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HomeMy WebLinkAbout0081 WALNUT STREET (M.MILLS) - Health 81 Walnut Street Marstons Mills A= 149-004 f i i V I I f UPC 10271 No. H� HASTINGS. MN 4 TOWN OF BARNSTABLE ,,—,LOCATION ` �,�`��� ��Cc.\ SEWAGE# �' VIILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.Wj�s-&,� SEPTIC TANK CAPACITY LEACHING FACILITY:(type)1��QS SAkC,3 C\C (size) 3—Sp 1X 8•�i x 6 �' NO.OF BEDROOMS OWNER PERMIT DATE; ( ( COMPLIANCE DATE: Q 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 facility) Feet FURNISHED BY-V�4�a vl Y�\��, .•�G, � y 0 Fi@$.,/c...--.................... THE COMMONWEALTH OF MASSACHUSETTS BOA RD F HEALTH � v ' .... Appliration for Disposal 10orksTonarurthin Prrutit Application is hereby made for a Permit to Construct (. or Repair ( } an Individual Swage Disposal System at: M - ........................... - f � .. L on• ddr 4 r t o. W /.. Owne Address nstaller Address d Type of Building Size Lot____________________________Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building ____________________________ No. of persons._.-.•--_______________-____ Showers ( ) — Cafeteria ( ) P� Other fixtures ...--------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. W Septic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter................ Depth---------------- x Disposal Trench—No..................... Width.................... Total Length------------_----- Total leaching area--------------------sq. ft. 3 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------.____-_-_______--. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_______________________. -------•------------------------------------------------------•-----------------------------•.•-----......................................................... 0 Description of Soil......................................................................................................................................................................... W -----•-------------•--------------------------------------------------------------------••-•-•----------------------------------•-•----------•------•--•----!---._....------------------------------. ------------------------------------------------------------------------------------------------------------------------- ---- - - ----------------------------------------------------------- U Nature o Repairs or Iterations—A wer when appli e.__—_ _,_,_. _ L � ._.: ------------------- -----•..... Lam= ..................................................1` -------- ---- 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 been issued by the board of health. Signed ---•-------------------------------------------------- - -------------------------------- t Application Approved By----•---- --- --6--.- ..4U4�- --- ----------------- �. � ate Application Disapproved for the following reasons:-•--••--------------------- - -------------------------------------------•-----•--------•----------------...... Date PermitNo......................................................... Issued------------- Date ,1 ------ --_--__��_.�_._--- -__ _�� -A �'W� No.---- ........ FEx. �.......f. ....... THE COMMONWEALTH OF MASSACHUSETTS BO RD F HEALTH OF...... ..: . Appliratiun for Disposal Works C onstrurtiou Prrutit Application is hereby made for a Permit to Construct ( . or Repair ( ) an Individual Sewage Disposal System at: 011 --•.•-- 4 gg -n-E'rddre o t Y s Own`e f y. ddress a •-••-----^^.--��-- ............ .............................. .......--------•------------•-•------................--•-•-------------........................... aI er Address d Type of Building Size Lot_______________________--_Sq. feet U Dwelling—No; of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -------------------------------------------------•-----.---- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------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--------------------- 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-.-.-___---____-_-.._-__ fTA Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--_____________________ a' ----•••------•----------••-•---------------------•-----------••-----•------------•---•--•----•.•-•--......................................................... 