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Home My WebLink About0017 CAPSTAN WAY - Health `i'i CAPSTAN WAY Centerville A = 192 — 110 N S M EAD No.2-153LOR UPC 12534 emead.com • Made In USA Ale—) 10H {IS®N iFE PAOOIICi IfE OESRPROGRAM aau�ens FiF No. &0 cl 4 Fee �. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes S " anon for Disposal *pstem �lCoustrurtion Permit r lica ion for a Permijtoo�ns'truct ) Repair(v�upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /_7 f lz� ( Owner's Name,Address,and Tel.No. �y Assessor's Map/Parcel 1 emv*-vi t I 3®k -7!,6 d 1 L7 Installer's Name,Address,an Tel. o. Designer's Name,Address,and Tel.No. Type of Building: / Dwelling No.of Bedrooms 3 Lot Size /7 -} sq.ft. Garbage Grinder( ) Other Type of Building ► No.of Persons Showers( ) Cafeteria( ) Other Fixtures 2 Design Flow(min.required) 3 3 0 gpd Design flow provided /p 2_ gpd Plan Date Number of sheets Revision Date Title r Size of Septic Tank Type of S.A.S. Z / Description of Soil P V At ryt S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Bo Health. Signed Date Application Approved by i'Vv' Date Application Disapproved by Date for the following reasons Permit No. Date Issued �� 3 No. ( �,of �. Fee TH;E,COMMONWEALTH OF MASSACHUSETTS Entered in computer: ._`...,,. i. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 5�- pplitation for Disposal Epstein Construction Permit plic i pon for a Permit to construct ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components e Location Address or Lot No./ (4LI951A R G✓ Owner's Name,Address,and Tel.No. Assessor's Map/Par-ccel /On�vt,� C.-lc ( /•�-�- j 0, 7 Installer's Name,Address,an -r-i 14o. Designer's Name,Address,and Tel.No. t3 iy c4 01t fi �o� y�7- 19k5-3 P--K," �''J - A 3�z — y Type of Building: Dwelling No.of Bedrooms 3 Lot Size/!!�A 4 k sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S 3 0 gpd Design flow provided �✓ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. t e ' Description of Soil L/0 P i tt 5 Nature of Repairs or Alterations(Answer when applicable) i Date last inspected: Agreement: �e The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance witl the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar�dqf Health. Signed Date Application Approved by / _ Date -7 Application Disapproved by Date for the following reasons i Permit No. ? 0/ a C � Date Issued - - --------- -------------------------------------------------------------------------------- � ,ci l t1cCq�— T�—ev�G h THE COMMONWEALTH OF MASSACHUSETTS 7 t�oX BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(__J1 Upgraded( ) Abandoned( )by %P at �] Co 13S f'otvn k >a i /I fhas been constructed in accordance ) with the provisions of Title 5 and the for Disposal System Construction Permit NOc'XIJ-�q'K' dated �/ 3// 3 Installer Designer #bedrooms Approved design flow c d gpd The issuancettth��It rm�hall n tbe con t ed as a guarantee that4he system wi fGnc'on.as-designed.DateInspector '- .'l ';11 v �/ 4rA.Kjj,L No.a Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 3Bisposar *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(-i Upgrade( ) Abandon( ) System located at / S 'f r 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. c Date -7 3 /3 Approved by -)Wm i FROM :down cape engineering inc FAX NO. :15093629880 Jul. 16 2013 02:10PM P2 N e U. ,\0 Thonlag�K Gcoffer'Dbrectar B FTA:M;R, Public HeRifla Rivi.sil)fl umps McK,agall iNrectur ),00 Main Street, MAL.02601 Office-,: 50F, 962A644 TLEMI Date: 0-'.d 0D. c P 4L)- -ws Usuud a permit to JD-,5tan a cjatro �,zptic system at c--.