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HomeMy WebLinkAbout0105 TIMBER LANE - Health 105 TIMBER LANE Marstons Mills A = 149 — 052 _ i I , � I c 3lo 96 c� Nll Q i la by JOO 04 °� yr TOWN OF BARNSTABLE LOCATION� SEWAGE# A 0 // - 7 z 3 VILLAGE 1�t Jr,,VC 'fflt I ASSESSOR'S MAP&PARCEL PY - 03 2, INSTALLER'S NAME&PHONE NO. J/�-l/q 4 5, �G1' S^�g 5 �y SEPTIC TANK CAPACITY LEACHING FACILITY:(type) S'"'-Pfl- F-A,- (size) . l �f o NO.OF BEDROOMS f OWNER 'We.KJ°7 c I70�Lll/e I f PERMIT DATE: 1, COMPLIANCE DATE: J - aI •�I Separation Distance Between the: Maximum Adjusied 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 f 300 feet of leach' g f cility) Feet FURNISHED BY A' JJ_L �� D� Aro F 41. 6 � 3 C d ATD 23 �_ No. �/ Fee L THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:�� PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for His sat 6pstrin Construction 3pPrmit Application for a Permit to Construct( ) Repair( ) Upgrad lj;�pjand n( ) ❑Complete System El Individual Components Location Address or Lot No.lO ,ft Jr 4, ��iY O is Name,Address,and Tel.No .�N�y O'0®�roe L Z. Assessor's Map/Parcel f L(� O s' Z 6, -,_ /. % 474rl� ON Installer's Name,Address,and Tel.No. Desi-ggner's Nam ,Address and Tel.No. �(e l� IUD FBI i &f�'6"I �1��t C`os �� '�r /lwe ee-� �e 9 p T `I 7eyA ov W10r /-2r jC4 Y4,jru a�'yb Y2 Y Type of Building: L' Dwelling No.of Bedrooms 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( l Other Fixtures Design Flow(min.required) A4 eyd gpd Design flow provided 4-/7 '5 gpd Plan Date Number of sheets Revision Date Title qq Size of Septic Tank �� �-1 Type of S.A.S. Description of Soil - -e ! S e! Nature of Repairs or Alterations(Answer when applicable) Sep P'- KF ma t/L `I 1_q Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He th. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 1 010 1 I—3 A3 Date Issued 9 54 T / No. ! �Y� Fee < � ` Entered in computer: TH COMMONWEALTH OF'MASS`ACHUtETTS Y es PUBLIC HEALTH DIVISION - TOWN OF BARN_S;ABLE, MASSACHUSETTS Application for B�) Upg,rade sal .p5 ern Construction Permit Application for a Permit to Construct( ) Repair ( and)n( ) ❑Complete System ElIndividual Components Location Address or Lot No.!o r A G P1Y O is Name,Address,and Tel.L o� .�.v / Assessor's Map/Parcel /'-(9' `0 5- 2 . Lmi /� S ? hY.c Installer's Name,Address,and Tel.No. >'n o/try- Des�,'ggner's Na e,Ad ress and Tel.N 02S r1 y74/O DU f{or /?� (c r �4 w �oc's / `�P_ Type of Building: j Dwelling No.of Bedrooms `7 Lot Size A Y P sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( 1 Other Fixtures Design Flow(min.required) t-/4!y gpd Design flow provided gpd Plan Date 11- Number of sheets Revision Date Title Size of Septic Tank �°°� ��- // Type of S.A.S. Description of Soil J T - 5 a! (//S� L...o q Nature of Repairs or Alterations(Answer when applicable) SE P T`C. Ke /4q/2 PF S Date last inspected: ' Agreement: The undersigried agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of f Compliance has been issued by this Board of Health. Signed Date/ "� �t Application Approved by Date Application Disapproved by - Date for the following reasons Permit No. Date Issued .•. -------------------------------------------=------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(v'< Upgraded( ) Abandoned( )by at AJA K J4 N 4 )*//�1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N dated 1 Installer v/ A S^e Designer Ohd/5 rho S-r,-j #bedrooms Approved design flow 4 - gpd` The issuance of this permit shall not be construed as a guarantee that the system wil • nctio e 'g ed. N' Date _ it Inspector .►--• �4-- --------------------------------------------------------------------------------------------------------------------------------------- ) �3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,MASSACHUSETTS Disposal �6pstem,.Construction Permit Permission is hereby granted to Construct( ) Repair *Upgrade( ) Abandon System located at / /iH {it 4,4,11,F- F'`v if Z 5 & k 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 t be co m leted within three years of the date of thi�permit. Date ! Approved 6 Town of Barnstable �'THE Regulatory Services Thomas F. Geiler,Director IAMSPABL& Public Health Division `"� Thomas McKean Director RFD MA'S A � 200 Main Street, Hyannis,MA 02601 Office: 508-862-46 4 �� Fax: 508-790-6304 Date: Sewage Perm't# %3 .�?Assessor's Map/Parcel `t o5� Installer& Designer Certification Form Designer: s34c�_ Installer: AV 0 1kn 1, � Address: Q, 1D1 Address: �; 1 1J�15Xo? Ma o D 7sao On / van ��,�, 1�O�was issued a permit to install a (date) (installer) septic system at o5 �'\ based on a design drawn by UV , �� address—dated '�: 1.pV�4 (designer)•, I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the I box and/or septic tank. Stripout (if required) was inspected and the soils I e found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)was inspected and the soils were foun satisfactory. A A Sti OF � /�tyss9 _ CHR►STOPHER ?—I v tall r ; Sig hir COS714 V m -->'- d NO.31305 e e � e i is gnature) (Affix - ere) PLEASE RE RN TO BARNSTABLE PUBLIC HEALTH DIVI��ON. 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. gAoffice formsWesignercertification form.doc e. lime Town of Barnstable Pa Ir I Department of Regulatory Services ' :.