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HomeMy WebLinkAbout0250 SANTUIT-NEWTOWN ROAD - Health 250 Santuit Newtown Road Marstons Mills A= 030-035 i i i 4 I i I Town of B. b-astable P# Department of Regulatory Services Public Realih Division Date— ,�9- ems$ 200 Main Street,Hyannis MA 02601 f A�fD µAS h Date Scheduled �""Time Fee Pd. i i t $oil Saitab AWss M' entfor Se spos Performed By: Witnessed By: LOCATION & GENERAL INFORMATION Location Address Owner's Name a�,(1 �Pt�1'vt r� a Vj ►�s Address S Q Assessor's Map/P4rcel: � 03 J I Engineer's Name �EPAIR Telephone# \OW 360 3 6 I NEW CONSIRUtT ON i P Land Use S�� N� Slopes( S'to / Surface Stones �e Distances from: Open Water Body }260 ft Possible Wee Area 7 )w ft Drinking Water Well? ft i - Drainage Way } Qd ft. Propsrty Line > �0 ft Other ft SKETCH:(Street name.dimensiods`of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) S � LPL VAT&0 8 �3 WA i I i I i I I I i i I Parent material(geologic) Depth to Bedrock wa Standing Water in Hole:' ti i� I Weeping from Pit Face Depth to Groundwater g Estimated Seasonal;Iigh Groundwater DtTERMIN TION FOR SEASO'.NAL HIGH WATER T, #LE Method Used In. Depth Obperved standing in obs.hole: ___n, Depth ro spll moults: tt. Depth toiweeping from side of obs.hole: i in. aroundWnter AdJuetment�..e, �Leve.... i ' _ A .faetor-..�4 Adj.CroundwaterLa:vrl,,,n Index Well# _ Reading Date Index Well level -- dl I PERCOLATION TEST . Datp. T1ut Observation i - I Time at 9" Hole# I i Time at 6" Depth of Perc /� Time(9"-6") Stag Pre-soak Time.@ (—W— End Pre-soak Rate MinJlnch 14 I i Site Suitability Asseasmeot: Site Passed Site Failed; Additional Testing Needed(Y/N) Original:.Public I'e$lth Division Observation Hole Data To Be Completed on Back— -- ***If percolag6n test is to be conducted within 100' of wetland,y rst notify the ou must fi rior to beginning. Barnstable Conservation Division at least one (1}week p 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 u,n qLoylt DEEP OBSERVATION HOLE LOG Hole# ?� Depth from Soil Horizon So it Texture Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Surface(in.) Consistency.%Gra el otl r, Q Go _ t 7"- 22" 2. f�..aP 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 m 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) Flood Insurance hate Map: - Above 500 year flood boundary No Yes y___ Within 500 year boundary No 7 Yes Within 100 year flood bounds No Yes Y boundary --. 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 p. rvious material? Certification I certify that on vl (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 'ning,expertise and experience described in 3,10 CMR 15.017. Signatu Date Q:\SEPTIC\PERCFORM.DOC TOWN OF BARNSTABLE LOCATION-2.5.0 AD SEWAGE# AQI3'36q Vl LAGEMaU_r s rylj/IJ ASSESSOR'S MAP.&PARCEL 30 / 34_-' INSTALLER'S NAME&PHONE NO.T;i&w1&s )�t�NnB� Sog� 3&2-7Y77 SEPTIC TANK CAPACITY / LEACHING FACILITY:(type) VG1Ce1 1120 (size) gZ6"A 13 NO.OF BEDROOMS-. 3 G1�be�f OWNERR,ene L. neil Brenda4— Dtoereaze, PERMIT DATE: COMPLIANCE DATE: 3 T 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 I borKof No�s� o A3 3S 33 35. M 4e 13y 4z A5 5/1 6539&f 3 Ve�� 0 0, . No. Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Oapp fication for TMZpagal Stem Cou5tructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade(V)/Abandon( ) ❑.Complete System [� Individual Components Location Address or Lot No. 25D S4 1-,IT NGj4?WIIJ �ner's Name,Address,and Tel.No.