HomeMy WebLinkAbout0232 MOCKINGBIRD LANE - Health 232' MOCKINGBIRD LANE, MARSTONS MILLs-
- - - - - ------ - ` A=029-022
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J TOWN OF BARNSTABLE
LOCATION A L . SEWAGE# 17— (
VILLAGE AA6 M5ASSESSOR'S MAP&PARCEL O2ci - Q,1-1-
INSTALLER'S NAME&PHONE NO.-Zov�- u s A �rcgw ;
� w.
P
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) ���„�; (size)
No.OF BEDROOMS � +5
OWNER NC,,,k.ti :D%P 9-ti
PERMIT DATE: 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 facility);� \ Feet
FURNISHED BY
Arin5 _ 14'
r�
Fee No. " d
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplitation for Disposal 6pstem (Construrtion ptrmit
Application for a Permit to Construct( ) Repair(SKpgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.2 39 iv1cw f,;eos'b VO Ln9 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel ,�V Gn1Lc 'D t I 1G
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
t7v�Sros A 3rowry T74C
T)rpe of Building:
Dwelling No.of Bedrooms 3 Lot Size 20,Y'7/ sq.ft. Garbage Grinder( )
Other Type of Building (rg 13 r° ,11-i No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) "C9 gpd Design flow provided 7 gpd
Plan Date _ '►� t/l�� Number of sheets 'y. Revision Date
Title
Size of Septic Tank t5x/S� Type of S.A.S. 5-00 5u`)(24 C hom o
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) INS o Syo !,Cd to a I"I -7 O C
S1�0 e-J'e
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.
Si Date 3
Application Approved by Date
Application Disapproved by - Date
t
for the following reasons
Permit No. � —� l{' Date Issued C�`�'
r
No. �l 2— t// Fee /a
THE CO EALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVI OWN OF BARNSTABLE, MASSACHUSETTS
0(pplication for Disposal *pstpm Construction permit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Zia A4C C k t", svj ITV (tee Owner's Name,Address,and Tel.No.
AA(, fvNS A611S
Assessor's Map/Parcel /t�wvc�
Installer's Name,Address,and Tel.No. Designer's Name,Address`s,,.and Tel.No.
l�. vv5\o s A 7�(owry
Type of Building:
Dwelling No.of Bedrooms Lot Size .20, y 7/ sq.ft. Garbage Grinder( )
Other Type of Building (�5 ,�_ No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) -A?zCj r gpd Design flow provided ')I/A 7 gpd
Plan Date � i
i7 � Number of shteets _ Revision Date
Title
Size of Septic Tank �` / t-r n,� Type of S.A.S.5-00
Description of Soil
t
k i
Nature of Repairs or Alterations(Answer when appli&dble)....trC 4Ce,� :Z 'S-00 C,Gr C l Cyo 7 U l YI WM b
�d
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 y
Compliance has been issued by this Board of Health.
Signed Date 3 ;2�2- ) 7
Application Isapproved
proved by C Date
Application by Date
for the following reasons
Permit No. / � "� Date Issued
-----------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( "� Upgraded( )
Abandoned( )by Ip c� �_i��,,�N �'nl C
at 12 Add lc„^jr-Q, ) 6eK MA Vas been constructed in-accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. --'P/7 C,7— 6 dated `?/),9
Installer -,,� A (, ,�� "� NC- Designer �r f6lN�PPCt V` WC k�
#bedrooms Approved design flow '� gpd
The issuance of this permit shall of be c nstrued as a guarantee that the system wil function(as deigned.
Dated-, , ' Inspector
----------------- ------------------------------------------ ------- --
No. DOI--/7—Cd 74 Fee 0 G
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal *pstem (Construction i3ermit
Permission is hereby granted to Construct( ) Repair(7 Upgrade( ) Abandon( ) ^ ,
System located at 7 '� /�( a �L t N` t{�� F�iJ:G A An i�FC>N 5 /V v)f� /�t q _
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed/within three years of the date of this permit.
Date /�� ,�� Approved by
Town of Barnstable
OFZHE T
�• "� Regulatory Services
Richard V. Scali, Interim Director
* BARNSTABLB,
MASS. Public Health Division
ap i63g. �0
Thomas McKean,Director
200 Main Street,Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 5� l Z I i I Sewage Permit# `L01 I—p77G, Assessor's Map\,Parcel OZ9 _Oz Z.
Designer: nq y►eet'�nWO►'�f5 (�c • Installer:
Address: 1Z W, C rb,,-// ,e ld `l d Address: ip-a -edx 1,L(.S',
T:�,e s rota zb 20 3 Z.
On _'3-12_J'7 ea w,A r Nv% �- was issued a permit to install a
(date) (installer) -
septic stem at 23Z K�'n leire�i M f I<s r
p y 9 ��� based on a design drawn by
eief (address)
E►n� ine���'ny LLkrL .t Ill( , dated
(designer) '
-- b� I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes,such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (Le.
,greater than l 0' 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. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructe nce with the terms
of the 1\A approval letters (if applicable) ai►OF
PETER T. `
W NTEE
CIVIL
n a le-r's Signature) No.359og
RFGISTE"ti
(Designer's Signature) (Affix Designer tamp 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:!Septic\Designer Ccrtitication Form Rev 3-14-13,doe
Town of Barnstable P# lsze r
Department of Regulatory Services
' Public Heal h• ��� t Division z r 3 { 1-7
HAM ' Date
i639 ,e� 200 Main Street,Hyannis MA 02601 + m
' f �
� h.r
Date Scheduled Tune� '
Fee Pd. �• �-O-t�-��t3 ,,.;
_J
1 �
Soil Suitability As essment for Sew e Pispos l N
Performed By:�R_e.,-MLE;k+..Z@ S15 Z �
Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address Z M�`�{�n S�0\� �, a Owner's Name
rA aJ'S i-OVIS M t% 11 S _ Address z3z MC-Ut,.,u9 b o"al Lc,Mt e,
Mq�i-cr1c- ►-�Cl l s M(4-�2�0 �
Assessor's Map/Parcel: O Z9-0 ZZ' ' tt. I Engineer's Name J50 i ri (6 �[�
� � 1�'a'(v�s ` C
NEWCONSTRUCTION REPAIR 'X Telephone#
Land Use BS► ALA+ cC
Slope('Yo) (' �— Surface Stones er r,_A
Distances from: Open Water Body AJ A ft `Possible Wet Area I V
ft Drinking Water Well/ 1�d •ft
Drainage Way_AL/ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locati(ns of test holes&perc tests,locate wetlands In proximity to holes)
�i
15
Parent material(geologic) opt�-uJ QS `X Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: /vd Weeping from Pit Face ,N>a^t
Estimated Seasonal High Groundwater _>
DETERMINATION FOR SEASONAL HIGH WATER TA13LE
Method Used:
Depth Observed standing in obs.hole: in, Depth to sail mottles:
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft,
Index Well# Reading Date: Index.Well 1ev01._ Adj,f ctor Adj.Ciroundwater Level, o
PERCOLILTION TEST bate Time.
Observation nn-(-�
Hole# �� �C 1`�� Time at 4"
Depth of Perc i ?j Time at 6"
Start Pre-soak Time @ (� S,,vLcA Time(9"•6")
End Pre-soak
Rate Min./Inch. G Z
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 on (1) week prior to beginning.