�rwameta,: Public Health Division Date 61y 200 Main Street,Hyannis MA 02601 Md Date Scheduled Al-,V)) Time ® Fee Pd. Soil Suitability Assessment for Sew isposal Performed By: Witnessed By: LOCATION&GENERAL INFORMATION 'r Location Address r-- Owner's Name O�Q)ONN ►o,�Twrse . c.* 1� way AMAddress /QS �IW18'C�`�— LafNL Assessor's Map/Parcel: i 4t/ — d 5 Z Engineer's Name e— NEW CONSTRUCTION REPAIR Telephone#' 15D b Land Use /FCS)D J'z A-t-- Slo es� p (°°) Ll>— Z. Surface Stories /`///VL Distances from: Open Water Body ft Possible Wet Area JV't—ft Drinking Water Well l Drainage Way I CO t ft Property Line ft Other f RKIGwT7cnJ ft w 4ALC-- 160-t— SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r Parent material(geologic) Depth to Bedrock �1 Lr— � Depth to Groundwater: Standing Water in Hole: �]�A1�L Weeping from Pit Face Estimated Seasonal High Groundwater �//✓T' DETERJvVNATION FOR SEASONAL HIGH WATER TABLE Method Used: hl A— Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date 23/time /b: Observation Hole# _ —�� Time at 9" Depth of Perc lJ�� Time at 6" Stan Pre-soak Time @ /0 r'0 Time(9"-6") End Pre-soak CouwD «TM—IVXt71V' Rate Min./Inch .4 z ply Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) !� Original:Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC ' •t . .. CL DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent ° Gravel o--(1' D4 l,�Js� 7t sti Moue- _zy' Q Z f GO` G GK�r.�rc— GG= 20 Cz_ DEEP OBSERVATION_HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other - Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) �j G�� �� 5�✓� 2t N60t Zi-t—60 r GI 2 G _ Ob�i%td✓bti 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) 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 Rate Mao: Above 500 year flood boundary No / Yes Within 500 year boundary No V Yes Within 100 year Flood boundary No Yes 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 pervious material? Certification / I certify that on (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 training,expertise and experience described in 310 CMR 15.017, Signature Date Q:\SEPTIC\PERCFORM.DOC _ I .... ..;.tea ._±:v`^` ,-. • - _ _ TOWN OF BARNSTABLE L"A A SEWAGE# 7 3' 3; LOCATION 1 d A VII;LAGE � G."� ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. ed ..a,a� ,� � 7d- r-7 SEPTIC TANK CAPACITY G'�a LEACHING FACILITY: (type) (size) OF BEDROOMS -0 � 13VMDER OR OWNER PERM TTDATE: '� — FY COMPLIANCE DATE: :Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Feet Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Edge of Wedand:and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by Jq 'j i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS . DEPARTMENT OF ENVIRONMENTAL PROTECTION §VjFFD APR 1 ¢ 2005 TOWN Off. 8;, ; .;;ABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1 0 5 Timber Lane ® � Mars tons M.ilTs 1 9 Owner's Name: Francis Ryan I Owner's Address: PO Box 745 W Barn, table Date of Inspection: —0 Name of Inspector:(please print) William E_ •Robinson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P 0 Box 1089 Centerville, MA Telephone Number: (508) 775-8776 CERTIFICATION STATEMENT t certify 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 the inspection.The inspection was performed based on my training and experience in the proper function d maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Sec 'on 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: _�d Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of ReaRhw DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the .DEP.The original should be sent to the system owner and copies'sent to the buyer,if applicable,and the approxing authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 i � r Page 2 of 11 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1 0 5 Timber Lane Marstons Mills Owner Fran FranC15 Ryan Date of inspection; •—O Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Syste Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: A i � s B. y em Conditionally Passes: e or more system components as described in the"Conditional Pass"section need to be replaced or repaired. he system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer y s,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,a ibits substantial infiltration or exfilration or tank failure is imminent.System will pass inspection if the existing � is replaced with a complying septic tank as approved by the Board of Health. "A metal eptic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating at the tank is less than 20 years old is available. ND expl bservation of sewage backup or break out or high static water level in the distribution box due to-broken or _ obstruct pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approv of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND xplain: The system required pumping more than 4 times a year due to broken or obstn!cted pgre(s).The system will p inspection if with approval of Board(with PP of Health broken pipe(s)are replaced obsbvcdm is=ovod ND expl in: If Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 105 Timber Lane Mars tons Miiis Owner: Francis Ryan Date of Inspection: . e 4 O C Further Evaluation is Required by the Board of Health: onditions exist which require further evaluation by the Board of Health in order to determine if the system is failin to protect public health,safety or the environment. 