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HomeMy WebLinkAbout0070 SEA ROBIN ROAD - Health 70-Sea Robin Road Marstons Mills P A = 122 044 i ,l t )W'4�N OF BARNS i ABLE LOCATION 6t SEWAGE# II L A G E l`vi��� ASSESSOR'S MAP&LOT NAME&PHONE NO. SEPTIC TANK CAPACITY O GO v �G LEACHING FACILITY: (type) �i �/� (size) zOC30,c�20 S. NO.OF BEDROOMS— 3 BUILDER C'O!TTDR"' PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility D?- ;;"" 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 et of ach�i�nn�faci ' ) i(//i¢ Feet Furnished b l"�/O 1`�`i` �O12T lce�44, ����C ��� � ��� �'� a� �� a 0 �' � a'' r, BORTOLOTTI CONSTRUCTION, INC. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ,' Address Prop .----- ------------------- E �� -- _— C /c>,/l --- ----- -- ---- -- --- ---.._-. ------- .- -------=-=—do OFe"an�°e� Date of Inspec}9j )"oW Nlap1Z Parcej Owner — ...-:.- ---._ ----- ------------ .-- ._ S- CHECK IF THE FOLLOWING HAVE BEEN DONE: PART A CHECKLIST- 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 THE SYSTEM HAS BEEN RECEIVING NORMAL FLOW RATES DURING THAT PERIOD, LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. (,-"_AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A. ✓ THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. 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. v THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON-INTRUSIVE METHODS. THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B - SYSTEM INFORMATION RE ENTIAL FLOW CONDITIONS SID -- -- --------- 3 No of Bedrooms _ — -No of Current Residents _1l/G _Garbage Grinder Laundry Connected to System A/b Seasonal Use NORESIDENTIAL: ------ ---......... -- -- -- ---------- --------------- Calculated flow) WATER METER ,f. Pumping Records and Source o I formation: _�------- GALLONS ' SYSTEM PUMPED AS PART OF INSPECTION?A/ IF YES,VOLUME PUMPED = GALS Reason for Pumping: — --- _ TYPE OF SY M: — — ----- -- Septic tank/distribution box/soil absorption system Single Cesspool __ _ Overflow Cesspool Privy Shared system (if yes, attach previous inspection records, if any) Other(explain) Approximate age of all components. Date installed,if known. Source of information. SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? /YU SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B - SYSTEM INFORMATION (Continued) SEPTIC TANK: _ Depth below grade: 3 Dimensions: Q S S Material of construction: Jk,-"Concrete Metal FRP Other} Sludge Depth ,f,i Distance from to of lVdge to bottom of outlet tee or baffle Scum Thickness G / Distance from Top of Scum to top of outleWe or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments: - aovPr-3 3 CZ0 /Gd DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: -- — - oL)o PUMP CHPMBER: 0 Pumps in working order? Comments: - IL ABSORPTION SYSTEM (SAS):IF NOT PRESENT,EXPLAIN: TYPE: - /000 /Ur �21-e-0:c sVL Comments: sQ4 Z/021re c6sIZ Lac P7' vl - o ., o 4�0/Piih� 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 Y 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' C> axl s( DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER METHOD OF DETERMINATION 0 APPROXIMATION: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - FAILURE CRITERIA (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? Static liquid level in the districution box above outlet invert? Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? Required pumping 4 times or more in the last year? Number of times pumped Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiltration? tank failure imminent? Al Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? IV Within 50 feet of a surface water? IV Within 100 feet of a surface water supply or tributary_to a surface water supply? Within a Zone.I of a public well? /V Within 50 feet of a private water supply well? /Y' Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools &privies only, not the SAS)? A/ 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 coliform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D - CERTIFICATION INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399 CERTIFICATION STATEMENT 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—SITE SEWAGE DISPOSAL SYSTEMS. CHECK ONE- Z. , HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED AREAS 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: ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY TOWN OF BAMSTA.BLE � LOCATION 76 Saa Q.b, , �� SEWAGE # 4 90? i VILLAGE S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. e,,, to Cry f SU 8 Y ad yo a f SEPTIC TANK CAPACITY /od'e LEACHING FACILITY: (type) 61 ,0_6 6enC CCO-00-rC1(size) /01 X of NO. OF BEDROOMS ;Z BUILDER OR OWNERtC`� PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility No CC i 2� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) _ All Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) _ �"� Feet Furnished by I-A Ina V� 27 r � S A► A �q ' 3 b3 33r10 q As' Syr I 3s- ��•` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -- Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zfppftratton for ;tgpool *pgtem Couetructton Permit Application for a Permit to Construct( . )Repair X Upgrade( )Abandon( ) El Complete System )<ndividual Components Location Address or Lot No. # 10 5E44, jZID e, Owner's Name,Address and Tel.No. ID 1`a 1F2.EO SEM Assessor's Map/Parcel �a a 5 A N►�, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. a8--40 Type of Building: Dwelling No.of Bedrooms�_ Lot Size a4 X 0osq.ft. Garbage Grinder(A//4 Other Type of Building Q one- No.of Persons Showers(-t/) Cafeteria Other Fixtures &W m:Z 1 —P►v �1� Design Flow �J�J� gallons per day. Calculated daily flow gallons. Plan Date Number of sheets ` Revision Date Title Size of Septic Tank fxi$:r Dcr\ Type of S.A.S. Description of Soil 0 ` tj b'a'ZS Nature of Repairs or Alterations(Answer when applicable) QC 0�� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this Board of Health. Signe Date Application Approved by Date Application Disapproved foi the following reasW AA Permit No. Date Issued No: W- 06 g } l.' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF, BARNSTABLE, MASSACHUSETTS - ZIpplication for Zi5pool *pgtem Construction Permit Application for a Permit to Construct( )Repair(<)Upgrade Abandon( ) El Complete System 'Individual Components Location Address or Lot No. -+C) !$e,4 -ZOBUd 'Z�g Owner's Name,Address and Tel.No. 1-4I F'fL1EO 'S C-M Assessor's Map/Parcel S M E iaa o C Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4028 5 31N -4 �- Type of Building: Dwelling No.of Bedrooms Lot Sizesq.ft. Garbage Grinder Other 'Type of Building w nF'p No.of Persons rZ �--- Showers(t/) Cafeteria( �/S ..,a Other Fixtures D@sign Flow J© gallons per day. Calculated daily flow �?�\ . `1) gallons. � Plari'Date I' n's Number of sheets 1 Revision Date Title . czs car,end, ��c�� Size of Septic Tank Yu+s-r t pm r. �_.�\+� Type of S.A.S. �u> Q—� Description of Soil � � � c 1 ra+�� '� �' Nature of Repairs or Alterations(Answer when applicable) �or1 t7 � 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 Certifi- cate of Compliance has been issued by this Board of Health. Signe D Date , _- - L—5-1 Application Approved by t,ln Date Application Disapproved for the following reasto x' v Permit No. �C. Date Issued �.. