HomeMy WebLinkAbout0012 TIFFANY ROSE LANE - Health 12 Tiffany Rose Lane, Marstons Mills
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TOWN OF BARNSTABLE
LOCATION 0 7F'r- + f SEWAGE# -�14,— �
VILLAGE �JMg cP ASSESSOR'S MAP&PARCEL j/ -�
INSTALLER'S NAME&PHONE NO. -Z G 1 Sra�`1?I-I Xl l
SEPTIC TANK CAPACITY Lac!r"i t �44 IGYJt7 .
LEACHING FACILITY:(type) tG 0 - (size) jc�
NO.OF BEDROOMS
OWNER
PERMIT DATE: Io• 13- J/. COMPLIANCE DATE: (9
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Q— Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) f4c-- Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
QZia A-tiZ ef, r{(eati.Ls L
-� 57 � 3
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No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
2ppliLation for Misposal *pstem Construction permit
Application for a Permit to Construct( ) Repair(+K Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. �o? 1_ Owner's Name ddress,an el.No. � 7 S
1 )3 '/
• � x�rs Fin ,��/� Gri
Assessor's Map/Parc [l`� 02,' 16
Installer's
-Name,Address,and el.No.�/�-'yj/-935 esigner's Name,Address,and Tel.No. Z)8.
rborwoz �Yfa`'� c'Y� c�nG P.(9•IDS°7b7' 1C17 .. inC�e�/Y , y �f EC[.v�
D L a�7S
Type of Building: Q �1
Dwelling No.of Bedrooms J Lot Size o?�y ISM sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures p
Design Flow(min.required) 3 gpd Design flow provided � / gpd
Plan Datk A" 1;V-11 o Number of sheets p / Revision Date
Title '1 i 1��., 9-�/�Qryte��p V Ajf6d67S NIPS . A4/f
Size of Septic Tank /S t;1 Type of S.A.S. a��Y �[y�,bp ���( ,� o�X lo?�13
Description of Soil &Ze 42g S
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 Environmental Code not t lace the system in operation until a Certificate of
Compliance has been issued by this Board of Health. -
Signed Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. ac i 1 D 3 U 3 Date Issued -112 J 13 I Ly
No. Fee-- I Dr'�-
t' THE COMMONWEALTH OF MASSACHUSETTS Entered;n computer:
/
Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Rpplitation for Disposal *pstrm Construction Permit
9
Application for a Permit to Construct( ) Repair(uK Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. �01 (�,���� , . Owner's Name Address and Tel.N . 50� -'13 7 -
// ,�-/ic Ions � ,Wca�r-(t- e e rp,4 � /k i,=W yw;60 47'
Assessor's Map/Parc �/- Qnol yn a y�
Installer's Name,Address,and Tel.No.5'zDE'77/-735 Designer's Name,Address,and Tel.No. 669- -74 P `VSV/
r6or}o(65CCL Qvrr-,{-fib i-n ,.t ne- P.6.GX'76V c ilry����t inFetri%�j, g3�M�tt v, 5,1-
O 4. n ,O M 0,-7S
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 0?)y41 S sq.ft. Garbage Grinder( )
Other Type of Building a �,� No.of Persons Showers( ) Cafeteria( )
Other Fixtures f/
Design Flow(min.required) 336) gpd Design flow provided T gpd '
Plan Dat ,���� Number of sheets Revision Date
Title 5e. .t k"_,4 6 iy;//$ if{
Size of Septic Tank,Y=4 l5 l Type of S.A.S.WV�5(/`0 �4a h6e 0k(Ay44;t:X/o?,93
Description of Soil a S
i
Nature of Repairs or Alterations(Answer when applicable) +
X n
Date last inspected:
f
Agreement: �+
The undersigned agrees to ensure the construction andrmaintenance of le'afore described on-site sewage dispd'sai system in
14
accordance with the provisions of Title 5 of the Environmental Code and not t lace the s)sterri in operation until a Certificate of
Compliance has been issued by this Board of Health. _
Signed Date
Application Approved by r Date J O /t
Application Disapproved by r` Date
for the following reasons -��
Permit No. a0l 1 n 3 3 Date Issued � � j
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(16 ') Upgraded( )
Abandoned( )by �Jor tD�a ans&,%J'-ik Inc•
at /�2%,� 0,4 :�50s� fS'iyl� /1/415kc 91/b has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 6 I dated
n n t
Installer rt� 0y��i �, -,&e, Designer 1 L
#bedrooms 3 Approved design flow 3 y� gpd
The issuance o this permit shall not be construed as a guarantee that the system wil fun ion as desig d.
Date I iJ ' Inspector h(
/ I �
No. ()_y I /W,� Fee M.._.-
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstetn CoustrUction Permit
Permission is hereby granted to Construct( ) Repair(k/) Upgrade( ) Abandon( )
System located at /) �IPIW-
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date (d Approved by ��- {
NOD-17-2016 05:17 From: To:150e7906304 Pa9e:1-'I
Town of Barn9table
Regulatory Services
Thomas F.Geiler,Director
g s publye Health Division
Thomas McKean,Director .
290 Mon Str"t,$yannis,MA 02601
Fax: sob-790-6304
Office: 508-862-4W
Installer&Dee er Certification Form
rcel 4-3/t)a
Assessors NIAPpa '
Date: �f Sewage Permit# _ (�7
r
P
D
es' er. ®W installer: a o
Addreas: I. - Address: ��D- �- 71,� —
14,1P
on 10!131 �0�G t_1,n3�issued a permit toinstalla
te) (a er)
septic system at12
(e bred on a design drawn by
A.S dated A ��' 0-014
to
I cer�zfy vv ch gepjjc include minstem orapprovedced changes ove was i h as lateral cord
reed lc atioa of thethe
the design, Y
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (
greater than 10,IWral relocation of the SAS or any vertical relocation of any component
- of tl�e septic system)but in accordance vial State&Local Regulations. Plan revision or
certified as b y'clesigner to follo`v.
