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Home My WebLink About0060 ELLIOTT ROAD - Health 60 Eliiott Road Centerville A=248-052 db SiMEAD No.2-153LOR UPC 12534 arn..a..com • Yada In USA rm �ur�o�oswmiKrw ItISH Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 60 Elliott Road _ Property Address Amy Bullard Davies Owner Owner's Name information is Centerville Ma 02632 4-28-15 required for every page. City/Town State Zip Code Date of Inspection I 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: ! / 0 key to move your cursor-do not Matthew F. Gilfoy use the return Name of Inspector key. Excavation Company �y Company Name 14 Teaberry Lane Company Address Sandwich Ma. 02644 City/Town State Zip Code (508)477-0653 S113640 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 Evaluation by the Local Approving Authority 0 4-28-15 Insp tor'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 inspecti n and under the conditions of use at that time.This inspection does not address how the syst m will rform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form: bsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. City/Town 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•3/13 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 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name 01 information is required for every Centerville Ma 02632 4-28-15 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 N Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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 %day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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 i 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4M ,•�'' 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 349 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 , 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: 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 Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d see below 9 ( Y 9 (gP ))� Detail: 2013-13,000gallon 2014-15,000gallon 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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: owner- new tank 2013 not pumpe yet 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 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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: 2013 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1'6" Depth below grade: feet 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.): At time of inspection building sewer appeared to be in good working order no sign of leakage. Septic Tank (locate on site plan): 1' Depth below grade: 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: 1500 gallon Sludge depth: 5" t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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 2" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? measured 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 appeared to be in working order,Tees present no sign of back- up.Liquid level equal with outlet invert. Tank should be pumped for maintenance 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 s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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 ❑ 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 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. Cityfrown 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 appears to be in working order no sign of carryover. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. Cityffown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2(500gallon) 13 x25'x2' ❑ 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.): At time of inspection leaching appears to be in working order with no sign of hydraulic failure. Chambers had 2" of standing water at time of inspection. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 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-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 y 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information.is required for every Centerville Ma 02632 4-28-15 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 A)- Z4` 13i- zs' A2- sl,y� .82. 