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HomeMy WebLinkAbout0270 GREEN DUNES DRIVE - Health 270 GREEN DUNES DR., CENTERVILLE A= 245 026 i. UPC 12543 t illl - No, 53LOR HASTINGS, h4N MAP ECOJECH PARCEL Environmental LOT www.eco-tech.us - -- THIS FORM IS A FACSIMILE OF THE STANDARD SEPTIC INSPECTION FORM ISSUED BY THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION(revised 6/15/2000) TITLE 5 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 270 Green Dunes Drive Hyannisport Owner's Name: Fran Doyle Owner's Address: 270 Green Dunes Drive RECEIVE® Hyannisport,MA 02647 Date of Inspection: July 10, 2003 Name of Inspector: (Please Print) David D. Coughanowr,R.S. JUL 16 2003 Company Name: Eco-Tech Environmental TOWN OF BARNSTABLE Mailing Address: 43 Triangle Circle HEALTH DEFT. Sandwich,MA 02563 Telephone Number: (508)364-0894 CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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: X Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature �S Date: J J)y 14, ZD 43 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 NOTES AND COMMENTS Inspector's Note—> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 270 Green Dunes Drive Hyannisport Owner: Fran Doyle Date of Inspection: July 10, 2003 INSPECTION SUMMARY: Check A,B,C,D or E/ALWAYS complete all of section D: A] System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B] System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no,or not determined(Y,N,or ND). in the_for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not),is structurally unsound,exhibits substantial infiltration or exfiltration,or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or breakout or high static water level in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced. ND explain The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain 2 Page 3 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 270 Green Dunes Drive Hyarmisport Owner: Fran Doyle Date of Inspection: July 10, 2003 C) Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety and environment. 1 System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2) System will fail unless the Board of Health(and public water supplier,if any)determines that the system is functioning in a manner that protects the public health,safety,and environment The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 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 by a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form 3) OTHER 3 Page 4 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 270 Green Dunes Drive Hyannisport Owner: Fran Doyle Date of Inspection: July 10,2003 D)System Failure Criteria applicable to all systems: You must indicate either"yes"or"no" to each of the following for all inspections: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. yes no X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high groundwater elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well X Any portion of a cesspool or privy is within 50 feet of a private water supply well X 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 by a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form) No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore,the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E)Large 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 You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone 11 of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in section D above the large system has failed.The owner or operator of any large system considered a significant threat under section E or failed under section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 i Page 5 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 270 Green Dunes Drive Hyanniport Owner: Fran Doyle Date of Inspection: July 10,2003 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant or Board of Health. X Were any of the system components pumped out in the last two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available as N/A) X _ Was the facility or dwelling inspected for signs of sewage back-up? X _ Was the site inspected for signs of breakout? X _ Were all system components,excluding the SAS. located on site? X Were the septic tank manholes uncovered, opened,and the interior of the septic tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum.? X _ Was the facility owner(and occupants,if different from owner) provided with information on the proper maintenance of subsurface disposal systems? For information on the proper maintenance of subsurface disposal systems please go to: WWW.ECO-TECH.US The size and location of the Soil Absorption System(SAS)on the site has been determined based on: X _ Existing information.For example,Plan