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HomeMy WebLinkAbout0152 WAKEBY ROAD - Health 152 Wakeby R'o a Marstons Mills A = 043 - -58 i 'own of Barnstable P# of� Department of Regulatory Services • ' Public Health Division Date • o �warest$. � I MAsa i6J9 tee$ 200 Main Street,Hyannis MA 02601 '! r Date Scheduled Time Fee Pd. / I Soil ,Suitability Assessment fog e Disposal ✓1� "\,r ! Witnessed " Performed By: � `/� Witn s B y: LOCATION & GENERAL INFORMATION Z, Location Address .� �l !P-VV 'i Owner's Name Address t�JA¢/ie Assessor's Map/P4rcel: a I I Engineer's Name Dl'Z,•rre.i.- A& NEW CONSIRUftON REPAIR Telephone# Land User ji�f',v r ` ram Slopes Surface Stones ��OU , 2-oo ft Drinkin Water Well 2 ft Distances from: Open Water Body ft Possible Wet Area g i C� /0 ft Other ft btainage Way ft Property Linc SKETCH:(Street name,dimensiods of-lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) EXIST. LEACH PIT --'-_- bW.P- O ay - ,,.�• see note 10 $ oor 0 0 - EXIST. 1,0 OG l—ra.ao SEPTIC TA K ' BENCH MARK TOP OF CONCRETE — BULKHEAD CORNER ELEVATION _ EXISTING " BARNSTABLE GIS DATUM 0 pWELLING j n TOP OF FNDN vL EL = 88.66-I- O G t PICaGI S` Parent material(geologic) Depth to Bedrock�) I ^ / 1 Depth to Groundwater. Standing Water in Hole:' r" i Weeping from Pit PGCe Estimated Seasonal Nigh Groundwater i DtTERIVII.NATION FOR SEASONAL HIGH WATER TA.DLR Method Used: td sall mottles: Depth Clbperved standing hole: in. Depth In, in obs. in. ©roundwater Adjustment it Depth tolweeping from side of obs.hole: A .faetor..,..— Adj.Croundwater Level,,e Index Well# — Reading Date Index Well level PERCOLATION TEST Date xlPIC Observation Time at 9" Hole# (_ Time at G" Depth of Perc 4J ....------- /l 3 Time(9"-6��) — Start Pre-soak Time.@ >c� End Pre-soak � - � y Rate MinJlnch ' y Additional Testing Needed(YIN)Site Suitability Assessment: Site Passed - -- Site Failed; — Original:.Public Halth Division Observation Hole Data To Be Completed On Back— j ***If percola>ibn test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) wedk prior to beginning. 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 1�4 1/ C �zi3 v 11 II 24-�- l C- nY,"11 Al1d , j,7 41' 1 J9" C 5 G DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) 1 L' � lvlt' 2 y P OBSERVATION HOLE LOG Hole# Depth from Soil izon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc 3'o Gravel DEEP OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon Soil Texture Soil Color Soil TOther Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) �c Flood Insurance Rate Map: 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 p rvious material? Certification I certify that on L (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 requir inin ,expertise and experience described in a10 CMR 15.01 . Signature l �� Date l Q:ISEPTICVERCFORM.DOC TOWN OF BARNSTABLE LOCATION /�2 u����'G�U /200e/ SEWAGE #11 7- VILLAGE ASSESSOR'S MAP /& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1006 LEACHING FACILITY: (type) 2 ;5'�D 6,01 � /L�/iae) ZS^X NO. OF BEDROOMS-3 BUILDER OR OWNER 4011/*41 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching aciqi ) / Feet Fumished by 12IiG �L 3:: No. Ir �� l _ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes fltlflratlon for Misposal 6pstem Construction Vermit Application for a Permit to Construct(Gr Repair(GfUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 15Z W14 k!:'ey ors Owner's Name,Address,and Tel.No. Fstirv' Assessor's Map/Parcel a y — 0_S? Y _ InsSo ller's Name Address,and Tel.No. • 41a-2 80-`7!S Z Designer's Name,Address,and Tel.No. ,f 08- ✓ s cpl, D-`l3r�try^o $/ �4rr1✓{�1-G �� rYI�4r Dyl_S' f'!'Ji�� L: svGl''K//G Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ? Design Flow(min.required) 3C� gpd Design flow provided 3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when a plicable) i¢l� D- G,d L , cs UZ/ TG� ev ,.5TONI� #f"D!