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HomeMy WebLinkAbout0251 BAY LANE - Health 251 Bay Lane Centerville Fl� , �1 ,,�„� A = 166 057 7a I Olxford NO. 152 1/3 ORA o TOWN OF BARNSTABLE I,'0CATION J,-g( Z&—I Lac. SEWAGE# =�61/_3-7:/ VILLAGE •l�L,'t2-y(L CLL ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.-Zn)_'-;6tz9�l C tom, t= SEPTIC TANK CAPACITY 1 eco-4.AYL LEACHING FACILITY:(type) �r t:Z (size) NO.OF BEDROOMS . -3 °f p� f U Mtd-- OWNER t24.l6 PERMIT DATE: j- L(-I f 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 y 300 feet of leaching facility) /7 Feet FURNISHED BY��d�r�/t ��..� � _� ., Zpi --- - - -- - - - O S"'�i�✓r+L �� yo�,C Lwvu� .. :j TOWN OF BARNSTABLE Li OCATION .. �f Lti( SEWAGE# .10 1(�- VILLAGE 'N—Maa3 )I P._L.Lf-- ASSESSOR'S MAP&PARCEL jr=6-QSs-7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY t "C' O coo LEACHING FACILITY:(type) -Fi Cz'LL (size) -S/46 S NO.OF BEDROOMS OWNER t p PERMIT DATE: -g(- 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 Q 300 feet of leaching facility) 4 7 Feet FURNISHED BY r 40�j o/ �'- Commonwealth of Massachusetts Title 5 official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 251 Bay Ln Cottage C Property Address G^+� Jean Rugg Owner Owners Name information is `/ required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection r.+ m Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information -filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono key the return Name of Inspector Y DiBuono Sewer and Drain \ ." ,Ba Company Name ` 8 Johns path Company Address S Yarmouth Ma 02664 _ City/Town State Zip Code 508-364-9587 S103522 Telephone Number License Number B. Certification 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluatio y-the Local Approving Authority 8/12/16 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 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 DEP. The original should be sent to the.system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address --r Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 pag, e. City/Town State Zip Code Date of Inspection 1— :- B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System contain a 1,500 GI septic tank as well as a 1,00 GI pump chamber and a leach field pipe in stone 13) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicatingthat the tank is less than 20 ears I y old is available. ❑ Y ❑ N ❑ ND (Explain below): 15ins•3l13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 " Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 t \ Commonwealth of Massachusetts w Title 5 Official Inspection Form lSubsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning-in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system,passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of inspection- B. Certification (cont.) Yes No ❑ ® 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 SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply El ® PP Y or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,,-for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ 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 II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 251 Bay Ln Cottage Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® . ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a pla'n at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 1 Number of bedrooms (actual): 1 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M a,•'' 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is Centerville Ma 02632' 8/12/16 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: System contain a 1,500 GI septic tank as well as a 1,00 GI pump chamber and a leach field pipe in stone Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 106 Gpd Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Lulms3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 t , Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owners Name information is Centerville required for every Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 2016 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? 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) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1/27/04 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 6"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑.polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts- W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3„ Distance from top of scum to top of outlet tee or baffle 42 Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.).- No evidence of leakin Tees and or baffles in place at time of inspection Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees are in place and levels are normal. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form.,Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level and at normal level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ -No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): ' If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ - leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 10x20x5 — ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Field is dry Cesspools (cesspool must be pumped as part of inspection) (locate on site 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 ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments /p 251 Bay Ln Cottage Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): No ponding no break out Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 6 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 11/5/2003 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ _. Checked with local Board'of Health - explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high groundwater elevation: System is raised. GWE at 72" Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 TOWN OF BAPNSTA-BiE'- LOCATION SEWAGE n >. / VILLAGE U r'�%i.' ���' ASSESSOR'S M.AP & LOT — " INSTALLER'S NAtME &PHONE NO. �J �`_/%`i i�.=''S! %— SEP'nC TANK CAPACITY �'�Uri �•'`"G�i /��'�G'1 ��:) LEACHING FACIL=: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: �'/� %/%� ''� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by _ • 66 .... ......:. ....,.. �:;T.-,.i 140 JR .�i ss ,4 r. .... ` .,'roe.�-�'t.• Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Cottage Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632- 8/12/16 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All-Systems) completed ❑ System Information — Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 R Town of Barnstable �,ME Regulatory Services Thomas F. Geiler,Director r BAMSPABLE, r hUM Public Health Division 1639. 10 Eon A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: '7 8 &X Y Sewage Permit# _20a`/- G y o Assessor's Map\Parcel M 164, Pam1 57 Designer: Sjrzp►u, A . W I sch , P-e. Installer: f3 o r+v l o H-i Cortsf. Address: g i z naei., s tra-e r Address: 0. 0 . 13ex ?n c/ O 4&.493 6Z&9S "orslu+s Mils . WA O2-6q,5,1 On 1 f 2-7 0 q 13 a�-o Cm-:. C.. ,i, was issued a permit to install a (date) (installer) septic system at o25/ /_26 ",L Leh/c ti;/4 based on a design drawn by (address) c5,�,0hch A G/,lse.,, P,e. dated (designer) X 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. A/o,,f,-: A cc cc/ vu.np e_ka n6w/Ja/,/sC I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. -v�N OF � 90�U STEPHEN G� (Installer's Signature) SAL L Uj 30216 O��SS 7/ T A E¢� , 7/&I AI esigner's Signature) (Affix -S Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc TOWN OF BARNSTABLEL L-:)CAnON _7-57 Aq V C©1100'-e SEWAGE # YFLLAGE GeOZW'tll le ASSESSOR'S MAP & LOT -Z:25 INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY 2-540 Soo T�'/O�DS4�d ' LEACHING FACILITY: (type) (size) I J Y .2 6 �Y / 'NO.OF BEDROOMS I /� BUILDER OR OWNER PERMTTDATE: I�Z J'CU� 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 i Z 3 i c geAT 10 1 43- 63- . -3 No. E �'""� �U/ j Fee THE C CrOINWEArTH OF MASSACHUSE Entered in computer: s PUBLIC HEALTH DIVISIO TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migpogar *p5tem Couttruction Permit Application for a Permit to Construct( . )Repair(V)Upgrade( )Abandon( ) OR Complete System O Individual Components Location Address or Lot No. /d� Owner's Name,Address and Tel.No. Assessor's Map a%115-7 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( /�d Other TI pe of Building L'O No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow //41 gallons. Plan Date ?ZZ Z 3 Number of sheets / Revision Date Z D Title 2 /4T % Cc� �✓� Size of Septic Tank of S.A.S. 432"©/1e Description of Soil, Nature of Repairs i Alterations(Answer when applicable) rq&+r i4 cy\ Date last inspected: __11,,N1NG ENGINEER MUST SUPE:,V. Agreement: !STALLATION AND CERTIFY IN WRITi;. HE SYSTEM WAS INSTALLED IN STR:;,; The undersigned agrees to ensure the construction and maintenance of the-afore-described?gn-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 Certifi- cate of Compliance has be ' s f He th. / Sig Date /A `® Application Approved by Date Application Disapproved for the following reasons Permit No. �}�` —�t� Date Issued =�. No. Fee �s ~N 1 1 THE COMINONWEAL`TH OF MASSACHUSETT. Entered incomputer. - lYYs PUBLIC'HEALT141DIVISION�-TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for igpogar *potent Congtruction Permit Application for ajPermit to Construct( . )Repair( V)Upgrade( )Abandon( ) EE Complete System El Individual Components Location Address or LotNo. sf �� J� , Owner's Name,Address and Tel.No. Assessor's Mapf t0 ' L�� /l(�/� c/ 7 �i !/ UC a t I Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. t Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building 6101MP P No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow //D gallons. Plan Date 9//Z X9 3 Number of sheets Revision Date Z�,? Title P f/l ��/� �. /fir %I' l'aUPS�`C4/j�a?�e �S`/ C�C� v Size of Septic Tank Z ©U 0V 1VW1t�/�G'x�fi�,pe of S.A.S. Description of Soil Nature of Repairs o Alterations(Answer lien agpl'icable) �?�dL �'�- r (A on Q , t ✓i 1 Date.last inspected: r Ac �` _ 1 Agreement: 3' 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 Certifi- cate of Compliance has be p is ism �yPthis ,oard a Health. Signed n �� Date /ZLY 'y Application Approved by ` _ rj Date , Application Disapproved,for the following reasons Permit No. `r} —�L/U Date Issued / v -- ------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage,Disposal System Constructed( )Repaired( V�Upgraded( ) Abandoned( )by ®� `,�q % at __ Z S� �a/ H, Cry 7GG'/"l// /lam has been construe ed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 00 y- (l�(V dated /�2 7 °L< - Installer Designer The issuancetofithis/permit shall not be construed as a:giWAtee that the system will(r nction desi tied. Date '11 (�I i)�� ..Ql� t e�ci r .H 1 Inspector �� I �"�• -7/9f��` No. ��'Z` f..