at the Board of Health. _ X Determined in the field(if any of the failure criteria related to part C is at issue,approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 I Page 6 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 270 Green Dunes Drive Hyannisport Owner: Fran Doyle Date of Inspection: July 10, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 7 Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 770 gpd Number of current residents 2 Does the residence have a garbage grinder(yes or no): yes Is laundry on a separate sewage system(yes or no): no :(If yes, separate inspection required) Laundry system inspected (yes or no): n/a Seasonal use(yes or no): no Water meter readings,if available(last two year's usage(gpd): 762 gpd—irrigation system in use Sump Pump(yes or no): no Last date of occupancy: current COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow(based on 310 CMR 15.203):: gpd Basis of design flow(seats/persons/sgft/etc.): Grease trap present: (yes or no)_ Industrial waste holding tank present: (yes or no): Non-sanitary waste discharged to the Title 5 system: (yes or no). Water meter readings,if available: Last date of occupancy/use:_ OTHER: (Describe): GENERAL INFORMATION PUMPING RECORDS Source of information: System not pumped in recent past(Owner) Was system pumped as part of the inspection: (yes or no) No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM: X 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/Alternate technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe) APPROXIMATE AGE of all components,date installed(if known)and source of information: Age: 4+years Certificate of Compliance issued 7/15/98(BOH permit#98-118) Were sewage odors detected when arriving at the site: (yes or no) no 6 Page 7 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 270 Green Dunes Drive HyanniMort Owner: Fran Doyle Date of Inspection: July 10, 2003 BUILDING SEWER_(Locate on site plan) Depth below grade: 2 ft Material of construction:_cast iron X 40 PVC_other(explain) Distance from private water supply well or suction line 20+ Comments: (on condition of joints,venting,evidence of leakage,etc.) Sewer is vented through roof and appears structurally sound with no evidence of leakage or backup into dwelling SEPTIC TANK: X (locate on site plan) Depth below grade: 15 inches Material of construction: X concrete_metal_fiberglass_polyethylene other(explain) If tank is metal,list age_ Is age confirmed by Certificate of Compliance_(yes or no):_(attach a copy of certificate) Dimensions 11.5 ft x 5 ft x 5 ft(1500 gallon) Sludge depth: 6 in Distance from top of sludge to bottom of outlet tee or baffle: 28 in Scum thickness: 8 in Distance from top of scum to top of outlet tee or baffle: 6 in Distance from bottom of scum to bottom of outlet tee or baffle: 10 in How dimensions were determined: Probe to top of tank Comments: (on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Pumping recommended at this time and maintenance pumping is recommended every years Liquid level at outlet invert.Tank and tees appear structurally sound and functioning as intended.No evidence of leakage in or out GREASE TRAP: none (locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle:_ Date of last pumping: Comments: (on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 I Page 8 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 270 Green Dunes Drive Hyannisport Owner: Fran Doyle Date of Inspection: July 10,2003 TIGHT OR HOLDING TANK: none (Tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal _fiberglass_polyethylene_other(explain) Dimensions: Capacity: gallons Design flow:_gallons/day Alarm present(yes or no):_ Alarm level:_ Alarm in working order(yes or no):_ pumping:Date of last Comments:(condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX: X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: at outlet invert Comments:(note if box is level and distribution to outlets is equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.) D-box appears structurally sound with no evidence of leakage in or out.Effluent level at outlet invert. No solids in tank. PUMP CHAMBER: none (locate on site plan) Pumps in working order: (yes or no) Alarms in working order: (yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 f Page 9 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 270 Green Dunes Drive Hyannis port Owner: Fran Doyle Date of Inspection: July 10, 2003 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan;excavation not required) If SAS not located,explain why: Type: _leaching pits,number _leaching chambers;number X leaching galleries,number 1 _leaching trenches,number,length _leaching fields,number,dimensions _overflow cesspool,number —innovative/alternate system Type/name