/41z7 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved b Date 6 -9 Application Application Disapproved by Date for the following reasons Permit No. Date Issued C7"711.11 f gh i /�q'/� No. 5521'A'ECOMMONWEALTH Fee V V OF MASSACHUSETTS Entered in computer:PUBLIC HEALTH,DIVISION - TdW_ 06 BARNSTABLE, MASSACHUSETTS Yes application for �?Disposal .pstem Constniction Permit Application for a Permit to Construct(Z,)- Repair(,_,�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /572 /IA14 k/;3 V 01o14 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel U y 0 � SG1 Installer's Name,Address,and Tel.No. S'o$-,'L 60-'7%S 2 Designer's Name,Address,and Tel.No. J,)>�pA U--_ l314rrv5 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �,) Design Flow(min.required) CJ gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Xl/J'06) Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when a plicable) rr/��� J'_ (�i X �J - UU L>�/�i- �X LLlra��`jj-� s /ZZ I Sn) - Vi/, 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. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ( �/� / Date Issuedi�/ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(Z Repaired( :f)— Upgraded( ) Abandoned( )by U-e !?j4y-"_5 at / 5"2 a,40 k-4 1561 1 04J W,, /till/11 has been constructed in accordance r with the provisions of Tide 5 and the for Disposal System Construction Permit No.. dated �l1 Installer s/05 t dui U,-, 00.....J S Designer i #bedrooms 3 Approved design flow god The issuance of this permit shap not be c nstrued as a guarantee that the sy. em wil cti n a esign d. Date Inspec r -----------------�-------- --- - . _ __--- ._- . _ -------------- _ . No. ' � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct(G-a- Repair( y— Upgrade( ) Abandon( ) System located at /5-59 W14X/'/31i 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 b completed within three years of the date of this p it. Date j �J �� Approved by Town of Barnstable THE'�'�.� Regulatory Services Thomas F. Geiler, Director • BnaxBrABLL 9�pT, Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-362-4644 Fax: 503-790-6304 Installer & Designer Certification Form Date: i( Sewage Permit# 2 D//—�Assessor's Map\Parcel Designer: ` 'G� N Installer: `—ud7 Address: Z/ Address: �(�x b � LAiz ��_ 6- Grdwi/% /1A+ On .S Z�—// `a j e�, e������vas issued a permit to install a (date) J� (installer) septic system at '% 2, based on a design drawn by (address) dated t� (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 revocation of the distribution box ancb'or, septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF- _Mgssgc DA� E R r(Istaller's Signature) 11 0 SOI TA" \"k- __VVY1'—' R�I'� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-264doc ' TOWN OF BARNsTABLE �. ;.c..)CATION. l.>®` lil1,Q/c e� SEWAGE #-����v� VtI_LA,GE All ASSESSOR'S MAP Q LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY-- LEACHING F.A.CILITY:(tppe)Ne4h- 1006' —)-1� NO. OF BI;DROUM.S._--3 PRIVATE WELL O . NUI IAIC WAT ER BUILDER OROWNER /!1/1l1/•¢� i i DATE PERMIT ISSUED: o?3 D,1rF COMPLIANCE ISSUED: VARIANCE GRA.NTI;D: Yes __ _ .�No�/ . �� 6 /��i --- a4 �� �� � � © ° ti kk TvcJ2J f,�J.$-�� jt/��e �y •�� Fizs.... .4 ...'-_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........... - --------- ----------------OF...........--------......------.....-...-------------------------------------------------- ApplirFation for Uh4pooFal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) o Repai ( 1,-�an Individual Sewage Disposal System at: ... ------------------------------------------------------------------------------------•-------••---- .............. o................................................ ddress or Lot �o. ....._ / . ............. -_... ._._..._...... ....................... ----------------.--- -- -----------.....------------ i own tidress pola Installer Address Type of Building Size LotA ,G2®a_�....Sq. feet U Dwelling—No. of Bedroom................__.................Expansion Attic (/J) Garbage Grinder (/0/p aOther—Type of Building --__ --_--•-------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------------------------------------------------------------------------------------------••----------•-.---•---- W Design Flow..........S-5.......................gallons per person ,D I eqtp Total daily�(iow..................................Z ....._....gallons. WSeptic Tank—Liquid capacity.!