0 Description of Soil............................................................................................................................... ------------------------------------ x V -----------------•------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------ ------------------------------------------------------------------------------------------------------------------- = ----------------------------------------------- U Nature of Repairs or Alterations—An,wer when appli le__�____ f , - - __...__`___.__....______-____--- ----------- "" y -d------------------------------------------------- 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 been issued by the board of health. Signed _I....-•-••----•--------•----•----•--•---•--•--•---•-•--••-•-•-----••---••-•-- Application Approved By........... f at Application Disapproved for the following reasons----------------------- ----- -------------------------------------------------------------------------------- ----•-•--•------------------------•-•---••-••-----••---------•-•---•••---.._..-•-•-•--•---•-••------......_ ------------------ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..., ..... .... . ...........OF.......... .�_ . CIertif irate of Tom liia ttre TI IS I TO CE IFY, a 'the Individual Sewage Disposal System constructed ( or Repaired ( ) by.......• --• •---- __r ---- . •• ............................................................ ......................... .....•---- AInsle- -- - ---- ,--... `at.. ; A. has be " ins a e m'accor ance with the rovt�t ns o I of �e State Sanitary Co as described in th p v � e application for Disposal Works Coristruction.Permit No._....__ '. .................... dated----- ..? ._._._._.__. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANT E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1� .......T� iOWI ............OF......... ..... ............ �. NO.1 " •-- 10, FEE----- Diapn,sa 7ks ClIon trurtt ai P.erutit Perto Construct on Vis' hnreby granted__._.____ �i _, �( epair ( ' ) Indivi al Sew ge �spos System at No.---------- 4 F tre 41...... as shown on 'the application for Disposal Works.=Construction rm' No. :_. ated_-__ �l ------------------ I - � . •--•-•...•-- ---- ---- ,g o ea�^�i. � r ' DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS l No. Fee THE COMMONWEALTH OF MASSACHUS'ETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpfitation for Oisposat 6pstem Construction Permit Application for a Permit to Construct( ) Repair(,Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.�, \y�v S > Owner's Name,Address,and Tel.No.Oq W Gt a, rcS2 rn Assessor's Map/Parcel P'1m Tk6 s �`h,A5 Installer's Name,Address,and Tel.No.R.G�ae� ��-�,�r-1 Designer's Name,Address,and Tel.No. cn . `3o ?c 3� ( S��- te1?�-6©ems F . �,�,oxao3o Ste$ - �`;,�- 3�Sb Type of Building: Dwelling No.of Bedrooms Lot Size '`►3' sq.ft. Garbage Grinder( ) Other Type of Building � No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 Q�> gpd Design flow provided 773 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank _L©pd Type of S.A.S. \Pd->3 Q\?­CG-Cl G Description of Soil <171,1�_- QV�:�%c U, Nature of Repairs or Alterations(Answer when applicable) Gv 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 by Date /7, G Application Disapproved by Date for the following reasons Permit No. 7O l 2,7 Date Issued 1/ No. H 2-7? Fee THE COMMONWEALTH OF MASSACHUS'�ETTS-"' Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS - . 01pplitatlott for Disposal 44pstrin (Construction 3permit Application for a Permit to Construct( ) Repair(,.,,/Upgrade( j' Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. t i \h v� 5 Owner's Name,Address,and Tel.No.Qq o,,j 4 Ao TcQ r•o Assessor's Map/Parcel n6r-?a.s t A-�\� Installer's Name,Address,and Tel.No.R Coc�.Y �opG ram. Designer's Name,Address,and Tel.No. P.o . 43 o >c 3 7 ( �2- SPY 7-C�os"'S" Type of Building: Dwelling No.of Bedrooms Lot Size 13 3 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria Other Fixtures Design Flow(min.required) 3 gpd Design flow provided 7 3 gpd Plan Date Q� S c Number of sheets , Revision Date Title Size.of Septic Tank Type of S.A.S. Description of Soil ���. �14 v� _ _` Nature of Repairs or Alterations(Answer when applicable) a < ins 3��� � e�r�� c�� .