7 QF d�
OANIELA,
OJALA
CIVIL y
(Inst er'S Si n3t11Y� , No.46502110 Ca
4
IRT
eta �sslAMAt
esiper's sib uxe) (Affix Designer's Stamp Mere)
PI,E ABLE )P LIO HE LTH Q E IIY iO ICE
COIVAPLIAN WELL Noy.'EIS D UN'TiYa BOT TBIS KM ANTI AS-►OID�LT AItD
gECE sD o�THL IEiA17J � I,E L! AI,TH If SIO YOU.
();Heallh/Sepur�Gc��n�onPnrrra 3-26-p4.doc
Town of Barnstable >P#
f
n F
t]) partmet�of Health,SaetandEnvtronmental.Seewlces; 9
PublicrM,ii ltli Diiis><`on
`367 Main`Street,Hyannis MA'026OF
BAMSTABI.B, .
MAa9.
1a�� , b� Time I G _ Fee Pd. l(I0
w date Scheduled � S T 1 �ri -
r
®al Suitability Assessmaent for Sewa 'e Disposal
Witnessed By'
Performed By: fG tOQ �l C`CtC
:::.:::::::::::::::..:.......... ..::::g.. ..: TLQ : `► + QUA.:.::: i:::.::::::::.::::::::::.:.«,;;;;;;;;;;;>;::.::::::::.,:::::.:::.:::: ::.:.::. ::.::,..;
:: ::::::::::::: �.....�........... � Owner's Name ,
Location Address / ��VVVJ
Assessor's Map/Parcel:3/0
U y��� Engineer's'Name JQ,t/� �e
NEW CONSTRUCTION REPAIR Telephone# 0 j
Land UsePS!(!�f Slopes(%)_67 �d Surface Stones
i
Distances from: Open Water Body Z� "' D It Possible Wet Area ft Drinking Water Well ft —
Drainage Way > . ft Property Line _ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
� 1
40
c�
F
Parent material(geologic) l tS� (FGi( Depth.to Bedrock .�
Depth to Groundwater: Standing Water in Hole. I Weeping.from Pit Face
Estimated Seasonal High Groundwater_
0A� lyJl>i:;Y.Y?1J 'L',laird?:;.:::.:,.:>:;;;;>;::.>::;;;.:o-:.;.::.
Method Used: t'"
Depth Observed standing in obs.hole: in. Depth to soillmottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment tt•
Index Well,#___._,_ •Reading Date:_.--- Index Well level ' Adj°lfactor "" ' Adj.4Gioundwater Level_
` 71
` :•.`.}•:.ry>•y'•:..•::.': ..
•Sii>?is2i ?ii#i#':`:`"::':`>kt#t ?
_ Observation _
Hole#' J� ' Time:at 9'�, ,,
P'
Depth of Perc _ Time at`6
Start Pre-soak Time Q �I GS Timey(V-V)
End Pre-soak
i
Rate Min./Inch ��►��� ►.�
Site'Suitability Assessment: Site°Passed-• i w�` Site Failed;. Additional:Testing Needed(Y/N) 131
Original: Public Health Division Observation Hole Data To Be,' m'Plet6dlbn' 'Back
Copy: Applicant
::;.>:.>:.::;.:::.::;•;:;.;;::;::;R:::;S::�:;:.::..:�.. s•,:.:''.:r,:,.::..,.;'S' .r "._...:::: .:.:, <:.':.::.1...,X. isii;py i;`;i?ii!iii6ii!iii-••w %#i'iEi i::• is 3?i i i:`' ? i'2i i��iF';`:i'ii:
•• ' ��• • '
fo
0 it�'� �Slozn
Ol tier
Dentli from (USDA), (Munselt Mottling (Structure,Ston
es, 3oulderes.
uface(in.) °
1p p
�Z�l-lam /-t�r
1 �
4. • �
V.
:D'epih from Soil Horizon Soil Texture Sol!Color Soit,. Other
Suiface(in:) �' " ,` (USDA) (Munselt) Mottling: '(Structure,Stones,Boulderes.
,' 4 c sistena,°°Gravel)
�Gt WIZ
::: X.
:.::::.: . : : ::. :. . :.. ::.::: :. . .: x,Ir:.: , : :.::.::>: :.: :..::.::::::.:..............
::::::::.:::.. . . .:: .� Y .::::::.::. ...... :
::::::. n : : : : .:::::.:::.::.:.::::::::::::::::::::.:::...................
,Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munselt) Mottling (Structure,Stones,Boulderes.
Consistengy.°°Gravel)
X.
Depth from Soil Horizon Soil Texture Soil Color Sod Other
Surface(in.) (USDA) (Munselt) Mottling (Structure,Stones,Boulderes.
onsi en °o Gravel)
Ahooditnsutrance g8ate 10Tan z - . _
hi Above 500 year flood?boundary,-No_ Yes
Vith.In-500.:yearboundary No Yes
r WttliiiIO'0 year'floodboun8ary No `.—Yes
ta*» �-
I)'bpth o1 aturally®ccurriug 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? �
hf,not,what is the depth of naturally occurring pervious material?