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(K) Abandoned( )by �L1�oA�i:r4 FM .r'0 l at (7 w vtd 9: has been constructed in accordance with the provisions of Title 5 and tpe for Disposal System Construction Permit No 5 1,4-� dated o Installer iv Designer !EZ The issuance oft 's p t shall not be construed as a guarantee that the tem Mill _ 't nn as esianed. Date _ S /9 y�7 Inspector r..... _------------ ------ ------ ------———— g No. Fee 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwi5pooa[ *Pgtem construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade V_)Abandon( ) System located at 70 S c 0 R 0 S i r r,z, , r 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:Constr /ction Aust be completed within three years of the date of this ermit. Date: Approved by J L/ �/ TOWN OF BARNSTABLE LOCATION 76 Sa4 Q`L. , SEWAGE # 4.--cl I? VILLAGE s ASSESSOR'S MAP & LOT. INSTALLER'S NAME&PHONE NO.��r� wt 24 F-�t SO a Y a8 C/o a if SEPTIC TANK CAPACITY /04 49 a 1 LEACHING FACILITY: (type) kiarAlftA6 CCWOVL,r (size) /a RS NO. OF BEDROOMS BUILDER OR OWNER ��Cr� g rn g�f PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching'Facility /V Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Na Feet Edge of Wetland andLeaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished.by I A B a y f ,Al yq . 3l 31 .E A3 91 . 3 3a 33 .1� A y o?9 0 �� y�• By sa ,� RS 1 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems.Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM 1, iaJ sttat ,hereby certify that the engineered plan signed by me dated 5 I 110 5 ,concerning the roperty pZat 1rx meets all of the following criteria: • This failed system is connected to'a residential dwelling only. There are no.commercial or business uses associated with the.dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests at the site without a health agent present. o There is no increase in flow and/or change in use proposed There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information). Col.CDC B) G.W.Elevation 5+adjustment for high G.W. 3.ice . = M .60 DIFFERENCE'BETWEEN A and B 4$, 40 � SIGNED : DATE: NOTICE Based upon the above information;a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. P P q:\SedC\ =eXemp. ocd ill . w Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: St a- 2�u4 , , nS4gc�kkk Lot No. Owner:_\ r _(*1r\ Address: Contractor: hck.. emu° Address: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. ........ .Date 6 O S . .................................. mo th/d y/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: �1h AO Appropriate index well.................................................... S 3 OBWater-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... '4 05 49,4 month/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ..............................................:........................................... (° STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water p levelat site (STEP 1) ............................................................,.............,... fr i Figure 13.--Reproducible computation form, 15 Town of Barnstable °F1ME, Regulatory Services Thomas F. Geiler, Director * BARNSTABLE, 9�A ' Public Health Division 'FD + Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 5/20/05 Designer: Shay Environmental Services, Inc. Installer: Capewide Enterprises Address: P.O. Box 627 East Falmouth Address: P.O. Box 763 MA 02536 Marstons Mills, MA 02632 On 5/13/05 Capewide Enterprises was issued a permit to install a (date) (installer) septic system at 70 Sea Robin Road, Osterville, MA_based on a design drawn by (address) Shay Environmental Services, Inc. dated 05/12/05 (designer) XX 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 of certified as-built by designer to follow. OF Mgss�c CARE EN '04tal 's Si ture) o SHAY No. 1181 0 IS-T . SgNITARtP� (Designer's Signature) (Affix Designe s tamp Here) 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. Q:Health/Septic/Designer Certification Form L r LO CATION;07 SEWAGE PERMIT NO. Lot 21 , Sea Robin Road 82-482 VILLAGE Marstons Mills INSTA LLER'S NAME i ADDRESS Dan Speakman BUILDER OR OWNER _1 A. E. Matson DATE PERMIT ISSUED 6/22/82 QDATE COMPLIANCE ISSUED 11/9/82 i fool cp, -- 3.s . rz kr %Jri. - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .I®l .