2r'g" 133- 28'6 REA A C< C3-3S'4 Qy- 3y' Cy- .39� O .0 00 � t5ins•3/13 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 , 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. City/Town 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: No Gw 120" 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: feb-14-13Date ❑ 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: Plan on file 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 60 Elliott Road Property Address Amy Bullard Davies Owner Owner's Name information is required for every Centerville Ma 02632 4-28-15 page. Cityrrown 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 No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered inc puter: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYitation for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(-� Upgrade( ) Abandon( ) omplete System ❑Individual Components Location Address or Lot No. (pb LU O-r &(� wner's Name,Address,and Tel.No. Assessor's Map/Parcel MAP 2 4 b Ae&tiL 5_Z U is..C-fb .n 5 c)g-2 q0 - q 22_,5 Installer's Name,Address,and Tel.No. V' esigner's Name,Address,and Tel No. t�3 �xcdva+>Un 51 �J77-0&63 Uovun - - 50�-31�Z zf541 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.r q firq 3 gpd Design flow provided gpd Plan Date I Number of sheets Revision Date Title Size of Septic Tank I L-1.1 Type of S.A.S. Z J Description of Soil 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 Board H lth. Signe Date Z �1 Application Approved by c Date 2... 2 Application Disapproved by Date for the following reasons Permit No. �2 0(,3 (o C , Date Issued a 2 M '1Vo. 1913 Fee o THE COMMONWEALTH OF MASSACHUSETTS Entered in c mputer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes r k 2pplicatiou.--for 1pisposal *pstem Construction 3permit Application for a Permit to Construct( ) Repair(.1) Upgrade( ) Abandon( ) omplete System ❑Individual Components Location Address or Lot No. Gj O E.L,U O T Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Jv1 Ap � PAQ�E�5 �u �S.��D(G n 5D� 2�� 22 5 24 Installer's Name,Address,and Tel.No. v` Designer's Name,Address,and Tel.No. 1_13i-3 �Y vivCt+&n 5ck- q-77-o&53 n CCqu Erg- 5 362- 454/ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.req ireedd) 3 30 gpd Design flow provided gpd Plan Date 7 (� Number of sheets I Revision Date Title Size of Septic Tank Type of S.A.S. t Description of Soil AP VV 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,Board f Health. `` ZZj � 13 Signe Q Date Application Approved by Date 42 >,P11 Application Disapproved by Date for the following reasons Permit No. 0 , Date Issued a ? v ' 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 �_i( cw o 1 (n n at (D(� has been constructed in accordance with the- provisions of Title 5 and the for Disposal System Construction Permit No G j —U 7 dated Installer w Designer t )n\&i C) G h j (")3Pw( #bedrooms �7j Approved design flow n gpd The issuance of this permit shall not be construed as a guarantee that the system will,functiori e'signed. � 1 Date /<' 1 � Inspector �\ No. 3 06 -7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal bpstem ConstrULtion J)Prmit Permission is hereby granted to Construct( ) Repair( 1) Upgrade( ) Abandon( ) System located at t<.D U Lu()T 0%)A-n and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date )Z�� 7 Approved by (( l 1 q ^ J ) 3 NPR( sl ttt� Cn d tc /�; / ` FROM :down cape engineering inc FAX NO. :15083629e80 Mar. 19 2013 10:21AM PI j��,_, �a �}�i �Eao�l;a�q f<'. �;e�'sa;<'. �pu�r$r�r.' a7vil oil. 200 I J"yim Street,uyimuis'MA 02601 C f L 908.962-M44 V'-x: & a e.P-rnn i t4 IJ .1 DAt, Sew, f vi Addre-W M4 On- -"T.Is i srrm--da Pc:.urit to it (;htLu) (installer) 01I..-I(fesi Fn druwu by CL Y'` cerfify vlmt the septic, 7'y�tem.re, ffcml"111 21}ryve v"a.9 s-absUmLiilly according fo thr, dc-,slpp, -whioLrargy include mL'UUr ,,k-;lpi:o-ve!61 changes �c)clj -,).g Ltcrul Of ILO, box undjolr Sc--Oic't'l.*.- t]ae septic; system referenced abun -wgg w.i.t.ji ma jor don., a 4rqtn-.r.than 10' I-,IteTal JT:JuWntion of she SAS ca aLcv-,jtrtical rn.1-c-uritiml of Ocuponc.ni- I-nit in nisl'Otl.OT to Fifllow. )AtA S4'aa-h lye, (-.IML �rn Ig -02 (AIS _�iATUHN JO.. t3A.P*ffTABLLe HEALTH NI Ic"OAIIANCE • WGT )JP; U;'F-RIED, ura-U, 160,11T. 'TMLI-I...uoxhl AND AS-BIA-f,Y CARD B."y'fai�j3AR114S'fA-'H.V,.P4,W:BLIC.a.L�L- -Cla)PMSJON. IIIALW YP U.. T'017T:1-2C :14.dor, r' 43 - 0 / f0 � Town of Barnstable pit �A �T NEE do Department of Regulatory Services * HARN5fABLE, + Public Health Division Date � 43 LI-3 7 MASS. 1639. 