�-tom 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 ( 7 1 Application Approved by �--�" Date Application Disapproved by Date for the following reasons Permit No. '70 11- 2�� Date Issued 8 l --------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Comptianre THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(v) Upgraded( ) Abandoned( )by at $\ C,.-_--'x—�vNG\ S`�', � ass IPI);\`S,has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No X11` -7 77 dated Installer Zz �__ Designer #bedrooms 13 Approved design flow 33 gpd The issuance of this permit sh Jall not b' co strued as a guarantee that the system will t c Date on signed. � . g ------------------------------- No. �]3 Fee /00. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstrut Construction j3erinit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) l System located at CfL�+A���\ t i✓G �!'�resv. A \s 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:C nstruction must be completed within three years of the date of this permit. Date 1 f Zy 1 Approved by — � Town of Barnstable . Regulatory Services Thomas F.Geiler,Director Public Health Division 1 9. s`� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Sewage Permit# 11 Assessor's Map/Parcel Installer&Designer Certification Form Designer: Lsu �9neenng Installer: Address: d 2030 Address: c:),3"ic 3?� On 6 0 was issued a permit to install a (date) installer) septic system at C,_Jz. 37 based on a design drawn by (address) CSN Gn5trrczflnh dated (designer) I certifythat the septic stem referenced above was installed substantial) according to p Y Y g the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were 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 Re ions. Plan revision or certified as-built by designer to follow. Stripout(if re t ted and the soils were found satisfactory. UNDA J. CyG pvfi, v (In tall er's Signature) 4 R 1 ,SAL (Designer's ignature) (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:\office forms\designercertification form doc « t" Town of Barnstable P# ' Department of Regulatory Services i Public Health Division Date � / f 200 Main Street,Hyannis MA 02601 Date Scheduled_ O ' Time / / Fee Pd. 06 Soil Suitability Assessment for Sokvage Disposal Performed By: C S N Witnessed By: LOCATION&9ENERAL INFORMATION Location Address 8 1 w A LA-14 �j Owner's Name 9At.Aj (/QUA rMp- , r P / M A r S 6A4 rd d 5 Address 81 �/ .I..lfi J'/ .I t p'fS 111.1 Assessor's Map/Parcel: t q ( o T Engineer's Name L,A-A A NEW CONSTRUCTION REPAIR `' Telephone# O .21 -7 15 4 Land Use ] lV)�a Slopes(�) �' I0% Surface Stones Distances from: Open Water Body 1u �A ft Possible Wet Area N IA ft Drinking Water Well Al A ft Drainage Way (to ft Property Line ft Other g SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands In proximity to holes) • ��� �F Git..�'r9 v Va Parent material(geologic)h lac i 61 00_6nL4) 11 Depth to Bedrock 7 i�0o I Depth to Groundwater. Standing Water in Hole: N l - Weeping from Pit Face l Estimated Seasonal High Groundwater tJ A DETERAIINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _- In. Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment—..------..- ft. Index Well# Reading Date: Index Well level , Adj.factor— Adj.Groundwater Level, e PERCOLATION TESL' bate I- I Tithe LooaM Observation Hole# _ Time at 9" li Depth of Perc _ Time at 6" Start Pre-soak Time @ a 'time(9"-6") f End Pre-soak �'2'0 Rate MinJlnch 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:\SEPPICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistewy.%GraveI) A ,M SL 10 1_ (o SI tP (d ju Gr,,'A • Spylnt_ (�e...S 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) - 13 �-(� �-MSL e � �IZ o • T- 31 SL lo'�R-s1V DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. Consistency, Flood Insurance hate Man: Above 500 year flood boundary No Yes ._./___ Within 500 year boundary No 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? P 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 tra ing,expertise and experience described in 310 CMR 15.017. Signature Date (6 i Q:\.S.EPglCIPERCPORM.DOC TOWN OF BARNSTABLE V L� ATION WAUeVr -'5 SEWAGE # 9r 7- V6 7 �WILLAGEMA#t3T-*MS 61E :t.1.- ASSESSOR'S MAP & LOT CUNSTALLER'S NAME & PHONE NO. Qt t-13 GrIcS . rnv-E. ?