•J...........OF..../ r�� .�1 rt j.C_ . ............................ Appliration for Bispnatt1 Works Tonstrar#inn Frrnti# Application is hereby made for a Permit to Construct ( 4<or Repair ( ) an Individual Sewage Disposal System at: .. ... Location_Address �/� or Lot.No. ................_.... __.... .. #s.1:-- ., .1"!� °" �` ?. .. 'I.'�:�:4�..07..��....... -`: �C.0 7 . _. ... Ow _ Address ................ ... i.,[.. ..C...f--e ................... Installer Address Type of Building Size Lot--- . $Sq. feet U Dwelling—No. of Bedrooms........... .............................Expansion Attic ( ) Garbage Grinder (NO) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures .-----------••••.................. ....... WW Design Flow..........��.......................gallons per person per day. Total daily Qflow............. 3 ..................gallons. WSeptic Tank—Liquid capacity��L gallons Length__.______ Width..._�z�_._... Diameter................ Depth.. _ ... x Disposal Trench— ..................... WidthTotal Len .....�, Total leachingrea---•----------.....=q ft. Seepage Pit No..... .............. Dia eter.... ..�..... Depth below innllet.......9;fZO.. Total leaching area.. a�� ..sq ft. Z Other Distribution box (� Dosing tank ( ) _ Percolation Test Results Performed b ...._.:_ ............. Date....-"V"A6./rp. ...... 0-1 Test Pit No. 1....od—'lrininutes per inch Depth of Test Pit../��/-. - Depth to ground water..... i Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ......................................................... R . ............................../.�........................�...4............... O Description of Soil... �.. - A �.� ---�to.-r ................ • ..- ..._ .. _--...5 ,-........................................................................ . W UNature of Repairs or Alterations—Answer when applicable............................................................................................... .................••••••----•--•--••--•-•••--•---•••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitar —The undersigned further agrees not to place the system in oper til a e sate of Compliance Irds L ss by the- oard of health. Stgned ��7 - �" ...------- �... -- ae Application Approved By........... �,��jx.. . A............................... •--•-- Application Disapproved for the f ollo%ving reasons:.................•----•--•-•--............--•-------•--•------................-•--=-•••-•...... ......--_ -•-••-•---•..................•-•--•----....................:..--•-•---•--------•------.........----...•_...........-----•---•-------------------•---.......------•-------....._..-------•-•-••--•._..._. Date PermitNo................................................._...... Issued....................................................... Daft t,t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Disposal Works Tonstrudion 11rrutit Application.is hereby made for a Permit to Construct (`►)°'or Repair ( ) an Individual Sewage Disposal System at: ...... .��.,c.-a. Z7 4x%Location a.....da.Te.S�—'ram. ..�.....- .......................:... ..�_�.. _yam. or Lot No. Owner Address W T?4 e 1 ._ �D�;?t�?.!�!.�!: -!`.-?........... `?. ...� ;r s .... --.. m a r ... .1 ....... ............Installer Address T e of Building ' Size ...� .-Sq. feet U Dwelling—No. of Bedrooms.........: ..............Ex Expansion Attic p ( )'° Garbage Grinder (NO ) aOther—Type of Building _-------•---•------------- No. of persons.......