Q:\SEPTICVERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Sdil Color Soil Other
Surface(in.) (USDA) I(Munsell) Mottling (Structure,Stones-Boulders.
on i tenc ravel)lay- y1�
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.AID Qravel� -
.7 3,b
66 •—)y G z JK--C. S44-114
i
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, o Grave
Y
f
t
1
DEEP OBSERVATION HOLt LOG. Hole#
Depth from Soil Horizon Soil Texture . , Soil Color Soil Other
Surface(in.) (USDA) 1 (Munsell) Mottling (Structure,Stones,Boulders.
onsi ten I
Flood Insurance Rate Man:
e",e.500 year flood boundary No Yes
Within 500 year boundary No—41 Yes
Within 100 year flood boundary No— Yes
Death 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?
s material?
If not, what is the depth of naturally occurring perviou -- .
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 tr ' 'ng,expertise and experience.descripled in 310 CMR 15.017.
�.
Signatur Date
Q:GSEPTIC\PERCFORM.DOC
J
LOCATION �OT I L�..�, IiJfj as aLlkl.l NO.
V I LLAG E A*m STC LIZ AI LA-S DATE l,Y�
®pQP FEE
APPLICANT G��c.� 4�+Q..� _._ V. ;
ADDRESS �i.TeP_-.j I Lue E 'f"i l-3 (�i Non-ref undabl
TELEPHONE NO. col e
ENGINEER EL0PCwb&E C-1-4&If,-j ftgtQ&' TELEPHONE NO 3T15` '124d-
DATE SCHLDULi D :: 11► 83
Applicant' s signature
SOIL LOG
SUB-DIVISION NAME " LCNb PchtO FftQMS'` DATE ( : � Ll • a3 TIME q _
EXPANSION AREA: YES v�NO _J .1.� C—LA l5 ENGINEER
TOWN WATER_ePRIVATE WELL JOf+N A=*& ( BOARD OF. HEALTH
Q.S caul. EXCAVATOR
SKETCII: (Street name,etc• ,dimensions of lot, exact location of test holes .and
percolation tests, :locate wetlands in proximity to .test holes)
NOTES:
• p
PERCOLATION RATE:
TEST HOLE NO: ELEVATION:7 TEST HOLE NO: I.L EVA,rioN:
2 �� Lid 2
i
9 .
4 4
5 5
6 6
- 5
� 8
9 :
9
1 U 1.0
11 "
12 1�:
13 13 .
14 14
T.5 15
1.6 l6
,I A
SUITABLE FOR SUB-SURFACE SEWAGE:; LEACHING. 'FIELD LEACHING P S_�i"
x'. -. ,.,LEACHING TRENCHES F
. UNSUITABLE FOR. SUBf-;SURFACE SEWAGE. REASONS: ' "
.. A
NOTE:, ENGINEERING 'PLANS MUST SHOW .NUMBER ASSIGNED 0 P ZC TEST APPLICATION
nRTf;T:NAL CgMRLET>~D E •P . AN BET URN Tn BOARD OF HEAD'.
A
' .. r-•, y'111'. 'R r1 Y'�T T I"T.*'I}'T1.` at`ni XY.. t..;_: x eY ' .. - -
'�7 2)w�/
AS SE,
OESSORSMAPND
AS
DIn Commonwealth of Massachusetts
Executive Office of Environmental Affairs RECEN ED
Department of FEB 2 9 1995
Environmental Protection
WEALTH DEF,4
William F.weld TOWN OF BAPiNSTABLE
Caovemor
Trudy Coxe
secrelery,EOEA
David B. Struhs
Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
MAP# PART A
PAR#��_g0,Q,7 CERTIFICATION
Property Address: V,2 moUl/N(o giszD ,tAnQ A'A?-3m^/"'11Asddress of Owner: CheYy
Date of Inspection: a-/�-9� (If different) I
'Name of Inspector:Trgme5 J6. SeA S
Company Name, Address and Telephone Number:
A 3 B Canco 350 Main Street West Yarmouth, MA 02673 (508) 775-2800 `
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes
Conditionally Passes
_ Needs Further Evaluation By the Local Approving .Authority
Fails
Inspector's Signature: Date: o2-/S-9&
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection
The original should be sent to ih'c"system ovrner anti copie xn; to lice bu)e:, if app;icaIA and tl-w aprro, ng au'hority.
INSPECT10 SUMMARY:
I Check A, B, C, or D.
A) SYSTEM PASSES:
I
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
B) SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not)
The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health.
(revised 8/15/95) 1
One Winter Street a Boston, Massachusetts 02108 • FAX(617)556-1049 • Telephone (617)292-5500
A
�' Primed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 023� moG/1/NGC�1� mH�sTans rn/ %I
Owner: Che,
Date of Inspection: 2—j5-9G
B]SYSTEM CONDITIONALLY PASSES (continued)
_ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health):
broken pipe(s) are replaced 1
obstruction is removed
distribution box is levelled or replaced
_ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
_ The systeni nas a Septic tanK anU suli ausuipiiun 5)'�Aeui al)d is wllhin 103 feci lu a SU[IaCE water supply or tr�SUtary to a
surface water supply.
_ The systen, has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
_ The s�'stem has a septic tank and soil absorption.,system and is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water
supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is
free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5
ppm•
D] SYSTEM FAILS:
✓ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
N Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS of
cesspool.
(revised 8/15/95) 2
f
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: a3a 10OCKi,v661ile-0 AAAC
Owner: Cheryl /ilel/e y
Date of Inspection: I
DJ SYSTEM FAILS(continued):
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
plh4
Liquid depth in commil is less than 6" below invert or available volume is less than 1/2 day flow
L✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a,surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliforrn bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
EJ LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above:
The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety
and the environment because one or more of the following conditions exist:
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone It of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 8/15/95) 3
5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: ,2.3a P1O001V05"eD iAive rr,,,925-MhS mr
Owner: CJhe2y/ He-ll /
Date of Inspection:
Check if the following have been done:
Pumping information was requested of the owner, occupant, and Board of Health.
✓ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
/As built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
The system does.not receive non-sanitary or industrial waste flow
/The site was inspected for signs of breakout.
t/All system components, 4;Kcluding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System on the site has been determined based on existing information or
/approximated by non-intrusive methods.
�►/ The faciliiy uccupa,-,!,, if diiierer.', it c„ner; .,•ere provided with information on the proper maintenance o(Sub-
Surface Disposal System.
(revised 8/15/95) 4
I
z '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: , 3d MOCKINLB/2a LAnfe mR2sTons /nr i(S
Owner: CheRy/ ief- �
Date of Inspection: -2. s_ n�
FLOW CONDITIONS
RESIDENTIAL:
Design flow:330 gallons
Number of bedrooms: 3
Number of current residents: Al
Garbage grinder (yes or no): A10
Laundry connected to system (yes or no): 15
Seasonal use (yes or no): 1f&
Water meter readings, if available: /995 + //5 DaD 44jj—Q ALS /995- <jA/AOAU
Last date of occupancy:
COMMERCIAUINDUSTRIAL:
Type of establishment:
Design flow: gallons/day
Grease trap present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non-sanitary waste discharged to the Title 5 system: (yes or no)_
Water meter readings, if available:
Last date of occupancy:
OTHER: (Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
IVO Aj e-
System pumped as part of inspection: (yes or no)_/(j
If yes, volume pumped. gallons
Reason for pumping:
TYPE OF SYSTEM
✓ Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool.