��n SI�Y Iti(.I"►i Is MA Assessor's Map/Parcel 3 Installer's Name,Address,and Tel.No. ©H4�f e0 Designer's Name,Address and Tel.No. a �i Clef Type of Building: 7&Z 7177 Dwelling No.of Bedrooms 3 Lot Size Z d l 00 sq. ft. Garbage Grinder (/VP Other Type of Building 64(zE No.of Persons Showers( ) Cafeteria( ) Other Fixtures h Design Flow(min.r qui ed?) 3d gpd Design flow provided 2 gpd Plan Date 7 Number of sheets n Revision Date Title Size of Septic Tank 1600 Type of S.A.S. 2 — S-p o Description of Soil Ct km Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environ I Code and not to place the system in operation until a Certificate of Compliance has been issued by ti. Signed c ate Application Approved by ate Application Disapproved by: Date for the following reasons __ Permit No. "i Date Issued 1 , i No: . Fee �Y / THE COMMPNWEAL`TH OF MASSACHUSETTS+ --w Entered in computer: des r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS applfcotion for 33i5po5aY *p5tem Con5tructiou permit Application for a Permit to Construct( ) Repair( ) Upgrade(vAbandori( ) Complete System dindividual Components Location Address or Lot No. ���O S,A NT1,1 ► I - rV eLrj pbu N (Qyner's Name,Address,and Tel.No. � rLl . n I ,► I4 ►1,�q _ Assessor's Map/Parcel �0/ S SMv\ Installer's Name,Address,and Tel.No. � Designer's Name,Address and Tel.No. lot ,c.��� U fl r'� Type of Building: 3 08 76Z 7177 Dwelling No.of Bedrooms Lot Size Z J Ci sq.ft. Garbage Grinder + ~Other Type of Building (% A i-Z/16 C7 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow min.r' uired gp g p Z gpd g ( q ) � -`y d Design flow provided �,t Plan Date > J '3 Number of sheets 2 Revision Date i Title S� (� / >V-Y'O— L'Y9 r e",C�� ` /cr ✓1 Size of Septic Tank O U U Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envirorjrnon_tal Code and not to place the system in operation until a Certificate of Compliance has been issued by this..Beard-of')•IUa1T] Signed i d/� e ate �_ l -Application Approved byt AIle I / Application Disapproved:by: / Date' for the following reasons -aPerm_it No. / Date Issued �wpvp��l _ _u _ THE COMMONWEALTH OF MASSACHU°SETTS r BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by tt } 1t / A r at �[� S(I1A fy+ -• i�P Ta;i� \ �� has been constructed-in accordance with the provisions of Title 5 and the for Disposal System Construction'Permit No.`s ,� j " "5, dated Installer Designer #bedrooms > Approved design flow, J gpd The issuance of this Pit shall not be construed as a guarantee that the systemwill fun on as designed. Date �,1-t Z Inspector ,C Vtr No. r `/� i Fee 711E, ,0.-._MON�WEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLEE'I IXI'SS "s.CHT7S'ETTS' �Bigooar �§potem QCongtruction Permit Permission is hereby granted to Construct ( Re air ( U/gr/adde� )VAando. (System located at /t� 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: Const ltio /must be completed within three years of the date of this wit.,- j DateR41 d Approved by / / � r/ l I Town of Barnstable Regulatory Services Thomas F. Geiler, Director sanxsrna[.a. 9�a IMAS& Public Health Division TEA. Thomas NlcKean, Director _ 200 Main Street,Hyannis,NIA 02601 Office: 08-362-164 Fax: 508-790-6304 Installer &c Designer Certification Form T Date: 13 l3 Sewage Permit# AOj 3--30Li Assessor's Nlap\Parcel d3S Designer: S ✓i(i Installer: c�l/t�c ,S Address: �sl address: 7/ tz, 5,4)1�Kx� On 3 1M was issued a permit to install a (d te) (insta r) septic system at o1 gD Maf: oY6 based on a design drawn by ��ddress) y . S `� dated I�' � 3 (designer) X1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral nvlocation of the distribution box an&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 anv vertical relocation oFany component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF Mgssq� y� DAfN. M. LA (Ins ;ers' ature) L�No 1140 y R£GISiE � SgNITAR�P� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNST BLE 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. Q: Health/Septic/Designer Certification Form 3-264.1doc LO;,CAT10NS� v�� � SAGE PERMIT NO. VILLAGE Yq ;� is INSTALLER'S NAME i ADDRESS r Cc, �i 7- 3 U I L D E R OR OWNER v ` d DA T E PERMIT ISSUED DATE COMPLIANCE ISSUED r 1 1 2� OC i R EA(L jc 0�6 No.