-rA_, L RVYM based o-,n a dcsign drawn by (addicss) {deb finer) (Latcd V7,0t:3 7T T certify that the scpflc, system re�'mmxd abovo -was j.1'uTiaUt:A_1 subsftah.ally according to the de-SIP, which may iiac.rade mi-jim appmve.d. ohalle cs .1 rjuch LLs lair rg' on.d tie distribiiiion box and/or sc.-plir,tans, T certify 111jif the septic: efejenced a0ove -wLis installed with m,.ijcy.0 rhRa.v 9 (iX, geF_fP_T IiVtl 10' .4terai rnloralioji of SIRS or any vurdnal i-ClocaLiou of any mljaponui� c.f flit qep6C,System) h-Lft in wiflL SLzda &Lock Rn,71tations. Plaii rcvisio-r (jT Lxidilr,d.Pph-6]t by dc-s.i,,;aeT to fidlaw. CID, OJAI—,& No.46,IiM s I 11gr �-au f, Psi.T It �11ARNSTjAg!Z —, M3TTC H.EA1;111 )NNISM1q. Th, R THL OTIT F0.RY,. ig-li'LTIM CARD -AN Q APF JUN. 'j"ffAKKV0U rl- rei bficiton&7,m,1-26-414.dc-c 07/03/2013 11:23 5087786023 SWARTZ PAGE 01/01 /7 L s � �v Ceti�e-r vel1 �.. 1 � w iw`rrr r raa�■ 9��0 . o r� t" o, �2, NO y 1 s� co ! � y / 9 TOWN OF BARNSTABLE LOCATION 1'1 (2gQ5Jc►t1 L)au SEWAGE# t2013 - 2tJg VILLAGE Cy-Mc V,l 1G ASSESSOR'S MAP.&PARCEL 19 Z - J 10 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /000 LEACHING FACILITY.(type) T!'znc 1%zS (size) 2 X 3 x 3 NO.OF BEDROOMS s.J OWNER IQ;cc r G PERMIT DATE: 77-3- 13 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 Az-3` A3.3& REAR A Y' Town of Barnstable P# oFtM rq4 Department of Regulatory Services / s ■ARNMEIM ; Public Health Division Date ` LL? Y MASS. 039. 200 Main Street,Hyannis MA 02601 DScheduledDU. D Date Ttme �0 Fee Pd. l f� 0 Soi Suitability Assessment for Sewage Disposal ` 3 Performed By: Witnessed By: v k- j� LOCATION & GENERAL INFORMATION Location Address / ��11 ✓VCGI Owner's Name r. Ce✓ �`/! �� _ ! Address t: Assessor's Map/Parcel: 9eZ��U Engineer's Name j l vV C010 e) NEW CONSTRUCTION REPAIR Telephone# f7 C) Land Use Slopes(%) Surface Stones —� Distances from: Open Water Body ft Possible Wet Area/(J/A-- ft Drinking Water Well y)JA Drainage Way ft Property Line —ft Other �- ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Co 9 -; Parent material(geologic) Q`ter U-05 (f- Depth to Be c '7 36 Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE:`.::: Method Used: Depth't)bserved standing in obs.hole: - .. -in. Depth to soil nioitles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST ---':Date Time ()kb Observation Hole# Time at 9" 4 Depth of Perc O Time at 6" Start Pre-soak Time @ fy;to Time(9"-6") End Pre-soak J'0 Rate Min./Inch G Z Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- —***1f percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC 1 DEEP OBSERVATION HOLE LOG' _. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven rtLL tv-1 Z 46 L 5 tC)-' 7q7 3z - 12 �c s -•y�yL/y .�- DEEP OBSERVATION HOLE LOG Hole# �- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) «VV0 x ej— II;L 6 -w 40 CZ-�Z DEEP OBSERVATION HOLE LOG " Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Graven DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) ar -� _140 Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? '\ If not,what is the depth of naturally occurring pervious material? Certification I certify that on llfe—1 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trainniiinng,�expertise and experience described in 310 CMR 15.017. Signature Date 7 Q:\SEPTIC\PERCFORM.DOC THE Town of Barnstable Barnstable �pF Tp�y Regulatory Services Department ;McaCft : � MASS. • Public Health Division T MASS. m i639• �� ArE0 MAt s 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 9163 May 30, 2013 Mr. & Mrs. Armand Lapierre, Trustees 17 Capstan Way Centerville, MA 02632 • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 17 Capstan Way, Centerville, MA was last inspected on 5/03/2013 by Ricky Wright, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that.the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • At time of inspection, leaching is in hydraulic failure. • Water level is above invert. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas McKean; R.S. CHO Agent of the Board of Health Q:\SEPTICU.etters Septic Inspection Failures or Future Evahl7 Capstan Way Cent May2013.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13655 71 n 13Z7TA0l1 r r Logged In As: Parcel Detail Wednesday,May 29 2013 Parcel Lookup Parcel Info Parcel ID 192-110 Developer LOT 59 I l Lot�_______ Location 117 CAPSTAN WAY l Pri Frontage F83 _� l Sec Road Sec Frontage -- l village ICENTERVILLE �� Fire District F-O-MM Town sewer exists at this address.N0 _ l Road Index r2 233 l Interactive Map Owner Info Owner I LAPIERRE,ARMAND J & RITA C TRS l Co-owner I� IERRE LIVING TRUST mm l Streets 117 CAPSTAN WAY �) Street2 City {CENTERVILLE State MA zip 02632 Country ! Land Info _ Acres 10.35 Use jSingle Fam MDL-01 l Zoning RC Nghbd 0105 J Topography Level l Road Paved �� Utilities(Public Water,Gas,Septic Location l Construction Info _ Building 1 of 1 Year 1986 l Roof Gable/Hip ( Ext�od Shingle _l Built- Struct Wall Living 1971 I Roof Fs h/F GIs/Cmp l AC None l ° Area I Cover. Type Style Cape Cod l wall Drywall Roomnt s 3 Bedrooms B �; Model Residential Floors^ardwood ( Rooms 2 FullInt l �' -411 Heat Total FHS'r Graae,Average Plus Type FHot Water ( Rooms 7 Rooms >� , az, . Heat Stories 01/2 Stories l Fuel(Gas Found-ation{Poured Conc. Gross 5128 Area Permit History. _ http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13655 5/29/2013 r Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. City/Town State Zip Code Date of Inspection 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 filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Ricky Wright use the return Name of Inspector key. B & B Excavation,Inc. ren Company Name 14 Teaberry Lane Company Address Forestdale MA 02644 City/Town State Zip Code 508-477-0653 S14595 Telephone Number License Number B. Certification X: IUD F 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. T�Ige ins:-p--phction All performed based on my training and experience in the proper function and maintenance)of olirtite . `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 Evaluation by the Local Approving Authority 4 5/7/13 In� 1gnature 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. 'X VFb t5ins•11/10 Title 5 Official Inspection urface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E%always complete all of Section D A) System Passes: ❑ I 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: 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. 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 indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way M Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. CityfTown 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 Y2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 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 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityrrown 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 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(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder. El Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d n/a 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current 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: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityrrown 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: 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•11/10 