1. S stem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the sy tem is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within So feet of a bordering vegetated.wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a su ace water supply or tributary to a surface water supply. The system has a septic.tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more front a private water supply well** Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and - the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. Other: 3 I Page 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 105 Timber Lane Marstons Mills Owner: Francis -Ryan Date of Inspection:-tiZ D. System Failure Criteria applicable to all systems: You us(indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or.available volume is less than IA day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100-feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a.public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private%eater supply well with no acceptable water quality analysis.]This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. Large Systems:To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: The following criteria apply to large systems in addition to the criteria above) y no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim We Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If yo have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owns or.r operator of any large system considered.a signi scant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.3 4.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1 05..Timber Lane Mars tons M1 s Owner: Francis Ryan s� Date of Inspection: y/ 0,3 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No PPumping information was provided by the owner,occupant,or Board of Health !/ Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? _ = ]-lave large volumes of water been introduced to the system recently or as part of this inspection?, L1 _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) v— Was the facility or dwelling inspected for signs of sewage back up? 1/— Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: . Yes no Existing information.For example,a plan at the Board of Health. v — Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)) 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 105 Timber Lane. Marstons Mills Owner: Francis Ryan Date of Inspection: - 0 FLOW CONDITIONS RESIDENTIAI. Number of bedrooms(design):. Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Z Sd Number of current residents: Does residence have a garbage grinder(yes or no):�i B Is laundry on a separate sewage system(yes or no):&a[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):/L o 2004— 51 , 000 Water meter readings,if available(last 2 years usage(gpd)): - 0 Sump pump(yes or no):�o , Last date of occupancy: a COMM/th L/I USTRIAL Type oshm t: Design ase on 310 CMR 15.203): gpd Basis o ow(seats/persons/sgft,etc.): Grease ent(yes or no): Industr holding tank present(yes or no):Non-saaste discharged to the Title 5 system(yes or no):Water adings,if available: Last dacupancy/use: C ribe): GENERAL INFORMATION Pumping Records .d S Source of information: J9 Was system pumped as part of the inspection yes or no): v If yes,volume pumped:_gallons•-How was quantity pumped determined? Reason for pumping: - TYP F SYSTEM — eptic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) y wn r) _Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all com onents date installed if known and source of information: Were sewage odors detected when arriving at the site(yes or no): Ile 6 )'age 7 of I I OFFICIAL INSPECTION FORM-NOT FOIL VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM I'AItT C SYSTEM INFORMATION(continued) Property Address: 105 Timber Lane Mars tons i s Owner: Francis Ryan Date of Inspecllon: BUILDING SEW (locate on site plant) Depth below gra e: Materials of co struclion:_cast iron _40 PVC_other(explain): Distance Gott private water supply well or suction lute: Comments_( n condition of juutls,venting,evidence of leakage,etc.): SEPTIC TANK:`(locate on site plan) 1 Depth below grade: � Material of construction: ✓Concrete metal fiberglass_polyctlrylcne _otltct(explain) —" _ If rank is metal list age:— Is age confinned•by a Certificate of Compliance(yes or no):_(attach a copy of certificate) I r Dimensions:_/ 'r- Q Sludge depth: —G1 >> Distance Gom top of slud�c to buttom of outlet Ice or baflle: Scunt thickness: 1—)— Distance from top of scull)to top of outlet Ice or baffle: _ Distance Gorn bottom of scum to bottom of outlet tee or baffle: l low tscrc dimensions determined: n Al_, GO L �d 12 S Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): ��o_� 7'� 41'�- GREASE TRAP:_(locate n site plan) - Depth below grade:_ Material of construction: concrete metal fiberglass�tolyelhylene_other (explain): — Dimensions: Scum thickness: Distance from top scum to top of outlet Ice or baffle: Distance Gorn bo om of scum to bottom of outlet lee or baffle: Date of last pun ing: Conunents(o pumping reconunendalions,inlet and outlet Ice or baffle condition,structutal integrity,liquid levels as related to ullet invert,evidence of leakage,etc.): 7 'agc 8 of OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOI01 PART C SYSTEM INFORIIIATION(continued) Property