®!,..gallons Length--- ...... Width../.......... Diameter________________ Depth................ x Disposal Trench—No--------------------- Width ... ............. Total Length_.__........._...._. Total leaching area--_-------__-•----sq. ft. Seepage Pit No..._-___r..._...... Diameter...:... ........ Depth below inlet...../......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �-' Percolation Test Results Performed by...............................-••---•-------••••--.....----•-•--------- Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_.___-.-_____-_______--- LX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--_____-_-__-----_-.____ Description of Soil � '` .................-� --.... � " . x Vie--------------- -- ��.......-------------------------•--------•--------•------------------------•-------•-----••-----------------------------•-----•--•--- U Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ •---------------------------•-----•------------------------•-------•---------------•..........-•--••-------•--•------------------------•-------•-------------------•---------------•----•--------•-•---- Agreement: The undersigned agrees to install the aforedescrib il Indio' ual Sewage Dispos stem in accordance with the provisions of ?I LE 5 of the State Sanitary Cod Th ersigne .urth r not to place the system in operation until a Certificate of Compliance has bee s e he 2 �? Signed.-- •-- ....... ---•----••..... ........ •... ............................ o -•- -- ----------------•-----•- Date Application Approved By................ ...-- ... - t-* j-----•---- ----------•-- ........... Date Application Disapproved for the following rea ons-............................•-------•-------------------------------------------- ----------------- .------------- ----•----------••---•--•-----------------------------------•-•----------------•-•---•-----•--••-----•-------------------------------------------•----------------...................................... Date PermitNo -T---- ------------------- Issued_----------.....------------------......-----•-•-------- iDate '+1 ......--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ...................OF...................... Appliratiou for Diupuual Vurkg C omtrur#ion nutit Application is hereby made for a Permit to Construct ( ) or Repair ( 4'0'an Individual Sewage Disposal System at• / / 1 �f� lwlw e'/ v� ................_...---•-••---•••............ ..... .. ........•••••-----------•••-------- ------------------------------------------------------•-------------------------I----------------- -1 j^.� n- dress or Lot No. .........?....�.--._.�_.I_._._..._ ...... ---- -------------- ------------ - ----•-------- -----•- C A . ' �'�� G✓�dress�... Installer Address i d Type of Building Size Lot._�� !� ?'®¢.Sq. feet V Dwelling—No. of Bedrooms. ..._.. ...........................Expansion Attic (A/) Garbage Grinder (IqO Pk Other—Type of Building .. .................. No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow.............. _.r.....................gallons per person per d�y,,. Total dailyflow...........�'_� ........ WSeptic Tank—Liquid capacity__�°�!.gallons Length._......_._ Width.._. ..._ Diameter________________ Depth................ x Disposal Trench—No.................... Width. ....... Total Length................... Total leaching area--------------------sq. ft. Seepage Pit No...___.._�._______.. Diameter........ ....... Depth below inlet......6......... 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-------.--__-__--._._.-. fZ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..-____--__.____--.._--. ............ Description of Soil.......... __ ��9��'�----------- 'T . -----�C------ ��•-�---'�./ . UW ./-./- .....'-'-----------•---•-----------•----•--------------------------'•-----------------------------••---•------------------'--'-------'-- Nature of Repairs or Alterations—Answer when applicable................................................................................................. -------••-------------------------•••-'•---•--------------------•-'•--------------'•....