__._................. Showers ( ) — Cafeteria ( ) d Other fixtures ...._.... ... W Design Flow..........4 ---------------------gallons per person per day. Total daily flow............03-:31_70------------------gallons. W Septic Tank—Liquid ca.pacityJf.M--:igallons Length..�-__...._- Width...�t��..._ Diameter................ Depth..5x�.•_-ti_-`- x Disposal Trench—No.....................� Width.................... Total Length-------------------- Total leaching area....................sq. ft. r._.Seepage Pit � �sl'?.__ _...__.._.. Diameter._.. ..... Depth below inlet.......l�s'.....::. Total leaching area:.�...'�'G.+_-_�sq. ft. Z „Other Distribution box Dosing tank ( ) Percolation Test Results Performed b :_.. __.. '7 ----:r"r, 'd�, �J AA/ /,P , Y ,�' --- , -�---•-------------•--... Date----'ra-�:-•-. • ,tea Test Pit No. 1....4CMzminutes per inch Depth of Test Pit.. 'Depth to' ground water.....! .... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil._fa "' C+ - t `"' 'p a °a'' ...". C .� _....... .. ►�i s a W �. v.'r. /... f �C� !• .. .. ae�Gam«!u'.f.._.._ a%�i +13?� -.•---- ------- -------------I........ ._... . ar ,; ►� ................ •------••-----•-•--•-•---•---•--------••--------•---•---•---.......•......------•------•--•-•----------•--•--.......--••--••-•---•--.....-•------•................•........._.......... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .-•------••------•---------------------------------------•-----•----------------..... -----•--..•....-----...-------•------......-•-••-•....-----......--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in oper tioonn it a ert' Cate of Compliance has been is! d by the board'oof health. i� "!` 3 o-' �It�" Signed_/!'%►e .....c-'.......... eD/e , Application Approved BY---.---- - Application Disapproved for the following reasons:.....................:::... .... ----.-••----•--------•--•--------------------------------------- ---•-•-----•---•........................•--•-•--------•----•-------------------•-•--••-•----.......-------•-----•••-•---••-•-•--•----•-•....•--...-•-- ............---- Date Permit,No.•----•--•77-=-•-----•---••..................................... Issued...................................................... Date ..THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 'HEALTH ....:...........OF.................. ............ Trrtif iratr of Contplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (V) or Repaired ( ) bY--•..................�,....-----•'.V.,5.t;------ --•------------------- .--.----.---• -----•---- ------------------------------------------------ - Installer at................::Z "L.1. *. � u.R----— :0 •s - ---------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLF. 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit:.No...... 2.-� ,.............. dated._...__.____.___...._____._.____....._..__...._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST AS A GUARANTEE THAT THE SYSTEM WI F NCTION SATISFACTORY. G _ . DATE.4: '�.2. . . ........................•------•-•----....,......--- Inspector.•• ---• ....................................................................... THE COMMONWEALTH OF. MASSACHUSETTS BOARD OF HEALTH ...... ......................O F..........................................................._............_............ a FEE. ...... Disposal Works Tvo strurtiott "Prrutit -;,,Permission is hereby anted.............. ,' _;, �` to Construct or Repair ( ) n Ind' ' ual Sewage Disposal System _at No.........� Z -c. ....•--........ ............................- --- Street as shown on the application for Disposal Works Construction Permit No..................... Dated. ? .................................. 