C'crtificati®n
b ertify that onQ�k
b (date)I Kdve passed the soil evaluator examination approved by the
Department of`Envlrodiiiental Ppotectiott and.that"the above analysis was performed by,me.consistent.w:ith
Ath'e required training,expertise and experience described in 310 CMR 15.017.
Date l V
Signature
2 TOWN OF BARNSTABLE s�
LUCATION L-6+' Z";' SEWAGE # '97
� / - ooy
V1 LAGE ^s7 '�< �'%�4�L5 ASSESSOR'S MAP & LOT
`%NSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) L-eti,� 9% (size) (000 44Lk s
(NO. OF BEDROOMS_ PRIVATE WELL O UBLIC WATE
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE .COZIPLIANCE ISSUED: ° -S 7
VARIANCE GRANTED: Yes No «`
I
i
o 3b
-------------
ASSESSORS MAP NO: a�3 a v 1 �
NO... 7::�y. .... PARIEL0: �� - G 3/. �y s Fps..... ...
THE COMMONWEALTH OF MASSAC
BOARD OF HEALTH
............... U / .....OF.......... /v.-��. 1_5-&e....................
ApVtiratiun for Diipuiitt1 Morkii Tunitrurtiun ramit
Application is hereby made for a Permit to Construct (V�or Repair ( ) an Individual Sewage Disposal
System at.-
i
.. " 2...... ... ._._t _.... Ms1"vs .i. r_....N1 :_..�
L 'on-Addr or Lot No.
/5. OI'swner Address
............................................._........
Installer Address //
1 Type of Building Size Lot_.___._�1.�4l ___.Sq. feet
Dwelling—No. of Bedrooms... Attic ( ) Garbage Grinder (0
p,, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
aOther fixt es -----------------------------------------------------------------------------------------------------------------------------------------------------
Design '
Flow____._.____ ________________________gallons per person per day. Total daily flow..............K ...................gallons.
W
WSeptic Tank—Liquid capacity._ QQ_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 ( ) Dosin tank (
g
Percolation Test Results Performed by.. Vj_.f::..ildfilAfe-__4Q..9141�1pYto
__. Date....... _9�: .......
,aa Test Pit No. L.�_�___minutes per inch Depth of Test Pit____________________ De ground water... .._._.......
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0 Description of Soil....... r :...
x •--•------------------- 'Tz'.:-. ,�_:__ l,!�.... v m =
---
V ------•-----•-•--.......-•-----------••------•-••-----••-•••-
W •---•----------- --------- - ......./.'tom. .- ...PU- ------ - - ------------------------------.._.._...__.._.._.....••---••-••••--
VNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________
-------••---------------------------•--•--------------•--.-..-----------=-----------•---•-------•--------------------------------------------------------------------------••••••--•-•-••--•...•--••••--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with
the provisions of 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.
Signed G 1---- •-•---•----••---------------- ----- �3/ l
Date
Application Approved By..........)..... _:c.. - - ............................................. -••----•- 1
Date
Application Disapproved for the following reasons------------------------------•------•-------------------------•-------------------•-•------•--•-•-•••--•_--•---
...........................................-.............................................................................................................................................................
Date
Permit No......50n__l_-1-I T--------------------•---•-.. Issued............. _ .?.........•----___
Date
No................_....... Fs$.........................
_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
r
r
Appliration for Disposal Works Tonstrurtion "trutit
Application is hereby made for a Permit to Construct (V, or Repair ( ) an Individual Sewage Disposal
System at:
� ,,,,�''" r's I r IE.
t�"� + '"" -' �f L:. :" .. .. � ''�`••• ..:s.F.:'J�y .........................r'is t: . '1. V f L( �,
........ .»`.�._..19..... I n-Ar[e�ss 01/ .r ! -or Lot No... `� .......... ............
---^.................. . ..... c.{----•,, i.!! ...:!'.�' /.....�a.2 �1 S..f_4-:.!...:. t .......
Owner I Address
/1 qy SSii-~.•y�••am�^•^ f ,�,-jt'. �,�(*^,-,~-
W y` ..... , .I B C ................................ +` ....----•-------..............................
Installer Address
UType of Building Size Lot.......Z14,-6. ....Sq. feet
Dwelling—No. of Bedrooms--- Attic �11rj}) Garbage Grinder O
Other—Type T e of Building ._..... No. of persons............................ Showers
fil YP g -------------•------- P ( ) — Cafeteria ( )
W Other fixtures ..........•---••......••••....•-
%a ;.. -------------........
W Design Flow.......•...6._'>.......................gallons per person per day. Total daily flow.................- ................gallons.
WSeptic Tank—Liquid*capacity.1ft.gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No...............•..... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---_---------------- Diameter.................... Depth below inlet.................... Total leaching area.................sq. ft.
Z Other Distribution box ( ) Dosing tank
''•' Percolation Test Results. Performed by___ ! ! _._ � (�1_ t'.._ i1 ''•l'_L.: _.. Date....... c`__..__.__..
`�a Test Pit No. L_ "W._tr''_.minutes per inch Depth of Test Pit____________________ Depth to ground water......._...._...........
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
...........a ?--- : --� --- ---------------------------------------
x Description of Soil........� �� g r -•----•----
v
.. ......�f --t f..�.1 'l _ tY! 'may,? ..- .-•............•-•._....
w --••- ••-• - = ` ��lt _.. ;,✓ i r -----------------------------------------
-----
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 TITIE 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.