200 Main Street,Hyannis MA 02601 Date Scheduled /1 �/ V Time b Fee Pd. 0 6, Soil Suitability Assessment fog age Disposal Performed By: Witnessed By: LOCATION&GENERA ANFORMATION- Location Address+ D �'I�'0 Owner's Name FO r C�GvI L ✓� ��i Address Assessor's Map/Parcel: 02�U �� Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use L a W Slopes(%)_G_ Surface Stones Distances from: Open Water Body >(0G ft Possible Wet Area «!l ft Drinking Water Well /w ft Drainage Way >too ft Property Line > 10 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ITV/ U � 73 -i o I Q N s /U �/' ' Parent material(geologic)P�� P�5 c�5 Depth to Bedrock >zoa v Depth to Groundwater: Standing Water in Hole: Al 4 Weeping from Pit Face /VA Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth.Observed standing in obs.hole: A//4 ia.� Depth to soil mottles: in. Depth to weeping from side of obs.hole N A} in. Groundwater Adjustment Al 14 ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST! Hate 2�I2/3 Time Observation Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch /( Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC 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 -s q L S rayR -3 z 13 L 5 ld y,�. �g 3z,r2c� G Iq /e5 0 yA DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel L S 10yA A8' 3&-I20 /1/65 l0YA Ell DEEP OBSERVATION HOLE LOG "i Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency-%Graven �i DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other _ Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency-%Graven Flood Insurance Rate Map: Above 500 year flood boundary No Yes t/ Within 500 year boundary No J Yes Within 100 year flood boundary No V7 Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? P If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature N IB''v��'`� &- Date Q:\SEPTIC\PERCFORM.DOC ti a. TOWN OF BARNSTABLE 7CATION_G O EL420? Qo( SEWAGE# 20/3 - OG 7 LLAGE (2r-^4try;1)G ASSESSOR'S MAP&PARCEL 2 $ STALLER'S NAME&PHONE NO. �'G` (3 rXQoj o1 o.4 i on 4177- 06S3 SEPTIC TANK CAPACITY /SOO 14ZO LEACHING FACILITY.(type) So09 a I L C (size) 13 x ZS X 2 NO.OF BEDROOMS 'L OWNER LOU%SG Fo rca n PERMIT DATE: Z-Z$- J3 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 r A)• 2G� AZ- 3i y t32 . 21 B3- 28'G RF A R G C3 . 35'G iffy - 34 CN - '79 , Q 3 y AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION GO E112t)-TrR�_ SEWAGE# 20/3 • 067 VILLAGE (2e.n4 rti;))c ASSESSOR'S MAP&PARCEL 'Z N 8 I S. INSTALLER'S NAME&PHONE NO. $$ Q EXCmV0.4 i on y179 3 SEPTIC TANK CAPACITY /S'Oo NZO LEACHING FACILITY:(type)�gQ��4�_rz•) (size) 13 x Z e x Z NO.OF BEDROOMS Z• OWNER LQtji-!rC F l"an PERMITDATE: _ 2-Z8•/3 COMPLIANCE DATE: �'�- /$• /3 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 A) 2G' al- zs" Az- 31'y" tie- 21"W" 33- 286 RCA PID C3 '3S#G" 04- 3y ' C4 - ,-19' CI O http://issgl2/intranet/propdata/prebuilt.aspx?mappar=248052&seq=1 4/24/2015 t ASSESSOR' S MAP NO. f PARCEL LOCATION 5 WA E PERM T Ho� VILLAGE y I N S T A LLE1 'S: _NAIRE ADDRESS t 11 U 1 L D E R OR OWNER DATE' PERMIT ISSUED h o,� G DATE COMPLIANCE ISSUED 9 o ,vj 4SSESSOP,S wAp NO: No.0 PARCEL N ..O. .................. Fmc.... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEAL ......... ...... .....40 '0015; OF. ... Appliration for Diapatial Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct or Repair (I"J'0an Individual Sewage Disposal System at: ...... ...........W10104k1_ r............ ------------------------------------------------------------------------------------- I Loc4tidhi-Aidress. or Lot No. 1-104---------------------------------- ----------—-------------------------------------------------------------------------------------- wner Address . ......... ............................... ... Installer Address U Type of Building Size Lot............................Sq. feet Dwellingo. of Bedrooms............................................Expansion Attic Garbage Grinder yp Other—T e of Buildin g ............................ No. of persons............................ Showers sCafeteria el 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_______________. 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................minutesperinch Depth of Test Pit__.____.__.__.__.___ Depth to ground water------------------------ Test Pit No. 2................minutes per inch Depth of Test Pit...._._._._.________ Depth to ground water.__._____._________.____ ....................................................................................................................... 0 Description of Soil----------- ....................................................................................................................... �4 U ........................................................................................................................................................................................................ -------------------- --------------------------------------------------------................................... ............ !..................................... Nature of Repairs or Alterations—Answer when applicable-------- -------- ---------0 U --------- ----- --- -------- ------ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T*TLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has; bee issued by _ e bo 0, th. Signed... .......j:... .... .. ------------ ----- ... Dat, ...... ......................................... 7 Application Approved By.......................... ... ..................... ............. ......... ............... Date Application Disapproved for the following reasons:__.............................................................................................................. ......................................................................................................................................................................................................... Permit NoJ"Is .................. Issued..........................................Date------- Date No. ...�... (� --- Fss...4.A2, r1 THE COMMONWEALTH OF MASSACHUSETTS �.. � BOARD OF HEALTH .[.. ........OF........ da�T. !o � -----------------•----___.__ Aliptiration for Dioposai Works Tonotrurtion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair (4-10an Individual Sewage Disposal System at: p /"'Y Yd4.rrf,,dr ,Js '7 4 1 � s` Location Ydres�, _ or Lot ISO. r i Owner Address Installer Address QType of Building Size Lot............................Sq. feet Dwelling -,<o. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pal Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures -----------------------------•-- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:: Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—NTo_ ____________________ Width.................... 'Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area_.................sq. ft. Z Other Distribution box ( ) Dosing tank (' ) Percolation Test Results Performed by------- --- ------------------- •-------•.................. Date....................................... a5.Test Pit No. 1----------------minutes per inch Depth of Test Pit__._.___________.___ Depth to ground water.....................__. Test Pit No. 2................minutes per inch_ Depth of Test Pit.................... Depth to ground water---------:_________.____ O Description of Soil. ....... x c, W -------------------------------------------••---••-----------------•------•-•--•---------------•------------•-------------------•---- o� U _ Nature of Repairs or Alterations—Answer when applicable_______: _r___,4,,_l.�:_ , ' :_Z•_________!_VZ-I! Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of T1TL j of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bcdd off ipalth. 15, ; '� Signed d f_ t?!,¢r�:s --- ....-- R =K`r `' '=� --••---- .._.=..... _` s 4 Application Approved By......... ;� ' 7f ...... ---.'--6------ -•--•---•---------•--------•--•------•---••--••---------------------------•_ Date--- Application Disapproved for the following reasons______________ ___..____. ---•-•---••----------------•-•---•-----------------------•--••-------•-----------------•---•-•--------._...-•--•-----------------------------•-----•------------------------------------- ---------- Date PermitNo.t- 61----------------------------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s •,�t .......-....OF. ,. ¢ A4............................. Trrfifiratr of Tontp.lianrr T,9 ZS I$ TO.CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired L y. ' ' ' _� _. 1, r s ff. �, Installer ' ; has been installed in accordance with the provisions of TTi' 7 of Th State Sanitary Code s des r din the application for Disposal Works Construction Permit No.--� ��.... .---•-•--- dated--------- /--(� .._.. THE ISSUANCE O THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RA EE THAT YHE SYSTEM WILL FUJPyGjT T__T DATE - .... Inspector.--•-•��-•-•-•••---------------------- ---------•---------------------_-•--- _Z. THE COMMONWEALTH OF MASSACHUSETTS J BOARD OF HEALTH / �' ...............! . ...........OF.........-----.... NO. ................... FEE........................ Rapooa1 Works Tonotr ion an it Permissionis hereby granted------------------------------------------••---------•----------•-•------••---------------------------•--........---------....---••--••-_---•• to Construct ( ) or Repair (' ) an Individual Sewage Disposal System 3 at shown on the application for Disposal Works Construction Permit Street No. _�::.... Dated..