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Other(explain)
APPROXIMATE AGE of all components, date installed (if known) and source of information: 1?0*3 ;r 913-67
Sewage odors detected when arriving at the site: (yes or no)
(revised 8/15/95) 5
' o
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: .23a? l"00c%n1GQ"rto ,CFN✓e /r1ARsTo n 9 r»�llS
Owner: Che2y l h'e-//�/
Date of Inspection:
SEPTIC TANK:,
(locate on site plan)
Depth below grade: r i
Material of construction: ✓concrete _metal _FRP —other(explain)
Dimensions: /000 GA//okl 'gCAS-'--
Sludge depth: /
Distance from top of sludge to bottom of outlet tee or baffle: 3XI
Scum thickness: P _
Distance from top of scum to top of outlet tee or baffle:_
Distance from bottom of scum to bottom of outlet tee or baffle:
N_
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.) `/ANK !.S 19 r" ijogw-/.A16 I-etJet GoNs iS9'S 0� !n)je 4" y-6Vr/e4* BA66/[
N0T'L ' Schedule .20 PUC P, e Q -Vo j4Wp rtzd m �(STrI 6aTIo'n f3?S1C
TlAofK C6rfe2 adQ111 U BP 2A L3ED
GREASE TRAP:_
(locate on site plan)
Depth below' grade:
Material of construction: _concrete _metal _FRP —other(explain)
Dimensions:
Scum thickness:
Distance from top of scum to too of outlet tee or baffle:
Distance from bottom + criim in hnnorn pf outlet tee o, baffle'
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
(revised 8/15/95) 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: k4ffe M42s77�nls mills
Owner: CheRyl l5'elley
Date of Inspection:
TIGHT OR HOLDING TANK:_
(locate on site plan)
Depth below grader
r
Material of construction: _concrete _metal _FRP—other(explain)
Dimensions:
Capacity: gallons
Design flow: gallons/day
Alarm level:
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX:✓
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and distribu;::c r.;..;:', e•.ide^ce of'olid., er, evidence of leakage into or out of box, etc.)
1ST2iBuf/on 456K l,s Ito" X 16rr gn13 !3 -3.2r' j6tJ0cs GtZAOC 7>j9rP4j6yT/6n
iS �u14 O F cJATe2 �YnCD SIDP Kr,acKocrfs RlLe 6onICC sTclbuf ren /sdX Is Ie1L)Ft!!%4
A.S p n eegs +x �3 P k pAi re-b o sz tLe_o 1 Hcep .
PUMP CHAMBER:_
(locate on site plan)
Pumps in working order.(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 8/15/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 0230? m4%cK1rV64i1CA MAC-
Owner; Chemyl Halley
Date of Inspection: .2- ►5- 96
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.)
!� /10d0 6RL.t.o L) 022>eC44-5T DiT /6(:.97-e0 6el6k) C.r•Rae-. A:: is '/i to cooe2 .
keNca*i j 6 is a6 r wor sLa, Le ACN avG AJeeb a *d Be /ePa1' ;ceD.
CESSPOOLS: _
(locate onisite plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater:
inflow (cesspool must be pumped as part of inspection)
Comments: (note condition of soil, sign: of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: _
(locate on site plan)
Materials sof:construction: Dimensions:
Depth of`solids:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 8/15/95) 8
I
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: /72ooK/NG0i2'p ,(Rive m/32sTans M,//-'
Owner: Che2y/ lie//ey
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
r
O
y �
05q 3�. O
DEPTH TO GROUNDWATER
Depth to groundwater: feet
method of determination or approximation: 0-r ///'6�,// £A
(revised 8/15/95) 9
L:
LQCATION $ [ WAGE PERMIT NO.
I / � -
-
VILLAGE
VISTA LLn'S MACE ADDRESS I'
WILD R OR OWNER
4. .
DATE PERMIT ISSUED
OAT E C0MPLIAMCE ISSUED ��
_,.
-�
��
__. v: A�
dv\
���- � �l
'�
4
P
4
Nod 3 ^ ��
4/0
........ ............ Fss...l....�...............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
rfh�.�........OF..........f/f.9W7;4&.r ............
Appliration for Dhip a al Works C onstrartion runfit
Application is hereby made for a Permit to Construct -(.-Kor Repair ( ) an Individual Sewage Disposal
System at: 1 V
Location-A es or Lot o.
......................------.C�./w...... ... ...:x�f ..... �d ------------ �`f..�. ��� r��/��.--------....
caner Address
--- . --- --..._ ............................... . '6..........................................
Installer Address
UType of Building Size LoOZ-0.1 .......Sq. feet
Dwelling—No. of Bedrooms---- ---------------------------Expansion Attic ( Garbage Grinder
Other—T e of Building ................ No. of ersons__..................._...... Showers
a YP g ------------- P ( ) — Cafeteria ( )
Other -
W Design Flow............ .................gallons per person per day. Total daily flow---- _3 _0.._...._......._.......gallons.
WSeptic Tank—Liquid capacity/,4#4allons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No...............4._.. Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area................_-sq. ft.
Z Other Distribution box (An Dosing tank ( )
.... � 1 Z- 3-3 Percolation Test Results Performed by___________________________ .�. ate.. . .....__........ .._
a Test Pit No. l. S.minutes per inch Depth of Test Pit....... . . Depth to ground water---_ _.'
�r4 Test Pit No. 2--: iinutes per inch Depth of Test Pit------t..------...._ Depth to ground water---- � -,C,
P4 .......................................1-.........-
O Description of Soil...............................0_ Z "f"
.
W • ......................................
•--•--------------------------------------------.---------------------------------------•-•---------•- ----•---------•---•-------------------•----------------•-•-----•-•---•-----•------=•-•-•-----...--
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
---------------------------------------------------------------------------------------------------------•----------------------•------•-•-----•-------....-••----•-------.........-----......_.....-•••
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITTLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issug by the board of hea
igned ...........
. - ------------••................................ �7 ....
to
Application Approved By....... ---•- - ...... ............................................................
......... y
Date
Application Disapproved f o t following reasons------------------------
--••-•..........•---•------•---•------------•-....•••---•--•-•---•---•-•--......-•----•--•••......-•••••.------•-•...•-•-------••--•--...--•-------------••-•--•--------------------•••-----•--•--•.....
Date
PermitNo......................................................... Issued.......................................................
Date
�3 ^ �
No..- - ........_---... Fps....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�� � , -
�`...r�.. '% '".............oF............`.- /....1.;.�......� ..� ...................
App ira tiou for 11hipg al Works Toni&atrfiaan Prrutit
Application is hereby made for a Permit to Construct (,,a`)'or Repair ( ) an Individual Sewage Disposal
System at: / "- ; --2
----------------- - . . --....--_._ ...•--.............-•--• �. .........---__....
,� Location•Address _ , or Lot No.
......................-- . .......--•---•----•. ............... -.. .............••--
Owner Address
a ...--•-.... .......E ,it� �'�...... `.?.. ``.. =`�
Installer Address
Type of Building Size Loth= $ j�__.._._Sq. feet
U — �...........................Expansion Attic (j�)L'J Garbage Grinder
DwellingNo. of Bedrooms______________ _
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures ?
xtures ...---•-------•----•-------••---
W Design Flow............. _•-.......-----------__,._..gallons per person per day. Total daily flow..... . __ ......................gallons.
WSeptic Tank—Liquid capacity.`10?( ��°allons 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 (,V) Dosing tank ( ) )
Percolation Test Results Performed by----------------------------�..............--_._...............-. Date... .............................
,aa Test Pit No. 1._/:erg;S_minutes per inch Depth of Test Pit-------- __ Depth to ground water......
f= Test Pit No. 2___1 a minutes per inch Depth of Test Pit------I_........... Depth to ground water_.__........................
"Z_.
a .........................................
r ------...................-••----,......-••-•-..............
