................. ... ....................OF
Appliratiou for Miposal Workii Tonstrurtion Frrutit
Application is h&b,y, made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
.............../_ ........................ ..................C /...... .............................................
_Locatiol'�-Addr,ss oE&t No.
...... A.t. . ...... ..... ........... ................. .............
0 r Address
-PW ............... ......
.......... ...... . ........................ ...ct.... ..
InstaY,
Address
Type of Building Size ....Sq. fee e�
Dwelling— No. of Bedrooms............. ............................Expansion Attic Garbage Grin'deL,�,
aOther—Type of Building '& z_U-4 e.... .No. of gersons....... .............. Showers (.;L) — Cafeteria
Otherfixtures .. ................... .......................................................................................................... .......
Design Flow..............................J.S.00flow........,.....0-----gallons per person per day. Total daily ...........................gallons.
1:4 Septic Tank Liquid capacity.4ajg!�gallons Length................ Width.....__......... Diameter..._.........._. Depth....._..........
Disposal Trench—No. .................... Width.................... Total Length................7 Total leaching area....................sq. ft.
> Seepage Pit No.___._..eO 7--------- Diameter... Depth below inlet.........a...... Total leaching area................sq. ft.
Z Other Distribution box Dosing tank
Percolation Test Results Performed by..........:............................................................... Date------.....------.......------....---...
Test Pit No. I.....ig...._.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.__......_.........._...
04 ........................................................ .........................................................I........................................
0 Description of Soil...._ IcII&I
..................... ...
U ....... ................. .....5W-C......5,4�........ ....... eA A 0,4,._A,
....................................................................................................................................................................... ....... ..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 T I T LE 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.
ApplicationApproved,B M . .... . ............................................................... ....
Application Disapprov r e following reasons:...............................................................................................................
................................ .....................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF......................................I.......................I......................
Trrtifiratr of Tompliattrr
T IS T ERTIF "That the Individual Sewage Disposal System constructed (,-<Or Repaired
y 'T
b .......... ... ... .. W... .................. ......................................................................................................
Installer
( at... ...... ........... .......
has 0een installed lin acco ance with the provisions of T LE 5 of The State Sanitary o of ribed in the
................
applicati6n for Disposal Works Construction Permit No..fi_!��.1_17 ........... date .... .... ........................
THE ISSUANgX OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GUARANTEE THAT THE
SYSTEM WIWPNCTION SATISFACTORY.
DATE...... ...................................................... Inspector------ ........ ..................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................................OF.....................................................................................
No ...........I...... FEE..1....................
%141 at k1i Mitrudion Vrrufit
Permissioni eby ....tuf 4.�'.ed............. ..... ............................. ........................ ........
to Constr Cl �'®r Re ividual e, Disposal System .......
Al....... . ..... ..... AA-At......... . ...................................... ................. ...................... ...................
at NX.....,......... e Street
as shown on the application for Disposal Works Construction Permit N�o.. ........ ./.... ated.0/'.___* .. .. ....................
.................................. ...... .............................................................
DATE. 2 Board of Health
2 11--------------
FORM 1255 A. M. SULKIN, INC., BOSTON
fi
LEGEND
Ilk; N i
-_------ -- - 78 PROPOSED CONTOUR
�,15��� 1 _ - x ----I-�3-z x , Ra to ro
�J' 3 53. 79 PROPOSED SPOT GRADE 9�P
4 2' �` I
ri—.-. CU®
_ rEXISTING CONTOUR
A. . TEST PITSTP-1 O. 00 O 1 -o
°n
b� z
53 ------ EXISTING WATER SERVICE o
BENCHMARK LOCUS Q�
LOCUS MAP N.T.S.
1 "
GPB 337- G an
6PB 42
O
SEaSED 9TP-2 PT1CTANK'
4
Qz
Ln
EXISTING 5.A.5.