--. ---/P Fss. .. . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H EA T I-� . .. . . Apphration for Diipniia1 Workii Towitrnrtiun Vamit Application is hereby made for a Permit to Construct (J/or Repair ( ) an Individual Sewage Disposal System at: .... s.. ./, f ...........,....... ..l ....... ocation-Address Lot Address Own L>a 1. �'Y_.......---�-O-IA..................1 .................. ...- .........././ 5T- Installer Address Type of Building Size Lot 3,..,rF/.0._....Sq. feet Dwelling—No. of Bedrooms....... Expansion Attic ( Garbage Grinder (�st Other—T e of Building No. of persons............................ Showers — Cafeteria Q, Other fixtures -------------------------------- . W Design Flow._.-k:as. ..................•..-•__gallons per person per day. Total daily flow-------7-7.0.._....................gallons. WSeptic Tank—Liquid capacity a&?_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 b b 4__ _1 v -4.;_.....��..:.............. Date?rCk/s........... 1.70__. aj Test Pit No. 1-----X-------minutes per inch Depth of Test Pit---f_A......... Depth to ground water.he�a.... '� �� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ......... ---- O Description of Soil...... Z._.YV.14a . ....................... V .---------------•--------•------•----------•---------------•------•-•-•-------•---•----------------•------------------------•------•-------•----•--------•------•-•-----........................---- ---------------------------------------------------------- -------------------------------------------------------.---.................................................................................. 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 i i p 5 of the State Sanitary Code— The und�Sl,urtl er agrees not to place the system in operit a Certificate of Compliance has been iss d alth Signed ` �' • •----------•- 2 -,;2 .. Date Application Approved By.... ..1c.: ..._.__..�_n. Z:. ......... Date Application Disapproved for the following reasons:....................................................................................•--.._..._.................. .................................•----------•---------------••--------------------....------------------------•---•----•••-------•-•---------------------•-••--------•--............................... Date PermitNo.------ ...... O ------------------ Issued-....................................................... Date No... ....... ... 1&1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CZ.i✓ 'JJ.............OF....... h7 lJ ( ._----•----------_._...___----_-___ Appliration for, Uispoii al Vork i Tonitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage`-'kDisposal System at: ..% 4.......... sr�, -_ ...... :......... 0_z.._ ._............ ........................... Location-Address Lo No. M-A . .................................... J Owne Address Installer Address QType of Building ���Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.__---0.---•_________________________Expansion Attic �� Garbage Grinder . PL4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------•-- ••--------------•-••-- - W Design Flow....... ______________________gallons per person per day. Total daily flow__.___._3:qC>.......................gallons. WSeptic Tank—Liquid capacityAs1070.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........I......... Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) f '-' Percolation Test Results Performed by ...__:.. .f! . ._-_.1� c ______ Date_1_"d _A..___....... Test Pit No. 1_______ ___minutes per inch Depth of Test Pi _���.._.__.__.__. Depth to ground water... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x --- -- l ---------- �._.._.. _ ---�- _..._.... ---�, c q!!_Ll '? �1 �/Zy4(/_1.................................. O Description of Soil x U •--------------------------------------•-•---------------------------...