Description of Soil �,1 ... .. ......... f!I�s'� -f •�' `-e .-.......................................
l
U
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 TITIL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance as been issued by the board of health. f
`Application Approved BY...... ...�'
...--------•........................................•--------------------
Date
Application Disapproved for a following reasons:----------•••--•-----•-••••••--•------------------------------------------------------------------------------
•-----•-------•--•••......-•............................•-------------•----------•---••--•••----•------•.._...-•---------------------•-------•---------------•-----•----•-----------------------••-•----.
Date
PermitNo.......................................................- Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS f
BOARD OF HEALTH
OF............./.......� .-... ..............l3fl.. �...�.--:
Tntifiratr of TuutpfiFanrr
THIS IS TO CERTIFY, That the Individual Sewage Dispo al System constructed.,�-<or Repaired ( )
by..................................... ,, ,�r. �s...._... = ---• -•--
In ,y "
has been installed in accordance with the provisions of TIT,. /o7rhe State SanitaryyC OF cribed in the
application for Disposal Works Construction Permit No......................................... dated...................................-.............
THE ISSUANCE 9f THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GUARANTEE THAT THE
SYSTEM V!ll FUN ION SATISFACTORY.
DATE...... Z Inspector.... ----•--------------•-----•---.------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
47 --7o ......I......OF............9.,.Of-/? .................
No......................•-- FEE........................
Disposal Workii 01J.11witrudion ami
Permission s hereby granted............................., .......�i_�3 .------.... --�"
to Construct (/I �.
) or Repair ( ) an Individual Sewage Disposal System
at No....................................... �/
._.
----••-••---• -og-----•---!� / .
S eet
as shown on the ap i ion for Disposal Works Construction Permit Dated................... ..................
{ .............. --------------------------._.............--------- --------
�j 2 Board of Health
DATE ' if_1._.........
1i FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
-.Jr
LOT 146 N 0,4- L40 17 S 790 /3, Lo7" !43 (vACAN-r )
NACA,+T) 5G 46. 45 ��"E... N.
L or 14 I ��vcN OF
2-0; 47/ SF.
O
/j 2887� N
Q�85'TURN�o� coh No v
eo �
(vAcA IJT)
Lcr 142.
LUT 140 P r�so� p� \p �� ZONED R.F.
(vACA.lT) MIN H1ZER. l ACRE
to o./.
. M/N FAON1r,9CE rac)ft
Per FRONT &
MIN S. 30 P1
GJ � M1N SIDES REAR-,�8. 15 ft .
0 �
-
ch z m' . E SQ A nc� PRca� ,v,., _, ,nc k4T
P ld
Soil o n� � !]I^ Gr1AP•vcI?TLt , G,-- E;'6,P.nND-
TeS`O�� 0 A Ff��-1GP- cLrv�E
Fv� V I
Q 26 -
Z14.J
Io4.S � 1 v� , TBM - Flo- e 6olf over
r� I ina,•+ out/,et of
I VIP lit
pi HYD
Q 0
1�,eta
Awl-
vi
pp
vG
ANO
`Ory ®, 1 ICI L. _—
LEGEND _----- --
EXISTING SPOT ELEVATION OxO 0 5, CERTIFIED PLOT PLAN
EXISTING CONTOUR 0 1,�P�ZX- OFMq\S�„
FINISHED SPOT ELEVATION � ' Lor i41 MOCKIN6BIU LRNE XgWONSALLS
FINISHED CONTOUR - - 0 --^�-. .;' ' p"'' ' .,
EP ~ IN
APPROVED , BOARD OF HEALTH F. d'se �i2 e o
Fss �� �
DATE ANENT �L SCALEI 1e S 30 DATEJON r90- "63
LL?dV��GE E*:FIINEER'N 21I . I CERTIFY THAT THE PROPOSED
etl
EGOSTERE REGISTE•R.ED JOB NO.g3ga� BUILDING SHOWN ON THIS PLAN
CIVIL LAND CONFORMS TO THE ZONING LAWS
LENGINEER RV DR. OF BARNSTAB E, ASS. '
L. A tiofED
7I2 MAIN STREET. phi• Blf+ ..'�'e oi_�g .__z :?
H YA N N I S,. MASS. " SNEET. . OF 2 DATE R G. LAND SURVEYOR
N07F /F E/ TNE.4 Tim` S=PT/C c:V K JR
20 FT. M/A/ -� '. P/T ARE /''JOKE THfi, /2 BELCry
r—�
/O f7 MIN. •?�4 0E� fa 24 'O/AM E TEk' CC VCR;TE CC YE 4
'51W A L L B,E B R O UG H T T O G•5'14 D E
EL Ck
lO�.o COVERS M/N. f�/TCN 1 1 =/N ORiVE 1V.4 Y 31 `J
r:
IRON PIPE 1OOdCAL. a o T o �
_
M/IV. PlTG/ �. D/sT. r r • • ��� `owl i'r.AS7FD 5T':yE
SEPTIC TANK o s
•
- • ' ' ' DEPTH • • ' ' � v o I :�!45tiED STD,YE
• s ` ♦ • • • . • v P.QEGZS T
• . N e o D SEEPAG E
/NV,-A-' Z-LEVAT/aN5 i86.5 X %.s 4-7I wD � ► � � . ♦{ r s • • . e • o '>/Tar
C.4 EQU/V
-75.5 x I.G : 78 C�/`D
INYZAT AT 84Jll-D//VG 103.5 FT
INLET :5�-)D77/C YANK 103.3 FT. 1-'IT CAPA--I-r•,I", S49 6,/D 10 FT OIA W. --4 C(5EE T� N>3VL-A-rd0
OUTLET SEPTIC TANK
INLET OIST/�/BUT/OA/ BOX FT. SEC T/0A/ OF GROuNO kv,4rfiT 7AeLE
O uTLET DI ST!q/B lITION BOX 10^1.-1 F7.
/A/L.E7- 4z-A CA?/NG T. Ip2.5 FT .FEWAGE O15,aOASA L SY.ST�/a9
L�ACN//VG PIT 7AB4//-AT/D/V
DESIGN CR/TEffIA sCAL-E %s" _ / - o" OMENS/ON A 2 S FT.
D/M.EN3/oN 13 FT.
N44+9BER OF BEDROOMS 3 D/MENS/ON G 4 FT. Mpr i
G.�RB.aGE'D/SPOSAL. UNIT I-lo+-tE SO/Le LOG
TOTAL E T//�'PATED FLOsN 33a GAL.�Di4Y SOIL TEST ,*I SO/L 7EST-*2 S0/1- TEST
,vu"gER OF 4E-AcmNG P/TS_ 1 -^—4 eY- 104.4 �EL FY, C I , t/L• e'S3 .
I� OATE OF SOIL TEST
S/OE(EACH/NG PE6t D/T 1.5S SQ,• RT. LoAAA RESULTS kvt' SSED dY ,.1 JAccof31
307-T0/+q LR,RCIIlNG PAR P/T 28 $Q FT. "eMC04A-r/O/V RA7-,= At La'S'S M!N INCN
T�TAG LEACHING AREA 2Gl- SQ- fT. Pet C0LA7-/o y R,4T�c 2 -r44AQ ,A.,lN.//NCH
RESERVE LEACN/IVGAREA 2« SQ. FT. �� nn 2.o '
I✓lE'{�
Or R;,s .; LT►�g 2t- t2/ SANG Lcn;r 14 1 - NA oc-.i�,_l 1-163 -S L/V-1=
o
=` o p 'LIP \ �/
v " r NBERG
J�ft 2W4 ® . 36 EL.ORED ENGINEERING CO,/NG.