%/I W SEPTIC TANK CAPACITY Jeoo 6"0 . LEACHING FACILITY:(type) 601-r" (size) 1600 NO. OF BEDROOMS PRIVATE-WELL OR PUBLIC WATER BUILDER�OR OWNER N L as wo -r DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: i 7 VARIANCE GRANTED: Yes No t t�"� �,. � � � � '!� r 0^► ). aer /�. �� »� "!►' t THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �(( �{ .'r-M ..O F......... 'E ApplirFa#ion for Mipas al Works Tomitrurtwi n Famit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Lot #7 Walnut Street,Barnstable 7 ................_........_...................................................................... .............................................................. C. B. oc�altion-Address walnut Iwo. ......................_.......................................................................... .........._....................................................................................... pw r Address W e ,.a -•----••--••----•---••••- ..... --s •----------------------------------------------------------------------------- Installer Address 21890 d Type of Building Size Lot-__ :f _._.______._Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ Design Flow...................fir............--...._.._.gallons per person per day. Total daily flow...............330.......................gallons. W 1000 8'6" ' " c� Septic Tank—Liqutd capacity_........___gallons Length................ Width..__._4.1Q_ Diameter........—.... Depth---5'8:'__._. W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No---------- Diameter........ Depth below inlet_....._6'......... Total leaching area...2 _._______sq. ft. Z Other Distribution box ( X) Dosing tank ( ) Percolation Test Results Performed by..........DcYle..Engirleerug_Agggi4�stlnc-. Date....fy-_Z7i19Z............... �a Test Pit No. 1__<_ ..._.minutes per in Depth of Test Pit.....12.......... Depth to ground water--__—-------------- ___ f= Test Pit No. 2__'�?._..._minutes per inch Depth of Test Pit...... ...._.__.. Depth to ground water---_—................ ---------------------------- ------------------•--•----------------------------•-•-----•----.--------•---•----------------•-•-•---••-•-•----•-•--•--•••----- O Description of Soil..----(1) 0_ 39' Thp & Wsoil,-30" — 144" Mediup&aoarse_clean card with.gravel•-•-••-•.__------ x 30" Thp &.suiasoil, 3Q" —14411 Mec7iun-& coarse•clean-sa-r�d•wit-h_grav�l.----------••---- V ----------------------------------------- -------W ----------------........................................................................................................................................................................................ UNature of Repairs or Alterations—Answer when applicable.__._........................................................................................... -------------------------------------------•-------------------------------------------------•----...--•----•----------------------------•----------------------------•-----------------•---......•-•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ;� the provisions of r�Tms 1 i t,E 5 of the State Sanitary Code The undersigned further agrees not to place the system in oper ion until a Certificate of Compliance has been ' ed by the boar of iea h. // ✓S 1�,� �. Signed ................. -........ .-- ----- ------ ✓�' •-•-•- .Date........ _..._ \^ w/ � Date Application Approved By--••-....... •-d�► ^.....-•--•-•............. -------•------------D-----•.............. ate Application Disapproved for the following reasons:................................................................................................................ -----------------------------------------------------------------------------------------------------------•---•-----•......-•-•----•-----••--•••-••••-•••••••------•---------------•-•--•-•------_.._. Date Permit No.......3.2._•-...44_7.................... Issued....................................................... Date I f t � � • THE COMMONWEALTH OF MASSACHUSETTS d. BOARD OF HEALTH Aliptiratiun for Dis i sat Marks Tondrurtuan rrmit a Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal ,. System at: Lot #7 " - ................-........-......................=.............................................. ...................... C• a �,+ "tion-Address w�y�y',Qr LotyNo. ......................W._t_i........................................................................ ............................................n6ii.iai4 a�.�..................................................... Oapgr �W .yAddress W 3 H iX7Li...... C7 a t Installer Address Y ra Type of Building Size Lot... !�..___ .____Sq. feet U Dwelling No. of Bedrooms............................................Expansion Attic Garbage Grinder p, Other—Type of Building ____________________________ No. of persons............................. Showers ( ) — Cafeteria ( ) : Otherfixtures ---------------------------------------•---•-•-----•--....--•-•-•---••----••••-------- --- •-•--•-•----•••-•••••-••-• _....... W Design Flow________________ ________________________gallons per person per day. Total daily flow..............MD•--...................gallons f IX Septic Tank—Liquid capacity... �_gallons Length 8 0!....... Width. Viop. Diameter._._....' Depth_.S.I.W........ f W x Disposal Trench—NTo_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. f t. - Seepage Pit No._____.1--__ __-___ Diameter___..____.___._._ Depth below inlet......6 ....... Total leaching area__ .........sq. ft, z -:Other Distribution box (X ) Dosing tank ( ) "Percolation Test Results Performed by---------D09.0.4. !'M! _ t :. Date_. _2iM J................ T - ,� Test Pit No. 1._____2_______minutes per inch Depth of Test Pit____L26________. Depth to ground water__ ___________________ Test Pit No. 2_ 2 6 per inch . Depth of Test Pit__._ ............ Depth to ground water.."'................. O Description of Soil-___-«�_ ."_ `_ ......... eude0�1! 3Er'" 1!4"M9ditm 6r t CLei-_.e.c3 Wft- 1---•------•------ ' x (2) 0 30N &eu4aatl, 30�' 14 "N1ec3iam acme clean sand with- ------------------ , w ----- x U' Nature of Repairs or Alterations—Answer when applicable_______________________________________________ ' -Agreement The undersigned agrees to install the aforedescribe4 Individual Sewage Disposal System in accordance with the provisions of i?mIWJ of the State Sanitary Code `The undersigned furti:er agrees not to place the system in operation until Certincate of Compliance has been ued by the bo of�h 1� Signed _ L s v' ! . f/ 1, J Date s ApplicationApproved By---••--- � .......... ............{------------------------ -••------------------------------------- r Date •r `L`• Application Disapproved for the following reasons-----------------------•--------•------------•-----...........:••••••----------••-•-•-••--• --•••••••-•------- .,s --••-•--••••--------•••------•-••---••--...•••--••••----••-••----•--••---•-••-•-•-•................••-•-----•-•---------•-----------------•----•-----------------------------------------------------•= Date Permit No.__.... Y .. ..7........ ... ..• •----------------._.. Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • ` ............. ....................OF..........BA ..................................................... C�rr�ifirtt�le of �unt�li�nrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by--------------- -a^ `.. -----�f = .................................................... f� Installer has been installed in accordance with the provisions of Ti TIZ 5 of The State Sanitary Code as described in the application for Disposal Works Construction.Permit No....... y 6 dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE ./. -" 7 Inspector...•---------•._... THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH u/ .........................OF......................_._._.__..___.....__.__..__.._.__.....__..._......_.._..---.... NO.__E.1...L10 FEE.... ..- Dispuual gkv Tuntr ion amit Permission is hereby granted............. r to Construct ( *or Repair ( ) an Individual Se rApe Disposal System / T y, ? '7 -_� cc_ _ <�y------�------..�------------------------------------------------- at No.-•--••-----••-- t - -•-_- ._.... Street as shown on the application for Disposal Works Construction Permit N _V P'l_7_ Dated.......................................... .........................• -.-- --- ......... ............... Board of Health DATE--------------. ............................