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 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1986 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: >20feet Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appeared to be in working order. No sign of leakage or blockage Septic Tank(locate on site plan): ' Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 1000 gal Sludge depth: 6" t5ins•11/10 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 °M 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 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 31" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? scour stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At time of inspection septic tank appears to be structurally sound. No sign of back-up. I 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 Ll&nr /10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 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.): 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 El 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 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 0 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.): At time of inspection d-box is deteriorated and must be replaced. Water is backed up into d-box due to failed S.A.S. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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,�tc�:_. t� of inspection leaching is in hydraulic failure. Water level is above invert. 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•11/10 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 M 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 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.): 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owners Name information is required for every Centerville MA 02632 5/3/13 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 I O - Al . q t A2.- 35 f h3 - �4o ' z I C7 --B I t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityrrown 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: >13'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: 6/13/86 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 ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 17 Capstan Way Property Address Armand Lapierre Owner Owner's Name information is required for every Centerville MA 02632 5/3/13 page. Cityfrown 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 A1o._.3;L:5 C 9 Fxs .... THE COMMONWEALTH OF MASSACHUSETTS ►� BOARD OF HEALTH �Z` I ...........................................OF......................................------------........................................ Appliration for Disposal Works Tonstrurtiun 11truti# Application is hereby made for a Permit to Construct ( /) or Repair ( ) an Individual Sewage Disposal System at: .....---.-•-....__-.___.-•-...... -. ...................................... ..� - --•- .� .. ............... ....... . ..... ._ .. Loc tion•Address or Lot No. gel 1� y...l�.r�.�.1�..... �1�..... . ------- ..---...: r�n�.:. .1�� .�� _st -!!Rrr_.A...t.►�..�t�� ! r"�Y...7r �s i 1� s -- Owner _Address w Ala.. r /�i C: •...-.. �'1...R..� ......,. Installer Address UType of Building Size Lot,. �...� �......Sq. feet �.. Dwelling—No. of Bedrooms.....:3...................................Expansion Attic ( j Garbage Grinder ( ) '4 Other—Type T e of Building No. of persons �.............. Showers (� YP g ---------------•--...----•-- P ( ) Cafeteria,( ) G4 Other fixtures ................ .............••-•----•-._._......_..._.. W Design Flow................��...................gallons per person per day. Total daily flow.....