��� -------------------------Fee - a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS �Digpogar *potent Construction Permit Permission is hereby granted to Construct( ) epair( V)"Upgrade( )Abandon( ) System located at I-et and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions�� Provided:Construction must be corn leted within three years of the date of this peinut. Date: / /�-`� �G Approved by '�� r 01/26/2004 09:54 150e4283750 BAXTER,NYE&HOLMGRFN PAGE 02 Bk 7709( Pa+203 *117414 DEE ) RESTRICTION WHEREAS, ELIZABETH S. UMBLY, also known a# Elizabeth A. Hambly, is the- owner of property located at 2Sl ..261' .F3ay,Lane;:,Barit- stable (Centerville) , Barnstable County, Massac uEotts, and being more particularly described in Exhibit "A4 attached hereto; and j WHEREAS, -ELmBm S. AAMBLY, as the owner ;of said land has agreed with the Town of Barnstable Board of Health to a rertrio- tion as to the number of bedrooms which can be included in the guest cottage heretofore built on said land as al pre-condition to obtaining a disposal works conatruetion permi''t in compliance with 310 CMR 15 .000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; and c WHEREAS, the Town of Barnstable Board of Health, as a pre- condition to granting a disposal works constru-4 on permit for a septio system in compliance with 310 CKR 15.2010 State Environ- mental Code; Title V, Minimum Requirementa for the Subsurface Disposal of Sanitary Sewage, and authorizing the{ issuance of an occupancy permit for the existing guest cottage ;located on this M property, is requiring that the agreement for thle restriction on -4 the number of bedrooms in said cottage be put on. record with the %o Barnstable County Registry of Deeds by recording- this document; N NOW, THEREFORF,, ELIZABETH S. HAMHLY does hereby place the r+ following restriction. on the above-referenced land in accord-- "' ance with her dgreeament with the Town of Barnstable Board of ry Health, which restriction shall run with the land and be bind- a ing upon all successors in titles to W 1. The guest cottage located at 261 Bay Line, Centerville, Massachusetts, may contain no more than one bedroom, and Elizabeth S. Hambly agrees that this shall be a permanent >1 deed restriction affecting the premises described in Exhibit "A" attached hereto, and that said kestrictiott may be released, modified or amended only by the Town of o Barnstable Board of Health or its successor'. H For Grantor's title, see deed of Ronald S. Hambly dated July 11, 1989 and recorded at the Barnstable County Registry of Deeds in Hook 6805, Page 253 . I 2003.EXECUTED as a sealed instrument this day of i Elizabea S. Ham l (COi n ♦7l0 1 01/26/2004 09:54 15084283750 BAXTER,NYE&HOLMGREN PAGE 03 COMMONWEALTH OF MASSACHUSFTTS (_ County of Barnstable v 2003 Then personally appeared the above-named 'LIZABETH S. HAMBLY and acknowledged the foregoing instrument to be her free act and deed, before ine I I 006,LA 5 . C Notary public My Commission expires: I i I i i i I i I i ' O oQ 2 i 01/26/2004 09:54 • 15084283750 BAXTER,NYE&HOLMGREN PAGE 04 EXHIBIT A The land With the buildings thereon known as 251 and 261 BaY Lane, Centerville, Barnstable County, Ma sachusetr9, being desoribed in Deed recorded with Barnst ble County Registry of Deeds in Book 6805, Page 253, an being shown' on Town of Barnstable Assessors Maps as Parcel R166-057, D� O� a� 1 i BAXTER NYE & HOLMGREN INC. ' Registered Professional Engineers and Land Surveyors 812 Main Street, Osterville, MA 02655 Tel. (508) 428-9131 Fax (508) 428-3750 1 1 1 1 1 1 1 1 1 1 1 1 1 Variance Request 1 Septic System Repair ' Elizabeth S. Hambly 251 Bay Lane, Centerville 1 1 1 ' ! �tMET ' DATE: FEE: AI IA ' I BAPNSTABL& 1639. REC. BY Town of Barnstablell.Ell. DATE: Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S,P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: �S I Bal L K-rry'l I Assessor's Map and Parcei Number: M&,, U-4 3 1.1 57 Size of Lot:-- z,S pill Wetlands Within 300 Ft. Yes v*' Business Name: No Subdivision Name: APPLICANT'S NAME: Elm-&lor-0% Ra v-%61 Phone Did the owner of the property authorize you to represent him or her? Yes ko- No PROPERTY OWNER'S NAME CONTACT PERSON Name: C,-it 2 jp� Name: 54ill A. WAso" . P.E. _ Address: Zgl f3a4 "yjc_� ccwh-e-UAIL Address: plz_ Milli Sf,-c,,+ C%-+rXujjLe Phone: Sbe- 77 !5 -Z/qcD Phone: Sag• q2&-5/_sp ilil VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) f?C JT.9-- !h= of C 4 C,0 Q kA.&�'- NATURE OF WORK: House Addition 0 House Renovation 13 Repair of Failed Septic System WOO Checkfis (to be completed by office staff-person receiving variance request application) __(Z Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) &oo' Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owncrAcasec only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. C:\Documents and Settings\decollik\Local Settings\Temporar-y Internet Fi1es\0LKFB\VARIREQ.D0C � I Variances Requested Town of Barnstable: Part III; Section 1.00, The One Hundred Foot Setback Regulation ' To allow a soil absorption system, septic tank, pump chamber, & distribution box to be 50'-60' from a bordering vegetated wetland. Title V; 15.211(1); To allow a septic tank to be—2 off a lot line in lieu of 1 . ' Title V; 15.203(2); To allow for the design of a one bedroom system in lieu of the required 2 or 3 bedroom system. A deed restriction will be recorded limiting the guest cottage to one bedroom. 1 #2003-063 ' HamblyVarience.doc r - ' A s. ! 4 I O w I -- ' S��k Rif, � � ; � �; � � r _ s ,„ z' � Y. -� � � ' � rt. _` �: `y� i N ��� 0 c � :: n - ;�, Z_ a. � �, :,.;f i �_ �1 N � � c �_ � ~� i .!• � y 4_ � �'` � �"�' i�f �� � � t � I m e 3 y �. r a P `� �' i � m R� k �' � A v€ as i n � � i1 �� j _ t i i� `� ��2 i - `Y, Si. �� �n.< >j s2s �!� v } fit: }++ 3. i��'. `� b � o A ,�� t � '. ';c • �.. 1 - 1 rrr _. P© 0 �'• -. •'•.• Ili - Jr •• .r .O Sp �c$ C� 11 6h O• BM 60 •-•��•° ♦ o . n Hatch A Q ran .r _ -/r ♦ «• ' - �' •� an erry _ •�U - '� F JaV1 o•• - a 0 0- z o P - •U y o�_ � �I 0 uo y flu _ 0 1 z L�—•�— _ COS' _ •p O .41OR © & SITE a- o .• �• r _mac ., _ .,. Q•= v �.�' .4 . • Q Crat, ttI . W�� I ' � �-• 50 ..- - :.x- ��`�rai a� �.-�t-s �'".� yif 1. off -...-,-. - LV ate.- • �• �\\ ---���� ,� �?"`�" -� � s $ �'e k'� ���,�""''9 ��.;"„'' "> MINI! �, 41 ""�Y� �Fa.h^�. S s x� •._34-a�` � 3 � � � "�- emu'-�..� Y: RE rf :�-`�-.� 't �.e rya '♦A x'` s ,� � ,� ,'� as4'-u`� -�� +. '�-..m v ' Locus Map _. Scale = 1: 25,000 1 BAXTER, NYE & HOLMGREN, INC. ' Registered Professional Engineers and Land Surveyors \ ;o ^ I �9 4 N t � aq.z 59 53 y,y / 1.48AC 8 Y k i � - r �,' I 9 9 s i2 4 rb �� o �o ' l ,4 1 ti G \ `r i I � O a5 \\1 w Z. - I ' Abutters Map Scale 1" _` 200.' 1 BAXTER, NYE & HOLMGREN, INC. ' Registered Professional Engineers and Land Surveyors ' Abutter List ' Map 166 Parcel 58 John P. Brooke ' 277 Bay Lane Centerville, MA 02632 i ' Map 166 Parcel 56 John M. Fallen, Jr. 233 Bay Lane ' Centerville, MA 02632 I� 1 �003-063 BAXTER, NYE & HOLMGREN, INC. Registered Professional Engineers and Land Surveyors j 812 Main Street,Osterville,MA 02655 (508)428-9131 FAX:(508)428-3750 I i September 1&, 2003 Board of Health Town Offices I 200 Main Street Hyannis, Massachusetts 02601 Re: 251 Bay Lane, Centerville ' Memoers or ine Board, This letter is to inform you that I have authorized Stephen A. Wilson, P.E to represent me on the matter of designing a new septic system for the guest cottage. ' Sincerely, . �" ' Elizabeth H mbly #2003-063 ' HamblyBoHl.doc ' Land Surveys Subdivisions Septic Design 9 Wetland Filings • Site Design EMIt ' ENSR International 95 State Road Sagamore Beach,MA 02562-2415 (508)888-3900 FAX(508)888-6689 www.ensr.com i September 8, 2003 i Steve Wilson Baxter Nye & Holmgren 00641-085 ' 812 Main Street Osterville, MA 02655. ' RE: Wetland Resource Area Delineation 251 Bay Lane Centerville (Barnstable), Massachusetts ' BN&H Job No. 2003-063 Dear Steve: ' On August 13, 2003, ENSR environmental scientist Naomi DeLoach conducted a field inspection at the above-referenced site to delineate the boundaries of wetland resource areas. ' The field investigations included an evaluation of the vegetation, soils, and hydrologic conditions. Soil samples were inspected at regular stations along the wetland boundaries for hydric soil indicators, such as low chroma colors, organic soil conditions, and presence of ' redoximorphic features (mottles). The presence of wetland hydrology indicators, such as water-stained leaves, sediment deposits, oxidized rhizospheres, and evidence of seasonal . flooding or inundation, were also indicated, if any, during the field evaluation. An assessment of the plant community was performed in accordance with the guidelines provided in the Massachusetts Department of Environmental Protection (DEP) document ' entitled Delineating Bordering Vegetated Wetlands Under the Massachusetts Wetland Protection Act (1995). Data was collected in the field to support our wetland boundary delineations, copies of which are enclosed. Based on our review of the data, it is our opirnon that the wetland boundary delineated at this site meets local, state, and federal delineation ' requirements. The bordering vegetated wetland was delineated with pink flags consecutively numbered from ' A-1 to A-10. The upland and wetland data transect plots were marked in the field using pink flagging tape. Data plots (Wetland #1 and Upland #1) are located by flag A-2 and A-1, respectively. The wetland is comprised of wooded wetland habitat located at the edge of an ' deep.approximately 70 square-foot open water area approximately to� 8 inches N. The wetland is vegetated with willow (Salix sp.), common reed (Phragmites australis), highbush blueberry (Vaccinium corymbosum), and marsh fern (Thelypteris thelypteroides). The uplands are ' Over 30 Years of Excellence in Environmental Services 11 �R® 1 Steve Wilson Page 2 ' red cedar Juni erus vir iniana , vegetated with willow, domestic apple (Pyrus malus), ( p 9 ) common reed,and poison ivy (Toxicodendron radicans). 1 In addition ENSR delineated one salt marsh boundary in accordance with 310 CMR 10.32 using pink.flags consecutively numbered from SM1 to SM11. These boundaries border the 1 rear of 251 Bay Lane along a portion of Scudder Bay. No bordering vegetated wetland edge was observed adjacent to the salt marsh boundary, therefore, no Appendix G transect data forms were completed. The edge of the salt marsh was delineated based on observations of 1 the salt marsh and upland plant communities, the apparent limit of the highest high tide line, and topographic indicators. Plant species observed as part of the salt marsh plant community included salt meadow grass (Spartina patens), narrow-leaved cattail (Typha angustifolia), and 1 marsh straw (Carex hormathodes). The upland community located adjacent to the roadway consisted of Virginia creeper (Parthenocissus quinquefolia), rugosa rose (Rosa rugosa), poison ivy (Toxicodendron radicans), scarlet oak (Quercus coccinea), and willow. 1 The inland wetland portion of the site is within an area of Estimated Habitats of Rare Wetlands Wildlife, or Certified Vernal Pools (WH 4120, Hyannis Quad) and is a High Priority Site of Rare 1 Species Habitats and Exemplary Natural Communities (PH 1646, Hyannis Quad), as identified on the 2000-2001 Edition Massachusetts Natural Heritage Atlas prepared by the Massachusetts Natural Heritage and Endangered Species Program. 1 Please do not hesitate to call me if you have any questions or need additional information. Very truly yours, 1 ENSR 1 Naomi DeLoach Kathryn S. Barnicle, PWS 1 Environmental Scientist Senior Wetland Scientist Encls. 