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0051 TUPELO ROAD - Health
S 51 Tupelo Road q= 057 — 889 ' Mars tons Mills ,I II I TOWN OF BARNSTABLE 1:«CATION S► "�.�pril�j �,�} - SEWAGE#;Z VIL:',AGE ASSESSOR'S MAP&PARCEL —M7 INSTALLER'S NAME&PHONE NO. y�o�a\� & SEPTIC TANK CAPACITYLEACHING FACILITY.(type) Q.c�tr�„s 1 9r31i (size) 1�1,J5-�j IT Jt'L NO.OF BEDROOMS OWNER P¢..s IL i e v�9tiZ ' PERMIT DATE: 12-2C, COMPLIANCE DATE: Separation Distance Between the: NoN C of- pvr Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYE\ our 1G � No. G L l Fee 1 vV THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppliLation for MispoSal 6pstem Construction 3permIt Application for a Permit to Construct( ) Repair( grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S/ 7,0 pe lv Owner's Name,Address,and Tel.No. /t4.-/5+-&v S AA i d r, Assessor'sMap/Parcel Wuv��jGcJ /LZ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. e,a�,l cis 3 co A L Nc g e cam-7��5 N i, )re/t%� l/ems Type of Building: Dwelling No.of Bedrooms _ r Lot Size o`Z O ti0�%� sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3O gpd Design flow provided ct( ' gpd Plan Date /r����//G/ Number of sheets Revision Date Title Size of Septic Tank J�:xt5F�,v Type of S.A.S. Q CROAK,)r'4 %C.DI y BcS� Ia Description of Soil Nature of Repairs or Alterations(Answer when applicable) co CCa m t 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 Health. Signe g Date 1;2,^;t Application Approved by �^ Date Application Disapproved by Date for the following reasons Permit No. VO Lf— Date Issued ��' . i t t No. G 1 � Fee /co THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes applitation for BispoBal *pstrm Construction permit Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot Rio.S'/ Tu pP w /7 Owner's Name,Address,and Tel.No. Asses or'sM Map/Parcel �'/S (ju4/CGJ lLZ t Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. *r' �c�z,1li s A 13 t o,.o tz� 1 NC 5--o f3 q.o-7/!5 � Type of Building: Dwelling No.of Bedrooms 2 _ pp Lot Size a©,UC.0 sq.ft. Garbage Grinder( ) Other Type of Building {e5%��� I CA No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2 30 gpd Design flow provided �3 y8,7 gpd Plan Date /�`¢ �/6/ Number of sheets ';)L— Revision Date FR• '7� Title Size of Septic Tank EX���„�� Type of S.A.S. 2 y,00 cPC&,o MAW--,('01 N.Str• ro e �O Description of Soil Nature of Repairs or Alterations(Answer when applicable) I N--j�,'r,0"2 -SCXD SRCA 1()t�) C'\f',M W[S w[\-U Date last inspected: j 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 k; Compliance has been issued by this Board of Health. Signe Date /,:7 - Application Approved by Date /1 (•-flLf Application Disapproved by Date for the following reasons Permit No. VOl c f— 4 f !� Date Issued �� a z i q _----------------------------------------------------------------- ------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by s „/ !,v at 51 7-optelo has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. aol L dated /0� ^'2 G /C� Installer cI \t.!, A t 1J(C,w�v Z n� Designer I r 7f/f #bedrooms 22 Approved design flow 217 gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date I 'L - Z G - i r..t Inspector --------------------------------------------------------------------------------------------------------------------------------------- No. r OI I �Ft I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Bisposal Opstem onsftuttion Vefmit Permission is hereby granted to Construct( ) epair(V' Upgrade( ) Abandon( ) System located at j C ra,} 1 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 perm�iL� 2 Date �a2'�C7'l�/ �"`' Approved by �k t i F , s Town Of Barnstable Regulatory Services Richard V. Scali, Interim Director Ftiv 'AeLE, POfic Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 rt Office: 5( -862'-4644 Fax: 508-790-6304 Installer.