of Technology Comments: (note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) Soils above leaching gallery appeared unsaturated. No evidence of surface ponding,breakout,lush vegetation,or other evidence of hydraulic failure was observed. CESSPOOLS: none (cesspool must be pumped at time 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 or no): Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.): PRIVY: none (Locate on site plan) Materials of construction: Dimensions:_ Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 I Page 10 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 270 Green Dunes Drive Hyannisnort Owner: Fran Doyle Date of Inspection: July 10, 2003 SKETCH OF SEWAGE DISPOSAL SYSTEM: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100'(Locate where public water supply enters the building) LOCATIONS A B 1 19.5 ft 20 ft LEACHING 2 14.5 f t 28 f t GALLERY 3 SETA K I PTIC B 3 16 f t 37.5 f t ❑ o 0 D-BOX 2 A EXISTING DWELLING # 270 W Z J W F Q 3 I GREEN DUNES DRIVE NOT TO SCALE 10 Page 11 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 270 Green Dunes Drive Hyannisport Owner: Fran Doyle Date of Inspection: July 10,2003 SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to ground water: 12+ feet Please indicate(check)all methods used to determine high ground water elevation: X Obtained from system design plans on record-If checked. date of design plan reviewed 7/13/98 Observed Site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of health-explain: Checked local excavators,installers-attach documentation) Accessed USGS database You must describe how you established the high ground water elevation. Approved design plan on file with Board of Health showed bottom of field to be 6.5 ft above bottom of witnessed test nit in which no groundwater was observed. 11 IN No. / Fee 1 OD THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3pprication for Migpogar 6pgtem Congtruction Permit Application for a Permit to Construct(V Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Pd&ess•er Lot No.5 r i 6 Owner's Name,Address and Tel.No. 6eGEW U NC-5'Daz. W. I�A 44 15pvz-7- ALVINA 131t-ifr _v_-Ano)zA+J -rJZ05TtZ Assessor'sMap/Parcel ri 54owr sr k ' A4AP 24S RL Zb E. war, vj_c A-j 14 0,42,32- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 6fZ Ah A 1 t4 -.IT -! 9S" */f4, MA.- 02GS5 Type of Building: Dwelling No.of Bedrooms 7 Lot Size 54,Sol sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -1`70 gallons per day. Calculated daily flow -770 gallons. Plan Date `)EC, 1& , I ft 91'7 Number of sheets I Revision Date Title -5 ITE 'Pi-0-.1 AT* LOT 5i � (13 61WEH b o-ge� 'Draws w,U jrr I gz Aww A-4 $A.tma-moeAm,'1a-yVd Size of Septic Tank loco GAL Type of S.A.S. egAMgmS ltJ n')[(o'3' F'ic-trn Description of Soil 5-riF_1-riF-)et) AA6-s310A/� Satin 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 Env'roEta2lode and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Hea Signed Date ...-� Application Approved by Date Application Disapproved for the following reasons Permit No. — Date Issued 1W_ e h� `i• r v rR 1 t No. " Fee 1O�( THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC-HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUS . 3pplicatron for iqo!6arpgtent Conttructior,,,,permit RApplication for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) �Complete System El Individual Components:. Location A44poes er Lot No.5 1 B N f' Owner's Name,Address and Tel.No. 6MEEN WNrl -0tZ. , W. I11.4,j 115 7 ALVINb F3d><1"E.�—Mo�d+J ,- iJST�E Assessor's Map/Parcel 1 5 µ bzr St" MAP 24S f ci. Z(-o ate'o M,a- `V'V ,,., Installer's Name,Address,and Tel.No. D igner's Name,Address and Tel.No. "`Akt,k B Axrt�z � N Yr� IN c. '�'�•4`131 /� // mow t Jc�� n a /��a � ._--- 01Z MAIN off 7 '9 S-9 S" --)-ra It.t.EIiAL O'ZbS S r� Type of Building: Dwelling No.of Bedrooms 7 Lot Size 54,SD2. sq.ft. Garbage Grinder Other `• 'Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures .� Design Flow 7-7 0 gallons per day. Calculated daily flow' 770 gallons. --,,Plan Date `DEC. , i`l 9'7 Number of sheets ( Revision Date Title 5ITE N Al- l,ar 5q 1, 10 6'ZeeH bu+le-S 'Drzlve W,l1,jrr rue AW1upN _5"Ma-,4veA4,Zv4'rd Size of Septic Tank 2aa0 GAL Type of S.A.S. CF14hii>3F. 5 itJ 12 �l L.3' �iS� Description of Soil 15,re41r1F)et) mw�lohn SA► C> y Nature of Repairs"or Alterations(Answer when applicable) Date last inspected: a ° Agreement: The undersigned agrees to ensure-the cons"rf action and n aintenance of the•afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the,Etiviron l ode and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Hea Signed C/' Date 7 Application Approved by Date'".- Application Disapproved for the following reasons l Permit No; Date issued w. -------------------!