�....o---------- -...............gallons. WSeptic Tank—Liquid capack 600—.gallons Length.........,—Width........•— Diameter............—Depth................ x Disposal Trench—No.__N...l4...... Width............0....... Total Length Total leaching area :.............sq. ft. 3 Seepage Pit NO.......I............ Diameter....J2........... Depth below inlet....Y........... Total leaching area..z�.`_(....sq. ft. Z Other Distribution box ( -4 Dosing tank ( ) E Go NGo,� z l s�S a Percolation Test Results Performed by..... ....�........................................................ Date.....d.�..--.c_-•-•--......_... a Test Pit No. 1_/_.S--...minutes per inch Depth of Test Pit.....t .......... Depth to ground water.._N 4.___.. f4 Test Pit No. 2-.L.'Z.......minutes per inch Depth of Test Pit....15............ Depth to ground water........`............... -• -- ..S.--... ...-•--•-... -•--------------------------...............-......................................... ODescription of Soil........--Z..°....Lo/9........................................................c3 ` ....................•---•----•--......---------•-•------•---------.._... vx 3----. ..� /-fiZ-sE �r .-:�.----•-• ---•••-----------------------------------•--........... ---..... -- UW •-•••-----------------------------------------------------------....-------------•-.-.-.------.....--•••••-•-•---•--••--- •--•••-...................................................................... Nature of Repairs or Alterations—Answer when applicable................I..................................................0............0.............. i ....--•••----••..............•--------•-----.............---•--•-•--............-•------.....------.-••--......._..-----=--•-----------...................----------.......---------...._.._..---..... Agreement: The undersigned agrees to install the aforedescribed Individual', Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—T undersigned further agrees not to place the system in opera ' until a Certificate of Compliance has n i su a boa 6 Appl' tion Approved By. /Ete -------------------- ------•---•--- i ... _ Application Disapproved for the f ollounng reasons:...................... ....•................................................................................ - -••--------------••••---............._..0-•-.......-----................_..._............................_--- ---••--•-••- Date PermitNo................................................ Issued_.....................................................- Date _ 1 No......(?..� ( Q THE COMMONWEALTH�'OF+•'MASSACHOSETTS J BOARD OF HEALTH ................ .......----- - Appliaett#iaan- f�r Disposafigurks Tonotrudiun trrttiit Application is hereby made-for a Permit to Construct (✓ ) or Repair (' 4 ) an Individual Sewage Disposal System at: .............__....__.......... .-----...._•---.................._.......Al T�✓ -Location--Address or Lot No ................- • a ��ui r.,./..S.. ... owner Address fl ....P. MAXLA— r......................:..........:....... .. Installer Address ........................................... Type of Building .-, Size Lot........... .......Sq. feet .a Dwelling—No. of Bedrooms___._.:=:___________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons___....__`_:�...__..___.___ Showers ( ) — Cafeteria ( ) d Other fixtures .. W Design Flow................. ----------."gallons per person per day. Total daily flow......>__:.`.:?...__.___..._____...._...__gallons. WSeptic Tank—Liquid capacity?'.._:_.'._gallons Length................ Width................ Diameter._.____.._______ .............gallons. x Disposal Trench—No._. .: ,: ........ Width....__''=:....... Total Length.........-::::..... Total leaching area.,..................sq. ft. 3 Seepage Pit No.......1_...._____.. Diameter.....!............. Depth below inlet...... Total leaching area...... ....sq. ft. Z Other Distribution box ( _-) Dosing tank ( ) a Percolation Test Results Performed by........A X.............'- '-:'._'_-___._.___________-__-______ Date......... Test Pit No. I__:f.'_'_......minutes per inch Depth of Test Pit....:..:........... Depth to ground water__.4.: ......... fs, Test Pit No. 2..4..::........minutes per inch Depth of Test Pit....:..:.:.......... Depth to ground water........................ Description of Soil........ I % - - _ V ---••--••-••--•-•------ ••------—=' —- •-1•-•.-••-�=•-•__'_'__._ ....__`...�.... :............`_..... -----------------------• -�-----._......---------•--------..........-. x ••-•••--•-••--•-•••-----•--•••-••--___-••-•-•••-••••--•----•---•••-•----••••••--•-•••-••...•-••-•-•--••-•-....•-•••••-----••••••...••--••••---•-•-••••...._..--••••.....••----•.._..--•-..._..---•-_.... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...........................................•---------••-----•-----------......-•--------...-------..._........-----------•-•----•--._.....-••...__........---•-...._._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 5 of the State Sanitary Code—Th undersigned further agrees not to place the system in operatio until a Certificate of Compliance hasrbiu d e boar,44i- eal�k- f Date Applvcation Approved BY--•-- ........................•-•-•--•--...---- �--•--•. •-._._....__..Cq � .. ate Application Disapproved for the following reasons:---------------------- -----0•-_--•---••--------------••-----------•--•-••----•----•-•••-•-•--•-----------._._ •••-•-••--•-....--••••--•••--• -Date..._..._...-- PermitNo.............................................. .._.... Issued-.........................--............................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......^.....!`.....T'' '.: ...i.......OF............... :...:.... ...................................................... (9rdif star of Toutplitturr. THIS IS TO CERTIFY, That the Individual Sew3ge Disposal S-stem constructed or Repaired ( ) by...............................................................................� •- V 1. :-- -f__f .... ........................... ......... ....... .... •-••• ...... at............................................J--�------------------------ ''j• z5-1/��11uer tdA-` •• A.0.1.f.............................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as desc i�ed in the application for Disposal Works Construction Permit No........�6__"_'_.Q I...... dated--..........�?_ ::�3�-___.�._._.______. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GiJARdNTEE THAT THE SYSTEM WILL FUNCTIONSAT FACT Y. ,�- ` 2�DATE...................................• = ..... 1 - Inspector..---------•---•�=••--•---•--••••--••• THE COMMONWEALTH OF MASSACHUSETTS +. j q "�, ,� j d BOARD OF HEALTH J No................ ..•- FEE....___--_...-.......... Disposal Works Tunu#rudiun randt Permission is hereby granted.....................:37-----)-)----------f.-Q•-0rw............................................................. -- to Construct (X) or Repair ( ) an Individual Sewage Disposal System atNo.................................... 9 Street ............ as shown on the application for Disposal Works Construction Permit No_____________________ Dated.__._____ G !......... ....)/ ...............................................- DATE_ .. 1 ! 