------.......---•-----'-------------------'------------------------------------------------"•-•---.........---• Agreement: The undersigned agrees to install the aforedescrib Indiv• tal Sewage Dis os stem in accordance with the provisions of:TT`.;. p 5 of the State Sanitary Cod The ersigne rtl re not to place t system in operation until a Certificate of Compliance has bee ss a ie �r7 Signed---- ---- ....... _ -----•------- -----------• ............................. ............Date ---t.e.....---...... Application A Approved B /Y �.. '............ s . ......... Date Application Disapproved for the following reasons:................................................................................................................ ---'--•--•-•--...'--'....•-----'-•-••-•...........•--•"-•-•-------'-•......-----••.....---•--......••••................•-----......--•---•--------••-••----"•-'•--•----'--•-•----------•--•-----...... Date Permit No SLID.......a-A=Q------------------- Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................... ............................... (Irrtifirtt#.e of Tootpliattrr THIS IS TO CERTIFY, Tha 1 the Individual Sewage Disposal System constructed ( ) or Repaired by --•-...... ..-- '.r,�:.G:_�!--•--•--------------- --••-•-•--•-........................----•-•-----...----...............-----------•-----------•. V/-ki, lr� Installer � at ------------------------------- - --.. •---!-...yj......-----------•---------------••-•-------•---•-••--•-----'••--------•----------•----- has been installed in accordance with the provisions of TIT;, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__.�t?.__.. �- k s`.__....._, dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE_......."............. _..�.._.l_ .:-. ........................ Inspector P ; THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH vc� ,................................ F........... .-•--•--•-•--...................--•---............---................. r._ ------ ..... FEE.. �............. BtsposallVorkii TwInstrt ion rruti Permission is hereby granted.......... =...... ........................................................•....................... to Construct ( ) or Repair kf an Individual Sewage Disposal System �J at No..•-----_..!_5_a....__....V��w--�c _Lj , t I�'1 Street , as shown on the application for Disposal Works Construction Permit No.._.............. Dated------------------------------------------ ........................•-•--•r....._.n........----•-. ..........._...- •------------ --------- DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 3 le — LO. 'TION � SEWAGE PERMIT NO. / A VIL1AGE -2&md6, INSTALLER'S NAME- & ADDRESS UILDE OR OWNER DATE PERMIT ISSUED J5 fl. 1 DATE COMPLIANCE ISSUED ���� ,. 7 9 _ s . No.--•-•- •------------ Y . ...... ..................... _• . THE COMMONWEALTH OF MASSACHUSETTS B04ARD OF HEALTH.: V. ~ ..............OF .......� '..._.....-...-........ Appliration -fur 430paiitti Workii Cnnn.itrnrtinn Vrrufit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ------------------------- -------------•--==•--••-------•-----•--�"-�-�� -------------------------....---:.:::--- L cation-Addre or Lot No.d Ow p p� Addr s a ................................ om'•._----��---------------- -�.---- -� � - °�' . �' � ................... Installer Address Q Type of Building Size Lot----------------------------Sq. feet U g— -__:_Expansion Attic ( ) Garbage Grinder ( )., Dwelling No. of Bedrooms_..__.__.. _____________________ — Other—Type of Buildings 1 ________ No. of persons_..__?�______________ Showers ( J ) Cafeteria ( ) a Other fixtures .Q W Design Flow_..___.__.: !'S_______________________gallons per person per day. Total daily flow..........d3_;3.Q....................----gallons. WSeptic Tank—Liquid capacitvLaP:P__gallons Length_.__.__....... Width................ Diameter_-_-__--.--_-_ Depth_..-_--_--.__... x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlej____. _________.___ otal leaching area......