1 ' 6F Over 30 Years of Excellence in Environmental Services APPENDIX G DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form Applicant: Baxter,Nye and Holmgren Transect No. Upland Plot#1 ' Project location: 251 Bay Lane,Centerville,MA DEP File No: Prepared By: Naomi DeLoach(ENSR) Date of Delineation: 08/13/03 ' Check all that apply: ❑ Vegetation alone presumed adequate to delineate BVW:fill out Section I only ' ® Vegetation and other indicators of hydrology used to delineate BVW boundary:fill out Sections I and II ❑ Method other than dominance test used(attach additional information) Section 1. Vegetation Percent Percent Dominant Wetland Strata Plant Species Scientific Name Indictor Cover. Dominance Plant? Category* ' Trees Domestic apple Pyrus malus 25 29 Y FACU Pussy willow Salix discolor 60 71 Y FACW* Vines Grape Vitis sp. 5 10 N ' Virginia creeper Parthenocissus quinquefolia 25 50 Y FACU Green briar Smilax rotundifolia 20 40 Y FAC* ' Saplings None ' Shrubs Common reed Phragmites australis 25 45 Y FACW* Red cedar Juniperus virginiana 20 36 Y FACU ' Pussy willow Salix discolor 10 18 N ' Herbs Poison ivy Toxicodendron radicans 10 53 Y FAC* Eastern hemlock Tsuga canadensis 5 26 Y FACU ' Red cedar Juniperus virginiana 2 11 N Small-flowered Agrimony Agrimonia parviflora 2 11 N. ' Use an asterisk to mark wetland indicator plants: plant species listed in the Wetlands Protection Act(MGL c.131,s.40);plants in the genus Sphagnum;plants. listed as FAC, FAC+,FACW-,FACW, FACW+, or OBL;or plants with physiological or morphological adaptations. If any plants are identified as wetland indicator plants due to physiological or morphological adaptations;describe the adaptation next to the asterisk. ' Vegetation Conclusion Number of dominant wetland indicator plants: 4 Number of dominant non-wetland indicator plants: 4 Is the number of dominant wetland plants equal to or greater than the number of dominant non-wetland plants? Yes ' Percent of dominant wetland plants vs.non-wetland plants: 50% . Transect No-14Yil f 0/(04(—d V<- Page i of 2 MA DEP 3/95 ENSR 11/00 APPENDIX G i DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form Section II. Indicators of Hydrology ' Soil Survey Is there a published soil survey for this site? Yes Location of Plot: ' Title/date: Soil Survey of Barnstable County,MA/March 1993 Upland Plot#1 Map number: 28 Near flag A-1 i ' Carver Coarse Sand(CdD)and Ipswich, Soil type mapped: Pawcatuck,Matunuck Peats ImA All flags pink . Hydric soil inclusions: Yes ' Are field observations consistent with soil survey? Yes Soil Profile Description ' Soil Horizon Depth-Inches Color Soil Texture Soil Mottling Comments Oi 2_0 Root matter, leaves ' A 2-0 10 YR 3/3 Loamy Sand None Bw 2-6 10 YR 5/4 Sand None ' C 6-24+ 10 YR 5/6 Sand None II Remarks: ' Other Indicators of Hydrology: check all that apply and describe ❑ Site inundated: ' ❑ Depth to free water in observation hole: ❑ Depth to soil saturation in observation hole: ' ❑ Water marks: ❑ Drift lines: ' ❑ Sediment deposits: ❑ Drainage patterns in BVW: ' ❑ Oxidized rhizospheres ❑ Water-stained leaves: ❑ Recorded data(stream, lake or tidal gauge;aerial photo;other): ' ❑ Other: Vegetation and Hydrology Conclusion ' Number of wetland indicator plants>_number of non-wetland indicator plants? yes ® no ❑ Hydric soil present? yes ❑ no ' Other indicators of hydrology present? yes ❑ no Sample location is in a BVW? yes ❑ no ' Transect No Page 2 of 2 MA DEP 3/95 ENSR 11/00 1 APPENDIX G DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form 1 Applicant: Baxter,Nye and Holmgren Transect No. Wetland Plot#1 Project location: 251 Bay Lane,Centerville,MA DEP File No: Prepared By: Naomi DeLoach(ENSR) Date of Delineation: 08/13/03 ' Check all that apply: ❑ Vegetation alone presumed adequate to delineate BVW:fill out Section I only ' ® Vegetation and other indicators of hydrology used to delineate BVW boundary:fill out Sections I and II ❑ Method other than dominance test used(attach additional information) Section I: Vegetation Percent Percent Dominant Weiland Strata Plant Species Scientific Name Cover Dominance Plant? Indictor Category* Trees Pussy willow Salix discolor 80 100 Y FACW* ' Vines Greenbriar Smilax rotundifolia 20 50 Y FAC* Virguua creeper Parthenocissus quinquefolia 10 40 Y FACU Grape Vitis sp. 5 13 N Poison ivy Toxicodendron.radicans 5 13 N Saplings Red maple Acer rubrum 10 100 Y FAC* ' Shrubs Common reed Phragmites australis 20 44 Y FACW* Highbush blueberry Vaccinium corymbosum 15 33 Y FACW-* Northern Arrow-wood Viburnum dentatum 5 11 N Leatherleaf Chamaedaphne calyculata 5 11 N Herbs Marsh fern Thelypteris thelypteroides 25 42 Y FACW+ ' Sensitive Fern Onodea sensibilis 10 17 N Common reed Phragmites australis 10 17 N . Virginia creeper Parthenocissus quinquefolia 10 17 N Cinnamon fern Osmunda cinnamomea 5 8 N ' Use an asterisk to mark wetland indicator plants: plant species listed in the Wetlands Protection Act(MGL c.131,s.40);plants in the genus Sphagnum;plants listed as FAC, FAC+,FACW-,FACW,FACW+, or OBL;or plants with physiological or morphological adaptations. If any plants are identified as wetland indicator plants due to physiological or morphological adaptations,describe the adaptation next to the asterisk. Vegetation Conclusion Number of dominant wetland indicator plants: 6 Number of dominant non-wetland indicator plants: 1 Is the number of dominant wetland plants equal to or greater than the number of dominant non-wetland plants? Yes ' Percent of dominant wetland plants vs.non-wetland plants: 60 /,, -,1 / Transect No �/G �i(f�-"1 D�11��1 '�/J� Page 1 of 2 MA DEP 3195 ENSR 11/00 APPENDIX G DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Form Section IL Indicators of Hydrology ' Soil Survey Is there a published soil survey for this site? Yes Location of Plot: ' Title/date: Soil survey of Barnstable County/March 1993 Wetland Plot#1 Map number: 28 Near flag A-2 ' Carver Coarse Sand(CdD)and Ipswich, Soil type mapped: Pawcatuck,Matunuck Peats All flags are pink Hydric soil inclusions: Yes ' Are field observations consistent with soil survey? Yes' Soil Profile Description ' Soil Horizon Depth-Inches Color Soil Texture Soil Mottling. Comments Oa 0-6 10YR 5/1 Muck No ' Oa 6-18 10YR 5/1 Peat No some sand A 18-24+ 5 GY 5/1 Sandy Loam No Remarks: ' Other Indicators of Hydrology: check all that apply and describe ® Site inundated: approximately 7-square feet of open water ' ® Depth to free water in observation hole: 1" ® Depth to soil saturation in observation hole: surface ' ® Water marks: ❑ Drift lines: ' ® Sediment deposits: ® Drainage patterns in BVW: ❑ Oxidized rhizospheres: ' ® Water-stained leaves: ❑ Recorded data(stream,lake or tidal gauge;aerial photo;other): ' ❑ Other:. Flod marks on trees,sulfur odor Vegetation and Hydrology Conclusion ' Number of wetland indicator plants>_number of non-wetland indicator plants? yes ® no ❑ Hydric soil present? yes ® no ❑ ' Other indicators of hydrology present? yes ® no ❑ Sample location is in a BVW? yes ® no ❑ ' Transect No Page 2 of 2 MA DEP 3/95 ENSR 11/00 t QUALITY PARK , 9xi2 Town of Barnstable VARM AIS A. Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,KS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. October 16, 2003 Mr. Stephen Wilson, P.E. Baxter, Nye, and Holmgren, Inc. 812 Main Street Osterville, MA 02655 RE Septic System fo Guest Cotfage at 251 Bay Lane, Centerville A 166 57 Dear Mr. Wilson, You are granted conditional variances on behalf of your client, Elizabeth Hambly, to construct a replacement onsite sewage disposal system for the guest cottage at 251 Bay Lane Centerville. The variances granted are as follows: PART VIII, SECTION 1.00: The soil absorption system will be located 60 feet away from wetlands and 26 feet away from a coastal bank, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The septic tank will be located 50 feet away from wetlands and 49 feet from a coastal bank, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The pump chamber will be located 62 feet away from wetlands and 34 feet away from a coastal bank, in lieu of the one hundred (100) feet minimum separation distance required. 310 CMR 15.211(1): The septic tank will be located two feet away from the property line, in lieu of the ten (10) feet minimum separation distance required. These variances are granted with the following conditions: WilsonHambly (1) No more than one (1) bedroom maximum is authorized within the "guest cottage." Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the guest cottage to one (1) bedroom maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The existing cesspool shall be disconnected from the dwelling and shall be either removed or properly filled with sand in compliance with the abandonment procedures contained within the State Environmental Code, Title V. (4) The septic system shall be installed in strict accordance with the revised engineered plans dated September 24, 2003. (5) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted revised plans dated September 24, 2003. (6) During the public meeting of the Board of Health, the applicant agreed to ensure that there will not be any clothes washing machines or dishwasher machines installed. No dishwasher machines or clothes washing machines are authorized within the guest cottage. (7) No garbage grinders are authorized at this property. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the close proximity of wetlands located on both sides of the property (east and west). The proposed system will replace an old cesspool and the engineered plans appear to meet the maximum feasible compliance standards contained within Title V. Sin rely your V�layn Miller, M.D. Chair an WilsonHambly �� ''4 "- � Bk 17769 P�73i�3 �1 �7�14 DEED RESTRICTION WI3EREAS, ELIZABETH S. RAMBLY, also known as Elizabeth A. • Hambly, is the owner of property located at 2S1 6.26113ay,1aney.,Barn- stable (Centerville) , Barnstable County, Massachusetts, and being more particularly described in Exhibit "A" attached hereto; and WHEREAS, ELIZABETH S_ HAMBLY, as the owner of said land has agreed with the Town of Barnstable Board of Health to a restric- tion as to the number of bedrooms which can be included in the quest cottage heretofore built on said land as a pre-condition to obtaining a disposal works construction permit in compliance G with 310 CMR 15, 000 State Environmental Code, Title V v Requirements for the Subsu , Minimum rface nmmee Disposal of Sanitary Sewage; and o WHEREAS, the Town of Barnstable Board of Health, as a pre- condition to granting a disposal works constr»p4 n*, �e-ri,a c___ n ScpLc system in LUX compliance with 310 CMR 15.200v State�uEnviron- ,s »rental Code, Title V,a Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of an M, occupancy permit for the existing guest cottage located or. this M property, is requiring that the agreement for the restriction on Nthe number of bedrooms in said cottage be put on record with the Barnstable County Registry of Deeds by recording this document; NOW, THEREFORE, ELIZABETH S. HAMBLY does hereby p r following restriction on the above-referenced land inaccord- N once with her agreement with the Town of Barnstable Board of health, which restriction shall run with the land and be bind- N ing upon all successors . in title: k I . The guest cottage located at 261 Bay Lane, Centerville, 10 m Massachusetts, may contain no more than one bedroo , and .4 Elizabeth S. Hambly agrees that this shall be a per premises>, deed restriction affectIng the ises described in 4' Exhibit "A" attached hereto a th t R, may be released, modified or amended only cbye the 1Town T�of o Barnstable Board of flealth or its successor. a , For Grantor's title, see deed of Ronald S. Hambly dated July 11, 1989 and recorded at the Barnstable County Registry Of Deeds in Book 6805, Page 253 , 2003. EXECUTED as a sealed instrument this day of�� 5�'fr 7 -= 1~Jlizabe S. Hamb1 -74 � O COMMONWEALTH OF MASSACHUSETTS County Of Barnstable 2003 Then personally appeared the above-named ELIZABETH S, HAMBLY and acknowledged the foregoing instrument to be her free act and decal, before ine , C Notary Public My commission expires: !a _ 0 2 , Q EXHIBIT A The land with the buildings thereon known as 251 and 261 Say Lane, Centerville, Barnstable County, Massachusetts, being described in Deed recorded with Barnstable County Registry of Deeds in Book 6805, Page 253, and being shown on Town of Barnstable Assessors Maps as Parcel R166-�057. 0 0 LOCATION F PROP RTY L.1 E Y OT BE AC DRAT STANDARD LEGEND NOTE:not all symbols will appear on a map Q�:� GOLF COURSE FAIRWAY r� EDGE OF DECIDUOUS TREES i EDGE OF BRUSH 1 ORCHARD OR NURSERY V-V-V-V EDGE OF CONIFEROUS TREES MARSH AREA � — — Map 186 EDGE OF WATER __�_ ---= DIRT ROAD E DRIVEWAY 166 # 230 E—PARKING LOT 7 — �—PAVED ROAD CC DRAINAGE DITCH # J` ---! � -- PATH/TRAIL FP PARCEL LINE O Mae 110 E--MAP# O 21 F PARCEL NUMBER #1 #186D E HOUSE NUMBER 2 FOOT CONTOUR LINE f E9 10 FOOT CONTOUR LINE Elevation based on NGVD29 t SPOT ELEVATION 00o STONE WALL _ �Ma 6 -X--X- FENCE w s RETAINING WALL ` 3 -; F r RAIL ROAD TRACK STONE JETTY SWIMMING POOL PORCH/DECK ❑ BUILDING/STRUCTURE DOCK/PIER i HYDRANT I e VALVE O MANHOLE# I� X O POST OFP FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T o SIGN ® STORM DRAIN N PRINTED SCALE:IN FEET TE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetiics(man-made features)were interpreted from 1995 aerial photographs by The James w NO 5b T30 AB !jen�largFd rml Ma rt�ta,wark.