Signed_ 2. .= !' %... .. .. .._.`, --.-•
Date
ApplicationApproved By--....---••-----.......•••••••-••••••--•••---•-••-•-•-••••--•-•----••--•--•--------------------- ........................................
Date
Application Disapproved for the f ollozeing reasons--------------------------------•------------•-----------------...._.._.....---------....._......_____...._....»
.................................•----.....----------------.........------•-----.........._............--I-•----._.................-••---.....----•-••---••••----•-•-•.....-••••-----••-••••-•-•..---•--.
Date
PermitNo.........r -1LI--t--------------------- Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
_ ) BOARD OF HEALTH
�°� /..► .......OF............ C:a:t/..�? � ..
QTrrtif iratr of Toutpliatta
THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( L4 or Repaired ( )
by------ v�• -----...Dk.1 �-----------------------------------•---•--•---.........,-%---.....----------.......------------------.....--- ......------...
Inst
at---- '"A� "r .. '1 i f_._ .14f. E!��,L) aller /l.!£:_,c _.!_!G���c .st:1.V..e?......... /..� -v" ......
has been installAd in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. (�
3.J DATE............... ...........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............. F.......... "...............
No......................... FEE........................
Disposal orko Tunstrurtion rrutit
Permission Yor
ereby granted...-----.�.. .'_.6'_ ....... ! -.�`(�'. .. ..............................
to Construct ( Repair ( ) an Individual Sewage Disposal System
at No..LX-.-t_4'L.f' _.:rlFFA&t 4._. ...... .... le..... C ..........................................
Street
as shown on the application for Disposal Works Construction ermit No..................... Dated..........................................
DATE........ L K . ........................... Board of Aeal h
FORM 1255 A. M. SULKIN, INC.. BOSTON
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LEGEND
EXISTING SPOT ELEVATION 0
PROPOSED SPOT ELEVATION SIN OF M `jN OP
� gss9' oa a�gs�y
EXISTING CONTOUR ---0---
o� ��� ROSINROSINPROPOSED CONTOUR 0 P A U L o vv.
A. r. i IL X
NOTE: THE LOCATION OF ANY UNDERGROUND "'"
SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON N 4 r� 313
o.i o 0
THIS PLAN IS APPROXIMATE ONLY AS DETERMINED �F
FROM RECORDS AND/OR VERBAL INFORMATION. �° G/ST ANosJ
THE CONTRACTOR IS RESPONSIBLE FOR THE 0
VERIFICATION OF THE EXISTING LOCATIONS IN
THE FIELD.
�EgISTERED ENGINEERZI T RLAND
LEVY & EI.DREDGE ASSOCIATES,INC. cLIENT � 0 OSE® PLOT PLAN
ENGINEERS — LANDSCAPE ARCHITECTS JOB N0,4:23=
PLANNERS — LAND SURVEYORS
DR. 9Y= IN
889 WEST MAIN STREET CHKD.BY=_._._
CENTERVILLE, NIA. 02632 SHEET_I OF 2 SCALE= DATE= -2
/Y07"F. /F E/TNER THE SEPT/C 7ANk OR
. .. L*EACN/n!G P/T ARE /yJORE 7r*NA,,V /2"BELO/V
4 olg. GRAo�,A 24'D/AMET.L=R CoNce,,FT.E COpiCA
scH�oc�L�40 SJS►HLC eE ,t9R004SH7- TO GJTA LW.(A- FX7'.AZ A
CONCRETE P Y.C. P/PBr JYEAV Y C^S 7- /RO/Y C o V-FR S//.4 L.L 0 U S --.0
O/ a COVERS M/N. P/TCN
_ �•OF.Q FT. ` !F/N OR/VEl�1/.4 Y
2 141m. CONCR�T�
CO VER CL EAIV .SA.-V L
' 6ACA LL
ER
:. "DMA.
ZC)GpvtG40 z*LAY-
' Ave. f?/PE • .a-o . • o ,o o CIF � -'��B
!►�/JV.P/TCN G.4L. • • • • • • •• • A •p.
D I ST; WA SHFO 570NE
�4�PRie r''T: SOP•T�/C TANK • : 4 •t • • • • • • • • e . •
BOX v • • • Ba • • • • • ••� �' M .
,:,. •• • • •EFFECT/VC_� • • 3�4 - f �2
.1;r • `° o � • • DEPTJSI • • • • ; o yVA�NED STONE
/s/x 2,5 ; ••gym • • • • • • , o
�3. �'� • a• • • • • • . • • • • • p,•y PRE44sr SE.EF'AGE
lNMMY LaLFYAT/ONS J/ v�7� =_ _ a =o, • • • • a • • • • ' pe o P/T OR EQU/V.
!/VYE/-T AT BL//LO/NG ®�FT. P�C� ! �� 5 6 tT D/AM.
//V.�E7- .SEPT/C T�4NK /D FT, �: � FT O/f�!►9. C(5--C 7AOULArJ0N,>
a-l74E7-SEPTIC TANK /b/.20FT. r
//VLET DISTR40V/ /ON 80Xl00.80 j7 OROUNO Wv4TER TABLL�
SECT/ON CIA'
ovTLErD*sTRlBurioN BOX iQa 9 6-FT
.S�'N�AGE OISPASA L SYSTEM
/JlfLET LEACHING P T/ Ido.0u T
- TA BULATlD/Y
LEACH//VG T
S
DJMENS/ON A -FT.