___._____..sq. ft. z Other Distribution box ( ) Dosin tanjjkL '-' Percolation Test Res4ts Performed by._ ' 2-- -_&VIU41. __ Date---7 _-1-1 2-----------. Test Pit No. 1.1 °'?__..__minutes per inch Depth of Test Pit____________________ Depth to ground water.._--______----____-- f� Test Pit No. Z________________mtnutes per inch Depth of Test Pit.................... Depth to ground water_-.---__-____-_.-__--._. a -- --- . O Description of Soil '-" ._.__... -= ------- x --------�---_` ..... --- UW ------------------------------------- --------------------- ---------------------------------------------------------------------------------------------------- -------------------------------------- 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 \I of the State Sanitary Code—Th ndersign urther agrees not to place the system in operation until a Certificate of Compliance has been issued e bo of eal Signed. -----------•---• -••--••••-----•--•--- -------------------- go Application Approved BY = --- .............. �--- Date - Application Disapproved for the following reasons--------------------••--•-------•---•----------•--------------___.__---••-•-----•-----------•------••----------- ._..--•--•-•--•-.._..--•-••--•----••--••-•--•_......_•--------------•-------•----•-•--••-----••--•----------------------•--------•---•----------••-------..._.._._..••------•----------••------•--_----- Date Permit No......................................................... Issued.....7-1,e^. -- ...................... Date A • o..... ------.. }� * y FE$...tT.�......._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - w-�X -------OF....... an ..................................... ppliration -fur 4%ipoiial Works T11nuitrnrtiun Vaniit Applicati is hereby'madefor,a.Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at L canon Addre or'Lot No ll !,. --- ----- -'----- -------------------- ................................ ct..... -- ......-----...-----•---- Ow Addt�ss a :-- r ' r' ---------------------- ...................... --- �t.. ------ Inktaller Address Q Type of Building ` Size Lot----------------------------Sq. feet V Dwell' €No. of Bedrooms..:______ ____________ ___Expansion Attic ( ) Garbage Grinder ( ) per,, Other Type of Building RtS+ @e.,�_ _____ No. of erson5__.1, ---------------- Showers — Cafeteria 1 P ( r > ( ) Q' Other fixtures- ----------------------- ------------------ W Design Flow____ r!�....".._-�._,tr:_ gallons per person per'day. Total daily flow.........3:3.0-------------------------gallons. W Width__.,_ s Length------? ..... Widtl--------......... Diameter---------------- Depth---------------- x --- ------------- Disposal tosal Trench—No capac.t}!P�'Q -gWi lhn____ _________ Total Length__._-._;_-__--__-_-- Total leaching area--------------------sq. ft. P Seepage Pit No___________ _________ Diameter--------------- :__, Depth belo . inI t___ ___.____.__ Total leaching area._._..___._.____sq. z.4 Other Distribution box ( ) Dostn 'tank d �` .`/� '-' Percolation Test Res i is Performed by.._ ` - � _ _ _ �- __. _a-.01 _. � [ Date..7`_a -------------------------- Test " W - Pit No. I.... ...___minutes per inch Depth of 'Pest Pit.................... Depth to ground water..,..................... !_ Test Pit No. 21�..........minutes per inch Depth of feet Pit.................... Depth to ground water__ __._..__.______. _ { i- e Description of Soil 3 '� . etwJ.. '_ x Lv�'� V ------------------------- W --------------- --------------------------7---------------------------------------------------- �. -------------------------------------------------------------------------------------- V Nature of Repairs` or'Alterations—Answer when applicable.________________________________________________________:-__.--_--..-.._- ._.._-:____-.-_.._ -------------------'------='-------- ------------------------------------- -- " Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with thegprovisions of Article XI.of the State Sanitary Code—T ndersigi urther agrees not to place the system in operation until a Certificate of Compliance has been issue he b d o . ea ' Signe •--- ................................. -------------------- .