�thi d epm Wdua&IatiRdFps bUj j o*jt (or fie Pla" c;bra d�� a P�m�ati°/�M arils y¢ �GHT%LE O�fKfIC�( 1 INCH=60 FEET* sar. on a ma. at a smle a�l" Parcel lines di itized hom03 town of Bomstable 0.aessofs tmc ma� Y r BAXTER, NYE & HOWGREN, INC. Registered Professional Engineers and Land Surveyors 812 Main Street,Osterville,MA 02655 (508)428-9131 FAX:(508)428-3750 September 25d, 2003 Board of Health RECEIVED Town Offices SEP 2 6 2003 200 Main Street Hyannis,Massachusetts 02601 TOWN OF BARNSTABLE HEALTH DEPT. Re: Variance Request, E. Hambly 251 Bay Lane, Centerville Revised Plan Members of the Board, Enclosed please find a revised plan for the above noted project. The revisions consist of • The delineation of a state defined coastal bank along the Bumps River side of the property and the requesting of an additional variance for setback to the bank. • A proposed water service to the main house is shown. This location is somewhat approximate and will be adjusted in the field. The proposed design has not changed from the original submittal. If you have any questions or comments please call me directly at (508)428-9131; ext. 13 Sincerely, St en A. Wilson, P.E. cc. E. Hambly, F. Sullivan,D. Cole, Conservation Commission(DA-03067) #2003-063 Hamb lyRevPlanBOH.doc Land Surveys • Subdivisions • Septic Design • Wetland Filings • Site Design SEP 2 6 2003 ' TOWN OF HEALTH t,k. J01M BROOKS 277 BAY LANE CENTERVILLE,MA 02632 PHONE 508.775.7118 FAX 508.775-7118 EMAIL RUMPSRIVER @AOL September 25, 2003 Thomas A. McKean RS, CHO Director of Public Health Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Director McKean, As abutter to 251 Bay Lane, Centerville, I have several concerns which I would like you to address at the 10/14 hearing for variances on this project. My concerns stem not from being an abutter, but from the deterioration in water quality and increase in odor of Bumps River/ Scudder Bay over the years. And the degradation of the bay/river from a place where my children could once swim and oysters could be placed to clean themselves, to the foul, lifeless place it now is. We have protective laws in place but clearly many liberties are being taken. Each home sale without an honest evaluation of the septic system and each variance granted represents a lost opportunity to clean our environment. I acknowledge that the proposed system will be an improvement over the system now in place but I question why any variances should be considered at all in such a sensitive area and without proof that the environment is not adversely affected. My concerns are as follows: 1) The property is described as a "Guest Cottage". The fact is that this house has been a year-round rental property for more than 20 years and, at times, has had 3 adults living full time in it. This is a rental / income property and should be given the same consideration as any business property but no more. Further, if it is now to be used only as a seasonal guest cottage, then a tight tank system, as required, should present no great problem to the new owners. 2) The adjoining property (Fallon parcel 56) was required to have a tight tank system at the same distance and elevation from the river and that property, although larger, really is used as a seasonal cottage. They say they were given no option. What is different here? 3) The main house septic system is not shown on the drawings. Isn't the proximity of the two systems relevant? Plumes and all that. 4) 1 call to your attention that the area across Bay Lane from the project is a bog wetland where the water level changes significantly with occasional blockages of the outfall pipe under Bay Lane, tidewater flowing in through the outfall pipe, and during very rainy periods. I further call your attention to the storm drains between the Fallon property and this property in which the changing tide can be measured with a tapemeasure and water may be observed flowing out one of these drains during heavy rain & certain tide conditions. Thank you very much for your time and for considering these points in your deliberations. Sincerely, mil YJ,. 6 o n Brooke cc:Friends of Skunknet & Bumps River Basin DA-03067 Massachusetts Department of Environmental Protection �d LLIilBureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability 9 "1NAM Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 `�'� ,', •`0 A. General Information Important: When filling out From: forms on the. Barnstable computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Elizabeth S. Hambly return key. Name Name 251 Bay Lane feb Mailing Address Mailing Address Centerville MA 02632 City/Town State Zip Code City/Town State Zip Code Title ,d Date / . Rev� .d D t if applicable'of Finni Plane an fl rlther nnni mante. I. l iuc and vaic\v� it v?a g uf.F. / . Septic System Repair - Guest Cottage Sept. 12, 2003 Title Date Title Date Title Date 2. Date Request Filed: September 12, 2003 B. Determination Pursuant to the authority of M.G.L.c. 131,§40,the Conservation Commission considered your Request for Determination of Applicability,with its supporting documentation, and made the following Determination, Project Description (if applicable): Septic system repair/upgrade. Project Location: 251 Bay Lane Centerville Street Address City/Town 166 057 Assessors Map/Plat Number Parcel/Lot Number wpatorm2.doc•rev.10/24/03 Page 1 of 5 DA-03067 Massachusetts Department of Environmental Protection �n+larq,i Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability • > IL8 9. Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 L � t��0�� B. Determination (cont.) ❑ 6.The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s),which includes all or part of the work described in the Request,the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c_for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ri �•_•._� .- 1 a ti',.t•, w ct is 1—ter' the sl1ab d'nviried Intc and any I 1 Aiterna Ives III'II ed tV UIG IVt vi1 YVI IIVII u�c pry ro adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. T he area described in I the equest Is not an area suhiect to nrotection tender the Act or the U R r. . Buffer Zone. ® 2.The work described in the Request is within an area subject to protection under the Act, but will not remove,fill, dredge, or alter that area.Therefore, said work does not require the filing of a Notice of Intent. See below ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act.Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). Sediment controls shall be deployed at work limit. Disturbed area shall be loamed and seeded. ❑ 4.The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone).Therefore,said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpatorm2.doc•rev.10/24/03 Page 3 of 5 i 0 • ' DA-03067 Massachusetts Department of Environmental Protection , . Bureau of Resource Protection -Wetlands17 LiWPA Form 2 — Determination of Applicability l Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 �'� ;a,•° B. Determination (cont.) ❑ 5.The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6.The area and/or work described in the Request is not subject to review and approval by: Barnstable Name of Municipality Pursuant to a municipal wet 2ln,rc ordinamce or bby.aw. . Town of Barnstable Ordinances Article XXVII Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on p7 ❑ by certified mail, return receipt requested on "1 isklv— ----z Date C i 20 This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan).This Determination does not relieve the applicant froth complying with all other applicable federal, state,cr kcal Statutes, 1r�•.:^:un`eB, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office (see Appendix A) and the property owner different from the applicant). Signatures: On this day of _ before me personally appeared ,to me known to be the person described in and who executed the foregoing instrument and acknowledged that he'she ted th ame as hi tid dees�! tary Public 7 J C My commission expires wpaform2.doc•rev.10/14/03 Page 4 of 5 • '' DA-03067 Massachusetts Department of Environmental Protection ti Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability r MAM Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 4''°T 6 LAI D. Appeals The applicant, owner, any person aggrieved by this Determination,any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office(see Appendix A)to issue a Superseding Determination of Applicability.The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form (see Appendix E: Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant.The request shall state clearly and concisely the objections to the Determination which is being appealed.To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations,the Department of Environmental Protection has no appellate jurisdiction. wpatorm2.doc•rev.10/24/03 Page 5 of 5 2vo �3� No. III (p 03 Fee THE COMMONWEA Tr OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for Zigoml *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(Pij Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. o 5-/ 0/9 L A�c Owner's Name,Address and Tel.No. C`e r lee,,/e L/iz/�aelYl h/�r"6� Assessor'sMap/Parcel /,66//0S� �6 G Installer's NS-1i Addre j and Tel No— Designer's Name,Address and Tel.No. C / 0-C-4 Y/rr dro ST g,9 Z ivy��c�/t�✓/Yi-,c r - SZ-C!✓/rv� 8.2 ha.�i �7 037r-•z<< y�t8 9�3i Type of Building: Dwelling No.of Bedrooms I Lot Size sq. ft. Garbage Grinder el` Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //0 gallons per day. Calculated daily flow gallons. Plan Date 9_/,._12003 Number of sheets / Revision Date Title Size of Septic Tank /S0o CA//,,, Type of S.A.S. /eAc'st plez) - /d Xa10t `f-50(--0's Description of Soil Af,Uer Ss- 6 A: Nature of Repairs or Alterations(Answer when applicable).nJ%t9///5,00�4 All 52 i,c Tina t /o o oC / 0— CnAw�be' ��iT'.3ox k0 lC)-o' �E:kect —ZC StoK��.r Date last inspected: ":�vllttG ENGINEER MUSTa 11ALLf1TION AND CERTIPI ICI,- CI Agreement: SYSTEM WAS INSTALLZ-o t:1 L... e The undersigned agrees to ensure the construction and maintenance of the'raf6f,ede�scribed on-site sewag disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has b*issedby thi Board o alth. Sign Date &0;. -a.00 SApplication Approved by Date Application Disapprovedowing reasons Permit No. 2-00 3-S_ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Comptiance JALLATa _" G'NE�A Ah THIS IS TO CERTIFY, that the On-site Sewage Disposal System6Cad t dgfe (► C��Re r $'(�-+)Upgraded( ) Abandoned( )by Sh�r�` �nr i y^ 0An,n�wAS INS�n�R 7 Has•been constructed n ageordance � &63'63� dated with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer occ A&C4//y/� Designer 8xr(7> -�t-„t f/vA,. The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector No. UO 7� Y"� Fee 101 t to(03 _= THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ' 01ppYication for Xigpoml *pgtem Congtruction_permit Application for a Permit to Construct( )Repair(P1 Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No: cc-,i!�r� /h Assessor's Map/Parcel /66Ia5 � Installer's NaajW,Addresg �l Te�JYo-, Designer's Name,Address and Tel.No. ivice /IrG / GS? Type of Building: 1` Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(All r Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures s Design Flow //p gallons per day. Calculated daily flow gallons. 3 Plan Date - / " ;1C0 Number of sheets / Revision Date Title. f fSao GFl//o.� /�f�cti t�f S-Size.ofnSeptic Tank Type of S.A.S. - Description of Soil /X —� Nature of Repairs or Alterations(Answer when applica\ble) �v /h�7 CCI r>>c��CJ- _ � i 1 t�3o� -- ly KXV ,( •C: cC�� S. 'rj..t* )�f` , r J 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 Certifi- cate of Compliance has been iss'ed by thisBoard �ealth. %SignedCri` Date Application Approved by Date /� D Application Disapproved for the following reasons Permit No. 2 00 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 S tJt r r Z,i, r I,f at _�S/ , L s.