SCALE / O _
�4
d?ESlGX CRl TAR/A DIJy,Eas/a N 8-�—FT'•
N!/JflSE'R OF®EDROOJ+�S .3 D/MENS/ON . C.�-FT
G4R4w4GED/5,Po5AL SOIL. LOG
TOTAL &�TIAMM.-D FLOW -�3-3 0 G.41 1DAY SO IL TEST A/ SO/1- TLCST#2 eS`O/L .TEST
NUMBER&W L,FACHtNz P/rs Ar -A Y, PATE op-SOIL TLtST . �O I9l 8
SAME LEiQCH/IVG PER P!T 1-5-Tj�g rT.: 0'-2 ro a RESULTS AW-r"ESSED BY -T.2
BOTTOM Lfi1CN/NG PER P!T SQ, pT. V ge p l L - PERCOLAwo" /LATE jol
S
TOTA4 LEACHING AREA ;7-6-t- SQ. FT. 2 _ W AE/tCOLA'T/oN RA7-&f*2 MJN.1/NC/
RESER G A YE CNlN FT.
MEDeUM -AND
4-4 7,ES7-
� qc ti. M�QIuM
P A U L
LEVY v, s C;RA�rEL
No iooso o LEVY& ELDREDGE ASSOCIATES. INC.
. FG/ST
' D 889 WEST MAIN STREET CENTERVILLE,MASSAC USETTS 02-
�N06ROV W,ND 4TER' APVCOUIV71-5e.o Cs/.EwrjTR�NpteQ :DATE Z $p
F7 GROIJNO h/.47'L.P A7 _4=/ -V.
JOB NO. 1 C5 32— SHErET�4F aL.
rY
,off S 8
CONINIONWEALTH OF MASSACkSETTS
e ro
' EXECUTIVE OFFICE OF ENVIRONMENTAL AFF. b ,rFCf
DEPARTMENT OF ENVIRONMENTAL PROT IOp � 2 g �
ONE WINTER STREET. BOSTON. NIA 02105 OF
61'•.S_•.'::C ►!� 0 I
T 99?
�
I
W'ILLIAM F W'ELD OXI
0,3vemc•
• Se:retar.
ARGEO PAUL CELLUCC1 DAVID B ST'RU}S
Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissions
PART A
CERTIFICATION
Property Address: V4V. AK4+ ST(V6 AtIIS Address of Owner: 'LC� to R-kT2
cDaie-of Inspection: $(Zg �`j (If different)
Name of Inspector: 0 f 0) Cl�o
1 am a DEP approved system inspector pursuant to Section115.340 of Title 5 (310 CMR 15.000)
Company Name:�/1q y4-,'e G n rr'r"eh 04 P.A /
Mailing Address: R p 1;,x e 3xf CF
Telephone Number: e-Se 1
c—
CERTIFICATION STATEME\T
I cenih that I have personally inspected the sewage disposal system at this address and that the information reported below is true. accurate
and complete as of the time of inspec,-o-. The inspeciion Kas performed based on m training and experience in the proper iunaron and
maintenance of on-site sewage disposa systems. The system:
Passe:
_ Conc,t,onaii\ Passes
tieee: Fu„he• E4uat;on S% the Local Approving Authont\
_ a.�s
Inspector's Signature"
The Svse^ Inspeco• Shat' submit a cope of this inspectjon report to the Approving Authority within them, (30) days of completing this
inspection. If the system is a shared system o, ha: a design floe of 10,000 gpd or greater, the inspector and the system owner shall submit
the repon to the appropriate regional oiiice of the Department of Environmental Protecjor.. The original should be sent to the system owner
and copies sent to the buyer, if applicable. and the approving authority.
INSPECTION SUMMARY: Check A, B, C, or D:
AI SYSTEM PASSES:
14,
1 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
COMMENTS:
BI SYSTEM CONDITIONALLY PASSES:
One or more system components as described in the 'Conditional Pass" section need to be replaced or repaired. The system, upon
completion of the replacement or repair, as approved by the Board of Health, will pass.
Indicate ,yes, no, or not determined (Y, N. or ND). Describe basis of determination in all instances. If "not determined", explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or
the septic tank, whether or not metal, is cracked, structurally unsound, shows subsantial infiltration or exfiltration, or tank
failure is imminent The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(z�.is�d 01/25/97) Page 1 of 10
DEP on me WonO Wae we: hm jnvww magnet state ma.uyoe:
Pnntee on Recycied Pam,
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner.
Date of Inspection:
BJ SYSTEM CONDITIONALLY PASSES tcontin.)�d
Sewage backup or breakout or high static water level observed in the distrib ion box is due to broken or obstructed
pipets) or due to a broken, settled or uneven distribution box. The system ill pass inspection if(with approval of the
Board of Health). Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due t broken or obstructed pipe(s). The system will pass
inspection if (with approval of the Board of Health):
broken pipets; are replaces
obstruction is removed
C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEAL H:
Conditions exist which require further evaluation by the B rd of Health in order to determine if the system is failing to protect the
pubitc health, safe*., and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH D ERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AN SAFETY AND THE ENVIRONMENT:
Cesspool or pri,.-% is within 50 feet of a s dace water
Cesspool or prig-\ is „ithin 50 feet of a ordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MA ' ER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank d soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water pply.
The system has a septic to and soil absorption system and the SAS is within a Zone I of a public water sup,)Iv well.
The system has a septic i nk and soil absorption system and the SAS is within 50 feet of a private water supply well.
The system has a septic ank and soil absorption system and the SAS is less char 100 feet but 50 feet or more from a
private water supply ell, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that
the well is free from ollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. ethod used to determine distance (approximation not valid).