--•------•--------------------------------------•-------------------------------------------•---------•••-••------•--•-------•. W UNature of Repairs or Alterations—Answer when applicable._____________________.......................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sage Disposal System in accordance with the rovisr s of ofMate Sanitar Code—T d furth rees not to lace the s stem in opeation6 ert ybIance has been*sue o ealie Signed.....................................................................................' ............................ Date Application Approved By.... = 1e..................................................................................... -------- ` Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------------------•-••....._--•... --------•-----•------•---•-••-----••------------------------••-----------•-------------......---------------•----•- -------- ---------------------------------------------------------•--....... Date PermitNo...... - 103........................ Issued....................................................... Date,s y. THE COMMONWEALTH OF MASSACHUSETTS BOARD F j TH ...................................O F..................................................................................... Trrtifiratr of TontpliFatta THIS IS T-i�47-7FY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.....__.... �/�:s`:. -�,....... es p�srrt�.. :'`-----"�t,�.cs -----C�i��3 'Installer at...........................................................................................¢"gi ......................................................... � --- ------------------------- has been installed in accordanc,,with the provisions of,.TITL j of The State Sanitary C,o e a§`de cribed in the application for Disposal Works Eons - ALL` �tr r k PP 1 x �. truction Permit No:---------------------------------------- da.ted-- --------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION-�SA tSFACTORY. DATE-------- � .................._. _ `Inspector= �- -•---------------------------- THE COMMONWEALTH OF MASSACHUSETTS ry BOA f6'0'07, ALTH / .............. .................I........OF.......................................:............................................. No....r-- ....... FEE........................ X i �rosatl or Tnn��rtutiort "permit Permissionti l'<fereb}�/granted;e::-r ,f� a= :-------- 4ee.5....................................................................... to Construct ( ) or Repair.:,( ) an Indivldual,Sewage_Disposal System at No.......................................... -- ����� :. ', .. _ 9 .... as shown on the application for Disposal Works Constructio it �- ______ .Dated.......................................... 3/yli ' r -F ; . ------------------------------------ ----- ........................................................... _ s„ Board of Health DATE....................................... "..-'------:. .;4 FORM 1255 HOBBS &"WARREN.''INCp PUBLISHERS + UL u 0 r) SEF' T>tSPCSAL Go-rToA^ Atz c 37 17 TOTAL L�E?a�6o►b Q Z, s u�1 GPD C1J� n- , .. PCBC,C>"T i C>W Et t�aT t u Z AW o2 L� 41 1 • rh k8 ' •4 I !1I I-t-ST i DF Fero = bo' q 7"�771C� 7 T77�� �J 4•�"� ¢rPP6 •.� IIJu• ' j7.C� �4a�M lMV• 'j: TA u W. e `flo�'� C 4t�Gt•1 d f Pt T Mum wasu� i 3 CE2 T I F I E ID PL-oT Pt__A N L�AGA.T10t.1 P �t�1✓,;�r'� �� �-{ i, ,_: t, �r Wo 5ctat.E� $GhL6 DA►Tt; 1 CmcT'tFY T"AT Talmo 77-0;? Me-LtuG S164mA PL d i� trL�E.FF.1ZEs.lGC µG2E. >w ' GoMPL. (S wtTt-t Tta&. S(xx L1aac-- 1 l + A► D OF I-Wf-: i TDtut•.1 of �?AL�Jr LA ?t..LL1.Q �v4f}t' Zz" (� rL tsTrm ttEv LAwco St.)Z\/iEwtr, TANS PL&W 1-f. 1.lOT BASED Ot.i AU 1► ,tT MWT OtTE.:.ZVtt.s.6 Mays. �tJiZvC( 4 TOG, OFFSET; •5"000> UOT t3E V'iEQ [Ag ptlGAuT To 'DCTeQMoNE 4.oT LtiJE;. �+ } - I o. D.. -.P� Fes$..... .................... THE COMMONWEALTH OF MASSACHUSETTS ./ BOARD OF HEALTH 0� 0. ' /L. ° `- -� SH OF M9 /1 d�..