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS :� TOP Of FOUNDATION 24"diameter concrete covers MARSTONS MILLS, EL=50.3 raised to within 0of finish grade TWENTY ONE(2 1)ADS ARC3GHC(36 16BD2) MA (or as noted) lnspecbon Port and cap with magnetic LEACH CHAMBERS IN BED CONFIGURATION WITH 0� marking tape to within 3'of grade THREE(3) ROWS OF SEVEN(7)CHAMBERS s� Existing EL=4B.8 EL=48.6j EL=48.5� 35 co Is 5.0' 5.0' 5.0' 5.0' 5.0' 5.0- om Race 3 z n t t Lane N ar # n �a Race lane p 47.5± /v Existing 47.2+ � C9 6� � •; � �r nay �� ' ©-BOX c N 41 Existing 46.3t 46,0f 45.90 45.73 45.40 Ewstrng 0_ N _ Existing lnspectlon Port(see Note#4) Family Gas Baffle 44.50 1 -9 TWENTY ONE(2/)AD5 ARC361-IC PLAN V(E�/V BdrtBath] Dmmg Kitchen o \�0 LOCUS Congest Run (36/6BD2)LEA 0-1 C1/ M ABER5 IN BED Fa 5 SCALE: I" = 10' Ewstmg CONE/GUR4TlON WITHTf1REE(3)ROWS f.andry OB-3 OF 5E(/EN(7)Cf�AMBERS EX/5T11V6 /000 GALLON Living 7 (11-20Rated) Bdr Bdr Garage 51TE LOCUS, 5E TIC TANK K D-BOX LE I CH CHAMBE9,5 EL=38.5:-Bottom of Test Hole Bath Z 3 NOT TO SCALE f LOW V I RO f I LE f LOOK PLAN "', 1 .) Assessor's Map 149 Parcel 4 CON 5T ICU CT I O N NOTES NOT TO SCALE NOT TO SCALE 2.) Deed Book 15749 Page GG 3.) Plan Book 239 Page 5 ► Lot 8 I.)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, TITLE 5 (3 10 CMR 4.) This property Is in a Zone II of a Public 1 5.000): STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, SYSTEM D E51 G N CALCULATIONS Water Supply UPGRADE, AND EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND 5.) Flood Zone: C FOR THE TRANSPORT AND DISPOSAL OF SEPTAGE, AND THE LOCAL BOARD OF HEALTH REGULATIONS. 5EWAGEDE5IGN FLOW REQU/RED:3 BEDROOM DWELLING(_0 Wooded Area //0 GPD/BEDROOM=330 GPD REQUIRED 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS POTENTIAL FOR VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO 5EWA6EDE5I6IV FLOW PROVIDED: TWENTY ONE(2/)ADS LEACH CHAMBERS/N BED LEGEND WITHSTAND AN H-20 LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE CONPIGURARON W171 FHREE(3)ROW5 OF SEVEN(7)CNAMBER5. �Al �, 4 48.8 Shed 0 `� VENTED TO THE ATMOSPHERE. Xt=[(330/0.74)/(4.8 FTz/PT)/5.0 LFJ = 16.6 AD5 UN1T5 on�°� o o �° 12.3 EXISTING SPOT GRADE 3.)TO MINIMIZE UNEVEN SETTLING,ALL SYSTEM COMPONENTS SHALL BE INSTALLED ON A REQUIRED(2/ PROVIDED) �Y7 O� l 24x5 PROPOSED SPOT GRADE STABLE MECHANICALLY-COMPACTED BASE ON 51X INCHES OF CRUSHED STONE. a ��� 4a.7 24 EXISTING CONTOUR 373 GPD PROVIDED>330 GPD REQUIRED 4.)COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE DISTRIBUTION _ 24- PROPOSED CONTOUR BOX, AND THE 501E ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN 6"OF FINAL GRADE. SEPTIC TANK CAPACITY REQUIRED: 330 GPDX 20095 =660 GPD REQUIRED 48.6 ,{ I� W WATER SERVICE LINE LEACHING FIELDS,TRENCHES, AND OTHER SOIL ABSORPTION 5Y5TEM5 WITHOUT ACCESS 5EPT1C TANK CAPACITYPROVIDED: EXISTING /000 GALLON5EPT/C TANK Wooded Area / O OVERHEAD UTILITY LINES MANHOLES SHALL HAVE AT LEAST ONE(I) INSPECTION PORT CONSISTING OF PERFORATED rL o 492 UNDERGROUND UTILITY LINES 4"PVC PIPE PLACED VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A 6AR13ACED15P05AL 15 NOT PERMITTED WITH T1115 DE51GN FLOW / A CAP,TIED WITH MAGNETIC MARKING TAPE, ACCESSIBLE TO WITHIN 3"OF FINAL GRADE. ��� TP-1 �� ! 49 rev G GAS 5ERVICE LINE TOP OF BANK 5.)PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID Q ---•-e--- LIMIT OF WORK %Q ON A MINIMUM CONTINUOUS GRADE OF NOT LESS THAN 2 FROM THE BUILDING TO THE SEPTIC TANK, AND NOT LESS THAN I%OTHERWISE. "° / /i O O O ^--� EDGE OF CLEARING Exsting 5eptic Components to ' J J -- FENCE be Abandoned(See Note#2/) 4 \ 0 TIP6.) DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4"DIAMETER ° / / 1 0 - o 0 , 'TEST HOLE LOCATION SCHEDULE 40 PVC(OR EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHERWISE NOTED. OB ! Cone \ ST SEPTIC TANK 49.7 ' LINES SHALL BE CAPPED AT END OR AS NOTED. Porch \ \� O ice\ / / c� x� Q DB DISTRIBUTION BOX 7.)LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2)FEET BEFORE 48.7 Wooded Area i �� d. \ SAS SOIL ABSORPTION SYSTEM PITCHING TO THE SOIL ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED �' o O�h / O .Reserve RESERVED FOR FUTURE USE TO ASSURE EVEN DISTRIBUTION. 