-- APPlication Approved By. Date A�,pp*ation Disapproved f ors th.e"following reasons:----•----- -------- ---------------------- ----------•-•-•-•---•-•--•------------ .--.---------------•- Dae Permit No........................................... ............. Issued..... IJ-. - .................... ", Date ,r- THE COMMONWEALTH OF MASSACHUSETTS ` _BOARD OF HEALTH ,, 3 t... .. .. ........` OF.;.... .. i............................ r, Trrt f irntr of 101,11mpliaurr 1 CERTIFY Th t the ndi ual Sewage Disposal System constructed ( ) or Repaired ( )TH T '"' ' �'� 8f -- --- ---------------4'. In alter has been installed in accordance with the provisions of XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit Nck�§)---__:+ _ 4�".......:...... dated. .. /./--70_..__.____...__.__. /THE ISSUANCE OF THIS CERTIRIPATE .SHALL NOT BE CONSTRUE© AS A GUARANTEE THAT THE S1STE.M Viltly�FUNCTION SATISFACTORY. DATE------- � ............. ---- �� ._................. Inspector----- ---------------------------------- ,< THE COMMONWEALTH OF MASSACHUSETTS ARD OF HEALTHY +Z..5; _ ......! f3... ,.;.. ..... . ...OF....... ,► .............•---------- . No.................... 5 .. FEE_;-- ........... Di u ttl urk C11uftifr r iun PrrMit Permission is hereby granted----------klZ-Ilk_--------- .---- !A-------------- -------• P to Constru t ) r Re air ( ) a .Indi idual Sewage isp sal Syste at No:-.. �''14s �' j --- - -- _..�- ....` , - !l-l-- _r........ ' trees � as shown on the application for Disposal Works Construction PeF'i�piit N Dated_ _ R ' �............... Board of Health DATE---:: .`.j _`------- ---------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - � J I // J i J977 �'�!. ✓6J J(rf I nC +;ate,_+.,_ t . _�� F G=yfT FG 9 7 7'4u �3,7y e /0 0 �� K rcr/ram r, ' J ag CG-V-T FtCp pLOT PL ��tJ 5,0 CGt TIP14 T�44,7 T14C-= �wJ(� 5t-lowQ P�_At.1 � �"�2c�.lCi✓ C-CaA/%.PL G W ITI-i TOG 5ID'E.L "C-- 1 r�ktt� 5ETi3��CbC '.C-QUICE=IvtL+.1TS a� TNT l._o; �3 - REG1S tt-Z�t� LAt-ty ;U�v��fon_S �'t•1lf� V LA1-.1 14 L IOT 13ASC=V 0►4 A Q5TE1`:ftl_t C o SASS. -1 , 'Ttac-- C3�.C_ ri=�"S ,440ujLx> ARPI-i r-A F-1T" t,br f;i�_ USCD t-u UI TC--V-Mil,.lt_ L.O'T- LIWCal ( , M. MILLS — 1_2— ft�— LEGEND hh 4 EXIST. LEACH PIT It 87, 57.38 ft PROPOSED CONTOUR o Pods see note 1 O rent 00Inap SyEO ® PROPOSED SPOT GRADE 32 'po TH-2 —— 98 —— EXISTING CONTOUR � SITE 88-------`\ \ ® Y + 96.52 EXISTING SPOT GRADE _ WAKEBY ROAD \ cn ® 1 cl EX15T. I ,O OG W— EXISTING WATER SERVICE \\ �' p SEPTIC TA TEST PIT K 1 � _ i O i 18.40, LOCUS MAP N.T.S. 87- ----- GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL s U BOARD OF HEALTH AND THE DESIGN ENGINEER. MATERIALS SHALL CONFORM TO THE RUIREMENTS BENCH MARK X�STD 1�1 G �_ 2 OF THEALLRSTATEDENVIRONMENTAL CODE, ,TITLE V. AND ANY APPLICABLE TOP OF CONCRETE E L�NC' LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: BULKHEAD CORNER EL — 310 CMR . VARIANCE (1) (B): W 1) A 1.00 FT. VARIANCE FROM 310CMR 15.221(7) TO ALLOW LEACHING ELEVATION = 87.90 D TO BE 4.00 FT (MAX) BELOW GRADE VS REQ'D 3 FT. (VENT/H20 PROVIDED) PRIO BARNSTABLE GIS DATUM -TOP OF F6+ 3 TOEINSPECTIONIAND APPROVAL BY THE BOARD OFCHEAL HSAGE DSPOSAL SYSTEM SHALL NOT BE BAKFILLED AND THE 88. DESIGN ENGINEER. E� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING p FROM HOSE SHOWN HEREON SHALL BE REPORTED TO HE DESIGN yL ENGINEER BEFORE CONSTRUCTION CONTINUES. N GQ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. a 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF HE CONTRACTOR OR OWNER TO NOTIFY HE LOCAL BOARD OF h HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. - —— 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. i 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY i THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 86 86 CONSTRUCTION. 