�. ...... OF..-...... !. -Q,9t-------------------------- LPL ss u o�� ROBERT Appliration for Bigpnia1 arks C�nntitrnrtion am . GORDON rn U HARRISON Application is hereby made for a PeriTyi to Const-uct (k) or Repair ( ) an Individual S a spb' O Q System at: ` Cr�Yil,4 flkl t-07— el A& Location-Addre ' or Lot No. /�/ �- _ ... .. � - ............................................... d� lr �1KI.. /tX ..fl.L O ner Address ............. Installer Address dType of Building , Size Lot-------��....................._ U Dwelling—No. of Bedrooms.._.,.._.. ' Expansion Attic ( ) Garbage Grinder (NO) p, Other—Type of Building ..._.:.: _ __... No. of persons____________________________ Showers ( ) Cafeteria ( ) p' Other_fi lures .•------------------------------ d - W Design Flow........_2 ........................gallons per person per day. Total daily flow_:...____a�cq ..__._.._._._._._gallons. WSeptic Tank—Liquid capacity.�0_Cr`�gallons Length---ff !_..... Width__"= .�.... Diameter________________ Depth.._.-....... x Disposal Trench—No..................... Width....,.............. Total Length.................... Total leaching area______--•__•___---sq. ft. 3 Seepage Pit No.................... Diameter.... ......... Depth below inlet-----6._......... Total leaching area.....9--.�V'7_.sq. ft. Z Other Distribution box ( ) Dosing to ( ) // Percolation Test Results Performed by._.. .. ...>. �__. z 1 _ ___._____. Date_...' '._� <�_ ............. a Test Pit No. l ----minutes per inch Depth of Test Pi..................... Depth to ground water------------_----------- f% Test Pit No. 2................minutes per inch Depth of Test Pit.. ................. Depth to ground water........................ r. --- p... y� .. O Descri tion of So �`� ` ` °� l. �� "6 A�. 2� 3/ ----� . x - - ` --1----------------••--••------------•---•-------•-----------......---------------------------------------------...---------•-----------------------------------•-----.... U w ----••••--••-----•..................................................••--•••••--••-•-•••••-••----••-•----•-•-•-------------•-----------•......••••--•••----•••-----••-•--•-••-••-----•-••-••-•--------•-- UNature of Repairs or Alterations Answer when applicable............................ ........... .. ................................................. .......... ...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the of provisions 'TT LE, p ' ' of the State Sanitary Code— The undersigned f rtl:er agrees not to place the system in operation until a Certificate of Compliance has been issue the rd e lth. Signed.. ... .---- 1024- ------------Date---•��----_---- — Application Approved By � .......2—�./,.... -------- - -- ------- Date Application Disapproved for the following reasons--------------------------------------------------------•--------------------------------------------------•••--- -------------------------------------------------------------•-------------------------------------------.---------------------------------------------------------------------------------------------- P'� Date PermitNo......................................................... Issued-- ........................ Date I FEE 3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... .......... ...................OF..�.................................................. OF M,4S Appfiration fo.r Klhipoiial Vorkfi TnmUnr ion Vrrm-t ROBERT OWNGORDON rn o HARRISON Application is hereby made for a Permit to Construct (Y) or Repair an Individual Se D1%6?j CQ System at- tA'r .5AA1 rul 7— - AetWrotVAJ, fib,................................................................................................. .................... ....... ................................................ ocatio ddxc - 04.