3) OTHER
(revised 04,125/91) Page 2 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Propert- Address:
Owner:
Date of Inspection:
DJ SYSTEM FAILS:
You must indicate either "Yes' or "No' as to each of the following:
I have determined that the system violates one or more of the following failure criteria defined in 310 CMR 15.303. The bans
for this determination is identified below. The Board of Health should be contacted it determine what will be necessary to correct
the failure.
Yes No
Backup of sewage into facility or system component due to an overl ded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or s ace waters due to an overloaded or clogged SAS or
cesspool.
5ta:tc liquid level in the distribution box above outlet invert a to an overloaded or clogged SA5 or cesspool.
Liquid depth in cesspool is less than 6" below invert or av ilable volume is less than 1/2 day flov.
Recuired pumping more than 4 times in the last year OT due to clogged or obstructea pipe's .
Number of times pumped _.
Any por,;on o;the Soil Absorption System, cessp of or privy is below the high groundwater elevation
An por::on of a cesspool or privy is within 1 0 feet of a surface water supply cr tribuian to a surface water supply.
_ Any por'ior, of a cesspoo' or prn-� is withi . a Zone I of a public well.
Am po-oc- of a cesspoo! or pri,.-• is w him 50 feet of a private water supph we!
An por:�on of a cesspool or prnv i less than 100 feet but greater than 50 fee: from a private water supph- well with,no
acceotabie mate, qualin ana!vs!s f the well has been analyzed to be acceotab e. anach copy of well water analysis for
cohiorr-, baceria volatile organs compounds, ammonia nitrogen and nitrate nitrogen.
E7 LARGE SYSTEM FAILS:
You must indicate either "Yes' or "No" as to ch of the following:
The foho�%,ng criteria app;� to (arg systems in addition to the criteria above:
The system serves a facilin v,•it a design flow of 10,000 gpd or greater (large System; and the system is a significant threat to
public health and safes and t e environment because one or more of the following conditions exist:
Yes No .
the system is ithin 400 feet of a surface drinking water supply
the system s within 200 feet of a tributary to a surface drinking water supply
the syst is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped Zone 11 of a
public ater supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 NAR 5.00 and 6.00, Please consult the local regional office of the Departmen: for further information.
(revised 04/25/91) Page 3 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address
Owner: (Q6rLlTZ,
Date of Inspection: 50\tC,\C l
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes No
Pumping information was provided by the owner, occupant, or 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 volumes of water have not been introduced into the system recenti', or
as pan of this inspection
As built plans have been obtained and examined. Note if they are not available with N/A.
The fac:lin or dwelling �%as inspected for signs of sewage back-up.
The systern does not receive non-sanitary or industrial waste flow.
_ The site vas inspected for signs of breakout
o All s\stern components. excluding the So,' AosorpUon System, have been located on the site. Y
•, e The septic tans: manhoies were uncovered, opened. and the interior of the septic tank was inspected for condition of
banes or tees. materia. o' construction. dimensions, depm of liquid,,depth of sludge, depth of scum.
The size and location of the Sol' Absorption Svstem on the site has been determined based on
The fac,lrt\ o�%ne, ano occupants, if difieren: from owner were provided with information on the proper maintenance of
Sub-Surface Disposal Svstem.
Existing information. Ex. Plan at B.O.H.
_ De-,ermined in the field of am of the failure criteria related to Part C is at issue, approximation; of distance is
unacceotabie (15.302t3lb`?
(revised 04/25/57i Page 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR.St
PART C
SYSTEM INFORMATION
Property Address:
Owner:
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL:
Design floes .p.d.,/bedroom for S.A.
Humber of becrooms o3
Number o;current residents OZ
Garbage g-, der (yes or nog—E[14
Laundry co-•^ected to system (,yes or no'. lS
Seasonal use tees or no,._IW
Water meter readings, if available (last two ;1; year usage tgpd): U 0
Sump Pump lves or no;_ O
Last date o-' occupancy _ ►.��
C0NI.MERCI A,UIND UST RIAL:
Type of establishmen:
Design fios% _galions.,ca%
Grease trap present Ives or no_
Indus:na! %Haste Holding-Tana; present ves or no_
Non-san tan waste d!scnargec to the Tate 5 sysem ;yes or no_
\%ater meter readings if a,a,labie
Las:Pa:e o: 0 c:.P2--C%
OTHER: .De:cribe
Last care of cccuoana
GENERAL INFORMATION
PUMPING RECORDS and s urce i in'ormatior.
N vtjuik fowo NS447O J
System pumped as par, or inspection: rues or no.
If yes, volume pumped ttallons
Reason for pumping
TYPE OF SYSTEM
_ Septic tank,/distribution box/soil absorption system
Single cesspool
Overflow cesspool
P rn)•
Shared system (yes or no) (if yes, attach previous inspection records, if any)
I/A Technology etc. Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information:
Sewage odors detected when arriving at the site. iyes or not Act
(revised 04/25/91)
Page 5 of 10
SUBSURFACE SE�NAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property dress: 12,`15rk" i-sx.
Owner:
Date of Inspection: 3�Z i�l7
BUILDING SEWER:
(Locate on site plan)
Depth below grade.
Material of construction: _cast iron _40 P�'C _other (explain!
Distance from private water supply well or suction 11-c
Diameter
Comments: (condition of joints, venting, evidence of leakage, etc.)