TO BE PUMPED
I i ' ' - - 19,E FILLED W/SAND
JI W ! _- - ` ��f EXISTING TANK
, � O _ TO BE PUMPED, RUPTURED FILLED NTH 5AND GENERAL NOTES:
I� Cld \ ,l � �
I ' W 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
Ln
I
NJ
• _ BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
iV �' �, i f -�'-- -~ f � � OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
� / I BENCHMARK: LOCAL RULES AND REGULATIONS.
cp —� ✓ , NO. 140 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
2 __ , f, � r , !� r CORNER OF DECK TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
l / I I/2 STY. r r/._ ......... ... ELEVATION = 100.00 DESIGN ENGINEER.
i/ f'r% // /" / fr WD. FRM. / l (AS5UMED DATUM)
r / / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
err /f f /r : r ''f / r /T.O.F. = 100 3G''/ } I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
/ , J/� ENGINEER BEFORE CONSTRUCTION CONTINUES.
f 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
f B€TOONC.
1 � 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
DFJVEVtrAY Mqj, 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S.
LOTS i i � 1 1 A f 4�` l �� ��� PETER T. 6� 9_ ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
McENTEE TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
APN 5 7-S ;!blATEB� �/�. �` � o CIVIL "' 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
27,574±SF PROVIDED FRC)I�I No. 35109 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
f PEACH TREE LN �. � � RfGIS�E��� `�� CONSTRUCTION.
TO HOL15E SS, �G��� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
,,� 1 o(e IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S.
j r'Ill. AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3).
r = 53. 14' — — 1 116.86 }' EEngineedngWorky
ROPOSED SEPTIC SYSTEM UPGRADE
R 805.92' a NOI°5715"W ' PEACH TREE ROAD MARSTONS MILLS MA
_____---- ��� _________....—..__________________-________________- Prepared for: Robert Greer, 140 Peach Tree Rd, Marstons Mills, MA
EDGE OF PAVEMENT
by: Surveying by: SCALE DRAWN JOB. N0.
PEACH TREE ROAD ����� • ingl�orks HOOD SURVEY GROUP 1"-2p' P.T.M. 130-06
�� t ossfield Road P.O. Box 1724DATE CHECKED SHEET N0.
MA 02644 Mashpee. MA 02649B1N 5313 4 14 06
(508) 539-7799 P.T.M. 1 of 2
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH' TOF F.G. EL: 96.5t FOR A DISTDANCE OF 1SHALLv5''TAROUND THE 5
(EXISTING) EXISTING F.G. EL: 98.0t(EXISTING) F.G. EL: 96.8t PERIMETER OF THE S.A.S.
�/
MAINTAIN 2% MIN SLOPE OVER S.A.S.
INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO 4-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER CHAMBER SHOWN ON PLAN AND SET COVER/S
TO WITHIN 6" OF FINISH GRADE
WITHIN 6" OF FINISH GRADE IN SERIES WITH STONE ALL SIDES
WITHIN 6" OF FINISH GRADE
4" SCH 40 PVC L =16' a[ L=23'
6• 4" SCH 40 PVC 1 4" SCH 40 PVC 2" LAYER OF 1/8" TO 1/2"
as $ as DOUBLE WASHED STONE
S= 2% (MIN.) io' 14" ® S= 1% (MIN.) 6' ® S= 1% (MIN.) ®®®®05
e 48" LIQUID 2' EFF. DEPTH 30
®aa®®®®
n INV. ELEV.=94,67 INV. ELEV.=94.50 -3/4"-t 1/2"
.,r.'.:v:•r. LEVEL
INV.EL=96.00 GAS D—BOX.' 4' 5.2' 4 DOUBLE WASHED
BAFFLE EFFECTIVE WIDTH = 13.2' STONE
INV.EL: 95.75
PROPOSED 1500 GALLON SEPTIC TANK INV. ELEV.=93.00
TIE IN TO SEWER AT
INLET END OF EXISTING ' TOP CONC. ELEV.=93.80 —BREAKOUT ELEV.=93.5
SEPTIC TANK NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING
INV.=97.60t PIPE INVERTS PRIOR TO CONSTRUCTION. INV. ELEV.=93.00 a aaaaa
2) SEPTIC TANK AND D-BOX SHALL BE SET LEVEL as=� ---aaaaa
AND TRUE TO GRADE ON A MECHANICALLY COMPACTED BOTTOM ELEV.=91.00 4 x 8.5' = 34' 4'
SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 4'
310 CMR 15.221(2). 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 42.'0'
3) INSTALL INLET & OUTLET TEES AS REQUIRED. T.P. EXCAVATION OR G.W.