+c GP,i/t- & _/r has been constructed n actordance with the provisions of Title 5 and the for Disposal System Construction Permit No. -7"3-63 s dated Installery/_0r /"/aCa %r Designer jrtx fr' - Ny 77/co The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector s _ -- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1iqual *pgtem Congtruction Vermit , Permission is hereby granted to Construct( )Repair( k")Upp.grade( )Abandon( ) System located at �S/ 3�/ Lfl,�r ` (e,77 ,c, f(r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to ' comply with Title 5 and the following local provisions or special conditions.- Provided: Constructio mut be completed within three years of the date of this permi Date: /� /0-7 Approved by ��- 1 FROM SYKES & COLE FAX NO. : 508 775-5682 Ort. 31 2003 11:45AM_P2 10---08-2003 rS 12 Z O40 DEED RESTRICTION WHEREAS, ELIZABETH S. HAMBLY, also known as Elizabeth A. Hambly, is the owner of property located at 251 6.26:L.Bay ,Lama-4,-Barn- stable (Centerville) , Barnstable County, Massachusetts, and being more particularly described in Exhibit "A" attached hereto; and WHEREAS, ELIZABETH S. HAMBLY, as the owner of said land has ab agreed with the Town of Barnstable Board of Health to a restric- 0 tion as to the number of bedrooms which can be included in the *-A guest cottage heretofore built on said land as a pre -candition -ri to obtaining a disposal works construction permit in compliance 0 with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for `the Subsurface Disposal of Sanitary Sewage; and a raj WHEREAS, the Town of Barnstable Board of Health, as a pre- condition to granting a disposal works construction permit for Q a septic system in compliance with 310 CMR 15.200 State Environ- mental Code, Title V, Minimum Requirements for the Subsurface a Disposal of Sanitary Sewage, and authorizing the issuance of an occupancy permit for the existing guest cottage located on this property, is requiring that the agreement for the restriction on the number of bedrooms in said cottage be put on record with the %a Barnstable County Registry of Seeds by recording this document; N 4A NOW, THEREFORE, ELIZABETH S. HAMBLY does hereby place the � following restriction on the above-referenced land in accord-- fy once with her agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be bind- ing upon all successors in title: 0 I. The guest cottage located at 261 Bay Lane, Centerville, ra Massachusetts, may contain no more than one bedroom, and 4 Elizabeth S. Hambly agrees that this shall be a permanent ,y deed restriction affecting the premises described, in- N Exhibit "A" attached hereto, and that said restriction may be released, modified or amended only by the Town of o Barnstable Board of Health or its successor. H a For Grantor' s title, see deed of Ronald S. Hambly dated July 11, 1989 and recorded at the Barnstable County Registry of Deeds in Book 6805, Page 253. 2003.EXECUTED as a sealed instrument this �� r- clay of ���a►�" f Elizabe S. Hambl FROM S•rKES & COLE FAX NO. : 508 775-5682 Oct. •31 2QQ3 11:46AM P3 COMMONWEALTH OF MASSACHU'SETTS County of Barnstable / �/ 2003 Then personally appeared the above-nalned. ELIZABETH S. HAMBLY and acknowledged the foregoing instrument to be her free act and deed, before me Ot:AA S. Notary Public My commission expires; I 2 ] r =ROM SYKES & COLE FAX NO. : 508 775-5682 Oct. 31 2003 11:46AM P4 EXHIBIT A The land with the buildings thereon known as 251 and 261 Bay Lane, Centerville, Barnstable County, Massachusetts, being described in Deed recorded with Barnstable County Registry of Deeds in Book 6805, Page 253, and being shown on Torn of Barnstable Assessors Maps as Parcel RI66--057. TOWN OF BARNSTABLE � LOCATION ��� �� /� COAZ?fe SEWAGE #ZW j-pr10 i VILLAGE ����' ASSESSOR'S MAP &LOT `9�7 INSTALLER'S NAME&PHONE N0. � � 1 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) .2 6 Y NO. OF BEDROOMS BUILDER OR OWNER ' PERMTTDATE: 1JZ7�oLI 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 j Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by U , Z 1. 3 43- 1 33 TOWN OF BARNSTABLE LOCATION �S f /JAy 14Ak- SEWAGE # �LLAGE Un—OV' ASSESSOR'S MAP & LOT A 0 7 rF INS ALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /0VV GAL LEACHING FACELITY: (type) 77t-16�% ' / �x 9'X 30 (size) NO.OF BEDROOMS BUILDER OR OWNER 114 PERMTTDATE: 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 leac ng facility) Feet Furnished by 'rel IV O a t'l Foie 7 3 D 3 r \ 1 t 1�O 13.6 �T 14 (�3 ' COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED JUL 2 9 Z003 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 251 Bay Lane (Cottage) Centerville, MA 02632 Owner's Name: Betty Hambly I C U Owner's Address: CHAP PARCEL, ' ®� Date of Inspection: July 3, 2003 LOT �J Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Osterville,MA 02655-0049 FAILED INSPECTION Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT 1 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes ' Conditionally Passes Nee Further Evaluation by the Local Approving Authority 4copyy Fail Inspector's Signature: Date: July 6, 2003 The system inspector shall sub of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane(Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 1 have not found any information which indicates that any of the failure criteria described in 310 CM 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: 2 f Page 3 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane(Cottage) Centerville. AM Owner: Betty Hambly Date of Inspection: July 3, 2003 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 public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,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 any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory, 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane(Cottage) Centerville, AM Owner: Betty Hambly Date of Inspection: July 3, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow ✓ 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] NOTE: Single cesspools jail in the Town of Barnstable. Yes (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 251 Bay Lane (Cottage) Centerville, AM Owner: Betty Hambly Date of Inspection: July 3, 2003 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection n/a Were as built plans of the system obtained and examined ?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example, a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 251 Bay Lane(Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): I Number of bedrooms(actual): 1 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110 Number of current residents: 1 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system (yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): 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/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped approximately 1 month ago-per owner Was system pumped as part of the inspection (yes or no): No If yes, volume pumped: _gallons-- How was quantity pumped determined? Reason for pumping: The owner was going to pump the cesspool after the inspection since the cesspool was overflowing. 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) InnovativeJAlternative technology. Attach a copy of the current operation and maintenance contract(to be obtained.from system owner) Tight Tank Attach a copy of the DEP approval Other (describe): Approximate age of all components,date installed(if known)and source of information: Unknown Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane (Cottage) Centerville, MA Owner: Betty Ham* Date of Inspection: July 3, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron 40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage, etc.): SEPTIC TANK: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane (Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): 8 f Page 9 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane (Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 SOIL ABSORPTION SYSTEM(SAS): None (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits, number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields, number, dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): CESSPOOLS: ✓ (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 1 single Depth -top of liquid to inlet invert: Up to the cover Depth of solids layer: -- Depth of scum layer: -- Dimensions of cesspool: 4'Wx 5'Tx 64" bottom to grade Materials of construction: Block Indication of groundwater inflow(yes or no): -- Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.): Liquid was up to the cover. The cover was to grade. The cesspool was 45'to the wet lands and in ground water. PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane (Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. �ro�T �6.(. 014 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane (Cottage) Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: ✓ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Ground water was approximately 6'+/-below grade per wet lands and tidal river in close proximity. This report has been prepared and the system e n r r r yst m inspected� d filed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection andlor this report. 11 TOWN OF BARNS':ABLE iO,+�A "13giv 411—r- SEWAGE VILL-AG ✓ ! ASSESSOR'S MAP & LOT lr� "dS 114STA,LLER'S NAME & PHONE NO. 4, (��Y /5 r�e�i-S SEPTIC TANK CAPACITY O O LEACHING FACILITY:(type) d (size:) PTO. OF BEDROOMS 2-- 'PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: '— DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No .. �f f � ��G F �� � w I�' e T or � � " ,:� - � �� �! � � � ,( �, y ; ` lr , � , � _ J Im �SESS&,S MAP NO- a � No ....... Fes$ — THE COMMONWEALTH OF MASSACHUSETTS _ BOAR® OF HEALTH ` ........... �5............................................... Appliraatinn for Uh4posaal Works Tumitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: r �� L cation� ........ dresss or. Lot No. .................... - .- -----••--•-.--•-•----. .........._...........---•-•......•••--.-- ........._....--- - r Lot. Address a ......... ------'--....••••••..................... Installe Address d Type of Building , -2— Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ................ ............... . w Design Flow............................................gallons per person per day. Total daily flow-------- -©....................gallons. 1:4 Septic Tank—Liquid capacity......_-----gallons Length................ Width................ Diameter---------------- Depth................ f xDisposal 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. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to groun,n l,&4 a LrA ------------------------ WVA------------------ x Description of Soil.............................................................................................. jpwiwl-�.......- 14 U ••••-•-••••-•••••--=........................................................................................................... �� IV! - - w U P P �-1,M ' Nature of Repairs or Alterations—Answer when a livable...._:..._._.___. ± ______G'� _C�-_--__--1_.4 _________ ____________ . 1ar�a_c � - f --- `�,�1� _ f I _/� 1 Agreement: �"�N�' c - 41/('C" I t(?pC' The undersigned agrees to i all the aforedescribed Individual Sewage Disposal System i accordance with the provisions of i-T..E i of the State Sanitary Code—The undersigned further agrees not to ' ce system.,in operation until a Certificate of Compliance has bee s /y he bo F7_ . ` Sind..... • -- -• . •••. --•---•• ----- D e Application Approved BY -------•--- --..._--••-.. ......... .... &.7.......... ate Application Disapproved for the following reasons:--------••-----•----•--•-------•--------------------------'---•-------'-'•--------"•--••-....--•-••-••----•--- ..--'•"•-•'-•-•-'--.._......•-•••-•-••'••-•••-•••-••-_...--••---••••-•••--•--•-••-••--•----••=-•-....•--•-••-•••--•-••--•-•••••--••-••-•-•-••-••••-----------•-•••-•••••••-•-----------••-•"......•___ Date PermitNo. ......................._.... �---------- Issued........................................................ Date A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------f 1DId 11J..........OF.......... . ......................... Applkation for Bi_qvoiial Works Tonstrurtion Prrutit Application is.hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: . . ......... ........ C, ----------(:�.. .. .................................................................................................. lio n n-�Idd,ess or Lot No. .............. I..... . ........................ ................................................................................................... Address....._: . .... ......... Instalie Address 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 Otherfixtures ...................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow........=4_2-Q....................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth_._..__..__..... :4 Disposal Trench. No. .................... Width..........._._._._.. Total Length......_......_...._. Total leaching area....................sq. f t. Seepage Pit No.-:_._______-_____-- Diameter.................... Depth below inlet................_._. Total leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ 'Test Pit No. I................minutes per inch Depth of Test Pit..........._........ Depth to ground water_--___----__-___-----. fs; Test Pit No. 2................minutes per inch Depth of Test Pit..__._..........._.. Depth to ground water.._....____.___......... ............................................................................................................................................................. 0 Description of ................ Soil..................................................................................... ........................................ ... .............. �4 .......... U ....................................................................................................................................................................................................... ................................................................................................................................................................ �1 1--------------;--- ------------- U Nature of Repairs or Alterations—Answer when .......C o- p-_x ------- ........ ... ............ w Agreement: The undersigned agrees to install the aforetre�s�cribed Individual Sewage Disposal System ill accordance with the provisions of T I TLE 5 of the State Sanitary-Code—The undersigned further agrees not to ace V system in operation until a Certificate of Compliance has been iss,Pd e bVA of health. SSo, ne ............................ .. . .. .......................... D t-e not to Application. Approved BY---------- . ..... A. .......................... ................... -------71-1&. . ........... Application Disapproved for the following rewons:................................................................................................................ .....................................................................................................................................................................................I'll,------ Date Permit No .... ..........G.:S�............ Issued........................................................ Date THE. COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH wN.................OF......... . .. . . ... .. ......Trrfifiratr of Toutpliaurr THIS, I&L- TO CERTIFY That the I dividual Sewage Disposal System constructed or Repaired W.. -c ----- .......................... ....... ... ............................................................................................. Installer ........L._(Q----------Can-1......................................................................................................... at................... ..............—A- has been installed in accordancy-with the provisions of TITIE 5 of The State Sanitary Code as.described in the application.for Disposal Works Construction Permit No.......-- -----Z>Z_2:t... dated----------- .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................................I................................... Inspector.................................................................................... C)S-7 THE COMMONWEALTH OF MASSACHUSETTS SUBJECT TO APPROVAL OF BOARD OF HEALTH BARNSTABLE CONSERVATION .............OF............... ISSION No...K...U- FEE..... ....... viaposal Works To II trgyp fa mit ------ - s-Permission i hereby granted .. k ------------------------------------------- to Construct or Repair ( \,,?"an Individual Sewage Disposal System atNo...... I .................................................. . .............. ..-_.. .... --------C.!,� ..................... ....................... Street — as shown on the application for Disposal Works Construction Permit No. Dated ------.--- .......................... ............................... Board of Health DATE.......................3..t4ylu............................. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS t�Lr---tGq-noW (nip 2.I�ltrx�ms NoO�srosal.=�zFxc_r G+o c.c� ��d �a •d.G`1�J c SAND AMA W11 RLACX 3��, ��po 11` flr�K ARouN f� L�c,HiN� `-r�2�nlC,�l z•� 3, I w Z, SA� tEt-7� Tc� aZ: �NsTR � �ML-ZVR-►o� �GAiNsT' �it1L��1N� 'Tn : lo'� i l vj i +`I : `) r l �C tC, ac- CyC� elf 'V r� l ' tlr ( t `rtc ( ( rcc � ot• i I 13 3 1 a-�b to aag.� X.4 3 a.lo t3.� 4 4r) (0 A GENERAL NO CY) ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH 0 12.7 DH TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 FN6 S ST44'00o W 40111�- 128 ANY LOCAL RULES APPLICABLE. WF SM-3 100 ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING 0.0 BY DESIGNING ENGINEER 2.0' WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, 00 0 N I x.8.6 NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT Af 9..6 FOR INSPECTION. 1*4 5- 2A9 h.j(7x S C 4 THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN 00 x8.4 8.4 K APPROVAL BY DESIGNING ENGINEER ODI 17 WF SM-4 ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4- PVC., SCH 40 2 49 PUM WF A-9 .7 t PROJECT BENCHMARK DATUM = NGVD M28 OS CHAMBE K% T13M MAGNAIL SET IN PAVEMENT * ELEV.= 8.95' X1.9 oof 6.3 8 WF A-10 bq�Box RD-I 6.1 ZONING DISTRICT. 2ACRES "i;IR 3, PAVE MINIMUM LOT AREA. x 7.8 4 \ . I / Ell KIN! X 1.8 .5 / MINIMUM FRONTAGE. 20' TBM: �.5 AREA n LOCUS MAP SCALE: 1" = 20W TP# NAJL SET MINIMUM WI / DTH: 125' EL 8.95' .1c FRONT SETBACK = 30' SIDE & REAR SETBACK 10' 8.5 OVERLAY DISTRICTS. 3.1 t= RESOURCE PROTECTION OVERLAY DISTRICT X1.8 WF SM-!� SOIL LOGS DATE:AUGUST 26, 2003 x2.0 r A-8 RPOD m P#=P 10,554 71 AP - AQUIFER PROTECTION k IX 5 OVERDIG ENGINEER 7.8 LOCUS PROPERTY IS SHOWN AS: BOARD OF HEALTH AGENT: x 2.0 (SEE CONST. NOrTEs) .8 ASSESSOR'S MAP 166 - PARCEL 057 x2.0 V 7.3 Stephen A. Wilson,P.E. Sam White 7.9 7.5 LOCUS DEED: TEST PIT I TEST PIT 2 DEED BOOK 6,805 PAGE 253 9.0 7.4 -- 11 G.S.E. = 9.6± G.S.E. = 8.0±p x 2,1 7.� PLAN REFERENCE: SRI PLAN BOOK 19 PAGE 89 0"AP SANDY LOAM 0" \LAWN AP SANDY LOAM P.4 9.0 X 7.5 COMMUNITY PANEL NUMBER 250001 0016 D 7-2-92 2 ) WF SM-6 6 10 YR 5/4 12w 10 YR 5/4 A-7 THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES B, AID (EL11). B B 0.0 PAVED SANDY LOAM SANDY LOAM DRIWVE 14" 10 YR 6/4 18- 10 YR 6/4 7.6 CDNSTRUC770N NOTES. 9. C �2.0 C 18.0 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS. MEDIUM SAND MEDIUM-COARSE SAND X -\9. I Z THIS PARCEL IS LOCATED IN THE FLOW PLAIN. 10 YR 516 48- 10 YR 5/6 �A-6 C SAND (ALTI) 2(6 7.6 W-A 0 11 2'0 WF SM-7 2 81 1 3. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPOSED MEDIUM SAND W/TRACE OF SHELLS SYSTEM, BACKFILL WITH CLEAN GRANULAR MATERIAL FILL BEGRADED AS FOLLOWS: NOT MORE THAN 15% RETAINED ON No.4 SIEVE, NOT MORE THAN 90% RETAINED ON 96* 10 YR 211 10 YR 211 1 11 2 STORY 9.7 84" OILI �E No. 50 SIEVE, FRACTION PASSING No. 4. 10% OR LESS TO PASS No. 100 SIEVE AND I TAN 14 5% OR LESS ITO PASS No. 200 SIEVE, SOIL TO BE APPROVED BY ENGINEER FOR WATER ENCOUNTERED PERC 0 48* 7 LAW� 7.2 -5 COMPLIANCE PRIOR TO PLACING ON STE. AT 72* RATE 8 MINIIN 7,1 A LAWN 4. LOCATION OF U71UTIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS PRIOR TO MY EXCAVATION FOR THIS PROJECT 2. 7.0 X1.9 WF SM-8 CONTRACTOR SHALL MAKE THE REQUIRED NOTIFICA71ON TO X2.0 DIG SAFE (1-888-344-7233) AND APPROPRIATE WATER - 7, P DISTRICT TO DETERMINE U71UTY LOCATIONS. x 2.C� 7.6 DR �WFF� 4 3. 7.0 4. 5. ALL STRUCTURES BURIED DEEPER THAN 4' OR SUBJECT TO A-3 VEHICLE TRAFFIC SHALL BE H-20 LOADING. .5 WF A-2 DECK 6.0 �ro.A! 6.5 III K\ 6. SEPTIC TANKS AND PUMP CHAMBER SHALL BE WATERPROOFED PRIOR TO DELIVERY TO THE PROJECT STE. X ;5 A00171ONAL WATERPROOFING AT TAW JOINT SHALL BE 7.0 r1_ v9 5.5 WF A-1 PERFORMED AT THE 97E PRIOR TO BACKFILLING. LA" 'V X 6 -0.1 6. 2.1 UP #227-16 7. EXISTING WATER SERVICE FROM METER PIT TO MAIN HOUSE WILL HAVE TO BE WF SM-9 X 1.9 RELOCATED. 0.� 8. ALL D(CESS SOIL TO BE REMOVED FROM THE PROJECT SITE. A G NN*0 d� AN SET' GENIM NOTES FOR PtW IP- 1.ox N d 1.0 rj di 1. PUMP TO BE SIZO BY PUMP SUPPLIER. 0.1 r� 6.3 Z PUMP TO MEET GENERAL SPECIFICATIONS OF 310 CMR 15.231. 3. MAINTAIN CONSTANT PITCH FROM DISTRIBU71ON BOX BACK TO PUMP CHAMBER TO ALLOW FORCE MAIN TO DRAIN BETWEEN PUMPING. LU 4. INVERTS AND LOCATION OF THE SEPTIC TAW AND PUMP CHAM13ER TO BE FIELD X1.9 ADJUSTED AS NEEDED TO ACCOMMODATE EXISTING PLUMBING AT COTTAGE. . LEGEND 2.3 251 Bay Lane EXISTING PROPOSED 5. LEACHING FACILITY TO BE VENTED. 0 WF SM-10 9 Centerville, Massachusetts 6. VISUAL ALARM TO BE MOUNTED ON THE EXTERIOR OF THE A Stake & Tdc Set/Found 4 0 PK Nail Set/Found X 1.9 W SM611 2,4 % 1. 1 COTTAGE FACING THE STREET. PREPARED FOR \\ F 40 Concrete Bound -0.3 EN @ Gas Gate I Electric Meter X1.9 UROM BEING PM Elizabeth S. Hambly 0 Catch Basin TOWN OF BARNSTABLE: PART 111, SECTION 1.00, 100' SETBACK REGULATION. To allow 04 Water Gate TITLE a soil absorption system, septic tank, pump chamber & distribution box to be TV/Cable Box 0" 50'-60' from a bordering vegetated wetland. Telephone Riser Utility Pole Septic System Repair Guest Cottage 20 TITLE V, 15.211(l). To allow a septic tank to be -2' off a lot line in lieu of 10'. Contours 20OX00 Spot Grade 15.203(2). To allow for the design of a one bedroom system in lieu of a Test Pit 6 TITLE V, X three bedroorn system. A deed restriction will be recorded limiting the guest Cottage -0.2 B-A-XTER, NYE & HOLMGREN, INC. to one bedroom. Registered Professional 0 Engineers and Land Surveyors (9- E STEP N 812 Main Street, Osterville, Massachusetts 02655 AL Phone - (508) 428-9131 Fax - (508) 428-3750 C.I. COVER ADJUSTED TO COVERS LOCATED TO WITHIN F.G. NAL VENT 20 0 20 40 9" OF F.G. F.G.- :1:10.0 qql =GN EXIST. GUEST COTTAGE FG.- F.F. = 10.96 SINGLE FAMILY - 1 BEDROOM SCALE IN FEET REMOVEABLE COVER NO GARBAGE GRINDER EL 8.8 3' COVER DAILY FLOW = 110 X I = 110 G.P.D. APPROX. INV. 8.0 2* FORCE N 0 4o PERFORATED M SEP71C TAW 110 X 200% = 220 FOR PUMP PROVIDE INLET TEE INV. 9w MIN. 368 MAX. COVER USE 1500 GAL SEPTIC TAW SYSTEM SEPTIC TANK IW. 7.8 EL 7.1 (AS REOD.) 1500 GAL W. INV. =8.0 INV- .4 OUTLET PIPES USE 1000 GAL SEPTIC TAW FOR PUMP CHAMBER SCALE.1 =20' DATE:911212003 INV- 8.2 SCH. 40 (TYP) 7.5 7.3 REV. DATE: REMARKS 1 20' PUMP CHAMBER SEE PUMP NOTES RETAIL) 2" LEACHWG FMD DMIGN INV= 8.1 2a PEAS`ME ........ -" �-3 1 1/26 WASHED srotw � '1� ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED Cal 6* CRUSHED STONE BASE USE 4 - 4* DISTRIBUTION LINES IN AN 6" 2.5' 5o 2.5'- GROUNDWATER ADJUSTMENT INLET PIPE 10' 20' X 10' WASHED STONE FIELD AS SHOWN DRAWIN EL 2.1 110 G.P.D./.6 = 183 S.F. OF BOTTOM AREA REQUIRED C NUMBER (M" CROSS SECTION 'A-X USE 20' X 10'_ 200 S.F. AREA PROV10ED 3-063ws2.dwg TYPICAL SYSTEM PROFILE OBSERVED GMIYWATER 0- 1.75 DIST. BOX CLASS 2 SOIL. PERCOLA71ON RATE 1* IN 8 MIN. 0:\03\03-063\survey\worksht\O (8/26/03) NOT TO SCAU NO SCALE NO SCAIX /Ib FN�Z# ca 2003-063 GENERAL NOTES: , ' I ALL SYSTEM COMPONENTS SHALL BE INSTALLED 'IN, ACCORDANCE WITH « I TITLE V OF THE STATE SANITARY CODE DATED MARCH 31 1995 .