SEPTIC TANK: S
(locate on site pl n
Depth below grade C'tCU
y
material of consiructoon: 3concre:e _rne:a _Fjoergiass _Polyethylene _othenexpla,n
If tank is metal, lis: age _ Is age conf,rmec b Ce^afica:e of Compiiance _ (ties.'No
Dimensions
Sludge depth
Disiance from top o: siudge to bortorn of outie: tee o, bade
Scum thickness %
Distance from top of scum to top o+ outlet tee or ba'ie 1t�� �I
Distance from bonorn of scurr to bo-o r o, outie: tee c, bane
Now dimensions %ere determined
Comments
(recommendation for pumping. rondition of iniei and outle) tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage. e;c.i %N1N'ChtCr
unrooki et,
GREASE TRAP:
(locate on site plan;
Depth below grade:
Material of construction: _concrete _metal Fiberglass _Polyethylene _other(explain)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle.
Distance from bottom of scum to bottom of outlet tee or baffie:
Date of last pumping:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.;
(roviiod 04/25,11) Pag• 6 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO% FORA
PART C
SYSTEM INFORMATION (continued)
Property Address: 1`t j'owl QCL►�
Owner: ?16rL%TL.
Date of Inspection:
TIGHT OR HOLDING TANK: � ?ank must be pumped prior to, or at time, of inspencin:
(locate on site plan,
Depth below grade.
Material of construction _concrete _metal _Fiberglass _Polyethylene _other(explain)
Dimensions:
Capacm gallons
Design flog galions"da,
Alarm level Alarm in „orking order _ Yes: _ No
Date of previous purmpin€
Comments
(condition of inlet tee. condition o- a!a,m and float switches, etc.)
DISTRIBUTIOti BOX: l.Cs
locate on site p:a-.
Depth of liquid le e' aoo•,e cube: irne
Comments
mote if leve! end d:s:•it -or, Is eeua'. ence of s�ds car .over, evidence of leakage into or out of box, etc.)
� llu,r,e� � N'U ; A.`tom .
PUMP CHA.MBER:,,JP—b
(locate on site plan.
Pumps in working order: (Yes or No'
Alarms in working order (Yes or No
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 04/25/9') pig• 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO', FORM
PART C
SYSTEM INFORMATION, (continued)
Proper Address: Z Ttff tlJ� tdu.,
Owner: Q021I'�
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):A�
(locate on srte.pian, ti possible, excaJ ion not required, but may be approximated by non-intrusive methodsi
If not determined to be present, explain:
Type-
leaching pits, number. Xy
leaching Chambers, num r._
leaching galleries, number:
leaching trenches, number,tength:
leaching fields, numper, dw nensions
over,"!o),s cesspool, number
Alternative system
Name of Tecnnoiog�
Comments.
Incto condition of sod. signs of hydraulic failure, level of ponding, condition of veget trgn, t
•
CESSPOOLS:
(locate on site plan
Number and configura'.on
Depth-top of liquid to inlet rnyer,
Depth of solids lave,
Depth of scum la>•er
Dimensions of'cesspooi
Materials of construction
Indication of groundwate-
inflow tcesspooi must oe pumpeC as par, of inspection,
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: �+
(locate on site plan)
Materials of construction: Dimensions:
Depth of solids:
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 04/25/91) Page I of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued';
Properh ddress:
Owner: f V)1 1
Date of Inspection: 2�(�
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells wrthin 100' (locate where public water supply comes into.house)
!la
L
r
��- M10
Page 9 o! 10
ti
SUBSURFACE SELVAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Properh ddress: 6?—C�ffftyA t.
Owner: yoI-t
Date of Inspection:
Depth to GroundwaterA 36 Fee;
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observation of Site (Abutting property. observation hole, basement sump etc.)
Determine R from local conditions
Cnecl, %%ith Iota' Board o• nea'tr,
Chel FEMA Macs
Check pumping records
Check local excavators. installers
Lse 'LSCS Data
Describe in vour o%%n. %'•oroz no,.% %oc es:abh5ined the High Cround�,%ater Elevation, (Must be completed-
,�, t CCS j N S f�Tl_PtJ c•
ALL
TEM
S SHALL
SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR BE NOTES
(NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION:
PROVIDE MIN. 20" DIAM. WATERTIGHT 1, DATUM IS NAVD 88
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE FCONCRETE COVERS TO WITHIN 3" GRADE
2. MUNICIPAL WATER IS EXISTING � P Rac Lone
\
TOP FOUND. EL. 109.3' FILTER FABRIC OVER STONE 3. MINIMUM PIPE PITCH TO BE 1 8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 1O5' / C) P� Vc P�6o
NOTE: 2" MIN. WALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST
PRECAST H-10 THICKNESS REQUIRED BLOCKS OR UNITS TO BE AASHO H-10
PRECAST RISERS
RISERS (iYP.) 9
4"DSCH40 PVC MORTAR ALL Locus
2'0 104.52' COMPONENTS H-10 5. PIPE JOINTS TO BE MADE WATERTIGHT.
s" MIN. SUMP PIPES LEVEL 1ST 2'
12" MIN. TNT. DIM. ENDS (TYP.) 0 SIDES 1 02.83' �\
IN ACCORDANCE
a
°°�°�o eImm
° o o ° WITH 10 CMR 15 00 TILE
6 CONSTRUCTION d
10" 14" 1kE` o o ° o H 3 0 (TI 5.) o p\
TEE TEE � � o � 000c o00 00 >0°0°0°0°
103.1 2 0 0 0 0 o WATERTEHT D'BOX '00°00°00°0° 0��0���MM0 c= �OOD00°000000
11 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND As Mei s
0 0 0 0 0 o O > ° ° o o OQ�F1 FP ����Q0��� o 0 0 0
o00000000000 °0°0°00 O O O O D O G7 O O O O O O O O O00000000**EXISTING ,/GAS BAFFLE; o�000O,�o10- FOR LEVELNESS c i °0°0°0°0 ��0��0000� (������00� ;°0°0°000 � NOT TO BE USED FOR LOT LINE STAKING OR ANYSo ool
SEPTIC TANK ° ° ° ° � � o � 00000 � o o � oo � � 000 ° ° ° °
°°°°°°°° 00.00000 100.0 OTHER PURPOSE.