�Fc/s r E��° =L R 2.4 7/2 MA/N S T -
' SUR��-i i c,s��NAL =ti c•, �A �NO GROCIN[7' iY�4TER' ENCOCJ/VTf{EO CL/ENT,
G/eO U V D YvA TE/P AT DRTE of, t9, 83
J08 No., 002 SNE.ET 'L-OF 1-
TQWN OF BARNSTABLE ,
LOCATION �-o T /y/ A*Aa�P`rINA61,Pe) ?/ SEWAGE#
VILLAGE ✓yi A/P ST ih/L� S ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY 10 0 D GQ L G�
LEACHING FACILITY: (type //7 (size)
NO.OF BEDROOMS 3
BUILDER OR OWNER
PERMITDATE: G - 3 COMPLIANCE DATE: 7 °2` �3
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
0 9
eok,
c9t o�-
TOWN OF BARNSTABLE
a
LO►: �= TION�3� Pd.Gr1 A)513 ►kO L,4 SEWAGE # 94, - 2-7
'VILLAGE /Z 3TGYo S ltl S ASSESSOR'S MAP & LOT . t�Z2
INSTALLER'S NAME & PHONE NO. ) O w' `13d - 0 S 30
v
SEPTIC TANK CAPACITY O-U�
LEACHING FACILITY:(type) I (size)(,k 6
NO. OF BEDROOMS - PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER C la �►2I�-/ ��e,( ( `�
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
74`1::jr v14'j,
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiun for Di-vivuutti Work Tunutru inn- Prrutit
Application is hereby made fora Permit to Construct ( ) or Repair (- an Individual Sewage Disposal
System at:
• C� a .l-`'° e l.t'z_.D. ---- --------•--------•-•-•---••--•----------------------•------------.......--•--••-------•-•----.....
Local' n- -\ddrg or t o.
---�f 1--- -�__�__U .........
i.lO .................
................
Owner Address
-------------------------------------------
Installer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling— No. of Bedrooms........ ------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons-_-____-___-_______---.--- Showers ( ) — Cafeteria ( )
Otherfixtures --------------------------------------------------------------------------------------- ---------------------------------------------------•---------
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 ( )
0-4 Percolation Test Results Performed by---------.................................................... ............ Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
94 ---------------------------------------------------•-------------------------- ----------------------
---------------------
0 Description of Soil........................................................................................................................................................................
x
U ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--••-•••--
UW ------------------------------------------------------------------------------ .......................................................5------- % ,
Nature of Repairs or Alterations—Answer when applicable...__�� __ �-ill. .(.-/-_._.. ____. ..
----------------------------------------------------------•-----------------------------------------------------.......------------------------------------._....------....------------.........--•.----
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 Compliance has rbeN issued the board of health.
Signed . .. --------�-/-(�- ----- -- -------- 1
�/�/ - Dace
Application.Approved By ------------------- ---------- --- ---- ------------- ------------ -- ------------ -----_- ------�.:............. �g'.....
Application Disapproved for the following reasons- ---------------------------------- --------------------.................----------......------------------------------.
....... ................................................_.. .. ........
�l re
Permit No. ............. `.6.-- l - Issued ..................3 .. 1�e..-.....
ate
-----------------------------
ty
No..-J-
�+°" FEB...`�"�......................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Di-nVntittl Work.6 Toustrnr inn-rrrmit
Application is hereby made fora Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
--•---•----------------------------------•---•--------•------......-------•-•••------....--•-•••--
Locati n- 1ddr '-•or Iyt,L1o:
- --- ---------------
owner Address
a �4 -- ----------------------------------------------- ------- ...
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons--.-_------..------__-__---. Showers ( ) — Cafeteria ( )
dOther 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 ( )
Percolation Test Results Performed by-------------------------------------------------------------------------- Date----------------------------------......
a
Test Pit'No. 1................minutes per inch Depth of Test Pit.---_-----_____--_ Depth to ground water.....................
fZ4 Test Pit No. 2__'-,.........minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 ----------------------------------------------------------------------------------•-......--•-•---•-.........................................................
0 Description of Soil........................................................................................................................................................................
x
U --------------------------------------------------------------------------••-•-----------------------------•-------...-----...------------------......................................................
-------------------------------------------- -------------------- ---------------------------------- -------------------------------------------- ------------------------- --•-----
U Nature of Repairs or Alterations—Answer when applicable.---_-�. ._Z'e?k7lz( i. r___r�..�..;
---------------------------------•....-----
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 Compliance has rbei,issued y the board of health.
Signed . _ . L�`---- --------- ---- -----------------...---------... ............ _. �lv
_ -Dace
Application,Approved B ................ ``....... ��..� :. :.:
PP PP Y ;; ...... - -- ----- .... .. .......... ........ Dare
Application Disapproved for the following reasons- ----------- ----- ------- -----------------------------------'.............----------------------------------------------------
-------....................................................---------------------...-------- ------------------------------------............................................"`------, are ---
D
Permit No. .................../.............y....... - Issued ... . y- ---- are....�-----------
-------------------•--•- �_�_>__ �._,.__--,_ ------ ---._.--.^....o-_=..._._.,----....--.��
THE COMMONWEALTH OF MASSACHUSE17S
BOARD OF HEALTH
TOWN OF BARNSTABLE
(11'ertifirate of C11ompl anre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( , ) or Repaired ✓ )
g P Y P
by ------------------------ �__..ot' �_ ... .-----------------------....__--- .....__----- ------------.----------------------------------------------------------------------------------
_- Inycdlrr �•
at °2 3. ...... JG . .11'C L-. ...../��1��C'., tiS.../tIlz i✓.-_S------------------------------------------------
has been installed in accordance with the provisions of TITLE 5�f The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .._�t---..-...-2_.;'._..._..._.. dated .� .�/..--..�,G....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFA %RY.
DATE........ j ..... ! � G[ - - Inspectorp -.--�% �'� �f
- --
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE . r L/G
No...... ......... FEE.
Uispniitt1 Vorkii �u�t tr rtinn rrmit
Permission is hereby granted.-------a------G v-'R ----•---------------------------•--------------------------------
to Construct ( ) or Repair (�an Individual Sewage Disposal System
Street �f
as shown on the application for Disposal Works Construction Permit No.��___�_�___ Dafed.__:- _.'----`y_.--_................
. / . /� Board of Health
DATE.............. =---- �/
FORM 3s5oa HOBBS 6 WARREN,INC..PUBLISHERS -
• LOT T146 N es4. 1,8 11"E 1- S 790 1� La 14'6' (VAC AWT )
46
LOT 1 4 1tN OF At 0
,�
2-01 4'7/
nV4 p N
N° No su
\°)x� a` a'
(vACA►.rr)
Lar 142.
LOT 140 \ Q 1A ZONED R.F.
(vACAUT) O M 1N AREN. 1 AC AE�-
o .1,lip T[-` ? MIN FA0Nr44E 1.50ff
0 PIT �. N MIN FRONT S,6. 30 P1
M#4 SIDE 4 REAR-5S. 15P .