Address: 105 Timber Lane Marstons Mills Owner: Francis R an Dstc or impcctioo: T►G11T or 11OLD1NG T K._(tank nwst be pumped a►time of inspection)(locate on site plan) Depth below grade: Material of eonstructi concrete_metal fiberglass_polyethylene other(explaul): Dimensions: Capacity: gallons Design Flororno): gallons/day Alarn presAlarm leveorking order(yes ur no):Date of lasComrnentsd float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Conunents(note if box is level and distribution to outlets equal,an)-evidence of solids carryover,any evidence of - leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working o cr(yes or no):— Alarms in work-in rdcr(ycs or no): — Conunents(note ondition of pump chamber,cundiliun of pumps and appurtenances,etc.): Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 0 5 Timber Lane , lvlar�stons Mi=s Owner: Francis Ryan Date of Inspection: —6 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If.SAS not located explain why: Type v aching pits,number: " leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): ed S`d � u` Hp CESSPOOLS: (cesspool must be pump Idas part of inspection)(locate on site plan) Number and configuration: _ Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater i ow(yes or no): Comments(note conditi0 of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site p ) Materials of construction: Dimensions: Depth of solids: Comments(note cond ion of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 105 Timber Lane Marstons Mills Owner:_Francis Ryan Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. S 6p s f 10 Page l I of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 0 5 Timber Lane Marstons Mills Owner. Francis Ryan Date.of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you e0 lished the high gund water elevation: 11 -;. TOWN OF-B—A NSTABLE LOCATION, "1�CA A SEWAGE # Va:LAGE AS ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. Al ASEPTIC TANK CAPACITY /4-6`6 LEACHING FACILITY: (type) J �� (size) J"�� NO. OF BEDROOMS BUILDER OR OWNER �� PERMIT DATE: COMPLIANCE DATE: —/0��� 76 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 1 e319ir- �i No. e— Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS rtcatiou for i o Y�a gteut o� � � tvaruction Permit Application for a Permit to Construct( )Repair(x X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 10 5 T i mb e r Ln, Owner's Name,Address and Tel.No. 4 2 8—6 5 6 0 �ssr'sMap/Pazcel Marstons Mills Francis Ryan PO Box 745 / ,p W Barnstable 02668 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. W E Robinson Septic Service PO BOx 1089, Centerville, MA 0263 Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder(nd) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil a a n r9 Nature of Repairs or Alterations(Answer when applicable) Title 5 Leaching consisting of a new D—Box, and three H-20 precast leach chambers 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 th' Bard of H alth. Signed , Date �"a-�—�1 g Application Approved by Date — Application Disapproved for the following reasons Permit No. Date Issued � � . � .r ...."' 'i•-+L ._..d\..,.,.niu.ma.-fn +Le.+« n_.. ... • •_i{^. w»..+.iW.iwv. .w..W. - v ,., � .. _ .- . - « d 2) No. �E/ ✓ �'50.00 Fee i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN.OF BARNSTABLE., MASSACHUSETTS Yes 2pprication fd.r Migonl *patent Construction Permit Application for a Permit to Construct( )Repair fix)Upgrade( )Abandon( ) Complete System ❑Individual Components - I Location Address or Lot No. 105 Timber Ln', Owner's Name,Address and Tel.No. 4 2 8—6 5 6 0 Marstons Mills Francis Xy-qn PO Box 745 Assessor's Map/Parcel / d.,f- W•Barnstgble 02668 Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and'Tel.No. W E Robinson Septic Service PO BOx 1089, 'Centerville, MA 02632 Type of Building: Dwelling No.of Bedrooms 4 Lot•Size sq. ft. , Garbage Grinder(no) Other Type of Building sgr�s-3 Showers( ) Cafeteria( ) 7-` IL SIT Other Fixtures Design Flow gallons ner day. Calculated daily flow gallons. Plan Date Numbei�stieets Revision Date Title Size of Septic Tank r,' Type of S.A.S. Description of Soil sand , z � f Nature of Repairs or Alteration`s(Answer when ap licable) Title 5 Leaching consisting of a new DBBox,/and three H- 0 precast eat chambers f Date last inspected:. 1' 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 and of ealth. Signed 31,l� • - Date '" = -�j Application Approved by Date Application Disapproved for the following reasons s, Permit No. s g Date Issued - '' f7 ————————— ——————"———————————————————— p f T�F.�OMMONWEALTH OF MASSACHUSETTS _ 5 - +� l MotIlSTAdLE, MASSACHUSETTS Ryan l i Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (xx)Upgraded( ) Abandoned( )by at 105 Timber Lane, Marstons Mills has been constructed in accordance�' } with the provisions of Title 5 and the for Disposal System Construction Permit No "• � dated Installer W E Robinson Septic Ser**ce Designer The issuance of this permit shall not be construed as a guarantee that the system will functio s e5igned. Date- S' Inspector \� IN �+ ——— ---- -------------—-------------Fe$50.00 No. THE COMMONWEALTH OF MASSACHUSETTS + �� PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Ryan Mig;poaf 6pe' tem Construction Permit Permission is hereby granted to Construct( )Repair(x)Upgrade( )Abandon( ) System located at 105 Timber Lane Marstons Mills i Installer W E Robinson SepticjService 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`,., '- - ____ _�T _//.; Provided:Construption must be coia leted within three years of the date of e it. Date: ` �� Approved Ilk *1 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, William E, Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated S�-�— ,concerning the property located at 105 Timber Lane, Marstons Mills, meets all of the following criteria: * There are no wetlands within 100 feet of the proposed leaching facility. * There are no private wells within 150 feet of the proposed septic system. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) `? SIGNED:_1, DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 20-1998 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). Zl D/J►TE-PER-NA-1T 1_5SUED - fe WICCS No.. .)-.0_j......... Fss....... d.:. .... a7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0F...................... .........�L� A.VlAiratinn for Uiii niial Workii Cnotu4rurfton Vrrmft Application'is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal .r System at: �M 4. k---LANE A BE-------------IMRS1P 8 ....... i�LS de Lot N •.C� . _.t.I`... CA M � --._!- ss Installer Address /'(' UType of Building Size Lot.aO',t�y�o_._-___-_Sq. feet Dwelling—No. of Bedrooms-_._�____________________________________Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons-------- _------------------- Showers ( ) — Cafeteria ( ) Other fixtures -------------------------------- W Design Flow........ ............................gallons per person er day. Total �-,iily flow-------- 0.........................gallons. WSeptic Tank—Liquid capacitylOOP---gallons Length..... ...... Width... .......... Diameter--------.------- Depth.._.--._-.----. x Disposal Trench—No- ____________________ 'Width/__-___-____------- Total Length_-_.-__--___.._---.. Total leaching area--------------.-----Sq. it. Seepage Pit No......L------------- Diameter....... Depth below inlet-------------------- Total leaching area--.-.--_:.-_.____sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by---------------------------------------------------------------------- --- Date------------------------------------- .. Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water.__.---_----_-.._-.-_- �14 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-_.-__.--_._-.-----__. Description of Soil_ �� _.__.. - 9- ---------I----- ------------------------------------------------------------------------ -------------------------------- x -� V ------------------------------------- -------- -------------------------- ------------- ---------- ----------------------- f ------------------- ------------------------------f_..--------------- U Nature of Repairs or Alterations—Answer when applicable.........................i�--_-_.-__�_.____---._..__-_-.-_.--_._- .--._-._...-__-___-_.__--- ---------------------------------------------- ------------------------------•--•----------•------•------------------------------------•------•---- -------•---------------- •--------- --------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued by the bo rd of heal h. q� Signed.. .. �� /!�Z��-�.• p�.� � ` Y IC� al/1%AI �.Jf�V Y�IL 1 r7f�0 ate Application Approved BY �` ... ............ ------......e_ ----•---- u A dication Di PF Disapproved for the following reasons: =>---- ----- ....................................................... 7 -� Date ---•----•-- Permit No..------- -----------....................... Issued......... - --•-• ----------- -•--•-------•--•-----.--- Date .. I No.--- ......... ....... -� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HgALTH Appliratinn for Mgpuiittl Vork,6 Cnnm6nrtion Prrntit Application is hereby made for a Permit to Construct ( ) or Repair (Kan Individual Sewage`.Disposal System at ----�,T--�- -�--. / -!-All-E--------------A.1'SIPN3--------I i L S------------------------ .COLUNNA--. .. , ' e ------M—�_ � :y l41___�,� ._ ° -°`_N -----WNG..- `Q ---- uR 5S p Installer �er UType of Building Size Lot_4044.yaR________Sq. feet Dwelling—N.o. of Bedrooms-___-....................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------.---------re:____-__ Showers ( ) = Cafeteria Othr fixtures ----------------------•------------------------------------------------------=;----------------------------------------------•---------------------- 10 W Design Flow-------- ................................gallons per person er day. Total ily flow--------- .--. ....................gallons. P4 Septic Tank—Liquid capacitylOP0...gallons Length----- Width... ..-._-_ Diameter________________ Depth................ xDisposal Trench—No. .................... Width __________________ Total Length------------_----- Total leaching area--------_-----------sq, ft. Seepage Pit No......I............. Diameter_.__._C_.___...._ Depth below inlet..................... Total leaching area-____-___________sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by----------- --------------•-----••...---......___..-----------•------•---• Date_--------------------- ,a Test Pit No. 1________________minutes per inch Depth of "Pest Pit.................... Depth to ground water------------------------ (� Test Pit No. 2................minutes per inch Depth of Test Pit---- Depth to ground water__-__-_____-___-___._-.