__ __l._�_1-. -' ............. t a PP P C _ :: .. f------------ t Board of Health FORM 1255 HOBBS &-WARREN, INC.. PUBLISHERS SESSOR'S MAP NO. PARCEL $ o , ATION _ S WA E PERIN�if N�9 LACE ` NSTA LLER'S NAME A ADDRESS l.- B U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUEDr-l1 L fA b i I ` J SYSTEM PROFILE MARkED'VSTE WITHC MAGNETIC TTAPEAOR BE (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. NOTES Route Q° PROVIDE C.I. WATERTIGHT ACCESS COVERS TO FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE APPROX. NGVD 2" PEASTONE OR GEOTEXTILE (OR C.I. COVERS TO GRADE IF UNDER DRIVEWAY) 1. DATUM IS TOP FOUND. EL. 57.2' FILTER FABRIC OVER STONE ado 2. MUNICIPAL WATER IS EXISTING o a 56.0' MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 56.0' a° a 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. PREC;H-.1 BLOCKS OR S�boo/ Q C r RISER PRECAST RISERS 4. DESIGN LOADING FOR ALL PROPOSED PRECAST . ; yo 4"OSCH40 PVC MORTAR ALL H-10 UNITS TO BE AASHO H-20 NTS PIPES LEVEL 1 ST 2' 4' COM PON TYP. 4, �END S (�P') SIDES 5. PIPE JOINTS To BE MADE WATERTIGHT. *53.75' 10" 1500 GAL H-20 14 o ° ° ° - TEE SEPTIC TANK TEE =Mm 0 M=®l =rllt- O -®� Im 'o°o°o°o° 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCEAPPROX. 5 . 53.0 6" min. sum ;°0°0°0°0 0 0 0 0 0 0 0 0 0 0 0 0 0 o 0 0 0 ;00°0°0°0 ONLY ° ° ° ° ° ° P ° ° ° ° ®�0�00(�00� ��00�00�1� ° ° ° ° WITH 310 CMR 15.000 (TITLE 5.) �o�A * 000000 12" min. int. dim. 0000 GAS BAFFLE ° ° ° ° ° ° ° ° ° ° �O��l�(�0®®C ®tea®�a00� o°o°g°o° = G °o°0°0°0 000a aooaaoaoo00000000 ° ° ° ° o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND Locu Odd ' S0.0' NOT TO BE USED FOR LOT LINE STAKING OR ANY 4' LIQ. LEVEL (ACME OR EQUAL) 52.27 52.10 °°°°°°°° ° ° ° ° OTHER PURPOSE. •`'• °00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Off'{. - .^p0O^O^OpOnpO^p0'pO�pO'p00 GOCOCOU0°Or?n?^?9OnO'OOOOOO ' » H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. 3/4"-1-1/2" DOUBLE WASHED STONE 4 MIN. %- (2) UNITS REQUIRED } ALL AROUND PRECAST STRUCTURES `- 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83'' 9: COMPONENTS NOT TO BE BACK Y O OR o COMPACTION. (15.221 [21) CONCEALED WITHOUT' INSPECTION,BY 8ARD OF V MIN. �p\ �� HEALTH AND PERMISSION OBTAINED FROM BOARD OF-HEALTH. ( 2 SLOPE) ( 21y, SLOPE) ( 1 % SLOPE) i�') - LOCUS MAP I 0 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LEACHING 45.8' BOTTOM TH-1 CALLING DIGSAFE (1-888-344-7233) AND NOT TO SCALE FOUNDATION 18' SEPTIC TANK 27' D' BOX 12' FACILITY NO GROUNDWATER FOUND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF GROUNDWATER EXPECTED WORK. ASSESSORS MAP 248 PARCEL 52 *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL AT ELEV. 20t PER TOWN MAP UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 11. ANY UNSUITABLE MATERIAL ENCOUNTERED PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. SYSTEM DESIGN. GARBAGE DISPOSER IS NOT ALLOWED PROP. VENT WITH CHARCOAL FILTER } SSA AND BUGSCREEN (FINAL PLACEMENT BY DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD 1 / CONTRACTOR WITH HOMEOWNER TEST HOLE LOGS / coNsuLTATION) USE A 330 GPD DESIGN FLOW ENGINEER: DANIEL E. GONSALVES, SE #13587 / 55.0 6 +56.0 SEPTIC TANK: 330 GPD (2) 660 � 4.9 � WITNESS: DON DESMARAIS,' RS / 12.70' USE A 1500 GAL. SEPTIC TANK � 1 /. .0 + 55,9 DATE: 2/12/13 CEA0H1N'G: 1 5.5 PERC.' RATE _ < 2 MIN/INCH Q' / -F ss,2 s.s SIDES: 2 (25 + 12.83) 2 (.74) 112 GPD 13862 0 o a cRAVF� oRit� s,7 BOTTOM 25 x 12.83 (.74) = 237 GPD SOILS P CLASS # / o. ss sss 56s TOTAL: 472 S.F. 349 GPD /4SQ 4 55.7 0 co ( ) ) / USE 2 500 GAL. LEACHING CHAMBERS ACME OR EQUAL 1 ELEV. z ELF w`W�� s.7 TH 1 WITH 4' STONE ALL AROUND 0., 4 55.8' 0., 4 55.9 V / \ 6.o ss.9 5 .9 �4, k,\ ;6.0 TH 56.0 q q •� ts 6.1 ,ly 56.0 LS LS �� 55.9 LIGHT 54.8 10YR 4/2 10YR 4/2 6 / LOT 1 5„ 6,9 \�/\ 11,284f S.F. 56.2 s, 56 B B 56. BENCH MARK TOP OF BOTTOM 5 STEP AT LANDING ELEV. = 56.8 / \ \ EXIST. DWELL. 56. 6 LS LS TOP FNDN. _ 6.0 1OYR 5/8 1OYR 5/8 \� ELEV. 57.2' o' p ; , MA I 3.2 53.1 36 52.9 54.5 r p APPROVED DATE BOARD OF HEALTH .9 / 4. , 56.2 56.2 TITLE 5 SITE PLAN C C \ S6 56.1 56.2 PERC / \ \ OF Ms Ms 54.4 7s \ 11210, 60 ELLIOTT ROAD +-,55.6 56.2 CENTERVILLE �F 55.7 10YR 6/6 10YR 6/6 ��9 y -,1,55.6 ss 55� PREPARED FOR 6.0 56.1 B&B EXCAVATION/ �h 56.2 120" 45.8' 120't 45.9' FORAN NO GROUNDWATER ENCOUNTERED FEBRUARY 14, 2013 �n o�n�' off 508-362-4541 �`5m ;'��, fax 508-362-9880 EL le m downcape.com fl` 011A down cafe engineering, inc. 502 �� J�a civil engineers Scale: "= 20' land surveyors 939 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 13 � 0 (0 - ----------- -------- -------------