102.27' 102.1 ' °°°°°°°°
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL.
3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR z R er Ro
ALL AROUND PRECAST STRUCTURES
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' CONCEALED WITHOUT INSPECTION BOARD OF
COMPACTION. (15.221 [2]) b HEALTH AND PERMISSION OBTAINEDD FROM BOARD �
Ui OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR
CALLING DIGSAFE (1-888-344-7233) AND MAP
�`V�f 1/�
95.0' BOTTOM TH-1 VERIFYING THE LOCATION OF ALL UNDERGROUND Se ' LOCUS
( 10 % SLOPE) ( 1 % SLOPE) 97 NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. SCALE 1"=2000'f
89
8' D' BOX 12' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED `ASSESSORS MAP 31 PARCEL 4-8
FOUNDATION— EXIST. SEPTIC TANK FACILITY
SHALL BE REMOVED 5' BENEATH AND AROUND THE
PROPOSED LEACHING FACILITY. SITE IS LOCATED WITHIN A ZONE II
*THE INSTALLER SHALL VERIFY THE ��
LOCATIONS OF ALL UTILITIES AND ALL `S 12. EXISTING LEACHING FACILITY SHALL BE PUMPED
� AND REMOVED OR PUMPED AND FILLED WITH CLEAN
BUILDING SEWER OUTLETS AND � V
SAND.
L E G E N D ELEVATIONS PRIOR TO INSTALLING ANY
PORTION OF SEPTIC SYSTEM 91> 9�
99— EXISTING CONTOUR ��, �� C
**INSTALLER SHALL CONFIRM MINIMUM SEPTIC
X 99.1 EXIST. SPOT ELEV. TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY A- s'
99 — PROPOSED CONTOUR FOR RE-USE. REPLACE WITH 1500 GALLON BOO\ 96 SYSTEM DESIGN:
—
[ ] SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF 'o� `9d' GARBAGE DISPOSER IS NOT ALLOWED
198.41 PROPOSED SPOT EL. NOT SUITABLE A-
DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD /
TEST HOLE r —
YY o USE A 330 GPD DESIGN FLOW
2� SLOPE OF GROUND J�
SEPTIC TANK: 330 GPD (2) = 660
C-O--, UTILITY POLE 105 N
' } o
' 2P FIRE- HYDRANT o. `101. �70 **RE-USE .EXISTING 1000 GAL. SEPTIC TANK
by0
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING \ LEACHING:
SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD
} BOTTOM 25 x 12.83 (.74) = 237 GPD
LOT 25
TEST HOLE LOGS TH2
�' TH1
TOTAL: 472 S.F. 349 GPD
ENGINEER: CRAIG J. FERRARI, SE #13871 0 20.49 ACF USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
DAVID W. STANTON RS m� WITH 4 STONE ALL AROUND
WITNESS: �4x
2
DATE: 10/5/2016 ' > 92
PERC. RATE _ < 2 MIN/INCH } 107 DECK ��`., '
MA
9 APPROVED DATE BOARD OF HEALTH
CLASS I SOILS P# 15163
' ENCHMAR
ELEV. 2 ELEV. CO'R. BULKH D
0" 1 105' =1 .3 NAVD 8 s
� 105' 0"
A J / EXISTING
A DWELLING
LS LS E � TOF = 109.3 2 10YR 4 TITLE 5 SITE PLAN
6 -
10YR 4 2 /�
„ 9/ „ / /E
� OF
8 g / ARAGE
LS #12 TIFFANY ROSE ROAD
10YR 5/8 10YR 5/8 /10 �on MARSTONS MILLS MA
24" 103 27" 102.7' 6� `�
108
PREPARED FOR
PAVED
C C DRIVE BORTOLOTTI CONSTRUCTION
PERC
DONOGHUE
VS M S 28 78. �p� o r--� v—JA i
O
� Asc9 n,. r�As �� jSNO Mds DATE: SEPTEMBER 5, 2016
rr 106 �(NOFMgssga`� DANIELA. DANIEL
R G
1 OYR 7/4 10YR 7/4 o� o� p . ,;, ti� o OJALA �� DAiIEL A. off 508-362-4541
o� LA N� " CIVIL °'o A. OJALF fax 508-362-9880
A 105 " �IVIL No.�',6502 Q I`' OJALA A No,409 a downca e.com
P a w I;c.40 �0 P
! 46502A0 xe /�
STrcF \� \ G �� it p�
O �, R SS/ONA� �N � FFs� n c.
engineering in
F STE '
120" 95' 120" 95' ONAL civil engineers
^,� '-r* ` � '
scale: l"= 20' ,�j _ y, -� land surveyors
NO GROUNDWATER ENCOUNTERED l O
939 Main Street ( Rte 6A)
LICE # ' —�®® 0 10 20 3o ao so FEET DATE DANIEL A. OJALA, P. P.L.S. YARMOUTHPORT MA 02675
/� 16-300