Gnu a'' \°
A • e
-'(c 95r.�h1<D /t�•�
QQc3l�rld.! t,+.rAC K_ T
C( -soil E °'!; o P^ ze,.n- 0 7al Gr IAP-M 1iL , G, El,.6 PAND-
Ta PATV Ce- CLAJSE`O�
o �
0 26'- PL ED a Rk ox
2 FND Et-• 0o•0 14.v
CA
•ems
1oQ S \v I I TB1✓1 - F/a.19Q LO o✓so"
PIP "[ I f/»qn� o..flct of
% i� PRE Hyo. E-/,I03-><
Y•O O�L I I NYC
es
?q \ 1 2-04.2
-z-srs�� QO LjpgrN
---pR MEN�.or /40, pR1VATC
of l _--
�-
LEGEND --- --
EXISTING SPOT ELEVATION Ox0 o CERTIFIED PLOT PLAN
j OF
qs�;
EXISTING CONTOUR --- 0 ---
FINISHED SPOT ELEVATION Q� ?� \ . 1nr 141 P10CKINI,$lQD �NE MAWONS/1f
FINISHED CONTOUR 0 •'r PII
�` EV IN
APPROVED s BOARD OF HEALTH F�" '6 �� z� SAIi1115•r !\ ♦ *
S/ONAI `•- �
DATE AGENT SCALE, 30 DATE1JAN 190 S3
tLDREDGlE' ENGINEER/N6 CQ /NG CLIENT I CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED JOB NO. &�t?�_ BUILDING SHOWN ON THIS PLAN
CIVIL LAND CONFORMS TO THE ZONING LAWS
ENGINEER RV DR.BY'- JP2 OF BARNSTAB E, ASS. ' ExLERT
r
N . ,�.C.Ir, A� wco1E D
?12 MAIS R i i.Ill.8
HYANNIS, MA$S. SHEET.1. OF 2 DATE RHO. LAND SURVEYOR
CEWFIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION 1'EI(A11 l' (1V1T1IOU'1'DESIGNED PLANS)
1, q- , Ci-AA CU hereby certify that the application for disposal works
construction permit signed by me dated 3'` ) y` G , concerning the
property located at kf a c�,x%!2�% 131 A-0 meets all of the
following criteria:
• There are no wetlands within 3oo feel of the proposed septic system
• There nre no private wells within I So feet of the proposed septic system
The observed groundwaler table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in(low and/or change in use proposed
• There are no variances requested or needed.
SIGNED.� DATH: 1 L/
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
IMinch a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
(his plan should be submilledi.
,,
�' �.
.� {� � �.
�� � �
�X
� ��
I � � �
d `.,�•.ram.-`...'
`LOCATION IWAGE PERMIT NO.
VILLAGE
/ �� -
�"INST LL,E., 'Si N# III i ADDRESS
}
11 UILDE R OR OWNER
DATE PERMIT ISSUED r.
DATE COMPLIANCE ISSUED. � ��
f
y {
L o �3
i�TO. s �...... Ficim ...0..................
THE COMMONWEALTH OF MASSACHUSETTS
�- BOAR® OF HEALTH
.-.®1���-.oF................/. f� C_ 1 -......------.........
Application is hereby made for a Permit to Constructor Repair ( ) an Individual Sewage Disposal
Y
j "� (iC 1
stem-a---••-Z•9. -----•--.... -�-3-J -.... , �� /: .....
Location-Address or Lot ,Ns�
---------------------------
Add ess
Installer Address
d Type of Building r(`� Size Lot__2.Q'. �1 ®Sq. feet
U Dwelling—No. of Bedrooms...................:.....:..................Expansion Attic (y Garbage Grinder
`-4 Other—Type of Building No. of persons............................ Showers — Cafeteria
04 Other fixtures -------------------------------- -
W Design Flow.....................�.S.........gallons per person per day. Total daily flow............... ...........gallons.
WSeptic Tank—Liquid capacity{.()O&allons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No...............I._.. 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 ( )
Percolation Test Results Performed by.......................................................................... Date...............................
Test Pit No. 1_ ,Sjr. inutes per inch Depth of Test Pit------
-__�_ Depth to ground water-------A,,I-- -
(z, Test Pit No. 2__ ...minutes per inch Depth ?f Test Pit......I__.......... Depth to ground water---------
?% l?�
ODescription of Soil...-----••-----------••-••-......---�1 (� ............. dr/jf�+., °?�! -•...` U�
UU ---••-••••-•----•------••-•----------------•----•---•-----------••.... ---------- . . .•----------
---- ...
' --!---------- ..................•••-•.
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
••---------------------------------------------------------------------------------------------------------------------------------------- .............................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of 1
r �%
ne -•-:..•--.•-•-- � " .-• ---------•-••-----•. ._...-- --- .../...3
ate
ApplicationApproved B -- .--- --------•-----........................................................
Date
Application Disapproved for e f ollowing reasons----------------•-----------------•----------------------------•-------------•--•----------......-------•-.......
...........a•••••••--•--•--•-••.-••••••--••••••••--••••-•-•..............•-----------......_..------•--•-•••-•••-•--••---•--•-------------------••-----------------------------•-•••••---••-.....•-----
Date
Permit No......................................................... Issued.......................................................
------------
Date
..................
THE COMMONWEALTH OF MASSACHUSETTS
�.. BOARD OF HEALTH
.........F`'l'«L/. ..OF................r�,
Appliration for UbipwiFal Vorkg Tnntraartion Permit
Application is hereby made for a Permit to Construct (,14 or Repair ( ) an Individual Sewage Disposal
System at: t--- /
........................d,..... ..1............_. /� s�j � ! 4 /---� ---•--•--L�' /f..................
Location-Address or Lot No.
......................---•--•••....- .... r....._.... ..... ..................... ...
w,r f-•-•••............................
Owngr Address
W _1 � JS
,-� ........................... ..- .......... -•-•---------------••----•--•-------..............:..."`. .--•--................-•----
Installer Address _
d Type of Building �N^�!i � Size Lot-2.. ?." _ ._ Sq. feet
Dwelling—No. of Bedrooms..............I'�. —.../A:�46.`P&Expansion Attic ( X> Garbage Grinder (f-)
pa4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures -----------•••• -••---••------• .
W Design Flow.....................'=c: ........gallons per person-per day. Total daily flow.................. .-_ ...........gallons.
W Septic Tank—Liquid capacity./_LN!4 4*allons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No..................... W- idth.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No------ ------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( f) Dosing tank ( )
aPercolation Test-Results Performed bY.......................................................................... Date........................................
a Test Pit No. LZ—X'5 Kminutes per inch Depth of Test Pit.......•t..._... Depth to ground water.._._._!-�'-��"~.�-
Test Pit No. 2___�f&�I�minutes per inch Depth of Test Pit.......c1._ ":`:. Depth to ground water........!"at:'.....
x ......... n i P'"............. ,-- =M-r... -....................' --•--------
Description of Soil......................................1 .(�, I
-------------- `-;;, r �', c , -�+ .... .. ......................? r1 3
-----....••. ----...._
� R.
U Nature of Repairs or Alterations—Answer when applicable................................................................................................
----------------------------•-----------------------------•----•--•-----------------................----•------------------...--••••-••-••-••-_.._...•••-••••••-•-•-••-••-•--•••-•-•----------....----•-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT1Z- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of hea R:1
ifner --------- ......._.. ,
� � ate
Application Approved BY r -----------------• ---
Date
Application Disapproved for following reasons:-----•-----------------•---.....----•------------...---•-------------........................................
....----•-•------------------------------------------------------•----------------.......--•-------•-----•----------------•-••-•--•--•--•--•---•••----•---•-•••-•-•-•---------•--------•-••-•••--•••-•--
Date
PermitNo........................................................ Issued•.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
____�--- ----"" BOARD OF HEALTH
.......:....................OF....................... ............................................................
Trrtifiratr of Tomplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (�h)or Repaired ( )
by ! `f� '.-,' ------•-•-----------.............. ......._y_..�.......•----------------
Iat..................................... 1. w1 —••�/�' ' nstaller f .i P. _ .f/ � .. /+! X/ 4 .
�7- -•
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code s cribed in the
application for Disposal Works Construction Permit No..,?i->._.��..................... da.ted_..,�r__�._
THE ISSUA E OF THIS CERTIFICATE SHALL NOT BE CONSTRU S A GUARANTEE THAT THE
SYSTEM WHI L UNC ON SATISFACTORY.
