HomeMy WebLinkAboutReview Checklist ���O//�� TOWN OF YARMOUTH
SEWAGE PLAN REVIEW CHECKLIST
. Location: A.M.��-� Lot � Zone of Contribution: In Out_ creage
� Commercial: ResidentiaL• �
Street: � �
Village: Floor Plan: ✓ #Bedrooms:
Owner: Installer: �
Address: Phone: �
Phone:
Builder: Engineer: � �--
Address: Phone: - -�r 2__
Phone: _ ,� .�- � �� �
N/A YES O
l.Required#of co ies received
2.Date of soils exam and ercolation test not older than 2 years �.�
3.4-5 ft of naturall occurrin ervious material,above wa.ter ta.ble ��
4.Foundation 2 ft above hi int of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com onents Var.:
6.Benchmark indicated and shown-NGVD if near wetlands .
7.S tic tank minimum 10 ft from foundation,deck Var.:
8.Leachin minimum 20 ft full, 15 ft cra.wl, 10 ft slab Var.:
9.Leachin minimum 100 ft from wetlands Var.: �- .
10.Leachin minimum 150 ft from drinkin welU25 ft irri tion well Vaz.:
11.Ta.nk/leachi.n minimum 10 ft from r erty line Var.:
12.S stem meets all other setback r irements Var.:
13.Uses ad'ustment for maximum hi oundwater Var.:
14.Leachin set 4-5 ft above adj.water or bottom of test hole Var.:
15. S stem not in to or subsoil(A,B horizons)or 5'removal '
16.Pro osed contours are suita.ble �� ;
17. S stem meets slo e r irements-min. 1/8", '/4" eferred L� '
18. S stem meets breakout r irements PVC liner: Wall: �,� '
19. S ified tee sizes are ro , baffle on outlet tee `--�
20. Sewa e is under 10,000 d for arcel
21.No ba. e dis osa.l
22.S stem ade uatel sized for its intended use
23.Minimum 6"stone or com acted below tank and dbox '
24.Manhole covers withi.n 6"of ade, um chamber cover to ade
25.Ins ion ort on lastic chambers/leach field ��
26.Electrical ermit for um cha.mber/S arate meter for du lexes .
27.Pum system-2" line,wee hole,check valve,tee in dbox, um size '
28. S tic tank/ um chamber to be factory wat roofed i
29.Vent rovided if leachin below 3 feet, under drivewa / arkin ';
30.Buoyancy calcula.tions for tank/ um chamber '
31.E ' eer to ins ect and cert' soils: wall: commerciaL•
32.Engineer/Re ' ered Sanitarian and Land Surv or stam s/si ture ��
33.H-201oa.din is sub'ect to vehicular traffic, oundwater
34.Title V A lication and ermit fee, installer si ture
35.Foundaxion footin min.2 feet above ad'usted ound water for new house •�-
36.Deed Restriction r uired max. #bedrooms: max. flow: d
37.Check area lots for groundwater/Label oundwater in Assessor's Ma
Plan reviewed by: �03��
40 Squirrel Run outside Zone II 08.10.2015
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1 ; �..�� Stephen A. H�as Engineering , Inc.
� '"�� '"��'" . P.O. Box 16
South Dennis, MA 02660
508-362-8132
sahaas@comcast.net
CERTIFICATE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
LOCATION OF SYSTEM: 40 Squirrel Run, Yarmouthport, Map 123, Parcel 88
JOB#: 15-036 PLAN DATE: 07/30/2015
DATE(S) of/TYPE OF INSPECTIONS: Final - 10/21/2015
I, Stephen Haas. Civil Engineer, duly licensed as such in the Commonwealth of Massachusetts, do hereby
� certify that this firm has visually inspected the constructed subsurface sewage disposal system shown on the
reference approved plan, and further certify that the system, as constructed, generally conforms with acceptable
tolerance to the regulations, as varied, set forth in 310 CMR 15.000 and the Town of Yarmouth Board of Health
Regulations.
,
October 30, 2015
Signature Date
_____._�.._,
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NOV �4 2U15
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