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION
AS MANUFACTURED BY TUF—TITE, ZABEL OR EQUAL. NO G.W. ENCOUNTERED
SEPTIC SYSTEM PROFILE BOTTOM OF TP EL: 85.2 (TP-1)
(3) 5" DIA.OUTLETS
t5.5• 76' 2" N.T.S.
= E o P TER
"
McENTEE J
15.5' O ,: it --------42'---------� o CIVIL
6" 8„ j I No. 35109
z" `J i PROPOSED S.A.S. DESIGN CRITERIA
H-10 LOADING
D--BOX I --------------------- I NUMBER OF BEDROOMS: 3 BEDROOMS
N.T6. SOIL LOG SOIL TYPE: CLASS I
„AI DESIGN PERCOLATION RATE: 2 MIN,/IN.
DATE: APRIL 6, 2006 DAILY FLOW: 330 G.P.D.
SOIL EVALUATOR: PETER McENTEE PE, CSE DESIGN FLOW: 330 G.P.D
_ GARBAGE GRINDER: NO
WITNESS: NO WITNESS-CLASS 1 SOILS LEACHING AREA REQUIRED: (330) = 445.9 S.F.
rCE3E3EBEa
®®®®®®®. 33" TP-2 De th74
;� W ®®®®® EIeV. TP- 1 pepth Elev. —� PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY
�' ®®®®®®® 0 96.2 O" 95.8 0"
lr) tij ,D O A LOAMY SAND A LOAMY SAND
c ��' 6'' �- 10YR 4/2 10YR 4/2 USE 4-500 GALLON LEACHING CHAMBERS IN SERIES
102" cO 95.9 4" 95.5 4"
B LOAMY SAND BLOAMY SAND SIDEWALL AREA: 2(13.2' + 42.0') X 2 = 220.8 S.F.
IOYR 5/8 10YR 5/8 BOTTOM AREA: 13.2' x 42.0' = 554.4 S.F.
4" KNOCKOUT 93.5 -C C 32" 92.8 — TOTAL AREA:
36" TOTAL AREA = 775.2 S.F.
�
20" DIA. COVER
' DESIGN FLOW PROVIDED: 0.74(775.2) = 573.6 G.P.D.
KNOCKOUT O/4" KNOCKOUT 62" £__... »....... ----- — ' ._....._ __,.-�
"�'`'" I MED, SAND MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE
�.�
4" KNOCKOUT 1 2.5Y 6/4 2.5Y 6/4
71
u 140 PEACH TREE ROAD, MARSTONS MILLS, MA
/ f�i ,/7 / Prepared for: Robert Greer, 140 Peoch Tree Rd, Morstons Mills, MA
500 GALLON CAPACITY, H-10 LOADING / ' P.T.M. 130-06
F10USE '/ 85.2 132" 85.8 120" Engineering by: Surveying by; SCALE DRAWN JOB. NO.
CHAMBERS / / f ! !' r' i ; Engineering Worb HOOD SURVEY GROUP NTs
N.ts PERC RATE: < 2 MIN/INCH 12 West Crossfield Rood P.O. Box 1724
S.A.S. LAYOUT NO GROUNDWATER ENCOUNTERED Forestdole, MA 02644 Mashpee, MA 02649 DATE CHECKED SHEET N0.
P
(508) 477-5313 (508) 539-7799 4/14/06 P.T.M. 2 of 2
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