- �•� 1�-------r----•--••••- D Description of Soil_(-_QA6►------- •�--•---- ------ia.......................................................... ---------------------------------------- x ---•- A.lc. --------------------- ----------------- ----------•---��-5-�•-- ---- ----------------`-`----- --------------------- 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 Article XI of the State Sanitary Code—The undersigried further agrees not to place the system in operation until a Certificate of Compliance has e issued by the board of health. 5 l,; VICE Of 'I�I'�"., t/a1 F. tKL" ate ApplicationApproved By /� ............................................................................ -----•--•---•---•-'• ----------------- Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------•-------- U .- -._...-•--------•............... Issued.._.... _.-- ----= •----•------Date Permit No_________ __..... ________ - Date f.'THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ak!kr...............oF..... i 4K..frAP�b.1.e........................................... IVITrrtif irate of 01komplianrr THLY IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired "`9it ( ) by........... ��'--•--•-W 1k"-�r•--- ----- I staller at------�c.n � r .'`s�b�-...---------- L`--..'-- --•-- .... Sr'}w-----......,..«-- S has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit'-N ;:_ �_ ________________________ dated...... .................. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. .............................................. Inspector---------- ---------- •-••-• - .... THE;mCOMMONWEALTH OF MASSACHUSETTS' BOARD OF..• HEALTH .... OF 40frlc'S7� 6t ... Rnpoiial Workii Tomitrurtion Wri t'it Permission 'is hereby granted________Cr&Ay_.__. lt�✓K- to Construct ( 7O-or Repair ( ) an Individual Sewage is;sal System � ... at No.- �T=-•---c / fl LlPA,f /t1fi�.t SI�•GGc.9 /Gf/� �'� :T ._._ _... . -- -.--. •-- •----•--•-••. -•••-•------•------••--••--- z Street as shown on the application for Disposal Works-Construction 'Per i o _� t ..................................- and of Health DATE...---•--- .��-----�-- --� --�- --7�........... FORM 1255 HOBBS & WARREN, IN .. •PUBLISHERS '' .3 tsd.'741 # �7 GAL. APP oX. i �4 P,DR(L� �o Owl - t �O rr - � Live o X , LF--7 X (�tN u - -- S � ) LDS - /h�•S�, . �� ti�� R LAND- MA C)N {; coN I�RM (ro �L�. CODE- Q-T- "rH� kRN T BL t6ARD oF_ (4C-Al-TH �N� f��► iN��1 NS ECTO S_ .4. .� VILE PRESIDENT ; COLUMISA LC`_A1't4ER C , IN G. SENDER. Be sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) I (Additional charges required for these services) I ❑ Show to whom,date and address Deliver ONLY where delivered to addressee RECEIPT Received the numbered article described below I REGISTERED NO. SIGNATURE OR NAME OF ADDRESSEE(Must always be filled in) I CERTIFIED NO. 895525 2 SIGNATURE OF ADDRESSEE'S AGENT,IF ANY, INSURED N0. J-�' l� i DATE DELIVERED SHOW' ELIVERED(Only if requested,and include ZIP Code) 3 I � I U.S.POSTAL SERVICE OFFICIAL BUSINES \V th C 1J, A P R '1 3 Us :,+ .GAF OE $300,. Poo" of DeI 6*9 Of ka W SENDER INSTRUCTIONS Print in the space below your name,address.including ZIP Code. RETURN • If special services are desired,check blocks?on other side. TO • z • Moisten gummed ends and attach to back of&Wale. b CO ro co Board of Health - Town of Barnstable 397 Main St. �'; HYANNIS MASSACHUSETTS 02601 'fir .-. dy f• 3 ° - +• ?• eJt 105 Ti 3' Y v Yae� s Apr . r , ^r a. ` 24,. 74: r 2• „ . ., �-.,i t •r J. y 4h Y i 'R'4.. y � j h Y . - 4 i.r � ... 4.r'l � ' s, -i • 4 Jl�. r yy,4 F ��.. ... 11 Re lka tuber` Lane,,, -.,` .;Marstons Mills r ft - eti4 .• . 14r«.4 Edward+H. °Kf ea1e III 'De epwodd give Falmouth, MassaChusettsKneial y..Y .4. • t r f; M , Auer., thorouch 'study and caretxl•deliberation Yconcerning our 4(3;,flfl0' square. foot °regu anon ' i t ryas .de deec ',by the 'Roard.•that�'a,, var ,hide would ::not "•be' requ�.red,%pni 'alli•definitive. ` 'subdivisio:hh plans 'approve'd lay the.`"Board',of Realth:and Plahn, ing o'Board prior to;,Apr,il 12 - 1974. However t ndiv dual seept�.c,�syat�ms must .be 1poated 150 M f eet•'ErOm :private or. -publid- water D '•r , All other 'Town,off' Barnstable ,and,"State,Hda1t'h Regulations k`` apply::` - tt� zrs very truly, {• �. r , ,. f'Z"OVM- OF BARNSTABLE BARD` OFy HE]hLIH n Yr .- S-i-• .l i Al A! r �F. E J y + + •.r . s ., «r •yk'3# pY.`�!. R.a, f'>,_r. -y r. • ! 4 f• 4',f - - ', Y 4 FS rx ,i 4 ' . f � ' .. `r'`•t <.. - + x4 'c- a L' kr+• r ••'t i y r r I f.,.t' r . '�a' d 7 r I Y I I I I r P . I c> O P 0- Pn I AJ Ol I Ab �Nk Lcit; . ...... qJOAQ- A . M.0 rni. AAA a AA I Ar - — — — 010, Le- 1p I I I ' V 1 1 1 - --- - --� �- y - -- - .�.;.. --�-- - — -- --— --- .�.�—s:�.ti •�. ---..._-- -------- — _ ------- ------ I. -- y ,�.� — — -- .. � i 1 j i_______ ,. � a M ' __ _ _ �_ `I `. 1 S i t r « v II � _ ` I � ; I , _ ' i L� t .,� I i I f1I 1 �� t SCHEDULE OF ELEVATIONS NOTE: SEWAGE SYSTEM PROFILE 8c DETAILS 1. RISERS AND COVERS TO GENERAL NOTES FINISH GRADE NOT TO SCALE 1 FIRST FLOOR = 1 54.6 2. H-10 COMPONENTS AND 1. ALL CONSTRUCTION AND MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL 2 TOP OF FOUNDATION = 2 53.6 SCHEDULE 40 PVC PIPE THROUGHOUT 1 54.6 CODE (310 CMR 15.00 T 3, THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING ITLE 5), AND THE LOCAL BOARD OF HEALTH. Gj 3 PIPE INV. AT FOUNDATION = *(TO BE VERIFIED 3 51.20 A TRENCH PERMIT FROM THE LOCAL MUNICIPALITY OBSERVATION. PORT S=2� MINIMUM 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN F►�4CE LANE 4 INV. OF PIPE AT SEPTIC TANK INLET = 4 50.90 2 53.6 IN WHICH THE WORK IS BEING PERFORMED. PERMISSION OF THE LOCAL BOARD OF HEALTH. 