& Designer Certifkation.Form Date: t-L Sewage Permit#ON�� Assessor's Map\Parcel ' C_ Des,gDe �. �,ga� Installer; 'Adzes i � �� ��>;��-- ��ss�t P fGQ Address: P 6, ra. 2C9 - `���^�`" ``�` was issued a permit to install O a date) (�nstalles) "s} tern at {AYk based on a deli' dray b septic �.,•i,7; .-xuz1r-1 -CL WZr-�r._, ,_-t dated (designer)' certify that the septic system referenced above was installed substantially according to e design, which may include minor approved changes such as lateral relocation of the istribution box and/or septic flank. Strip out (if required) was inspected and the soils ere found satisfactory, certify that the septic system referenced above was installed with major changes (i.e, eater than 10' lateral relocation of the SAS or any vertical relocation of any component f the septic system) but in accordance with State & Local Regulations. Plan revision or rtified as-built by designer to follow, Strip out (if required) was inspected and the soils leere found satisfactory, certify that the system referenced above was constru : 0P with the terms of e IAA approval letters (if applicable) 1 ET ER T. � McENT CIVIL staller s Signature) • esigner's Signature) (Affix Designer's Stamp Ilere) :E RETURN TO BARNSTAIiLE PUBLIC HEALTH DIVISIOI�x. CERTTPICAT E' 0 COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH TIES FORM AND AS B L CARD ARE RECEIVED B Y THE BARINST ABLE PUBLIC HEALTH DIVISION TRAN C YOU. Q 1Septic esgner Certification Form Rev 8-14-13.doc Town of Barnstable _ Department of Regulatory Services i seaatarente, ` Public Health Division Date � XAS& A i639 ♦e� 00 Main Street,Hyannis MA 02601 �fC Date Scheduled �'/�r/ STime4ffi G O. �C� r � Fee Pd. • Soil Suitability Assessment for Se e Dispo Performed By: �J,0"MC co I-Cf Su sue-l-S--/2 Witnessed By: 7 LOCATION& GENERAL INFORMATION Location Address Je / Owner's Name . {�Fv�vtlo wJ(��ff-&Ij M Address lM4�S S M.W.5, Mr+ Assessor's Map/Parcel: — Engineer fC/-e✓ Mc. 7 6 G �-� 's Name i n,� NEW CONSTRUCTION REPAIR t Telephone# �O — �(7 7—_5_3 I Land Use _ �Slo es �2 Surface Stones '✓ _ Distances from: Open Water Body- .2 &)ft possible Wet.Area C ft Drinking Water Wellft Drainage Way A ft Property Line 26 / ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) YT MG i i �� --may -� ------------ ra Parent material(geologic) l�"/ �►"�� Depth to Bedrock Aj® A Depth to Groundwater. Standing Water in Hole: ✓-'Jcr-_R Weeping from Pit Face Estimated Seasonal High Groundwater DETERIVIINATION FOR SEASONAL HIGH WATER TABLE Method Used: c� Depth Observed standing in obs.hole: in, Depth to soil mottles;��,T �,r - le, _ .✓ Depth to weeping from side of obs.hole- a ln, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level- Adj,factor— Adj.Groundwater Ixvel PERCOLATION TEST Datg� .v Thne,.� Observation Hole# 1� Time at h" _— Depth of Perc 1J v ( Time at 6" Start Pre-soak Time @ 2y \� JTime(9"-6") End Pre-soak M Rate Min./Inch Site Suitability Assessment: Site Passed Pe' 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 J DEEP.OBSERVATION HOLE LOG Hole# :1 Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling '(Structure,Stones;Boulders. n i ten Gravel) C - M S S 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.% rave A Sam 1-5-t DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. fogsistency, o Gravel) l • 1 - --- — —., DEEP OBSERVATION HOL E LOG Hol e# S Other Depth from Soil Horizon Soil Texture Soil Color Soil Dep , Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders. nsi t n Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No s l Yes Within 100 year flood boundary No!\, Yes Depth of Naturally Occurring Pervious Material Does at least four feat of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? it If not,what is the depth of naturally occtrring 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 10 CMR 15.017. Signature C�/ Date3 C Q:\SEPTiCTERCFORM.DOC TOWN OF BARNSTABLE LOCATIOA 2 l 14�2e t0 SEWAGE # '76p 3 A) VILLAGE C04,.,;T ASSESSOR'S MAP LOT INSTALLER'S :IAbiL'• 6i PHONE NO. ACk, �uTmc 77/-y/v�� SEPTIC TANK CAPACITY `BUD LEACHING FA.CILITY:(type)_.a, �� !" (size) J,000 NO. OF BEDROOMS PRIVATE WELL O BLIC WATER BUILDER OR OWNER�T;�.1,c jaicv,p, 005k;',,z DATE PERMIT ISSUED: `® yOOF DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No Se Q 53; �(C 7R/ �*I •L I No. . ......._....... Fps......... .._............ THE COMMONWEALTH OF MASSACHUSETTS p� BOARD OF HEALTH TOWN OF BARNSTABLE Applira titan for 11isps al Works Tonstrurtiun 1krutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: s� TvP�� (2o�rD Location-Address or Lot No. Lj ......................_................... •--•----•----•-•--•---• ....._.. ............_... O n r Address a ---ctc r Cm C we . Qa. 22,b C Z Installer Address QType of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q, Other fixtures -------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length---------------- Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------------- Diameter.................... Depth below inlet---.---------------- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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........................ R+' •----------••••-•-------------------•--••••------•----....---•--•---------------•---•-•-••-•--....--......................................................... 0 Description of Soil................................................................................................................................ U P �� !c - ` db�? G.s�.LLo......................L-�JsC.EI---•--. ........................................ ...... W �----------'..--------5.....-J-�-------------- . UNature of Repairs or Alterations—Answer when applicable_...C? .......- _..._.'�_.`z..._ �v....S -� ----------------------------•-------------------------•---•---•--------•-----.._..........----------------•------------------------------------------•-----.......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com iance has betn\issued by the board of health. 6aci Application Approved BY - - -------------------------------------------- ------ --------------------------------------- Date Application Disapproved for the following reasons- ---------------------------------------------- ------------------------------------------------------------- -------- -- ----- .. - ------------------------------------------------------------------------------------------- Dace Permit No. .... ..... Issued ------...... l �a --- ---- ------ >�t 31 No�................. � � FEs............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE r J Alip iration for Disposal Works Tnnstrnrtion ramit r Application is hereby made for a Permit to Construct ( ) or Repair (,�an Individual Sewage Disposal System at: Sr 71ve 5 L-O (2Q,^ C Location-Address or Lot No. �`Sa3S.l._ Owner Address .— W -z zib Installer Address d Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons___--___-___---..-_-__.--_-_ Showers C • ) — Cafeteria ( ) 04 Other fixtures ................................................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ W 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.......................................................................... .Date I" ................................... ,.� Test Pit No. 1................minutes per inch Depth of Test Pit..................... Depth to ground water_-_____-___•_-__--____-. GT, Test Pit No. 2................minutes per inch Depth of Test Pit-________...__----•- Depth to ground water........................ a ------------------------------------------------------ •-------------------------------------------------------- =------._...-----••-- O Description of Soil ---------------------•-- - UWw�---------- -----------5�----- . -. ----------------- -------------------------------------------------------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp iance has be n sued by the board of health. Signed ------- - -- � ` ------- ----------- ` „r _ ----------------- ------------- -------...tp...96.