'S_.... ................. � � ............................................ DATE d , d of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS _ . • � � • • - • ram. ` �� „ r it r .� ✓ ti. ov Uf At .?�i'� �f .M.••�r.Jh/G'C.E-$..,-= . �<?.f�'_�'��1 .ram f�'�: urr..i favi.� 3r4 T/G.> ]'t") ui y .c.ir..,) / "' ,+� 1ClnJl .t t'' _t2_ 't=Jc,1C•� ` � c - �. Y.trx1 s!�� ,j�`1`�?/G ?o-���f' �,� ,� �,-�- .� � � ,. i ��_ 1 �y,,�'• -�'�._f;•-,���.�f!-�.�/ 3,r1� 7Z-r,-J .S' 'f _ /' r 1�47f A, OF MAR GAVIN No. 705.1, r 10' mina from 'NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A -A Olawo►�tw�r ALL OUTLET PIPES FROM THE Existing Foundation house to septic tank Septic tank covers meet be CHAMBERcover must be PROFILE VIEW OF LEACHING SYSTEM DISTRIBUTION Box SHALL BE t2. within 8 In. of finished rode D-BOX corer must be within 6 in. of finished SET LEVEL FOR AT LEAST 2 FT. CONCRETE COVER + TOF ELEV 100.00 9 grade AT finished grade "( +^ x With Steel Cover ode over SAS - ELEV- 97.00 ,(r 3 - S' OUTLET Grade over Septic Tank 98.00 Grade over D-Box - 97.DO r' S /�•b f r/i rows C""hee obne N 1/e'- r/!' reeh+d Pwtwv .:: (� "'�\it KNOCKOUTS INSPECTION cover must be -t5.5' +' g1K'v� Ly�! } gh i 12^ INLET d _w..�•••^`- i C+fiKe p.: 7 it bait*L. S - 0.02 3 HOLE H-10 within 6" of finished grade t\ OUTLET 14 - \ / � . DIST. BOX 3' Maximum Cover Top of SAS-EIev.=92.13 ,� , 2 70 sea Yin 1W o ;� F 10' EXIST. s-o.ot or Creator S- O.Ot O'per foot yy � // �+ ,{� to* at f'SPE X �, 1,000 L. 18, 1 cm t5S' 4" - SCH. 40 Te 1.75 S dyC� ( .+<werry FROM EXIST. FOUNDATION W � SEPTIC TANK S 20. Effective Depth G7 O t] O G Imo ,,. / t4 gyp ,`• ,,,,eMi Ir � C3 C3� CD PLAN SECTION CROSS-SECTION g.' r' V H-10 n 2Units28:5' - 17' 1 CONCRETE FULL FOUNDATI y - a0 4' 19' 4' - f,e„ '• £ -` m 4 (D II u 3. �_5 3.5 641Ieer Wry ram- 1 SYSTEM PROFILE 6 In.of 3/4'-1 , 2• i i � 3 HOLE H-10 DISTRIBUTION BOX compacted stone a 12 it 25' -� I c i 3 Effective length NOT TO SCALE Not to Scale - c Effective Vidth i > i a�i 1D65 Riid%ft%*j d w n"MTE�T 1 rfi, c c SOIL ABSORPTION SYSTEM (SAS) 6 In.of 3/4"-t 1/2' 5' PROVIDED o 500I- C H-20 LEACHING UNITS / WIGGINS PRECAST GENERAL NOTES ES compacted stone m Bottom of Test Hole I Bev.- 84.00 Not to Scale 1. Contractor is responsible for Digsafe notification NOTE: ALL COMPONENTS MUST HAVE RISERS TO Within 6" of Grade -----------------------`--- and protection of all underground utilities and pipes. Obs. Groundwater - Test Hole 1 EIev.= NONE OBSERVED 2. The septic tank and distribution box shall be set level on 6" of 3/4"-1 1/2 stone. 3. Backfill should be clean sand or gravel with no stones over 3" in size. Q0 4. This system is subject to inspection during installation ca co by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance I i I with Title V of the Massachusetts state code, the approved plan 1 / and Local Regulations, PERCOLATION TEST I I 6. If, during installation the contractor encounters any i j soil conditions or site conditions that are different 1 I I from those shown on the soil log or in our design Date of Percolation Test: MAY 17, 2005 I I Test Performed B Carmen E. Shay, R.S., C.S.E. i I I installation must halt & immediate notification be Y I ! made to Carmen E. Shay - Environmental Services, Inc. Witnessed By. WAIVER (per BARNSTABLE B.O.H) � 20 7 C,p y EXCAVATOR: Shay Environmental Srvcs., Inc. I 1 ���\ LOT 21 1, I' q C> 7. No vehicle or heavy machinery shall drive over the Percolation Rate: 2 MPI ® 30" I j I 24,100 Square Feet +/- I septic system unless noted as H-20 septic components. i 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. - 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. Test Hole I 1I �\ �- t N0. 