��4461 or.4ot�No. wfw, 4 71, ............................... ........ ................. ................................................ ................. .. ..........Address ...... ....... 7----------------- .................................................................................................. Install Address Type of Building SF I Size Lot.......................... .4ret Dwelling�—No. of Bedrooms--- ......I. ...................Expansiq&Attic Garbage Grinder (NO) Other—Type of Building No. of persons._.......................... Showers Cafeteria Other 1. _fimtures -------------- .................................................................................................................................. Design Flow......... ........... ----- -gallons per person per day. Total flow............ *15 a .....................gallons. 9 Septic Tank—Liquid capacity.b. gallons Length----67�..... Width-------- ....... Diameter................ Depth_..'' ....... 'Width..................... Total Length........Disposal Trench—No................ Total leaching area. sq. ft. Z I .... ir------ --- Seepage Pit No--------------------- Diameter....�V--------- Depth'below inlet__._.__.____.__.4.......... Total leaching sq. ft. Z Other Distribution box Dosing to Percolation Test Results Performed by... .. ........... .. ............ Date.... --- 12� , ,4 Test Pit No. I................minutes per inch Depth of Test Pit__.._............... Depth to ground water-------------------------- 0-4 44 Test Pit No. 2..................minutes per inch Depth of Test Pit__................. Depth to ground water_...._.............._... 9 . ...............t ...... ......... ..... ............. ..... .... ............. ------ 0 0, - ;L 4 ZJ A00 Des ion of SS ............................ ... ........................ ... ------ -----------------------------7-------------------------------- ------------------- U . .... --------- ............... --------------------------------- ........................7............................. ............................................................................ U Nature of Repairs Qr Alterations Answer whSn a,Dl)licable---------------------- ............................................... ..........V 4-4Z .................................................. ........ - ---------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TA_1Ti,:7, 5 of the State Sanitary Code—The undersigned frtlheragrees not to place the system in t operation until a Certificate of Compliance has been issuedory the U_66r etl.th. ....... ............ ......... Signed.. Date 2 Application,Approved Byjv•-•-•.......?4......w . . . .................................... ------------------------- ........ Date Application Disapproved for the following reasons:................................................................................................................ ..............................................................................................................-----------7--------------------------- ................................................... - I ?_/ Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... ...............OF....... .............................................. %'Urrfifiratr of Toutpliatta TH!>-q T CER�TTIF hat e IndivAal Sewage Disposal System constructed �" ) or Repaired b ...... ............ .............................................................................................. y........ .... ...t.,......... .. ...... Installer 1M.4.4".r................................ ....... ...............V�v ...................................at.......4442;rr--- 7..........sa. ..... has been installed in accordance with the provisions of TLIZ Z n i 5 of The State Sanitary Code as described* the application for Disposal Works Construction Permit No...6 �!!.70................. dated------2-In-_9 A_4�........