--- Dare A lication A roved B pp pp Y ;� \ Dare Application Disapproved for the following reasons- -------------------------------------------------------------------------........................................................... ------------ .. ---------------------------------------------------------------------------------------------------- vane -Permit No. / .'` 1 ...................... Issued ..-----------� Q �1 Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C rr#tfiratr of Tompltttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( j by------------1 e `�------- �,Js --------------------------------------------------------------------- --------------------------------------/...-..-...... ImOler at --------------5---1----------- -[U� �� Q��-- ...................... �\v-\-�------- has been installed in accordance with the provisions of TITLE 5 f The Start vironmental Code 4 des ed in the application for Disposal Works Construction Permit No. ----- - �' -- dated -----7- .-�. . .... ..... ....... .. , THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARMTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. ' .✓ ----�/---_---------------- Inspector .....-......... THE,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � 310 TOWN OF BARNSTABLE No._(... ............. FEE........................ Disposal�o .,,��((� n,� a ..hereby a g to Construct ( ) or Repair ( an Individual Sewage Disposal System t at No 5-!-------ZP--�_L..t0----- -----------------------f . Street ((�� al. as shown on the application for Disposal �t�orks Construction "er it No..l- ated_.__ / � ... � Board -- H�lth DATE--------. ................................... ...... --- ---------- ------------ 36508 HOBBS&WARREN.INC..PUBLISHERS -- J LOCATION ;����d �� SEWAGE PERMIT N0. YIL.LAGE I N S T A LLER'S NAME i ADDRESS JOHN A. AALTO .BACKHOE SERVICE 256 .Wp1 West ,Barnstable, Mass. 02668 B UILDE R OR OWNER Ju*►,e s Was k/-e `< Z /W.P yt-,f IY"j/s DATE PERMIT ISSUED DATE COMPLIANCE ISSUED O ,> /D[�h WiP -N l ,Q o yr ' 53 No.. ..:yl. l �. Fxs ... ....... .. � THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - ` c ( ................0E-- — !4 Tt 3L .................................... Appliratiou for Bhivo,ial Wurkti Towitrurtinn rantit. Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: ........��� .I..o....Rl y-1...---...N.��5�oc.��....�.!�� ...................l:��............�93-----------.....------------------•---.....--- Location-Address or ......................l0• . vUP Nglek................................ &.v , H �.__ _ - • ....................................... iL �A%✓�U/ Addrs_.Njl� ' ...�.!::. Installer Address d Type of Building Size Lot._____�_____W ______________Sq. fe t U Dwelling—No. of Bedrooms............. ...........................Expansion Attic ( ) Garbage Grinder f�) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other, fixtures _________________________________ ___ ___ W Design Flow......... .................................gallons per person per day.- Total daily flow_______ ....................gallons. WSeptic Tank—Liquid capacitylAP_gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter____________________ Depth below inlet.................... Total leaching area.........._.......sq. ft. Other Distribution box ( ) Dosing, ,k ) Z Percolation Test Results Performed by.........................__AAJQO�••________ ________ Date._ __ Z/ a Test Pit No. 1....Z,......minutes per inch Depth of Test Pit____________________ Depth to ground water_______________________-- (T Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to,ground water------__------------ P4 - ��} .•-•............... � -Description of Soil � � r _ /------------- ------ ------- �-- ------------------------•------------------.. x W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable.____________________________________________ --------------------•-••-••••----•-••---•-••----•••--••---•--------•---------------•-.........•-••••--•-----....-----------------••-•-------•-----------•••-•--•------------------------••-----....----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the i provisions of ?�;;-; p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue Eby the L--_- Zthl ? � :.._.. - -------------------------------- �i ae Application Approved BY SV - ..._.... -------- =-------------- Date Application Disapproved for the following reasons_---_............................................................................................................. .....................•-------•----•••-------------------------•-....-----•••-----•--•--••-•••---------------•••---•-----•--- Date PermitNo......................................................... Issued....................................................... Date r No.---•-•................. ........................... • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "=- i�JtLa OF... Apli irtt#iun for Ui4pnattl Workii Tnnitrnrtinn amit- Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal,' System at: i 1 f I 41"T' Location.A dr ss or ..... ................................ .. ........._..._............ r. Owner - Addre's'sM ✓r� •---•---_-. �&,1 e 6�'i9 tt.t► r T�' f x 5' rr, f .............`.. ,... Installer Address &/I boo < . Type of Building Size Lot..............................Sq. felt - U Dwelling—No. of Bedrooms................3.........................Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons............................ Showers — Cafeteria a' Othek fixtures -------------------------------- . W Design Flow........... ..........................gallons per person per day. Total daily flow...........................................gallons. WSeptic Tank.-Liquid capaci`ty..J WUgallons 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 Othef Distribution box ( ) Dosing--taa 1�K7(� ) A ;t ,. r �k] fit �,} �,,G... Percolation Test Results. Performed bY--------------=----------------•-•---•..<.�:`:-------•---------......_... Date....- ----.... ........_.. aTest Pit No. I.....9!....minutes per inch Depth of Test Pit.....................Depth to ground water........................ . f� Test Pit No. 2.................�lminutes per inch Depth of Test Pit.................... Depth to ground water-.__-______-_----_--___. O-s,�, -ate J .. _ =------------•------•-•-----•-----•-------. TZ D Description of Soil..... hI L UIT• ------------------------------------•-•-------•--------------------------•---------._._.......--•---------------•---•---------....--••••-•--•...---- V •--.....•••-••••-•••----••••-•.................•••--•••••-•••-------•-•--•-•-•--•-••••-----•---•---•-•......-----------•-••-----•-•-•-••----•--•---•----•--...-•-•----•--•---------•-------••-----••--`- W ------------•...•-•----------------•---------------•---•-•-•---------..........----------------•-----------------••------------------••----•-•----•---------•-•-------•----------••--- UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T`T L.:" y g g p y 5 of the State Sanitar Code—The undersigned furtl era agrees not to place the system in operation until a Certificate of Compliance has been issued by the b'Kai-d o�-ha lth. , -. j4 •t-=-- -------------------- f zdew. Application Approved BY i`-`•--'�.' !lr -trx''l. - ::.................... Date Application Disapproved for the following reasons:--- ----•-•-•-•---••-----•-•--•--------••------------------------•-•---------------••-•---•••-----••.........._ •-----••--•----•--•--••-•----••--•-•-•.............•---•----•--•.........---•---•----..........•----••-•... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... ... t.> ..-�...........OF......... u:t �:� �rrifirtt of (�untlittnrr u g Disposal System constructed ( ) or Repaired ( ) t by...T/�I��,IS-��C/�IFY hat the Individual Sewage ---------•---•---•---------- --------------------•---•----•-' ---------....._. } Alat... G4�� --1..