5 INV. OF PIPE AT SEPTIC TANK OUTLET = 5 50.65 11 52.2 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL 6 INV. OF PIPE AT D-BOX INLET = 6 49.00 13 52.4 VERIFY EXISTING TANK INVERT ELEVATIONS BE BROUGHT TO THE ATTENTION OF THE ENGINEER PRIOR TO PERFORMING THE Q` PRIOR TO INSTALLATION OF MIN. BREAKOUT OCUS 7 INV. OF PIPE AT D-BOX OUTLET = 7 48.83 14 52.4 4 50.90 PROPOSED SYSTEM COMPONENTS 15' RELATED WORK. 8 INV. OF PIPE AT START OF LEACHING FIELD = 8 48.37 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND 9 BOTTOM OF LEACHING FIELD = 9 46.37 �••�• 5 50.65 12 52.3 _ 10 49.2 I ONLY, PROPERTY LINES IS NOT TO B USED TO ESTABLISH PROPERTY S OR BUILDING 10 TOP OF STONE = 10 49.2 `; ':'• - ` � -�� u ���t �} Ii`-"d� �- �- �, �_ � � �- - ,-,; , - . ,- PROPERTY LINES AND BUILDING LOCATIONS ARE(GRAPHIC 0 -! - t- tT �� =� - `j- i"u� - -�_ NOT HAVING BEEN VERIFIED. NO REPRES REPRESENTATION OR CERTIFICATION AS TO THE r' 11 FINISHED GRADE OVER LEACHING FACILITY = 11 52.2 �r _ _ _ - _ - ; t -1 j- � E NEN ,J r! -�. -tj - 1 7 _- ! ( tk fi} 11- fir i�i ,, r - -. - _ ACCURACY OF THOSE SHOWN IS IMPLIED OR INTENDED. 12 FINISHED GRADE OVER D-BOX = 12 52.3 ,r'::x I ,: tt = " - - -{ = r�if- -t - .. , Tk, -uI- ! �Z - e OUTLET - T_ - - ��� ! - E--�� T,,II,,Tr ,r - f f 1 _!j__� _ _ _ _! . " F JT i!: it;� BMCK FILL WITH .. . f ". _ �..n�s�;_ - - - . - - D BOX -` ._ - i _�tt .. T� 4 a 11- ­11f CLEAN FILL ;i� 5. ALL DISTURBED AREAS ARE TO BE LOAMED, SEEDED AND MAINTAINED 13 FINISH GRADE OVER SEPTIC TANK = 13 52.4 !r !rt� ��,: MiN. - - w/ SPEED i tx i I'.. LEVELERS - r=- 1; _. 5=0.0 � - -:�� MIN. � � !� �-- �- TO PREVENT EROSION. 14 FINISH GRADE AT FOUNDATION = 14 52.4 L= 5 _i ��111�- S=0.02 L=47' ! [ L . . •.' _MIN. _ LOCUS MAP NOT TO SCALE 15 BOTTOM OF SEPTIC TANK = 15 46.40 i z S 0.01 L VARIES �, . ,.�� ! ., � .�I _. . _ --- -� •, �::=>.•• �• • � :• � ',-_. i!, 6. FOR PROPER PERFORMANCE SEPTIC TANK SHOULD BE INSPECTED AT LEAST' 3 51.20 ;:: - -lE' li- -� SCHD. 40 PVC TEES '!; ` ® ® -" ONCE A YEAR AND TOTAL DEPTH OF C AND SOLIDS EXCEEDS 16 TOP OF CELLAR FLOOR = VARIABLE 16 TBD ,.,;. � t. � 7 O t€'a - i , rt-,tt ® ® ® ® ®® •, ,� - -- N WHEN THE TO QE SUM �? I 1 3 THE LIQUID DEPTH OF THE TANK THE TANK SHOULD BE PUMPED, f� r TO BE INSTALLED �� -. In i am 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND 'ACKNOWLEDGED GAS BAFFLE _ �I j -_ _ 7 48.83 t ,t u� a !� t .. BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH, AND _ TO BE INSTALLED !.� 5' OF NATURALLY OCCURRING ai d' ! ll� il� PERvlous MATERIAL t !-� N CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. ;SANITARY CODE. 8 48.37 tit !f -I- , k ! t -. - ;-M111 � i NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. 16 TBD ti- -L - 8. TEST HOLE INFORMATION SHOWN HEREON IS LIMITED TO SOIL CONDITIONS FOUND » i iirlll I Ij .; 1 1,000 GALLON SEPTIC TANK _ EXISTING TO REMAIN IN SERVICE -= USE 3 GALLEYS VWITH: AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN IF AFTER PUMP OUT AND INSPECTION ---T IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND-'LIMITS OF IS FOUND TO BE IN GOOD CONDITION __ __" 36 STONE ALONE SIDES; 15 46.40 r - -1 . + - ) !i �T - 1'iI! ii �P_�t_ 39" BETWEEN SUCH TEST HOLES. 6"' MIN. CRUSHED STONE BASE 48" ALONG ENDS. 9. ALL ORGANIC AND UNSUITABLE MATERIAL MUST BE REMOVED FROM THE AREA TOTAL LENGTH = 40.0' TOTAL WIDTH = 11.0' DIRECTLY UNDER AND 5 FEET BEYOND THE PROPOSED LEACHING *FACILITY. THIS AREA MUST BE BACK FILLED TO THE ELEVATIONS INDICATED ON THESE PLANS WITH SELECT ON-SITE OR IMPORTED SOIL MATERIAL, CONSISTING"OF CLEAN {' GRANULAR SAND OR OTHER GRANULAR MATERIAL, FREE FROM ORGANIC MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS / DESIGN DATA SHALL NOT BE USED. THE FILL MATERIAL SHALL CONFORM TO�MA STATE HEALTH CODE TITLE 5 •- 310 CMR SECTION 15.225(3) AND SHALL HAVE / 1. BUILDING TYPE: EXISTING 4 BEDWOOM HOUSE PERCOLATION RATE OF BETWEEN TWO AND FIVE MIN. PER INCH, :BEFORE AND P�4h'CEL 7�9--1,36 AFTER PLACEMENT. SE,�w/CED Br TOE _ 2. DESIGN FLOW: 110 GPD PER BEDRt00M = 110 x 4 = 440 GPD 0 FINES t ANY N 0,4TEh' /'.4BCEL 149 133 3. DESIGN PERCOLATION RATE. <5 min/inch 10. ALL STONE MUST BE DOUBLE WASHED AND FREE FROM F NE AND P.4R62cZ- 1�9=1.3� S'Efi'�//CED BY TO,�/N 1�1�,9r'E,Q 4• GARBAGE DISPOSAL: NO ORGANIC MATERIAL AND MUST HAVE LESS THAN 0.2 PERCENT MATERIAL EXISTING 1,000 GALLON SEPTIC TANK TO BE KEPT IN SZ??V10ED BY TO!'YN G,147Z_i' 5. SEPTIC TANK DESIGN REQUIREMENT: 200% DESIGN FLOW FINER THAN A NUMBER 200 SIEVE. / SERVICE IF AFTER PUMPOUT AND INSPECTION IS FOUND 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCT OR TO BE IN GOOD CONDITION. 440 X 2 = 660 GAL. (EXISTING %000 GAL TO BE KEPT IN SERVICE IF TANK FAILS INSPECTION, A NEW 1,500 GALLON TANK IF FOUND TO BE IN GOOD CONDITIION, OTHERWISE NEW 1,500 GAL TANK SUPERVISE THE CONSTRUCTION OF THE SYSTEM. THE CONTRACTOR IS MUST BE INSTALLED AND EXISTING TANK FILLED WITH WILL BE INSTALLED). RESPONSIBLE FOR MAKING ARRANGEMENTS FOR INSPECTION OF INSTALLATION CLEAN SAND OF THE SYSTEM WITH THE LOCAL BOARD OF HEALTH. 