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. .................................. ..... Inspector_.. ............ .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF. .. .... . .......... ....................... FEE..Mn............. Permission Vhereby granted—....—... .... . ..... ... .......... ... .. .......................................................................... to Construct or Repai;.( 1� ividua ewa e Disposal stem atNo........ .......... ...0..... ............................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.... d .. .... . ............... ............................ ............. .............................................................. DATE..............................................................I.................. BoV of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS MARSTONS MILLS LOT 11 •. LOT 10 •°• TH-2`\ EXIST. LEACH PIT ` ` `- ` Off•. Pam••. p,SA ME1G5 ROAD L N oa,3p»E \ l TH_1 �\ �� �� , •� LOCUS 1� 95 __ �� �\ \ �yF � - 1V •••.• �� RfVER ROAD LOT 12 , �•'•Q�P v0 c LOT N AREA=23,810f S.F. GP�PG� \\\ �, OAK >> LOCUS MAP 0 LOCUS INFORMATION off+`� i PLAN REF: 222/157 .�. TITLE REF: 8775/142 PARCEL ID: MAP 30 PAR. 35 0\ ve nt IN ZONE II, ZONING: "RF"/ "GP" FLOOD ZONE: "C" uo 'EXIST. 1,000G COMMUNITY PANEL: 250001-0015-D DATED:08/19/85 /" ;"r ✓ - - Qo \SEP. TANK SEPTIC SYSTEM `,. REPAIR PLAN 6 LOCATED AT: #250 \ �_ 250 SANTUIT-NEWTOWN RD. vE MARSTONS MILLS, MA. GR Np PREPARED FOR ON- RENE L. & BRENDA C. DANSEREAU W , , �, AUG. 8, 2013 6' OF M Ass9 o i W TBM: COR. OF �`` �y t DA � i F��G CONC. STEP M 0 ! G EL=96.00 1 No. 1140 G W' ' '�E6IS1E0 LOT 8 wv �" G ;� MNITAR\a� - cv / SCALE: 1"=20' /per ,•F, O LEGEND MEYER & SONS, INC. - ' PROPOSED CONTOUR 1 - ® PROPOSED SPOT GRADE P.O. BOX 981 98 __ EXISTING CONTOUR EAST SANDWICH, MA. 02537 + 96.52 EXISTING SPOT GRADE W— EXISTING WATER SERVICE (508)362-2922 ® TEST PIT SHEET 1 OF 2 J 1569 L NOTE: INSTALL RISERS ON ALL COVERS TO WITHIN 3" OF FINISH GRADE. FINISHED GRADE (96.5-96.0) a �F.G.EL: 96.0 F.G.EL: 95.0 F.G. EL: 95.5 MAINTAIN 2% MIN SLOPE OVER LEACHING AREA VENT :s :v 2" OF 3/8" DOUBLE WASHED F.G.EL: 93.66 3/4" - 1-1/2" J. • . STONE OR FILTER FABRIC DOUBLE WASHED STONE A 6 4, 4" SCH 40 PVC :y 10'I 14„ 6 5= 1 ®®®®• O Ea ®®®®®®®®®®® A TEE'S ARE TO BE (MIN.) ®®®®®®®®®®® 4" scH 4o Pvc INV.92.15 2 EFF. DEPTH ®ME3E3 ®®®® INV.92.35 I NV.91 .98 4' 2 X 8.5' 4' GAS PROPOSED DB-3 EXISTING OUTLET BAFFLE EFFECTIVE LENGTH = 25' _ ..:-._•. -.. .-,:..�. - �-�. .. � DISTRIBUTION BOX INV. 92.60 INV. ELEV.= 91 .83 EXISTING 1 ,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON OF �Assq BREAKOUT OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL, OR EQUAL o� DARREN M. �, TOP CONC. ELEV.= 92.83 ELEV.= 92.83 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING \J�E� `f INV. ELEV.= 91 .8 •®5B •® PIPE INVERTS PRIOR TO CONSTRUCTION ®®®®® . ®®®®®®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TOE/Sj ®®®®®®® " GRADE ON A MECHANICALLY COMPACTED SIX SNITA?0 BOTTOM EL.= 89.83 ®®®®®®® INCH CRUSHED STONE BASE, AS SPECIFIED IN 3.75' 5 FT. 3.75' 310 CMR 15.z21(2) EFFECTIVE WIDTH = 12.5' 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK a r t SEPARATION 7.03 FT. WITH GALLON SEPTIC TANK IF FAILED, SEPTIC SYSTEM PROFILE DAMAGEDED,, NOT H2O LOADING, OR UNDERSIZED. SOIL ABSORPTION SYSTEM SECTION 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 82.80 (SECTION) GAS BAFFLE AS REQUIRED (500 GALLON (H20) LEACH CHAMBER) GENERAL NOTES: SOIL LOGS DESIGN CRITERIA 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL P#: 14095 NUMBER OF BEDROOMS: 3 BEDROOOM BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: AUGUST 7, 2013 SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. EXCEPT AS NOTED BELOW: SOIL EVALUATOR: DARREN, MEYER, R.S., CSE #1614 -310CMR15.405(1)(b): WITNESS: DONNA MIORANDI, BARNSTABLE B.O.H. DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. 