1t ( Board of a Ith • FORM 1255 HOBBSi& WARREN. INC., PUBLISHERS 'M 1 rs i �L)0 12� FrLu.aTA , J S +0LE: Z Art. �'JIATE 4,,97EO �3.Z 0 C I \ So is 5 `/V0 � 11rc ., TEST Ll Z` OF Af4 SO A. o00 0, C E V YCAI ti J � o ,p No.10050�O T G1 f/ 3O x / 1 ( \ PAUL A. / ,LEVY a L � n,T . 0 T No. 105I7 y 61 LEGEND «7 EXISTING SPOT ELEVATION Ox0 CERTIFIED. PLOT PLAN EXISTING CONTOUR --- p -- - FINISHED SPOT ELEVATION zo T S% CAPS77,14 n�/ Gv FINISHED CONTOUR 0 tiOl'L: The location of any existing underground sewerage, -- we11,, or other utilities shown on t;-.is plan is approx- IN imate only as determined from records and/or verbal \ information. The contractor is responsible for the SAJJ�S J&A. 1L214M S19* verification of the existing locations in the field. SCALE, / "�= 3_-:, DATE LEVY & ELDREDGE ASSOCIATES, INC. CLIENT. ":Auzzk_ 1 CERTIFY THAT THE PROPOSED ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. 951"J-A BUILDING SHOWN ON THIS PLAN PLANNERS- LAND SURVEYORS DR.BYI P/7. 11V CONFORMS TO THE ZONING LAWS OF BARNSTABLE MASS. 712 MAIN STREET CH. By, L 1111f& HYANN I S, MASS. SHEET OF DATE (3. . LAN4b =V Y R - __ E/ 20 FT. M/N• . NOTE /F TNER THES'EPTJC TANK OR LEACH/ivG PJT AV"- IJOR& THAN /2"BE40N/ /O F7 MIN ,rrR•''►OE� i4 24'O/AM&TER CONC eA CO SWALL BE D.POUGNT TG 4MAGE.(�AN EXTRA Fjnl= O GpNGRa•`TE q'PYC P/PE h+E.4Vy C/�ST IRON COVER .Sf/�4LL !3E USEO MI CODERS N P/TGN JF/IV DRIVEWAY' _ 2"J• Ml v. CONCRZ TE A a �y3rgpE co✓ER CLEAN -TA NO L/ U/D LEVEL /A. _ .2 6 LAYER p.Vc J�iR /DUD GAL. o •o o e o %4 PERTJ'T. I1 /C TAMK API 1 • • • • •• ► 4 WASHPD S7bNE D/ST. k.. 6 • • • • • • • �: • "•': SF� ®OX p f O 1 1 B 1 r • • • 1 � P e ' ?ir,••; e � D ° • °EFFECTIVE • ` • � 3 4 - � �2 ;':_. • " e 1 r DEPT1d • ° • o WA5HED STONE Z s 3 7 7 a a e P ' PRECAST SEEPAGE' • a. e 1 • • • • • • e v ••m P/7 OR EQL//V. /N!/EI� EL Ed/s�17"/®/1/S //3 'e /U = 113 a s o° e e • • . • • • e a o _._ o es Cc_ ri 3 0 /AlJAERT AT BI1/LDIN6 919-D FT. �i C-0 �,�c 7 - /Z FT O/f1 t�'!. C SEE WW /1-A77)ON� INLET 5,Clp' /C T-4NK .�`Z�FT, Ov-n--=T SEOT/C TAnH 97-6-FT. GROuNo I�tXlTE/� TABLE /INLET D/57RI400710N BOX FT SECT/O/V OP' 007ZE7015TR/BIrrION BOX <77-AFT 5EWAGE O/s°POSA L .SY.S�ff/�7 /AILET LPsiCHIIVG I�IT G' 7- Fr. T�9�1/L.�T/®IY LEACf///Vd%� PIT SCALE : y#- _ /-0� DI/d/ENS/ON DIES/GJV CR/TE/?/A D/Jy.�Jvs/®N $ FT. NU/•9BER OF BEDROOMS GARBAGED/SPOSAL UNIT o.v SO/L LOG SD/L 'TEST TOTAL EST/MATED /=LOW 330 G,44.1DAY SOIL TEST Al SOIL 7ES74*2 /YU148ER OF 40ACHIMG 0/7:3 !^ELLsY. / 'O: / �"ELEY, C'9• DATE aF Z , SOIL TEST —�- d U I S/DE LEACHING PER P/T 1—L—SQ, FT. 0 1-2 ' �u,�, RESULTS WITNESSED 8Y •2b F' �Gy/J�� 4007-TOM LEr�CN/NG PER P/T_L _L__SQ. FT .ss' _ �,`RCOL�4T/ON RATE At/ �-J"IJNyI/NCN TOTAL LEACN/NCr AREA 2�� SQ. FT. Z'_ )=WVCOL4T/ON RA7,E If2 2 MJ/V•�INCH .eESERVE L,--,4CNI NC AREA Z•L f SQ. F T. (H OF o pk O Lo r M i � �y t/ PAUL A. SA r F? 1 P A En � i LEVY •� �i F /. _ �9. L � ,"J �> ---4 A.. y j13! NO. 101517 r �So r» o i L E V Y o / , LEVY & ELDREDGE ASSOCIATES, INC. .o p No.1005-0 Q \i'!' �,��`' ;'. 7t2 "MAIN 37, 14YANN/9, MASS. 9o�FG I S T EQAl T: �v_ c. �_ DiiTE N ND GROUN�7 YV,4TER ENCOU/VTL�R...O C /E GIeOUNo Lv<1TER AT ELE1/ - JOB NO.- 8 SIn�-.�I SHEET?OF LO-C ON SEWN PERMIT NO. VI l AG E c I N S T A LLER'S NAME & ADDRESS - wx , 4'►�` B U I L D E R OR OWNER DATE PERMIT ISSUED / DATE COMPLIANCE ISSUED �' !j � Re,a2 ,aq b S � 4 � � H o s / � 3 � a° �/ � _ _ it ALL SHALL SYSTEM PROFILE`OFI`E MARKEDSTE WITHC MAGNETIC TTAPE OR BE PROVIDE MIN. 20" DIAM WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. NOTES ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 1. DATUM IS APPROXIMATE NGVD (GIS) TOP FOUND. EL. XX.X' Three Ponds \ - 2. MUNICIPAL WATER IS EXISTING MINIMUM J5' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 66.0' 67.