�' ts" ...td'`r1cer ................. ...........L� r '.._/'7li .`± /' has been installed in accordance with he provisions of TI r j of hei�tate Sanitary Co fie a de- r ed in the Al 4 � "0-9p 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. ; DATE.....`..............I I'll v.------•------•••---•--............ Inspect :A_1_11� ....... ---------------------------------?l t; THE COMMONWEALTH OF MASSACHUSETTS j�j BOARD OF HEALTH f/� / ...........................................O F....._.....-----...-.--..._....._..........--•------•-•--•--•----.................... �J No.......................... FEE........................ ion "Pamit Permission is eby granted------ ! .. ... --- ..........................................................y to Construgg IT or Repair ( ) an Individual Sewa tem •G[� <! /'(at No. °��E 1.�. '. ,G '- ' -------. . •. Street 9 1 (; d as shown on the application for Disposal Works Construction Perm' o_____041 Dated.._._..__...._�.__.__ ./..•................ �----------- ------•---- ------. ..................................- /� Board of Healt DATE-------------------�G_.�-•-.�J.................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 4�� .. TOTAL G�ESIC�IJ = 1I'L�j L.P.CS. " . ` -r-o�-At_ va►��f Fww = 33D 6.P'D. � past ���, 4g�sg !r v�r�cot_a-rioU �oT� : Clo SMIQ* olz LASS. ,' + �n�` "y 1 aoct:3 i 4.0, � r t AREA \ �►2p'� 1& j j tisa I 1j �� ��.,�•,•�.�'� _� ,,�--- sir � I � f u �� � uv �` All A ��.7 .�'�e+�` �":.','ter"'�• � II" h rw Air = S or >-N �z .a 4rpo� vlst Iw. Gay. 53.4 5�8501;.. -sox seenc 3 i►IV TA WIC 100o S3 ° �wv. I►rv. > LEAD N A Co v rr P�T • Mom• w�ru •% s WL1Sb1EL7 !i CG'TIFIED VL_C P_L Pcz�P'i L_� l LoGAT1o" �/t ;�'�z•T'Dl��r �lt.,L.-� •43 CG(ZTIt=Y THAT TI-;G tWVUL-L41 4a Sc-lotiv►.1 Pt_..AIJ Ri_r-���E►.1G� NF i_o►.a CcaytPt ,,(s LoT ZS SE'Tt'_,ACtC VC-QUIQGMcuTS o�= TNC: C'A`fG 81�Z e� `� '�� ,..._ �3/S.XTC=1Z �`-,, i•.IYC t2cG1S T4-A14_' h L_A►-1 l 0OT L' A,; cn.4 AN U•I���:JM C=►,l i ��u c_./t=_�( TIC O f=l=;FPS-�, ,I lowLr-> I ANI�I i GA.tiJ T // .c ;1� U� Lc-� r„ 1�r���t ���.1���(- �••t' t_II.I�':� - �/{1.t. �V�•�`t'1" 1 —— 97——EXISTING CONTOUR N / x.100.98 EXISTING SPOT GRADE 61.22 PROPOSED CONTOUR °• \ * W EXISTING WATER SERVICE 28 U UNDERGROUND WIRES RO fe q� / 1 x •92 � � TEST PIT 00 � � BENCHMARK I oev00 ° � P,T �o2P^ 0- LEGEND a o o ° x 0,78 LOCUS 3 A 4 Q. �� x 57. 7 n0010 , 7 60.99LOCUS MAP LOT 238 �-, � NOT TO SCALE B 051-08 EXISTING SEPTIC TANK �0,000 ISF 59,25 \ �� :.;.:• ; .:: TOP OF TANK, EL.=52.14 x 59.01 x 'Al� INV.(OUT)=50.80f I 59.68 � " • WALK ::."\..•.::...., 60.55 52.64 x :59.43...:::'.:,:::. .• x 61.45 r 53,15 I x EXISTING HOUSE(#51) s9 s 0, CO ��� T.O.F.=60.3f ( o \ 60.97 9 0, 52,71 2 52,59 + x O DECK ��. oy 59,5 (above) x 52.76 61.47 \ 52,82 O x 61.14 �� 59,52 Y E L7 x �iL` � x `9 c \ \� 53 82 x5�1•22 GARAGE 59,49: �y�`' 60.8161.70 J 51,62' 1 i _ i/ ,� ` 53.18 59 z1'..`. ::,.:.:... t x MA / CB 5914 Q�\� OF Ss�C =1 52,02 .p \ rLJ 54.04 W �• ,A ' / PETER T. r ' '; po'\ I ., McENTEE r / •12 I 'I 5 I x C VIL 6,3 9 M o Nk .,T 29\ Y3 / .c C TCH BASIN 12''. No 35109 �P \ 58.81 x 60,60 . M ? ® 58,83 o &G/$ZF��O o� LO •S x 57 qi O '1'pF G 59/46 O Z \\ \\52y� I i / -E 60,68 ELEC BOX / 58.79 S ENS IK 60.14 Yedge of lawn 1 I + . . . . . .2912J. so,4o 0' 51.53+ „ ' + 59,98 PROPOSED SEPTIC SYSTEM UPGRADE PLAN r-- S 84'48 42 W 57.73 s 51 TUPELO ROAD, MARSTONS MILLS, MA Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 EXISTING LEACH PITS Engineering Y� BENCHMARK SET OWNER OF RECORD En ineerin b SCALE DRAWN JOB. NO. OUTSIDE COR./BOTT. STEP WASKIEWICZ, JAMES R & 1"_20' P.T.M. 212-14 CONTRACTOR SHALL PUMP, EL.