48 � '�\\ aio o� UTILITY POLE 8.)GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE / \ l Q��am / a Frs p CATCH BASIN STRUCTURES IN ORDER TO PROVIDE A WATERTIGHT SEAL. s�o o�� b A \ FIRE HYDRANT �aq� 48.4 ) }�o awe d a DRINKING WATER WELL 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE / o� �/ O ■ CONCRETE BOUND SEWAGE DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM. L 10.) IN ACCORDANCE WITH 3 10 CMR 1 5.221, ALL SYSTEM COMPONENTS SHALL BE 4910 .4 v a MARKED WITH MAGNETIC MARKING TAPE. Existing 5eptic Tank to be (See Note#20) 1 1.)THERE ARE NO KNOWN WELLS WITHIN 100'OF THE PROPOSED SOIL ABSORPTION / \ 1 �� p�"�� 0) E SN OFM,ygge t \ C G SYSTEM. BENCHMARK \480 49 1 �// \�O ��o�Top Corner Concrete LIN ti 1 2.) FROM THE DATE OF THE INSTALLATION OF THE 501L ABSORPTION SYSTEM UNTIL u \ p � I RECEIPT OF THE CERTIFICATE OF COMPLIANCE,THE PERIMETER SHALL BE STAKED AND EL=50.00(Assmed Datum) ° \ � FLAGGED TO PREVENT USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. 48 \ n� 04 13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS �A1 �0 $S G/ST CONSTRUCTED AS SHOWN ON PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY `Sp LOT rrnn� S10NAL EN THE DESIGNER. ,%S 00, ` Area=20,753 S.F.+ vJ �`�' 14.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENTQ� I OF THE BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING Gy , \d�i Survey Work by.• THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS C, 48 `� OF THE PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE 15 REQUESTED. TE HST t 1 O LE LOG.J Q A & M Land S'ETYICG'S 15.)LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE C}Wn ry?� �� 618 Route 28, Suite 3 FOR DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR Test Hole#1 (EL=48.5±) P#13377 O V� Nest Yarmouth, MA 02673 TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, BUT 15 NOT LIMITED TO, REQUESTS Depth Layer Soil Class Sod Color Comments 1 0 Pb. (508) 737-1777 Email. arin7lend0comeast net TO DIGSAFE, ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. 16.)CONTRACTOR SHALL VERIFY THAT ALL WASTELINE5 ARE CONNECTED BY WATER 0"-4" Fill 4"-7" A/E fine-Medium Sandy Loam I OYR 4/2 Prepared for: TESTING WITHIN THE DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. 7"-22" B Fine Sandy Loam I OYR 5/G 17.)CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF 22"-120" C I Medium-Coarse Sand I OYR 5/4 60%Gravel David Margaret Wardrop 81 Walnut St., Marstons Mills, MA ANY SEPTIC SYSTEM COMPONENTS. 18.) INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL Test Hole#2 (EL=48.5±) SITE PLAN Proposed Sewage D►sposa! System NOT BE USED FOR STAKING, OR ANY OTHER PURPOSES. (5 1 Walnut 5t., Marstons Mills, MA Depth Layer Sod Class Sod Color Comments I CERTIFY THAT i AM CURRENTLY APPROVED BY THE SCALE: I° = 20' 19.)THIS PLAN DOES NOT CERTIFY, GUARANTEE OR WARRANTY COMPLIANCE WITH ZONING DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO BYLAWS, SPECIFICALLY, BUT NOT LIMITED TO, SIDELINE SETBACKS AND BUILDING HEIGHT 0"-9" Fill 3 10 CMR 1 5.01 7 TO CONDUCT SOIL EVALUATIONS AND THAT This Area is Served Prepared by: RESTRICTIONS. 9"-13" A/E fine-Medium Sandy Loam I OYR 412 THE SOIL ANALYSIS HAS BEEN PERFORMED BY ME CONSISTENT by Town Water 13"-37" B fine Sandy Loam I OYR 516 WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE 20.) EXISTING 1000 GALLON SEPTIC TANK TO BE UTILIZED. PVC TEES TO BE INSTALLED ON 37"-1 20" CI Medium-Coarse Sand I OYR 5/4 GO%Gravel DESCRIBED IN 3 10 CMR 15.01 7. I FURTHER CERTIFY THAT THE INLET AND OUTLET PIPES IF NECESSARY, AND A GAS BAFFLE INSTALLED IN THE OUTLET TEE. Perc @ 64" RESULTS OF MY SOIL EVALUATION AS INDICATED ON THE CSN j�® ATTACHED SOIL EVALUATION FORM, ARE ACCURATE AND IN �!� FA 2 1.) EXISTING SEPTIC COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN ACCORDANCE WITH 3 10 CMR 15.100 THROUGH 1 5.107 Engineering eerin SAND AND ABANDONED IN PLACE. AREA TO BE COMPACTED TO MINIMIZE SETTLING. DATE OF TESTING: 08/10/1 1 SOIL EVALUATOR: LINDA J. PINTO, P.E., CSN ENGINEERING 22.)THE ZABEL FILTER IN THE SEPTIC TANK OUTLET TEE SHALL BE INSPECTED AND CLEANED BOARD OF HEALTH AGENT: DON DESMARAIS, BARNSTABLE HEALTH DEPARTMENT O 2O q O GOBox ROUTINELY TO PREVENT CLOGGING AND BACKUP OF THE SEPTIC TANK. " PERCOLATION RATE: LE55 THAN 5 MIN/INCH IN "C I"LAYER P.O.cket,M0 Phone:(808)8-547850 (L- C) Teaticket,MA 02536 Fax:(808)848-8478 SCALE I"=20' 23.) PRIOR TO FINAL INSPECTION BY THE ENGINEER, SYSTEM NEEDS TO BE COMPLETE NO GROUNDWATER ENCOUNTERED Lin a J. Pinto, Ce tified Soil Evaluator INCLUDING BUILDUP FOR COVERS. 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