� r I 1 S 89'44'00" W , r 1 CB DH FND N ` `12.8 ANY LOCAL RULES APPLICABLE. r I .309.t WF SM-3 2.5 / , / I t� 0.o I r I ___--- , o. - 100• . + �, ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING • N fr,:r ' .J �c.ff0 `BY DESIGNING ENGINEER WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFIWNG, x•8.s O R �, Q /4? NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT , m�• , / / j �.' 1 1 i 1 a� FOR INSPECTION. ;. > pk YX ,xa.4 �PiS C '` < THESE'ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN�\ 8.4 C,�A - T K ' APPROVAL BY ,DESIGNING ENGINEER o 4 I � M v /v ,r '*•"r � ��r{.�'ta ,�.rrr _ WF SM 4 9. DISPOSALa xr , { , 3 TTe,>ALL SAN ARY SYS M T .•. 4 4 •zS ti''�,, ,:,;, �a`� F',"J6 c +. r t;�1`�'I$;s�" + t_. 4 ,�•7 -+gas.,, �� •S q � SYSTEM Q,,BE PVC SCH 0 �,,��, ,.•,y �tl" r .� ,I ,S , �,� �►; u.,.`, ; ''S�, t. wc^f1�,'r!'r �4tt4r,FJ.i�Jta' r15 z `7�' ',y 4s. ^°K•,,,?tS Y'`,, ,r' 'k .i F ?j"y i 3 v � � ,,. / 4.9 1 + I ` _ I ( / \ PUMP / WF A-9 1 \ 7 Njp 9 _ " F r try yi t a. ! t r'• Y F t ' 1 I ( CHAMBER � PROJECT BENCHMARK : DATUM NGVD M28 OS � II / / - a' •:5�e `` 5 C.�4"• 4 � ,,�"' *y dY~�4 v1. � n Srh) ! •�' ' .t}1 F I _ - • +;' " �S'� j i:rry(� �,�1�iiwi° l4S�. '''` i,.X.r r "°�;.ry} x.S�r$ '� p" ;aSx�a"S•'t� ° IBM MAGNAIL SET IN PAVEMENT x 1.9 , 8.95 A ELEV.- } In i �u�f'.'Sil>*z' ..Fe au °b?R >'yC:ri 3�1•"`ti .,><4 ,�.wY'v ��'ot';S)1 i, 1 I I I 1 \ $ , m ►a� tiS:�, r wc�r i� 5'�,u�v ,,i rt ,nr+k,Y k I`S,i sZ f y.e .t:r^ 1 I tx 6.3 + / % % WF A-10 I �•`� I. ! + �C-B�X So.O _ / / I - xti �'' � ' f�/'•k{4 ��*ro F, • /Y S�" y:. � �Ir 1'S. - 6.1 ZONING DISTRICT: RD 1 I 3. ��-� / / :•:,` �vvr iM Y✓, !I ;($ <.. r ,r..xS';°r�.i'Yv$�r'~�t i/�'i fkq?�t k r"°r �h . t,wS•Y^..jt 11 `� 4tr�!: PAVE[!' / MINIMUM LOT AREA: 2 ACRES r? r I x7 / , 8 t I / KING S , MINIMUM FRONTAGE. 20 N .• x 1.8 . - 13 AREA M IBM: MA • , / LOCUS MAP SCALE: 1 = 2000 W. o - TP# 2 NAIL SET / / / / . MINIMUM WIDTH: 125 1'1 % - • i I �� 3 - h 1 ' ,< EL. 8.95' FRONT SETBACK 30' SIDE & REAR SETBACK = 1'�' O 8.5 OVERLAY DISTRICTS: 1 x 1.8 / - SM-',� 3. I C ' I x2.o ,' + ` `� ' + WF A-8 1 RPOD - RESOURCE PROTECTION OVERLAY DISTRICT SOIL LOGS DATE:AUGUST26, 2003 �x 7.1 = ! AP AQUIFER PROTECTION P#=P 10,554 1 ) o- 11 ;�\ // sL ovERDlc LOCUS PROPERTY IS SHOWN AS: ENGINEER : BOARD OF HEALTH AGENT 1 1 x 2.0 (SEE CONST. NOTES) - 7 a I ` ASSESSOR'S MAP 166 - PARCEL 057 � _.J Stephen A. Wilson,P.E. x2.o .� \\� ; -x 7.3 7.9 1 1 Sam White 1 - _ 7.5 - 1 t LOCUS DEED: TEST PIT 1 TEST PIT 2 s.o ' 7.4 - ` I DEED BOOK 6,805 PAGE 253 x 2.1 �- , r ( ` G.S.E. = 9.6t G.S.E. = 8.Of 1 r - 1 \ 7.2! PLAN REFERENCE: i 1 1 \ I I l.4 i` J I \LAWN g.o BRIC - ' I I 1 PLAN BOOK 19 PAGE 89 0 AP SANDY LOAM 0" AP SANDY LOAM x .) 1� WF SM-6 �! r/ f� I - " \� •® wAtl 7.5 7 1 ;I ( \ COMMUNITY PANEL NUMBER 250001 0016 D 7-2-9.' g" 10 YR 5/4 12" 10 YR 5/4 + , `�, ( - + + IF1 A-7 THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES c��� ,' ' B, A10 (EL 11). B B 0.0 `� ,+� l ,, • o o SO '' I r' `\ J PAVED I I 1\ SANDY LOAM SANDY LOAM 7.6DRNE7 2 , 14" 10YR64 18" 10YR64 \ ` ; i 1 9. WCI /. ; I \ ` CONSTRUCT[ON NOTES. , I r I I 7 I x�.1 �_-. �\ � 7 � 18.o _� 9 _ � � + I \, 1 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS. MEDIUM-COARSE SAND �1 � t I I \` 1 4$" M101 YR 5 6D 10 YR 5/6 \ , ,i ` I r ( I I + •� 7 /� I , 2.; THIS PARCEL IS LOCATED IN THE FLOOD PLAIN. / 1 2'6 i i _ \ 7 0 11 1 WF1A-6 C SAND (ALTI) 2.10 WF SM-7 I I I I 7.6 , \ _ fs. , 3.8, ` 3. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPGSED 2 W/TRACE OF SHELLS MEDIUM SAND M SYSTEM, BACKFILL WITH CLEAN GRANULAR MATERIAL FILL BE;RADED AS FOLLOWS: 011i 1 '+1 2 STORY 9.7 `� , �'6 8I,1 ` + / l NOT MORE THAN 15% RETAINED ON No.4 SIEVE, NOT MORE THAN 90% RETAINED ON 96" 10 YR 2/1 84" 10 YR 2/1 TAN V�l d t�E `\ - I / 1 ` \ No. 50 SIEVE, FRACTION PASSING No. 4, 10% OR LESS TO PASS No. 100 SIEVE AND 7.z ' ,. 1 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVEI► BY ENGINEER FOR WATER avcournERED PERc o 4s /.7 + LAWN ' r` i \' \ COMPLIANCE PRIOR TO PLACING ON SITE. AT 72• RATE = 8 MIN/IN 7.1 + 1+ 14.1 WF A-5 \ 4. LOCATION OF UTIUTIES NOT SHOWN ON THIS PLAN, AT LEAST \ 7 HOURS PRIOR T Y EXCAVATION 2 OU S OR 0 AN EXCA A ON FOR THIS PROJECT 1 OJEC X2.0 g i // 1 '\ WF SM-8 2 �`\ ` \\ , 7.0 ,+ - `\ `\ CONTRACTOR SHALL MAKE THE REQUIRED NOTIFICATION TO i /.•. 1 ', �\ \�\ \ `�. - + -7. • i �+� , ��\ DIG SAFE (1-888-344-7233) AND APPROPRIATE WATER ` + x 2.0` , PAVIID ,7.6 DR DISTRICT TO DETERMINE UTILITY LOCATIONS. . I • S. 7.0 +1 - 4.8\ 5. ALL STRUCTURES BURIED DEEPER THAN 4' OR SUBJECT 1T) / 5 , s.s A-3 ('\WF A- VEHICLE TRAFFIC-SHALL BE H-20 LOADING. 6.0 + \ \ \ - \ W006 DECK 4• , � / s 2 W I I� .�```\s. ; \\\ \ � 6 6. SEPTIC TANKS AND PUMP CHAMBER SHALL BE WATERPROOFADDITIONAL WATERPROOFING AD PRIOR TO T TAW JOINT SHRY TO THE ALLLCBE SITE. - x,Q.9 ', I :` ►, `\\ �\ .\ 7.0 \\ 5.5 WF A-1 PERFORMED AT THE SITE PRIOR TO BACKFlWNG , 6.6 V 1.dI• 1 ; \ 2.1 �\ \`, sue. PN� �\ uP227-1s LAWN 7. EXISTING WATER SERVICE FROM METER PIT TO MAIN HOUSE WILL HAVE TO BE x 1.9 \ WF sM-9 ,•�' RELOCATED. �� �\ \ 9 8. ALL EXCESS SOIL TO BE REMOVED FROM THE PROJECT ,>ITE. \ V MAG NO \ SET r GENERAL NOTES MR PUMP SYSTEI( Er��SEER MUST ` 1.Ox \ \� \\ c K�� 5�0 `\ \\ ` G m 6.3" s� \ p '�PC,,"N CER•!US ICI .D 1.0 '-\ `\ o o� � \ �♦ `'� r I 1. PUMP t0 BE SIZED BY PUMP SUPPLIER. �p L�Tlcai ' SYSTEM %AIAS IN-TA �I� 1:a �s•: \ \ s s 6.3 z 2. PUMP TO MEET GENERAL SPECIFICATIONS OF 310 CMR I,i231. 3. MAINTAIN CONSTANT PITCH FROM DISTRINUT10N BOX BA(K TO PUMP CHAMBER TO •\\�\ �� \\\\ \\ \ \ �� ;� ALLOW FORCE MAIN TO DRAIN BETWEEN PUMPING. ' . 4. INVERTS AND LOCATION OF THE SEPTIC TANK AND PUMP CHAMBER TO BE,FIELD LEGEND ►G AT COTTAGE.�b ADJUSTED AS NEEDED TO ACCOMMODATE EXISTING PLUMBING ZJr' 1 Bay Lame EXISTING PROPOSED y �•��\ \\\ WF SM-10 2,3 w ,1 - 5. LEACHING FACILITY TO BE VENTED. I Stake & Tac Set Found \\� ` S 6. VISUAL ALARM TO BE MOUNTED ON THE EXTERIOR OF T \ � � HE Centerville, Massachusetts G PK Nail Set/Found \�.x 1.9 2.4 �ti1 . �� COTTAGE FACING THE STREET. \ \ WF SM-11 p PREPARED FOR o Concrete Bound -0.3 `� \� \ END �• '` �+ O Gas Gate \ 'PIP y • x,.9 yvAR>E M BE NG REQUESTED Elizabeth S Hambl 0 Electric Meter ❑ Catch Basin Ia Water Gate cF \.\ TOWN OF BARNSTABLE PART III; SECTION 1.00, 100 SETBACK REGULATION. To'ollow N a sort absorption system, tic tank, ump.chamber & distribution box to' be TITLE ® TV/Cable Box o � 50 60 from a bordering � toted wetland. am Telephone Riser \ g vegetated \ Septic System Repair Guest Cottage -O- Utility Pole \� �c� \ \� •: ,.+ 2p0 Contours �o .- TITLE V, 15.211(1). To allow a septic tank to.be.-2' off c lot line in lieu of 10'. y • 200xoo Spot Grade \ Test Pit o s,� TITLE V, 15.203(2). To allow for the design "of 'o one bed!•oom system in lieu of a a BAXTER, NYE & HOLMGREN, INC. -0.2 three bedroom system. A deed restriction' will,be'recorded limiting the guest cottage to one bedroom. Registered Professional Engineers and Land Surveyors �H or �gss9c S?EPHEN 812 Main Street, Osterville, Massachusetts 02655 AL Phone - (508)428-9131 Fax - (508)428-3750 y .30216 C.I. COVER - S Q ADJUSTED TO o �FG R� COVERS LOCATED TO WITHIN F.G. � VENT 20 0 20 40SS�oNAL E ' 9" OF F.G. EXIST. GUEST COTTAGE 10.0 F G.= *10.0 :'M DESIGN DdTA 2oa:7 F.F. = 10.96 F.G.= ..\/. .� .\ .� ..\ /. i /. i, i, i. i� /�./�/r/� /, ,� SINGLE, FAMILY - 1 BEDROOM ✓. .\/ / / REMOVEABLE COVER SCALE IN FEET -'NO, GARBAGE GRINDER • \\\ 3' COVER DAILY FLOW 110 X 1 = 110 G.P.D.. EL 8.8 APPROX. INV. = 8.0 2- FORCE MAIN ;. .', , :•f _ - INv. = 1500 GAL. - C -20 DATE. / 03 .,r .� - -. .:t•�,, �.�-� 4. .: - PROVIDE INLET TEE PIPES SCH 40 9 MIN MAX COVER ,. _ _ :.r•:-:��•.-•�•.--.-•.: r.. -.•. ,.•. .. ... FOR PUMP SYSTEM •• , ...I ��) . - ,. 7.8 SEPTIC TANKOUTLET 4 PERFORATED SEPTIC TANK 110 x 200x 22o SALE•1 •9/12 20 INV. INV. INV. =8.0 INV= 8.4 - INV 8.2 -- . :.. ~. •- - - - -.• -• '- EL 7.1 _• q •• _ (AS REQD.) � , USE 1500 GAL SEPTIC TANK 7.5 7.3 USE 1000 GAL. SEPTIC TA14K FOR PUMP CHAMBER PUMP CHAMBER Isr. Box r 20' /.\ /.\ \ /.\ /,\ /,\ /.\ /.\ /.\ /,\ /.\� REV. DATE: REMARKS SEE PUMP NOTES (SEE DETAIL) 2" R••••••L••••LL•�K•:SR. �• .. INV= 8.1 -.. 2• PEASTONE LEACHING FB. •DFSIGN - - _ ,f�3 4'-i 1 2' WASHED" `•-1 ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED e 6• CRUSHED STONE BASE c � � �� I �� 6„ 2.5' 5'�+-2.5' USE 4 - '4" DISTRIBJTION LINES IN AN GROUNDWATER INLET PIPE `� •, :. ,•. .. .,.. : .. i o' 20' X 10' WASHED STONE FIELD AS SHOWN (M� � EL 2.1 110 G.P.D./.6 183 S.F. CF BOTTOM AREA',REQUIRED DRAWING NUMBER PROVIDED'USE TYPICAL SYSTEM PROFILE OBSERVED GROUNDWATER EL- 1.75 DIST. BOX CROSS SECTION 'A-A' CLASS 22SOIL, 1 PERCOUTIONARATE In N $ MIN. O: 03 03-063 surve worksht 03-063ws2.dw NOT TO SCALE (8/26/03) NO SCALE NO SCALE { 2003-063 ENERAL NOITS, ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH 12,7 FND TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 CB I DH 1Z8 ANY LOCAL RULES APPLICABLE. S SW44'000 W WF SM-3 309.** ANY CHANCE TO THIS PLAN MUST BE APPROVED IN 'WRITING rn 00 ' .0 0. 13Y DESIGNING ENGINEER A 2.0 ca �U; WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, 0. N07IFY THE ENGINEER & BOARD OF HEALTH AGENT 9.6 FOR INSPECTION. 2AB (/x 'goo k - THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT''WRITTEN S 8.4 8 "N' P APPROVAL 13Y DESIGNING ENGINEER "At OD� WF SM-4 4 9, 9. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" NC., SCH 40 TP IN 4,9 PUMP---, F A-9 0,x CHAMBER PROJECT BENCHMARK DATUM NGVD M28 OS IBM MAGNAIL SET IN PAVEMENT 0 ELEV.= 8.95' Nvn X1.9 to WF A-10 so.o. ZONING DISTRICT: RD-1 COASTAL BANK Box 6.1 STATE DEFINITION 'V 3. PAVE MINIMUM LOT AREA: 2 ACRES x 7.8 PARKING 4? MINIMUM FRONTAGE. 20' '# -' TBM: MA 0.5 / X 1.8 3 R MINIMUM WIDTH: 125' LOCUS MAP SCALE: 1" 2000' NAIL SET EL 8.95' Ac FRONT SETBACK 30' SIDE & REAR SETBACK 10' 8,5 OVERLAY DISTRICTS: SM_!�/ 3.1 RPOD - RESOURCE PROTECTION OVERLAY DISTR SOIL LOGS DATE:AUGUST 26, 2003 X1.8 WF 8 iCT A- x2.0 :3 AP - AQUIFER PROTECTION P# P 10,554 7.1 OL LOCUS PROPERTY IS SHOWN AS: ENGINEER : BOARD OF BEALTH AGENT: 7.8 ASSESSOR'S MAP 166 - PARCEL 057 x 2.0 'ao'Dl� Stephen A. Wilson,P.E. Sam White Xv r' x2.0 COO. 7.9 LOCUS DEED: TEST PIT I TEST PIT 2 7.5 DEED BOOK 6,805 PAGE 253 7,4 G.S.E. 9.6± G.S.E. 8.0±p PLAN R x 2.1 W 7,� EFERENCE: 0" 0" I PLAN BOOK 19 PAGE 89 BRIC Ap SANDY LOAM AP SANDY LOAM P.4 9.01 x 2.)/ WF SM-6 COMMUNITY PANEL NUMBER 250001 0016 D 7-2-92 6" 10 YR 5/4 12* 10 YR 5/4 A-7 THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES B B 8, AID (EL.11). C3 9s PAVED SANDY LOAM SANDY LOAM 14* 10 YR 0,0 DRIVE 6/4 18 10 YR 6/4 7.6 old CONSTRUC17ON NOIIES. C I C y,2.0 8.0 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS. MEDIUM SAND MEDIUM-COARSE SAND X1.1 \9. 10 YR 5/6 k 48- 10YR 516 Z THIS PARCEL IS LOCATED IN THE FLOW PLAIN. 2 7.6 F�A-6 C2 SAND (ALTI) 2A0 WF SM-7 3.81 3. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPOSED W/7RACE OF SHELLS SYSTEM, BACKFILL WITH CLEAN GRANULAR MATERIAL FILL BEGRADED AS FOLLOWS. MEDIUM SAND 06. NOT MORE THAN 15% RETAINED ON No.4 SIEVE, NOT MORE THAN 90% RETAINED ON 96" 10 YR 211 84* 10 YR 211 I 1�1 2 STORY 9.7 we OILI No. 50 SIEVE, FRAC71ON PASSING No. 4, 10% OR LESS TO PASS No. 100 SIEVE AND TAN 6 E 7.2 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED BY ENGINEER FOR WATER ENCOUNTERED PERC 0 480 7 LAW� COMPLIANCE PRIOR TO PLACING ON SITE. AT 72w RATE 8 MINIIN \'14.1 A-5 7.1 '*N 4. LOCAT10N OF UTIU71ES NOT SHOWN ON THIS PLAN, AT LEAST LAWN 72 HOURS PRIOR TO ANY EXCAVATION FOR THIS PROJECT X1.9 WF SM-8 2. 7.0 CONTRACTOR SHALL MAKE THE REQUIRED NOTIFICATION TO X2�O 7, DIG SAFE (1-888-344-7233) AND APPROPRIATE WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. x 2.6 7.6 Ir DR 3. WF -4 7,0 4 A-3 5. ALL STRUCTURES,BURIED DEEPER THAN 4' OR SUBJECT TO VEHICLE TRAFFIC SHALL BE H-20 LOADING. .5 6,5 RIC WF A-2 DE6. ;0.0 j�zx 6 6. SEPTIC TANKS AND PUMP CHAMBER SHALL BE Vonservation Commission File #DA.03067 WATERPROOFED PRIOR TO DELIVERY TO THE PROJECT SITE. ADDITIONAL WATERPROOFING AT TAW JOINT SHALL BE 9 A)�' 7.0 WF A-I PERFORMED AT THE SITE PRIOR TO BACKFILLING. X 6.6 LAWN 7. EXISTING WATER SERVICE FROM METER PIT TO MAIN HOUSE WILL HAVE TO BE UP 0227-16 2.1 NIP RELOCATED. THE PROPOSED WATER SERVICE SERVICE LOCATION IS APPROXIMATE. X 1.9 WF SM-9 k V . 