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. a PRECAST H-io PROVIDE,INSPECTION PORT TO WITHIN 3" OF FINAL GRADE RISERS (nP.) 4. DESIGN LOADING FOR ALL PROPOSED PRECAST o WeQuaQuet 2'0 4"OSCH40 PVC 66.1 UNITS TO BE AASHO H-10 o Locu ,•, PIPES LEVEL 1ST 2' 2" DOUBLE-WASHED PEASTON Luke OR GEOTEXTILE FABRIC, a �o 10~ EXISTING 14" y. 64.0 5. PIPE JOINTS TO BE MADE WATERTIGHT. 00 r `y E. TEE SEPTIC TANK TEE 64.7t'* � o 0 0 0 0 0 0 0 0 0 0 6.6.,00000000 0� � o,00000 000000,oQ0000 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE � � o � z � 0 0 0`o 00000, o000000000000,000000000'0O0O�U�COP0000�O0 O:000000O�U�0 WITH 310 CMR 15.000 (TITLE 5.) w o00000000000 63.5 0�0�0�0�0�0�0�0�000�0�0�0�0�0�0�0�0�0�0 0 0�0�0�0 0.0.0000�0�0� o o ° GAS BAFFLE;' ,_o�o�o 0 0_ �0"0"0�0"0�0"0"0"0'0900000000000�0�0�0� �0�0�0 ,�g�0g0"00000"0 ' a� a .+'• ._ 000000000000000000000000 0000000 61.5 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 63.70' 63.53' FOR LOT LINE STAKING ANY 4' LIQ. LEVEL ACME OR EQUAL 4" PVC SET AT .005/ SLOPE NOT TO BE USED NE TAK OR g o :..•,.. ( ON 6" DOUBLE WASHED 3/4",- 1 1/2 STONE OTHER PURPOSE. 6" MIN. SUMP 12" MIN INT. DIM. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.6" CRUSHED STON s o0 5.6 9. COMPONENTS NOT TO BE BACKFILLED OR COMPACTION. (15.22E 15 2210[2,jECHANICAL CONCEALED WITHOUT INSPECTION BY BOARD OF o HEALTH AND PERMISSION OBTAINED FROM BOARD e�a� ( 6 SLOPE) ( 1 % SLOPE) OF HEALTH. ' LEACHING BOTTOM TEST .HOLES-1 & 2 EL 55.9' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP FOUNDATION EXIST. SEPTIC TANK 17 D BOX 5 FACILITY CALLING DIGSAFE (1-888-344-7233) AND *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE WORK. CONDITIONS IF NOT SUITABLE ASSESSORS MAP 192 PARCEL 110 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 66.39 0 12. EXISTING LEACHING FACILITY SHALL BE PUMPED �A AND REMOVED OR PUMPED AND FILLED WITH CLEAN 66.56 -A 66.47 .69 66.53 66. 66.69 SYSTEM DESIGN: TEST HOLE LOGS 66.7s GARBAGE DISPOSER IS NOT ALLOWED � �7 I-1 1_ 1_ 67.38 DESIGN FLOW: 4 BEDROOMS ® 110 GPD = 440 GPD j ENGINEER: ARNE H. OJALA, SE, PE 66.85 J / USE A 440 GPD DESIGN FLOW AVID 'STANTON RS , WITNESS: D ' q� °� Z.o 3= 440 GPD (2) = 880 JUNE 7, 2013 DATE: QP L �� RE-USE EXISTING SEPTIC TANK** PERC. RATE _ < 2 MIN INCH 66.91 66.83 2� LEACHING: CLASS I SOILS P# 14023 Q SIDES: 2[2 (43 + 3) 2 (.74)] = 272 GPD 67.01 67.16 " s' BOTTOM 2[43 x 3 (.74)] = 190 GPD ELEV. p» 66.4' p» 66.4' 67.20 TOTAL: 625 S.F. 462 GPD USE (2) 43' LONG x 3' WIDE x 2' DEEP FILL FILL LEACH TRENCHES OF PERT. SCH. 40 PVC PIPE AND STONE 10 8 EXISTING DWELL TOP FNDN. = 68.2' A/B A/B FULL BASE. LS LS LOT 59 -- 7.50 15,696f S.F. LjNo 12„ 10YR 2/1 1011 10YR 2/1 ( ROCK BASE. 70.39 BENCH MARK BULKHEAD. 67.5GARDENE E MS MS MA 14" 10YR 6/1 12" 10YR 6/1 APPROVED DATE BOARD OF HEALTH 06 07 6.1 \ x 67.47 B B THS 1N 1 K TITLE 5 SITE PLAN 3 td LS LS 4.37 6'5, 2 6.42 OF 10YR 5/8 10YR 5/8 - ---"- 7.21■ 7 32" 63.7' 32" 63.7' 17 CAPSTAN WAY 6 c c x 63.93 s CENTERVILLE PERC 4" 12" OAK Q01 OAK 6, MCS MCS \ � ' PREPARED FOR OF aid ts1�l10(�qqs 2.5Y 6/4 2.5Y 6/4 K ;��`SH �ssq �, ,� x 64. 1 6 126 55.9 126 55.9 a C7AhlI4L A. �s° �AraIEL ' r�J, LA B&B EXCAVATION/LAPIERRE j x 65.82 " OJALA m �' CIIV NO GROUNDWATER ENCOUNTERED �O � 01 � o sn. ,02 •9�, // ..\ w�.---- �� o � ' 0,. DATE: IT n r O \ fTAr c b% off 508-362-4541 5r a�GN`r "o 4t A. n fax 508-362-9880 ri yfi � C�}.1/?!� 0uf T 01 I downca e.com � �� , NOW cape engineering, Inc• > vk civil engineers Scale: 1 20 _... w- �' land surveyors = 939 Main Street ( Rte 6A) > 3- 102 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675