1 I I �` I 10. All solid piping, tees & fittings shall be 4" diameter Iy ` PROJECT BENCH ;MARK It Schedule 40 NSF PVC pipes with water tight joints. DEPTH soils ELEV. I � -,, TOP OF FOUNDATION \ p p g 0 97.00 �\ ---- ELEV. = 100.00 (Assumed) ��� --9g 11. Municipal Water is Connected to The Residence and Abutting Sandy Loam � I \\ �.'_----� �N �� �\ -_-- Properties Within 150 Feet. I � \� 36.75' 10 YR 3/2 1 - - THE PROPERTY LINES ARE APPROXIMATE AND \� 1�` COMPILED FROM THE SURVEY PLAN GENERATED BY 0"-6" Ae 96.50 � �� \ \ Failed R.J. AHERN, INC., LAND SURVEYOR, ENTITLED Loamy et dy \ \�` ' �`� Leach Pit "CERTIFIED PLOT PLAN OF LOT #21 SEA ROBIN ROAD, OSTERVILLE, MA 1a YR s/6 _ TIMBER RETAINING- TEST HOLE #1 DATED 09/22/82 _ 6"- 30" B. 94.50 \`WALL 0 ELEV.= 97.00 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN 25' THE SEPTIC SYSTEM INSTALLATION. Medium - \\\ t` I Sand 2.5 Y 7/4 \\��� \� 1 e F. y E'CHIN 7-AREy 4" PVC EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE OR 30"-156" C, 10( GALLON r-_ �.•,, . I -.i Vent REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION \ `�� SE�IC TANK 1 1 '_,T.`' ' v �\\ •� I Z--t-.-----,_-- A� ? j� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE t .\ FROM THE EXISTING LEACH•PIT TO BE DISPOSED �O 1 OF AS PER BOARD OF HEALTH SPECIFICATIONS. I o SCR ENED 20� �\\ NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY ,! PORCH ASSESSORS MAP 122 PARCEL 044 BRICK PATIO EXISTING t�l LEGEND V 2 BEDROOM W Perc #1 � Depth to Perc: 30" to 48" HOUSE EXIST. Perc Rate 2 MPI gp � - _--- #70 GARAGE 1`1 1O4X1 DENOTES PROPOSED Groundwater Not Observed \ SPOT GRADE No Observed ESHWT I t ADJUSTED H2O Elev. = None TIMBER Il it X 104.46 DENOTES EXISTING STEPS ,\ I� SPOT GRADE i I ;\ PROPERTY LINE \ PL P 94------- -------- � Ic 96P PROPOSED CONTOUR - - - - - -97 EXISTING CONTOUR GRAVEL 2-18" DIAM. ACCESS MANHOLES DRIVEWAY / DEEP TEST HOLE & PERCOLATION TEST LOCATION ;; , . .�'�;•� r�.y.: � ISO 6 FOOT STOCKADE FENCE IN 61.63 INLET / OUTLET 1 ( I I .; _ 50.00 / Il P LOTLANTHE ACCESS COVERS FOR THE G COM TANK. P DISTRiBUT10N BOX AND LEACHING COMPONENT a � �' ram„Tz a*v +^•t r"^; n',r" ,`•.F SET DEEPER THAN 6 INCHES BELOW FINISHED // / J` �---- - • ' GRADE SHALL BE RAISED TO WITHIN 6" OF STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. -' / �� 1 ---- OF PROPOSED SEPTIC SYSTEM UPGRADE PLAN VIEW INSTALL TUF-TITE GAS BAFFLES OR EQUALS .'� < � 3J, 1 PREPARED FOR .\\Q \\ , L = 23.07 /- 3-24" REMOVABLE COVERS-� , - � ' I A L F R E D �c M A R Y S E M ¢O' �I R 145•00 AT 3''min. clearance J I #70 SEA ROBIN ROAD I INLET 8" min^rl2 min. Inlet to outlet a. ts• INLET• �� , FOOT i�\� --- '-. - Uquid levees- OUTLET R�(;H, ` ►� --------- 5' ,. _ s� ,.- �� ,. 5, 7- o � OSTERVILLE, MA E " 4 0 min. Design Calculations 4 b� a+e» Liquid depth �� qs PREPARED BY: Number of Bedrooms. 2 Equivalent to 220 Gal./Day (330 Gal:/Day Min. per Title V) +,. .:.... ..;•.•j Garbage Capacity NP Minimum (Min. Per Title V) �e u • ; �, _ Leaching y Proposed: 330 Gal./Day C N1 rl �1 Y �ll 8'-a• 4 -t0 Septic Tank : 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL. Septic Tank. 0 20 40 50 �o CROSS SECTION END-SECTION NVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./Inch Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. = 222.00 galllns O P.O. BOX 627 TYPICAL 1000 GALLON SEPTIC" TANK sideWan Area: 0.74 gal./sq: ft. x 148 sq. ft. t09.50 gallons / TE�� EAST FALMOUTH, MA 02536 Providing: = 331.50 gallons , �gN�AR�Pa NOT TO SCALE SCALE: 1 ' =20 TEL/FAX 508-539-7966 Use:. (2) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH' • TO BE USED WITH 3.5 OF WASHED STONE ON THE SIDES AND SCALE: 1 20' DRAWN BY: CES DATE: MAY 17, 2005 4' of WASHED STONE ON THE ENDS. PROJECT SD742 FILENAME:. .SD742PP.DWG SHEET 1 OF 1 _ I {