0 ALL EXCESS SOIL TO 13E REMOVED FROM THE PROJECT SITE. MAG N% 9. EXISTING CESSPOOL TO BE PUMPED, LID DEMOLISHED AN) FILLED WITHSAND SET 4A� IP- 6 6 1.0X N 10 GERM NOTES FOR PUMP 1.0 Its -0.1 1. PUMP TO BE SIZED BY PUMP SUPPLIER. 6.3 Z PUMP TO MET GENERAL SPECIFICATIONS OF 3 10 CMR 15.231. 04 3. MAINTAIN CONSTANT PITCH FROM DISTRIBUTION BOX BACK TO PUMP CHAMBER TO ALLOW FORCE MAIN TO DRAIN BETWEEN PUMPING. -No 4. INVERTS MD LOCATION OF THE SEPTIC TAW AND PUMP CHAMBER TO BE FIELD LEGEND 2,3 ADJUSTED AS NEEDED TO ACCOMMODATE EXISTING PLUMBING AT COTTAGE. 251 Bay Lane EXISTING PROPOSED WF SM-10 b 5. LEACHING FACIL17Y TO BE VENTED. 9 Centerville, Massachusetts A Stake & Tac Set/Found 0' tlFound X 1.9 2.4 6. VISUAL ALARM TO BE MOUNTED ON THE EXTERIOR OF THE PREPARED FOR PK Neil Se 11 WF SM-1 1 COTTAGE FACING THE STREET. Concrete Bound -0.3 END C Gas Gate Elizabeth S. Hambly 0 Electric Meter X1.9 VARMCES BENG RM 0 Catch Basin 04 Water Gate TOWN OF BARNSTABLE. PART fit, SECTION 1.00, 100' SETBACK REGULATION. To allow TITLE a soil absorption system, septic tank, pump chamber & distribution box to be irz TV/Cable Box 50�40' from a bordering vegetated wetland Telephone Riser Septic System Repair Guest Cottage -0- Utility Pole 2W Contours TITLE t 15.211(f). To allow a septic tank to be -2' off a lot line in lieu of 10'. 200XW Spot Grade To allow a SAS to be 28' off a coastal bank in lieu of 50' 6 Test Pit X B-Aff-TER Nxt T & HOLMGREN, INC. -0.2 TITLE V, 15.203(2). To allow for the design of a one bedroom system in lieu of a three bedroom system. A deed restriction will be recorded limiting the guest cottage Registered Professional to one bedroom. OF IWq Engineers and Land Surveyors 812 Main Street, Osterville, Massachusetts 02655 TEP N Phone - (508)428-9131 Fax - (508) 428-3750 No..30216 C.I. COVER ADJUSTED TO is COVERS LOCATED TO WITHIN 20 0 20 40 ONAL F.G. VENT 9* OF F.G. F.G.- *10.0 DENGN E)(IST. GUEST COTTAGE FIG.- 10-0: 11���M��!!!!ZZC!I i�!I�1!��i I e�� M7 SINGLE FAMILY I BEDROOM SCALE IN FEET e e' / 77/777, F.F. 10.96 REMOVEABLE COVER NO GARBAGE GRINDER 3' COVER EL 8.8 DAILY FLOW = 110 X I = 110 G.P.D. SEPTIC TAW 110 X 20OX = 220 40 PERFORATED PVC APPROX. INV. 8.0 2* FORCE MAIN SCALE.1"=20' DATE:911212003 9' MIN. 3C MAX. COVER USE 1500 GAL SEPTIC TAW PROVIDE INLET TEE INV. 1500 GAL OUTLET PIPES T/I V, SCH. 40 (TYP) FOR PUMP 7.8 SEPTIC TANK 1W. INV. =8.0 IW= 8.4 INV­ 8.2 EL 7.1 (AS REOD.) 10 USE 1000 GAL SEPTIC TANK FOR PUMP CHAMBER 7.5 //<//1<//K/ REV. DATE: REMARKS 20' PUMP CHAMBER ST. BOX ........ MP NOTES ISEE DETAIL) 2 2* PEASTONE MACHWG FM DESIGN I §T24103 State Coastal Bank - -----�'40 1 1/2- WASHED STOU I ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED V41 1 01. NMI 3 INV­ 8.1 6" CRUSHED STONE BASE C! USE 4 - 4' DISTRIBUTION LINES IN AN 6" -7 5' 5 .2.5' 20' X 10' WASHED STONE FIELD AS SHOWN DRAWING NUMBER t2A �e('OA� INLET PIPE .10 110 G.P.D./.6 = 183 S.F. OF BOTTOM AREA REQUIRED t C�"_r d' k; I V Z' GROUNDWATER ADJUSTMENT EL 2.1 (MHW) X W- 200 S.F. AREA PROVIDED USE 20 0:\03\03-063\survey\worksht\03-063ws3.dw TYPICAL SYSTEM PROFILE OBSOM GROUNDWATER EL, 1.75 DIST. BO CROSS SECTION 'A-X CLASS 2 SOIL; PERCOLA71ON RATE I- IN 8 MIN. FN 'i r-C NOT To SCALE (8/26/03) NO SCALE NO SCALE 2003-063 ------------ .. ..... 1 I 1 • i / i r i / �' ,� � k1l (0 It G&NERAL NOTRS: i �' I �' o ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH ' °f r I TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 S 89'44'00" W r ' - CB DH FN � ' , 128 ANY LOCAL RULES APPLICABLE. 0.0 I � __- WF SM-32.5� / , 0: ' V 100, ,y ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING 7�: 10.9 t '- BY DESIG�NING� ENGINEER I It o , , , , , ok a?o. o WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, / /�/ i /) x,8.s o g.s W , ,� NOTIFY THE ENGINEER do BOARD OF HEALTH AGENT I a FOR INSOECTION. � / / / ( / 3. r7 11. ^ CID THESE E ATIONS MUST NOT BE CHANGED WITHOUT WRITTEN o00 � 8.4 8.4 R�C',(r A ' T K q APPROVAL BY DESIGNING ENGINEER ,- o ` ..~. :, �'• ,, . s ,,,.;: ' { I. , WF SM-4 �4 , r \ 6 9 '� o, " t I , r r I 9. c / , ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4 PVC., SCH 40 { ( , \ •�ik:;. \ .Kk .t f Y a. •� '� t ii..,SDI • \ U I � ,; (u; h, > 4.9 ,. ,,�> �<. .�hr �Ft� �:� PUMP # �o + ...a� ,; + t c: r r a _ I / WF A-9 +`' r�zy'�• �`s a. � '? tdt`� °',"d ati�t, a .s { - r CHAMBER �� / _ .: ><e Y •t ` 3FilL :-nc 1:4.rtt � I , ��;. ` , PROJECT; BENCHMARK . DATUM NGVD M28 S , r I Q t+, ,rti '.s.cG`` D.(,^,..• �.:.F .'�E'+..r r�r tr-t.*''�i_.,.�1 d` . '*-. , 2 ,. I tar!u' 8.8 . V x 1.9 r / a i r IBM MAGNAIL SET IN PAVEMENT ® ELEV.= 8.95 I � f I :i+n, / / / to �^y, +,,.Ciao r�( sr -"�..ar &N � .,y,"'V: li >•„r•\,K,..;J '.y. � 1 I I \ / / / �S./ nu 1 COASTAL BANK - r r 6.3 I50.0. WF A-10 0 +f? v a t' s 1 w o un + t -BOX- / r ^r: .s flgk_. I�,s ` I - STATE DEFINITION -I - / 6.1 _ 44,a l 1 0 ' ZONING DISTRICT. RD 1 „ F ' + Jam. i-- 1 I 7 PAVE - / MINIMUM t x 1.8 I � I I x�.8 �^ LOT AREA. 2 ACRES AREA Mi TBM: MA r MINIMUM FRONTAGE: 20 • ', \ . i I I t 3 0 - T'I� NAIL SET / ,/ MINIMUM WIDTH: 125' LOCUS MAP SCALE: 1" = 2000' EL 8.95 INC �r FRONT SETBACK = 30' SIDE & REAR SETBACK = 10' 5 ' OVERLAY DISTRICTS: t, x1.8 / - - \WF SM-�/ 3 I \ t r 'r x z.o I ` - A-8 RPOD - RESOURCE PROTECTION OVERLAY DISTRICT SOIL LOGS DATE:AUGUST 26, 2003 7. I ' 1 4.1 AP - AQUIFER PROTECTION I _ � 1 g- I f \ P#=P10,554 t x 2.0 , \ / - i 1 LOCUS PROPERTY IS SHOWN AS: � �� � / 1 �r•s 1 ENGINEER: BOARD OF HEALTH AGENT G / ' ASSESSORS MAP 166 - PARCEL 057 x2.o //. - - r Stephen A. Wilson,P.E. Sam White �/ 7.9 - 7.5 rr i' '1 LOCUS DEED: TEST PIT 1 TEST PIT 2 - \� r s.o I 7.4 - ; f DEED BOOK 6,805 PAGE 253 x 2.1 ; / l\ , r- , W PLAN REFERENCE: G.S.E. = 9.6 t G.S.E. 8.0f �/ \ 4 ; I \LAWN 9.o BRIC - wP � + I PLAN BOOK 19 PAGE 89 0 0 x 2.1 �t WF SM-6 r rr j �\ ` ® W. � AP SANDY LOAM AP SANDY LOAM \ / 1 , ` COMMUNITY PANEL NUMBER 250001 0016 D 7-2-92 10 YR 5 4 10 YR 5 4 A-7 THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES 6 / 12 / B. A 10 (EL.11). B B / J I ` 0.0 `�` � r i/ Il it !- � DRIVE \ SANDY LOAM SANDY LOAM 7.6 2 �„ ' 10 YR 6 4 " r CONSTRUCTION NOTES: 2.0r � / 9• a ,- ; ; \ \ 14 18 10YR64 X2.1' r,r /8.0 ' �j / �I I \� 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS 1 C \9� i I `�� 48 MEDIUM 10 1R SAND MEDIUM-COARSEO SAND • ,, �\ , /� \\ 1 2,6 �+ I i 7 04 I I{ `� 2. THIS PARCEL IS LOCATED IN THE FLOOD PLAIN. / /I 1 2.,0 WF SM-7 I I , , - 7.6 i rr� a wF`A-s ` C SAND ALTI 3. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPOSED 2 ( ) I I I W RA SYSTEM, /T CE OF SHELLS s �• �. BACKFlLL WITH CLEAN GRANULAR MATERIAL FILL REGRADED AS FOLLOWS: MEDIUM SAND OILS 1 ,1 2 STORY 9.7 ` .. ; ' , 1 NOT MORE THAN 15% RETAINED ON No.4 SIEVE, NOT MORE THAN 9OX RETAINED ON 96" 10 YR 2/1 84" 10 YR 2/1 t r TAN - d E \ 1s th 1 \ I No. 50 SIEVE, FRACTION PASSING No. 4, 10% OR LESS TO PASS No. 100 SIEVE AND 1 1 �..�--,,-- 7.2 jr o ��- 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED BY ENGINEER FOR WATER ENCOUNTERED PERC O 48' w� , 7.1 , t 114.1 WF A-5 \ COMPLIANCE PRIOR TO PLACING ON SITE. AT 72 RATE - 8 MIN/IN k, 1 ` 4. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST x1.9 ; `\ `` \ 72 HOURS PRIOR TO ANY EXCAVATION FOR THIS PROJECT � x2.0 ` 1 '� `� WF sM-8 2.��\ '�,,, 1 7.o t ` .� �•� \ CONTRACTOR SHALL MAKE THE REQUIRED NOTIFICATION TO \ 7. I ; DIG SAFE (1-888-344-7233) AND APPROPRIATE WATER / x2.0 \ \ I \ 7.6, PAVFID t� \WF -4 DISTRICT'TO DETERMINE UTILITY LOCATIONS • r / \ l n7.0t \ t a.8 5. ALL S UCTURES BURIED�\ \ A-� ('. ^ DEEPER THAN 4 OR SUBJECT t0 - - _- _ - ` 1 \ �� � VEHICLE �TRAFFIv STALL 9E oe-20 Lne�1!uG (0.0 II \\ \ \ - \ WOO DECK , 6:5. WF A-2 \�� !11I �` •�� ! \`\ i s s 6. SEPTI TANKS AND PUMP CHAMBER SHALL BE Conservation Commission File #DA-03067 \` wAU� \ , `\ cz -� WATERPROOFED PRIOR TO DELIVERY TO THE PROJECT SITE e ADDI110NAL WATERPROOFING AT TANK JOINT SHALL BE I \\ - \ \\ - \\ `\ \\ 7. -a1x 9 \ ; \ 0 ( \ ` 0 5.5 WF A-1 PERFORMED AT THE SITE PRIOR TO BACKFIWNG. \ LAWN 6.6 o a v ` 1.6 �, 1 }� '` 21 �\ -\`� s ENO � \ UP #227-1 s � h 7. EXISTING WATER SERVICE FROM METER PIT TO MAIN HOUSE WILL HAVE TO BE ^ - x 1.9 WF sM-9 ` `'' '�- RELOCATED. THE PROPOSED WATER SERVICE SERVICE LOCATION IS APPROXIMATE. �0�\ ,\\ \ \ '`'� \•�` \ ` �� \ \ ' 8. ALL EXCESS SOIL TO BE REMOVED FROM THE PROJECT SITE. 1.Ox \ `IP- \ ,� � yo G J `�\ - \<\\ \ ��10p � `,\ MA S N r r� Zo�'� 9. EXISTING CESSPOOL TO BE PUMPED, LID DEMOLISHED AND FILLED WITHSAND \ \ o- ET \ \ \ 1.0 6 6.3 Ai. No= FOR Pump =in X lift a s.3 o r ' 1. PUMP TO BE SIZED BY PUMP SUPPLIER. \` \ \ •� '' 2. PUMP TO MEET GENERAL SPECIFICATIONS OF 310 CMR 15.231. 3. MAINTAIN CONSTANT PITCH FROM DISTRIBUTION BOX BACK To PUMP CHAMBER TO \ \ \ ALLOW FORCE MAIN TO DRAIN BETWEEN PUMPING. LEGEND ��•9 \ \ \�` 4. INVERTS AND LOCATION OF THE SEPTIC TANK AND PUMP CHAMBER TO BE FIELD EXISTING PROPOSED \ WF SM-10 \ o AT COTTAGE. 251 Bay Lane - \ TO ACCOMMODATE EXISTING PLUMBING \ \ 2.3 W ' ADJUSTED AS NEEDED A Stake dt Tac Set/Found \��\ ��\ •'� • $ 5. LEACHING FACILITY TO BE VENTED. Centerville Massachusetts PK Nail Set/Found .x 1.9 �- o Concrete Bound -0 3\" �•� WF SM-11 2 4 ��til •,p' 6. VISUAL ALARM TO BE MOUNTED ON THE EXTERIOR OF THE PREPARED FOR O Gas Gate �\ END �, ��� COTTAGE FACING THE STREET. 0 Electric Meter x1.9 S .�� Elizabeth S. Hambly 0 Catch Basin YARI&WCES BEDVG REQUESTED ■ Water Gate c'o `�\ TOWN OF BARNSTABLE. PART III, SECTION 1.00, 100' SETBACK REGULATION. To allow TITLE ® TV/Cable Box N ® Telephone Riser \ a soil absorption system, septic tank, pump chamber & distribution box to be -O- Utility Pole 50'-60' from a bordering vegetated wetland. Contours ` Septic System Repair Guest Cottage 200" Spot Grade �o �\ TITLE V; 15.211(1). To allow a septic tank to be -2' off a lot line in lieu of 10: Test Pit `o.� \ s To allow a SAS to be 28 off a coastal bank in lieu of 50: -a.2 BAXTER NYE & HOLMGREN INC TITLE V 15.203(2). To allow for the design of a one bedroom system in lieu of a three bedroom system. A deed restriction will be recorded limiting the guest cottage Registered Professional to one bedroom. Engineers and Land Surveyors �P iH of M,46. 812 Main Street, Osterville, Massachusetts 02655 TEP N �cyG Phone - (508)428-9131 Fax (508)428-3750 C.I. COVER i No.30218 ti o ,Sy C!w 0 Q ADJUSTED TO \�o FGISTER� COVERS LOCATED TO WITHIN F.G. VENT 20 0 20 40 �FAl IST1 9' OF F.G. EXIST. GUEST COTTAGE F.G.= 10.0 F.G.= ±10.0 F.F. = 10.96 .� ,� ..� � � ..�/. /�j /� `� �� ` �� DESIGN DATA SCALE IN FEET 3 REMOVEABLE COVER SINGLE FAMILY - 1 BEDROOM .,. \ . NO GARBAGE GRIN 3' COVER EL 8.8 DER APPROX. INV. = 8.0 2' FORCE MAIN ;' ', _• . D = _ G.P.D. INV. = 1500 GAL - ' : • ',r _ ea_ - PROVIDE INLET TEE 4' PERFORATED PVC DAILY FLOW 110 X 1 110 G P,D 7.8 SEPTIC TANK I I - • ' •� ~-:- =fir•."••: •~' -.. FOR PUMP OUTLET PIPES - SEP11C TANK 110 X:200X = 220 DATE:9 12 2003 (�) USE 1500 GAL SEP11C TANK SCALE: =20 INV. = IN INV. �•0 INV= 8.4 NV- 8.2 ._• ' . :: EL 7.1 0 U P SYSTEM , •• (AS REQD.) SCH. 40 9 MIN. 36 MAX. COVER . /, /. /. /. /. /� /� /� /. USE 1000 GAL. SEPTIC TANK FOR PUMP CHAMBER 7.5 7.3 II • . PUMP CHAMBER ST. Box I� 20 /�/ REV. SEE PUMP NOTES (SEE DETAIL) DATE: REMARKS L 2 PEASTONE LEACHING FIELD DESIGN State Coastal Bonk 6' CRUSHED STONE BASE f�3 4'-1 1 2' WASHED sr ��' ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED e 6" 2.5' S' 2.5'' USE 4 - 4' DISTRIBUTION LINES IN AN 20' X 10' WASHED STONE FIELD AS SHOWN . • - ::.- • �O' DRAWING NUMBER GROUNDWATER ADJUSTMENT EL 2.1 INLET PIPE (MHW) --.�� 110 G.P.D./.6 183 S.F. OF BOTTOM AREA REQUIRED TYPICAL SYSTEM PROFILE oesERVEO GRouNOwATER v a. 1a5 DIST. USE 20' X 10'-- 200 S.F. AREA PROVIDED Box CROSS SECTION A-A 03 03-063 suNe worksht 03-063ws3.dw NOT To SCALE (8/26/03) -':'' CLASS 2 SOIL; PERCOLATION RATE 1" IN 8 MIN. G: No SCALE No scAl.E 2003-063 i