=53.82 (assumed) DIANE A Engineering Works, Inc. FILL WITH SAND & ABANDON 51 TUPELO ROAD 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET N0. MARSTONS MILLS, MA 02648 (508) 477-5313 10/21/14 P.T.M. 1 Of 2 r 9% NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:49.5 FOR A DISTANCE OF 15' AROUND THE SEPTIC TANK PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET 'TING,EX/ AND SET TO 6" OF FINISH GRADE. PROPOSED S.A.S. ' PROVIDE ACCESS TO GRADE OVER OUTLET COVER PROPOSED D-BOX PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" HOUSE(#51) GARAGE INSTALL WATERTIGHT RISER & OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F.=60.3f T.O.F.=60.3t COVER SET TO 6" OF GRADE F.G. EL.=59.0f F.G. EL.=52.7t F.G. EL.=52.8(MAX.) F.G. EL.=52.5t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. DECK above) WALKOUT (below) L = 23, Las, tk CO. 69.7' ® S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC SR , O1u-i 40 lo° aw $ as ,� ¢1• 14" EXISTING 48" LIQUID aawnann T LEVEL ADD INV.=49.27 PROPOSED�INV.=49.10 4' 4.8' 4' NGAS BAFFLEEFFECTIVE WIDTH = 12.8' PROP. S.A,S. 00 INV.=50.80t D-BOX \ INV EXISTING .=49.00 51 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS %----25�--I SURROUNDED WITH STONE AS SHOWN H-10 RATED SEPTIC LAYOUT TOP CONC. ELEV.=49.8t BREAKOUT ELEV.=49.50 NOTES: INV. ELEV.=49.00 maaa comma GENERAL NOTES: woman awes® 1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPE mama aaBaw INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=47.00 4' 2 X 8.5'=17.0' 4' 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 4' MIN. OF NATURALLY OCCURING BOARD OF HEALTH AND THE DESIGN ENGINEER. 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE PERVIOUS MATERIAL EFFECTIVE LENGTH = 25.0' 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ON A MECHANICALLY COMPACTED SIX INCH CRUSHED OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION LOCAL RULES AND REGULATIONS. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-1, EL.=41.3 - 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 3/4" TO 1-1/2" DOUBLE TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON WASHED STONE DESIGN ENGINEER. OUTLET TEE AND REPLACE IF NECESSARY. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 3" LAYER OF 1/8" TO 1/2" ENGINEER BEFORE CONSTRUCTION CONTINUES. DOUBLE WASHED STONE 5. ALL ELEVATIONS BASED ON ASSUMED DATUM (BARNSTABLE G.I.S.t). SEPTIC SYSTEM PROFILE (OR APPROVED FILTER FABRIC) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF SOIL LOG HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. DESIGN CRITERIA 7. WATER SUPPLIED BY TOWN WATER SERVICE. DATE: SEPTEMBER 23, 2014 (REF#14,487) 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. NUMBER OF BEDROOMS: 3 SOIL EVALUATOR: PETER McENTEE PE(SE#1542) 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS SOIL TEXTURAL CLASS: CLASS I WITNESS: DONNA MIORANDI R.S. HEALTH AGENT AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY (0.74 GPD/SF LOADING RATE) 52.3 A 0 52.5 A 0 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING DAILY FLOW: 330 GPD CONSTRUCTION. SANDY LOAM SANDY LOAM DESIGN FLOW: 330 GPD 51.3 10YR 4/2 12" 52.5 10YR 4/2 12„ 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND GARBAGE GRINDER: NO B B REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). LEACHING AREA REQUIRED: (330 GPD) 445.9 SF SANDY OM SANDY LOAM 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 49.0 /8 40" 10YR 5/8 INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL. .74 GPD/SF C 49.0 42" 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PERC C IS NOT TO BE CONSIDERED A PROPERTY-LINE SURVEY. PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 40/52 USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES MED. SAND 1 MED. SAND 10YR 6/6 ; 10YR 6/6 51 TUPELO ROAD, MARSTONS MILLS, MA SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:..............................................................471.2 S.F. 41.3 132 41.5 132" Engineering Works, Inc. NTS P.T.M. 212-14 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471 .2 SF) = 348.7 GPD NO GROUNDWATER, PERC RATE: <2 MIN./IN. 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. } (508) 477-5313 10/21/14 P.T.M. 2 Of 2 1