JJ
DATE.......... _.y.f!..... 3�..-•• Inspector---•----..... . •----------------=-•----................_......---•-•-•--••.......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 0 HEALTH
!....... GP"...•......OF............�� ......(..t ...`..e'�. � ...................
44/
Notes`.. .... ... FEE ...............
Disposal nrk._ Tnnotrnrtion Permit
Permission is h eby granted------------------------_. ..r'�y .e)...•------4911....•..•-----U------------------..........--------.....................
to Construct (.r')'!,or Repair ( ) an Individual Sewage Disposal System � //
Itl
at No.......................................... a
... ....................
J � r -Street
as shown on the appli do or Disposal Works Construction Permit No ____ ____________ ated. ._ l_.�` ................
----- .._.. ' r� -----------------------••-------...........------....._
2 Board of Health
DATE----•-'L-'-- ------3-•............................••----
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
r
.�_•_„__,��.���_�� ._____� ��--v"-""—.tea
TTjM -F1o.. a bolt ave.
- ------.-__- -__=__--_ -- - -. --®f-==_---_=-- --_-.- moire ouf'let o�
HD.
Elev 103.71
/"IOCKI l�/C,131RD ,LRN E (40' . PRIVATE WAY)
�-EI�Ge o F pAvEM�Nr 0 t .
1 o8N5 N O�o` POLE
/Ors O �: 1 (N g► 'II` 49 20�
0
\ IQ 4I N
,$ I.Ik•O
,AGAR 32•o , 35� r tr
u
PQoDasc 3 (3R 4
'J ro•o CAPE
� r . �
s Fig EL
U
ar3P w ae
o� a_ 7 ° Z ���PP�n. � q
(
/002l a G.xlot tt.
- - a
'/�d it O
OExparnsion l / y r� %ry �` ZONED P F
2 �
� 3
J �0') \0 MIN AREA / ACRE
w � O MIN FR.ONTRC,k' 1 SO>�
MIN FRONT S8. 3OP
O pBZ'vLF MIN Sj0E+fk9AR S)3. 15.4
OF
c EId.ISi h %x `dry
po.�8T4�0 O`Y A--SuNIC G
/257 •00
moo.. W
LEGEND
EXISTING SPOT ELEVATION. Ox0 CERTIFIED PLOT PLAN
EXISTING CONTOUR —__ 0 --' $ PHI I�}.�
FINISHED SPOT ELEVATION . R WEI, 4, LOT137 1''loCKING,BaRD 1NE NIARsTONS 111/ttS
FINISHED CONTOUR 0. � 66���. IN
APPROVED , BOARD . OF HEALTH i FS�IONAI�"��/
lh 1 oMA
DATE AGENT SCALES I" 30'. DATE= JAN 19 63
�r,�I?REDGE ENPINECRINf� CO. IN CLIENT,C e�- I CERTIFY THAT THE PROPOSE®
EGISTERE EREGIMR.IED�-'.,' JOB NO, 8500 .. BUILDING SHOWN ON THIS PLANCIVIL LAND CONFORMS TO THE ZONING LAWS
DR.SY: J�D � EyENGINEER VE OR -�JDD OF BARNSTA LE, ASS.
1 } As r�olt G '
712 M A I N STREET. CH. SY=......
N YA N N I S,. 'A.S S. of•2o•83 ,—
SHEET.L OF .3._ DATE G. LAND SURVEYOR
IY'JTE /F E/TNE•4Ts/S S=PT/C
20 FT. MIN: -� ?_,Ei4Cy/nrG PIT ,4RE /YORE TH.q,'� /2' BELOrV
TO GRAOE �.- "X,
JVC.4ZTE. i 4�PYC O/P�
GO T?"�
M/N. JP/TCN flEAYy CAST / PON CO YE? 5.�-/.=;.
T . EL= I Os•5 COYE �B PE,Q �/ /,v DR/✓Ew,a >'
,• � CD/V C�.E TE
UQ(//D Level-
CAST
-
/RON P/PE. I QOO a o T 7 . c e " T 'a
ST ' o / • • • • • • • r r ••" c
P&A Jam: . SEPT/C TANK eotr ? o f • . . r :.�s. J sr�.v� f
O 1 t A B I • • . • •0 • ' i
• • e ► 1 • D�PTi/ • • r ; o D N.45;%rED STJ,YE `
O a
o. . • • fl . • • . • . r p �.o P:?EGaST Sc5,SA7AGE
!Nl/PI� L�L�I�ATIONS 188.s x Ts 41 [�lD o � . r f �} • • • • 7 CR A5QuJV.
a
-7 8. 5 . x 1. o 7 8 G/ 6 FT D/A.�?. • L= `/S.3
/,•VyERT AT Ol//L.D/JVG IO� FT. !
INLET SEPTIC" TANK 102•�- FT. P T cf+Pnc�r( : 54Gt v/D I�- FT• OIAM. C SEE 7, 3ULATJON
OC/TLET SEPT/C TiuNK LL NOTE', v PoU�
INLET OJSTRJBI/T/O/ti/ BOX�•-7 FT. SECT/ON O F GROUND IY�4TFR TA04 E \ W5`(e TAL.F-"
c : ��
4s3.ra , ZA� r tay.
` OUTLETDI STR/Bt1T/ON BOX 0 - FF
I INLET LEACNINCr FllT. r6 I. Fr SEWA CH L7/S/YD-SAL .SYST.=-IW
- LEACHING PIT TABULATION
D,ESlGN CR/7•�R/� -SCAL.E• _ �`- D" OIMENS/ON Al 3 FT.
D/MENS/®N ts G FT-
vUMBER OF BEDROOMS 3 OMENS/oN G 4 FT. (,v1 II�t
G�Rd14GED/SPOSAL UNIT. 6.Ioi-tE SO/L LOG
TaT4L EBTI/rs.4"rED FLOrV a G4L.1,oAY SOIL TEST Jdt/ SOIL TEST 2
'(UMBER OF 4e4CNlNG P/TS_ f^ELG`Y. ��s•S �-ELFY• of, i/L• a3
0.4TE OF SOIL. TEST
S/DF LEACH/NG PER P/T Imo•8 S� FT. a_i 8 LOAM 91 RESULTS iV/TNESSED BY
3or-rom LzA CHINO PER P/T 113. ) 5G. F7' CO.CNT/OJV RATE A/ LES' MJN /NCH
ME-DSAt4D Na7�: �o.>
T17'.4G 4,ACNJiYG AREA 263.9 SQ, fT. 16"6 C P �tCOLr4T/ON R.4TE 2: Z7lAf`I
�n{ Curt FV ,
.•?ESErQVcGE4CN/NGAREA 'Lo3.9 SQ. FT. GCAVEL ct- f 2•
Cow - I F C!<+Y
tH OF g= ,� ?' -�2 MEfl �cCa✓,qT�o� GAF LcnT 3-7 -.-MULL-(Qe, LD LPrr.Il=
PH L " r.� 5Aw4 PIT TNle /Nv�u N1 �tC�IJS MILLS
r
cQ F c� W N�E;� - �ylt.�
� � � _-� ) �jNuvL7 �P�• G3
c O ti -rW6'CLOY 4C4Y�72,
CS ,' 2W4 E1-0RED616 ENG/MEER/NG Co,/NC..
q M
�� _+ p/ .���'VQQ y`ti � ��f '. EL� �1•S c 7/Z MA I" S T. , fl Yah/NI F, NS.q SS.