1) A 0.67 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW GARBAGE GRINDER: NO (not designed for garbage grinder) LEACHING TO BE 3.67 FT. BELOW GRADE VS. REQ'D 3 FT. (H20/VENT PROVIDED) Elev. TP-1 Depth Elev. TP-2 peps, SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 95.30 0" 95.50 0" TO ENGINEER D APPROVAL BY THE BOARD OF HEALTH AND THE A LOAMY SAND A LOAMY SAND LEACHING AREA REQUIRED: (330) = 445.94 S.F. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 94.72 10YR 3/2 7" 94.92 10YR 3/2 7„ .74 EFRO NO THOSE BEFORESHOWN HEREON SHALL NBE TINES.REPORTED TO THE DESIGN B B USE TWO (2) 500 GALLON (H20) PRECAST LEACH CHAMBERS W/ 4' LOAMY SAND LOAMY SAND 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 92.97 1OYR 5/8 28" 93.17 10YR 5/8 28„ STONE ON SIDES & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF C C BOTTOM AREA: 25 x 12.5= 312.5 SF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. y MEDIUM- MEDIUM- SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED PERC ® EL. 91.25 COARSE COARSE TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 1 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 2.SY 6/4 2.SY 6/4 CONSTRUCTION. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 82.80 150" 83.00 150" 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 250 SANTUIT-NEWTOWN ROAD, M. MILLS, MA 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PERC RATE <2 MIN/IN. (-Cl- HORIZON) Prepared for: Dansereau AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY NO GROUNDWATER OBSERVED 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Engineering by: Surveying by: SCALE DRAWN 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. • I, Darren M. Meyer, R.S., CSE, hereby certify that 1 am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. d(aepougall Survey N.T.S. DMM 15. ALL PIPING TO BE 4" SCH 40 0 1 8" FT UNLESS SPECIFIED to conduct soil evaluations and that the above anolysis has been performed b me consistent with the PO BOX98f / / ( ) y EAST SANDWICH,MA 02537 (�8) 419-1086 DATE CHECKED SHEET N0. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October. 1999. 5ns-W2-2922 08/08/13 DMM 2 of 2 it f! . vim► �e At 1-4 z - I 4 Sk al je f (`� t r � � -wo - f t w )Co , kidv�v- J1 r =� li _. -._ � �•.�.-�.,n..-�-.�.�`�.'�-•...+r+r.-•..,- •-_+.r��...e-' ';5�.�.:....�.-...� _.—.r '-'t• - �"��-r,-. -- - - �9:...'C^.��.."""T_+�' w.'�...���.o���.a.`�'�. SOIL LOG a Es fof.bT 99,SI_ t A4, � SE 1AG� LOW Le. Jt .,��'.' 4.^• t'4 E � � cv f� .r•! �} ? �r ii:.t :.•Yf il':�3 �i'e� ; ` 7.� i �.a� J7"� 4tuQ 9 4 : - —_-�- 9 l•8 3. SEPTIC TANK 1 j `17,8 4. All WORK ki 1ST C-L) it'f `` "r,T' !'4�' �'}tal'„1 ' ^" �� i -_• t ..1:..C.. —ITL&. 5 iS Ir. ISJYi,44 81iA�IRJ Or` #tli— H 4 1` REGULATIONS. I �� 1 5. BRICK TAINK, DIST. BOX & Pl; To t __1 I OF GRADE CC,A 6. THERE ARE .NO WELLS WIT'HIN1 :O^,.' M T+itS PIT ! 7. THERE IS NO SEWAGE LEACHR46 !!DO tj:S i t ✓ TQ0 89.6 i P10 l�Y ,T I 51,9� Per K/{�'TC�c �, r "� i 4y1 L PERC RATE4-y i 0 ILn�. FINISH 10 1 , 0 �� (` GRADE ���• 10 l, o 4w _ 10 4 P✓� 1) ,_ 4 a �� a `r� PIPE 2i4 3„� tJ� PIPE ' j` 4�j��c l I ��s'11g''I/2"MEkSI ED ?'" PIPE PITCH I/4'%FT.MiN. �-- -g__ __�w , -,:-A ___ ._ i I�EAS7'OiJE 1�_ Ij IPITCH;/`6"IFT MIR 7 1/2„WASHED !fvl Cl TEE j DI T BOX i i ai �� � FINES,DUST,IRON i L N O.OUTLETS- 3 ; , G DIAM. PRECAST, FOUNDATION SEPTIC TANK LENGTH = 8 f '--�- WIDTH = s' '8 LEACHING PIT 4- 1 +_ t0 SEWERAGE SYSTEIM, PROF1lLE 87,$) i NOT TO SCALE) -W-� WATER TABLE i LOBE i G. � R� � , l CALF _ GG SEWERAGE /,or � :�:'rU1T �✓E� �o r�.�,� rib PLOT PLR" Y++ITM E- AT SYST PROFESSIONAL ENGINEER �UATE /-/�"-$a 'I'/'4C`''d�15 FLINT LOCKS DRIVE C'�•k'��STA�LC � FOR 1L L 1,4 APLY bI1TH,MA3S. 0236 TE r, g U� �- y!!i rr►CI. v � M*q . -- 1