6. TOTAL LEACH AREA REQUIRED: 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL' AND S48'27'10"W TITLE 5: 440 GPD / (0.74 GPD/�SQ.FT.) = 595 SQ.FT. (CLASS I SOIL) • 51.60 180.76' VERTICAL CONTROL OF ALL SYSTEM COMPONENTS. a �j 7. TOTAL AREA PROVIDED: 13. TIGHT JOINT PIPING TO CONSIST OF POLYVINYL CHLORIDE (P.V,C.) "`�82 14" PINE 11' X 40' LEACHING TRENCH (SEE DETAIL) SCHEDULE 40, UNLESS OTHERWISE NOTED. f' w 11.5' EFFECTIVE DEPTH 2.0% LENGTH 40.0% WIDTH = 11.0' 14. THE CONTRACTOR SHALL NOTIFY THE DESIGN ENGINEER FOR CONSTRUCTION 3 RVE , �1 s INSPECTION AFTER EXCAVATION FOR THE LEACHING BED (PRIOR TO THE _ _ PLACEMENT OF STONE AND ALSO AFTER PLACEMENT OF PIPE ac STONE ,..., . y,.� - 2x40)(2) - 11'60 SQ.FT.SIDE WALL AREA AR A::.` ,5 ( PRIOR TO BACKFILLING :. ...,. BOTTOM AREA = 11x40 _440 SO.FT. ' 51.40 �� �.�t•;: + +♦ +�++• ++ +++ + +ter++�. .y _ ...,. �_. .<,.,, . , ,, ,. . ,; _ . ' RXIPrn 14.9-'0,53 15. DESIGN ENGINEER SHALL CERTIFY CONSTRUCTION OF SYSTEM AND MATERIALS END WALL AREA = 2x10)(2) = 4.0 SQ.FT. I I o a6 ( INSTALLED. THE CONTRACTOR SHALL PROVIDE A SIEVE ANALYSIS OF THE FILL ••-- PQii 1�' .'r i{ ++* +* +;� o" SEfi'!/,CED BY TOl#YN I�Yi4.TEfi' TOTAL AREA PROVIDED = 160 + *40 + 40 = 640 SQ.FT. MATERIAL REQUIRED. AN AS-BUILT PLAN SHALL BE SUBMITTED= TO THE LOCAL I 1 DECK N QF i +°'+ +'+ ` + ' ' + ' + t `',��. 5' R MOVE AND REPLACE BOARD OF HEALTH UPON COMPLETION. 50.77 I S I�G N O f .';.x" �.,,,`' 0.0' AS R NOTE 9 640 SQ.FT. x 0.74, SQ.FT./GPD = 473 GPD 0 TU Z / o 'Nc 2 ' �, # 16. NO RUBBER TIRE CONSTRUCTION MACHINERY SHALL DRIVE OVER' THE PROPOSED 1 I N IM! Fu 4.2 TOTAL FLOW PROVIDED 4�73 GPD SEPTIC BED EXCAVATION DURING CONSTRUCTION. � j 1 Fbu�i��i� EXISTING S w / SOIL ABSORPTION SYSTEM NOTE: SYSTEM IS NOT DESIGNED FOR A` !GARBAGE GRINDER. 17. DIG-SAFE AND ALL OTHER NECESSARY AUTHORITIES SHALL. BE NOTIFIED FOR EL If49.--OS -� EXIST. E ! nN� 1 I THE PROPER LOCATION OF EXISTING UTILITIES PRIOR TO ANY EXCAVATION. w EXISTING AR" GE / TO BE DISCONNECTED AND SZIIFV/CED BY P1'?1 9T OZI ZZ ,N o 1 DWELLING #105�NV. 51.2 I / z FILLED WITH CLEAN FILL, F.FL.EL. 54.6/ Iy� I OR REMOVED. m 5(3.75 / XIS NG PO CH ,,-�� 51,s o ►Ln � SOIL EVALUATORS LOG 1.0 I v o 52.27 , z'odw i © 0° / N Depth from Soil Soil Soil Soil Other w / /' U �' Z -P " ATE' Surface Hor. Texture Color Mott. Relative L C/l 2! \ �/ - ._...� / N s 'Q/LF'A�r (inches) (USDA) Munsel Factors o/ 'ti r q 20, 4411 S.F. � �� N �'y w / l q SFk�F ELEVATION DEEP OBSERVATION HOLE 1 EL. 52,0 NO _ EXIST. PRIVATE WATER WELL 1.24 � (A / 0 p F ;z1,;z 0"-s" Oa L/S 1OWYR 3/1 - - '� 5 S6 � �AT�A� �ti0 " " REVISION DATE DESCRIPTION BY APPR 155 FROM PROPOSED S.A.S. 3 10 ly s -24 B L/S 10)YR 6/4 SOME SILT 0, 8 1`` U S O<<`S' AU 16"-40" C1 L/S 2.!5Y 6/5 5-10X GRAVEL APPLICANT: EXISTING IRRIQATION WELL z z 52.01 �p J-S SF PERC, 0 60 122' FROM PROPG$E\D S.A.S. N �` Q�F 42.0 48"-120" c2 GRAVEL 2.5Y 5/s NOT WELL GRADED WEND' ODONNELL 1 w x` S2 G0 v f 05 TIMBER LANE \ L�5.81 --'" " `' L=119.19' w DEEP OBSERVATION HOLE 2 EL. 52.0 # MARSTONS MILLS, MA. 02648 .. . R=2144.78 Ce - R=1-7•A;736 ` , -- ; 0"-6" Oa L/S 1DYR 3/1 0.98 6"-24" B L/S 10YR 6/4 SOME SILT PROJECT: `»- 50.79 AU 16"-48" C1 L/S 2.5Y 6/5 5-10% GRAVEL 42.0 48"-120" C2 BONY 2.'5Y 5/6 NOT WELL GRADED SEWAGE DISPOSAL SYSTEM .REPAIR .D!,it�'SIGN GRAVEL 40 GY/DE ZANF PERCOLATION RATE _ <2 MIN. INCH 105 TIMBER LANE DEPTH TO GROUNDWATER = NONE ENCOUNTERED ITV- ti OBSERVATIONS BY: D/AVID W. STANTON MARSTONS MILLS, MASSACHUSETTS' SOIL EVALUATOR: CHIRISTOPHER COSTA, PLS. SE LIC.#450 t ,. DATE TESTED: 9/23/�'2011 EXIST. PRIVATE WATER WELL SHEET NO.: 1 OF 1 DATE: 09/19/11 .24 213' FROM PROPOSED S.A.S. ' f'AfI CEL 1�'9--0,59 � l � �c�'' SCALE: As Noted PRC FILE TIMBERLANE-100-.0DONNELL BY TOGYN `YATEf� �!. PAFCEL 1�9--060 �s DESIGN BY: DAVID FRENCH CHECKED BY. CHRISTOPHER COSTA,''PLS P� N. DOLIG.AS zNr� PREPARED BY. SEfr'vCEO BY Pf?/i,4 TE' bYELL y� C NEIDER , - �___... v o CtiRiSTOPHER cn CIVIL COSTA No. N O T E S °a.; n , . r, Christopher Costa & Associates, Inc. LEGEN��^^++ � NC 31so5 �' s. �p/ �iSTER D � 1p 1. THIS LOT IS NOT IN A FLOOD HAZARD ZONE f�''fiCicr ��►���E <®� AS SHOWN ON FIRM FLOOD, INSURANCE RATE MAP. GIVIL .EN6INEERINC� • LAND StVEYINi� • ENVF41+ T'AL GO .TINC� EXISTING PROPOSEDx, ' g ` `. 2. WATER SERVICE LINE SHALL BE LOCATED AND MARKED --- --��- OUR ELEVATION `` - r CONTOUR PRIOR TO ANY EXCAVATING AND( 110' MIN. SETBACK ►` `` .s�o o DISTANCE FROM SAID SERVICE TfO THE SEPTIC SYSTEM P.O. Box 128 / 465 East Falmouth Hwy. 508.548.6424 PHONE 50.5 50X5 SPOT GRADE LAYOUT PLAN �``P q�y, N, DOUGLAs SHALL BE MAINTAINED. East Falmouth, MA 02536 508.548,03s0 FAX www.castaassociates.com TEST PIT (TP) GRAPHIC SCALE ` �z cHRCOSTA HER ` Sc�VIL 3. ALL WATER LINES SHALL BE SLEEVED WITHIN 4" PVC Y DRAWING TITLE: 4) CDSCH 40 PIPE FOR 10 ON EACH SIDE OF SOIL ABSORPTIONS STEM, ❑ 0 CONCRETE BOUND (CB) so 0 10 20 40 80 :� N yi?� A'forR�csT�aO 4. GROUND ELEVATIONS ARE BASED ON AN "ON THE GROUND" SEPTIC REPAIR DESIGN PLAN �► -fj �`ss� INSTRUMENT SURVEY AND AN ASSUMED DATUM. 11TO INCREASE IN EXISTING DESIGN .FLOW Q ® SPIKE (SPK) ►t� �� �` �'/ �` , GAS VALVE (GV) ( IN FEET ) q-ti q z?.qq s t inch = 20 it. WATER SERVICE (WS) ASSESSORS INFORMATION: MAP 149 PARCEL 052 . -..:-. -. -.._.,....„.T...-.....,.ems«..............-. _ ...-,-.., .., -----