O Np.SUgd y /YO G�OUNc7 w�4T�R ENCO[/NTE.��O CL/ENT:G Bk;€� DRTE • oI•'Lo• 83
'L-
i
——gg—— EXISTING CONTOUR ecdc� Meis Rd
x 100.98 EXISTING SPOT GRADE 0o RIDGE ��' ��Aw g
CLUB
EXISTING WATER SVC. nJ n o
—G EXISTING GAS SVC. IA).
0 �
H14- OVERHEAD WIRES e ` WpOdRd p
IS TEST PIT
BENCHMARK0`'r j°� wood O�ck
LEGEND ,s
• S 84'48'12" W Long
N 79'�13 , Pond
r /,'65.56' 46400
O W Mockingbird LOCUS
LOCUS MAP
LOT 141 NOT TO SCALE
20,471 f SF
PARCEL ID: 029-022
102.80
X uSHED
102.29
CRUSHED STONE
101,921//_"� 102.16 PLAY AREA
x \i
EXISTING LEACH PITS 102.12 Tl U j \\ 102.08
TO BE PUMPED, FILLED W/ X I \ v
SAND & ABANDONED. I \ X 10 2.0 8 z
I \ x
EXISTING SEPTIC TANK I \\ A
TOP OF TANK, EL.=100.23 \
INV.(OUT)=98.92E \ /
� HAM CK
`\ _ � �ZV \ r:: a•: VENTLd
Z
00
+
� 10 .96 02.(t . N!�101,9100
rn 101, o
—i ➢ _
N ao �� N_{ TP-1
00
o ARD N 101,85
N kof 90 x 101,9 TP-2
O
101.74 "1
BENCHMARK "I X PA TIO
CORNER OF BULKHEAD 101.27 AC 1 2.39 X 101,57
EL.=103.27 101.73 ® 102,01
x I
J + 101.77 1 1.23
101.26 FENCE ,EXISTING FENCE
4
HOUSE(#232)
X T.O.F.=f03.27t
101.23
101.51 :...
I c� _ _ + 102.16 WALK ;.PA QED
X0 �.. .�.;.•� 101,21
EWA
100.86 LAM
o '100,84
I__ _01 101,67
101,32 i/ `�' 101,61 J
101230
--� 125.00 99,43_
T ..— gAJCH BASIN
100,57 NI 2�E :,: ;%f._ :..:., ;. ' 98,57 98,15 97.97
�— V
L r,_ z PAVEMENT 98D,99b,05 99,51EDGE �OF
10013 100.00 LASE
BIB
140 C
UP
INS
0 F MgSs9��G
PETER T. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
MCVILEE N 232 MOCKINGBIRD LANE, MARSTONS MILLS, MA
No. 35109 Prepared for: D.A. Brown, Inc, P.O. Box 145, Centerville, MA 02632
R£GI SZER�� F�
\�� OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
DILLON, NANCY J Engineering Works, Inc. 1"=20' P.T.M. 113-17
232 MOCKINGBIRD LANE 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
�7 MARSTONS MILLS, MA 02648 (508) 477-5313 3/4/17 P.T.M. 1 1 Of 2
NOTE: TO PREVENT BREAKOUT, FINAL GRADE
SHALL NOT BE AT, OR BELOW, EL.=97.3
SEPTIC TANK FOR A DISTANCE OF 15' FROM THE EDGE
PROPOSED D-BOX OF THE PROPOSED S.A.S.
INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER PROPOSED S.A.S.
OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE
INSTALL RISER & COVER OVER EACH CHAMBER AND
T.O.F.=103.27t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT
F.G. EL.=102.5t F.G. EL.=102.3t VENT
F.G. EL.=101.9f �F.G. EL.=102.2f
MAINTAIN 2% SLOPE OVER S.A.S.
L = 34' L = 5'
® S=1% (MIN.) p S=1% (MIN.)
4"SCH40 PVC 4"SCH40 PVC 2" LAYER OF 1/8" TO 1/2"
6" DOUBLE WASHED STONE
s io"I " 6 as $ as (OR APPROVED FILTER FABRIC)
14" 69a BBB
- a®eases
EXISTING 48" LIQUID aaaaaaa ---3/4" TO 1-1/2" DOUBLE
LEVEL WAS STONE
ADD 1 INV.=97.17 PROPOSED 4' 5.2' 4'
GAS BAFFLE D-BOX INV.=97.00
INV.=98.92 EFFECTIVE WIDTH = 12.8'
3 OUTLETS INV.=96.80
EXISITNG SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS
SURROUNDED WITH STONE AS SHOWN
H-20 RATED
TOP CONC. ELEV.=97.9t
BREAKOUT ELEV.=97.30
INV. ELEV.=96.80 ease
NOTES: aaaaaaaaaaa
aaaaaaaaaaa
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & BOTTOM ELEV.=94.80
INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. 4' 2 x 8.5' = 17.0' 4'
2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0'
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL
STONE BASE, AS SPECIFIED 310 CMR 15.405(2). 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION
3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM OF TEST PIT, EL.=89.8 =_
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL.
SEPTIC SYSTEM PROFILE
GENERAL NOTES: SOIL LOG
DATE: MARCH 1, 2015 (REF#15,285)
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL EVALUATOR: PETER McENTEE PE(SE#1542)
BOARD OF HEALTH AND THE DESIGN ENGINEER. WITNESS: DAVID STANTON R.S. HEALTH AGENT
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: 1019 A 0" 1018 A 0"
-310 CMR_15.405(1)(b): SANDY LOAM SANDY LOAM
1)'A 3' variance, depth of cover, for 6' (max.) of cover over S.A.S. 101.2 10YR 4/2 101.1 10YR 4/2
8.. 8„B B
3-THE SEWAGE-DISPOSAL SYSTEM_SHALL NOT BE BACKFILLED PRIOR SANDY LOAM' • '- SANDY'LOAM'
TO INSPECTION7AND APPROVAL BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER. 98.9 10YR 5/6 36" 98.8 10YR 5/8 36"
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING C1 C1
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN SILT LOAM SILT LOAM
ENGINEER BEFORE CONSTRUCTION CONTINUES.
5Y 5/3 5Y 5/3
5. ALL ELEVATIONS BASED ON AN ASSIGNED DATUM. 97.4 54" 96.8 60"
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF C2 PERC C2
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. M-C SAND M-C SAND
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 2.5Y 6/6 2.5Y 6/6
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 89.9 144" 89.8 144"
DIRECTED BY THE APPROVING AUTHORITIES. PERC RATE <2 MIN/IN. "C2" HORIZON
10. IT .SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY NO GROUNDWATER ENCOUNTERED
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING PERC REFERENCE: P-1583, 1/12/83, < 2 MIN./IN. IN SAND
CONSTRUCTION.
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
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND /EXISTING
NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. HOUSE(11232)
14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC ;� T.O.F.=103.27f
SYSTEM COMPONENTS NOT SHOWN ON THE PLAN �C
DESIGN CRITERIA
NUMBER OF BEDROOMS: 3 BEDROOMS 'St` 36.964.3'
SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF)
DKSIGN PERCOLATION RATE: <2 MIN/IN i p,
DAILY FLOW: 330 GPD i Q Qi. a $51�'59
DESIGN FLOW: 330 GPD N N
GARBAGE GRINDER: NO-not allowed with design Cn�
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF
.74 GPD/SF SEPTIC LAYOUT
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY
PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED
USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 232 MOCKINGBIRD LANE, 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. Engineering Works, Inc. N.T.S. P.T.M. 113-17
DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET No.
(508) 477-5313 3/4/17 P.T.M. 2 of 2