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. \ LOTS 1 2 B 8c 1 Q 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY \ AREA = 30030 sf +— AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY \ \ 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING \\ \\ 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. OTHERWISE) OF \ W 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW Assx�y \\ \\ OZ — _86 FOR THE USE OF A GARBAGE GRINDER DAR Mo ✓ \ Z \ ,,-- 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING MR 17. PROPERTY IS IN ZONE II OR NITROGEN SENSITIVE AREA. \ - , STEM \ �� SANI TAR\a� PROPOSED SEPTIC SYSTEM UPGRADE PLAN �43.36 ft 81.64 ft % 152 WAKEBY ROAD, M. MILLS, MA 86 _ Prepared for: William Fisher 62.50 EDGE OF PAVEMENT Engineering by: Surveying by: SCALE DRAWN ` MAP: 043 DARRENm MEYER,R.s. EcoTech Env. 1"=20' DMM ROAD Aoaox9a, WAKEBY LOT.• Os8 EAST SANDWICH,MA 02537 (508) 367-8097 DATE: CHECKED SHEET N0. 508-362-2922 05/22/1 1 DMM 1 of 2 NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS ELEV. TOP SEPTIC TANK FOUNDATION PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL RISER W/IN 3" OF GRADE OVER (Existing) OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) 88.66 F.G.EL: 87.0 F.G.EL: 86.6 F.G. EL: 86.5 FINISHED GRADE (87.0) VENT -!� MAINTAIN 2% MIN SLOPE OVER LEACHING A�R ---------------------------- .Y :Y .,•. 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" .• . STONE OR FILTER FABRIC DOUBLE WASHED STONE 6' 4" SCH 40 PVC ,o I e MIOF. ®®®®mWaamom ' TEE'S ARE TO BE 14 INV.82.85 S= 1% ( � ®®®®®®0a0aa 4" SCH 40 PVC 2 DEPTH ®®®®aaaaaa10 INV. 84.18 INV.82.65 4' 2 X 8.5' 4' BAFFLE. PROPOSED DB-3 = EXISTING ouTLET H-20 DISTRIBUTION BOX EFFECTIVE LENGTH 25' M AM INV. ELEV.= 82.50 INV. 84.43 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON BREAKOUT OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV.- 83.0 ELEV.= 83.0 TUF-TITE, ZABEL, OR EQUAL INV. ELEV.= 82.50 ®®f O ®mamamma® amammm® . ®mamma® NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING ®aa®®ma PIPE INVERTS PRIOR TO CONSTRUCTION BOTTOM EL.= 80.50 3.75' 5 FT. 3,75' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALL COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN SEPARATION 5.40 FT. EFFECTIVE WIDTH = 12.5' 310 CMR 15.221(2) SEPTIC SYSTEM PROFILE 3) REPLACE EXISTING TING1,000 GALLON SEPTIC BOTTOM OF TESTHOLE EL: 75.1 SOIL ABSORPTION SYSTEM (SECTION TANK WITH 1500 GALLON SEPTIC TANK IF FAILED, DAMAGED, OR UNDERSIZED. (500 GALLON LEACH CHAMBER (H-20) LOADING) 4) INSTALL INLET & OUTLET TEES W/ GAS BAFFLE AS REQUIRED SOIL LOG DESIGN CRITERIA P#. 13282 NUMBER OF BEDROOMS: 3 BEDROOOMS (NO ADDITIONAL FLOW PROPOSED) DATE: MAY 16, 2011 SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) SOIL EVALUATOR: OARREN M. MEYER, R.S., CSE. DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DON DESMARAIS, BARNSTABLE BOH DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. Elev. TP-1 Depth Elev. TP-2 Depth GARBAGE GRINDER: NO (not designed for garbage grinder) 86.60 0" 86.75 0" SEPTIC TANK: 330 gpd x 200% = 660 gpd USE EXIST. 1,000 GALLON SEPTIC TANK 85.93 A LOB SAND 8" 88 92 6 LOB s3n/N2D 10" LEACHING AREA REQUIRED: (330) = 445.94 S.F. OF Mgs�9� B SANDY 8�8 SANDY s%s .74 ' (� y 84.60 24" 84.50 27" USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4 STONE DA�RI M C 1 C 1 1`� ON SIDES & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D o EYE ` SANDY LOAM SANDY LOAM No. 1140 " 10YR 7/2 10YR 7/2 BOTTOM AREA: 25 x 12.5= 312.5 SF 82.52 C2 49" 82.59 C2 50" SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF PERC O EL. 81.10 TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D S01TAR�a� MEDIUM SAND MEDIUM SAND DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd ' 75.10 2.SY 6/4 138" 75.75 2.5Y 6/4 132" PROPOSED SEPTIC SYSTEM UPGRADE PLAN PERC RATE <2 MIN/IN. ("C" HORIZON) 152 WAKEBY ROAD, M. MILLS, MA NO GROUNDWATER OBSERVED Prepared for: William Fisher Engineering by: Surveying by: SCALE DRAWN • I, Darren M. Meyer, R.S., CSE, here certify that I am currently a DARRENM.MEYER,R.S. EcoTech Env. N.T.S. DMM y by y y approved by MADEP pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the p0 BOX 981 DATE requirements of 310 CMR 15.017. 1 further certify that I have'possed the Soil Eval. Exam In October, 1999. EAST SANDWICH,MA02537 (508) 367-8097 CHECKED SHEET NO. 508-362-2922 05/22/1 1 DMM 2 of 2 1