---- L`-1 — ——————— 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 at d+ 1 liihas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer z, ,-b Designer The issuance of this permit s all not be construed as a guarantee that the syste function%�n�ed. Date �- /S�- 2,5 Inspector t I —————---------------------------- No.� FeeTHE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS r =.i�pogar *pgtem (Construction Vermtt Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon System located at � ' ::! i z and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction mustbe completed within three years of the date of this er it. Date: ti ���`7 O Approved by 3 TOWN OF BARNSTABLE LOCATION 70 SEWAGE # _etlr'!/9 VILLAGE Ile ASSESSOR'S MAP &LOT �j5-0 Z i INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ,? LEACHING FACILITY: (type7L�L l t<< 3 (size) /;,X G 3 NO.OF BEDROOMS BUILDEROR /v ,.� - /�grfry �/U"�. �y, T✓��r r PERMITDATE: COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200'-feet of leaching facility) Feet Edge of Wetland and Leaching,Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ,,� � t G.f 3 10) 7 / y • o _ 5 60 i� TOWN OF BARN($ LOCATION -_�2 70 SEWAGE # fZ VILLAGE r SSESSOR'S MAP &LOT ZqS-o z 6 INSTALLER'S NAME&PHONE NO. ���y► . 176, _SEPTIC TANK CAPACITY LEACHING FACILITY: (type?_'C,/tc e 3 3 0.S (size) �rr7 G 3 NO.OF BEDROOMS BUILDER OR� �i s��e - %� �y �/1/��.�h 7✓r•���r PERMIT DATE: 9 t COMPLIANCE DATE: Separation Distance Between the: Adjusted,Groundwater Table and Bottom of Leaching Facility Feet Facili w Maximum j� Private Water Supply 1.Welland Leaching Facility (If any wells exist hr on site or within 200lf"ee of leaching facility) Feet Edge of Wetland and I:eachng;Facility(If any wetlands exist within 300 feet of leaching facility)`` Feet Furnished by l d� r ,13 '9 o v 316 30 5 60 �© I C - -- S ..." r R C _ of I q' '3 .. 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FlNI > r .� SH GRADE 8 q -., -.. •a- ; u •;: II . NOTES. II .�IIi II iI IIIi III Ii • . . • . ;..... x .•a. ..• ... ... . . . .. • .. .. RO,ap WATER SUPPLY FOR THIS`LOT IS MUNICIPAL WATER , •, _ `1 MAY COMPAC BE REPLACED .::. M TED FILL 3 MAXIMUM !0 ! .► a . ur WITH INSIIU MAT ERIAL • a + ► o •a LOCATION OF UTiUT1ES SHOWN ON THIS PLAN ARE APPROXIMATE. a. :a AT LEAST`72 OU S 10 _ w w a ,..;x .. H R PR R TO ANY EXCAVATION FOR THIS _ _ , PROJEC `TFf _T E CONTRACTOR SHALL THE ii1 a! a• _ ' NO - - PEASTONE TIFlCATION 'TO DfG SAFE 1 800 322 4844 .AND . --e , a , a - t ) , P - .h o A PROPRIATE WATER DISTRIC Fd IF .ENCOU' TER -LOCU �- T R LOCATION DATA. N ED REMOVE q v , .r..r .. 4 . ,.: �:• UNSUITABL F .: . . - * ,. ,.� ,_ � MATERIAL"'TO INSURE THE _ • .. ' of . r. w -� 3 THE CO AC 4 1 1 2 REMOVE UNSU T:, NTR TOR IS REQUIRF� TO SECURE APPROPRIATE SIDEWALL AREA 'bF "SYSTEM IS IN ., / I ABLE MATERIAL �.. - x jj . o _ , A _ PERMITS FROM TOWN AG E F CLE N `M U 2 DOUBLE _ ENCI S OR CONSTRUCTION DEFlNED A EDI M SAND OR`flLL PER „ 4, FOR 5 FEET iF APPUCAB �:, _.,. .:.. Y t PLAN. 310 CMR_15.201 1 .293 c� ! ASHED __,. r..• - q .. . _ - :4 ST N_ .:. 0 E 2 CULTEC 330 • . , _.-e....... NS R •> . ,. .. s I TALL.RISERS AS RE UI:.. y Q RED TO WITHIN 12 OF FlNISH GRADE k .:;. - .,,K - - , a:.. •' ,.,;.., , . --.. ...�.. • ' k ,. , .. - ALL STRUCTURES BU,, RIED FOUR FEET OR MORE OR SUBJECT`TO VEHICULAR T TRAFFlC 0 BE,H 2O LOADING� . 52 r : 46 ._.. 1 5 M . 2 mu _ _.. :. HYa c ,_. --.-.s. : . y.. 4 y.., ....:.. * :.. w :,.. , :.,a ,,. r 1.... ,. .]� r t .. \ _ ,4 ... , u..0ad a -,....w. : ,. LOC�1TfON MAP O C ! �...M NOT TO ` . HY NIS U SCALE AN Q ADRANGLE C S ALE• 1 25 000 0 L CATS VENT fSO IT _ . SSE , A SSORS IS NOT READILY S NE E , MAP P 245 ARCEL 26 0 L G OF SOIL EVALUATION , - , 0 Z NES � a DATE. 0. 24--96 , Ut F_ AQ FER PROTECTION OVERLAY DlS 1 e TR CT No. P 86E3 DESIGN DATA F 3; P IRAt R K L 1=0UIv ,, FND - SOIL EVALUATOR. STEP EN W TOWN OF BAR ST - EL 23.0 EL 2016 N ABLE ZONING DISTRICT. RD 1 BOARD OF HEALTH: 'EDWARD F. BARRY SING .N !F FAMILY - 7 $EDROOMS ; Gyp MINIMUMS to tN M , WITH 'NO GARB_ AGE GRINDER _ 'FG 2 AREA 43 56 2 0 S. F. -, LY DAI FLOW....: _. G G 2 7 x 110,GPD. 770 GPD E 2 0 T 9 CU FR N AGE 20 LTEC-330 ,.,, _ • ;' -SEPTIC TANK _ ,: TP 1 770 GPD x 200x 1540 WIDTH '125 , : � GPD R „ US p `. .;, ECHARGER'UMTS EL 22.5 E 2 00 !GALLON SEPTIC 7 `N:` _ A K ; = 19.0 - FRONT SETBACK 30 SIDE"SETBACK 10 20.3 0 = CULTEC LEACHING CHAMBER nr•s{r.N REAR SETBACK _ 10' _ EL 22.5 20 0 2000 GAL o RECHARGER 33OR A ! -?A, 3/2 SEPTIC TANK 19.8 0- _ ' 12 EL 21.5 . ..• 17.0 ALL PIPES TO BE 'SCHEDULE 40 PVC PERFORATED FLOOD ZONE C , 19.3 19.5 B S �.s v� s c. ANDY LOAM / , . ... `WITH C P FIRM CO MU .•:. .. ♦ O AP ED ENDS M NITY,PANEL 12 28 U EL 20. SE 1 - 4 00 2 DISTRIBUTION t1N E IN 9 RECHARGER UNITS No.'25 0 1 0008 D BEDDING AS , N E t A 12 x 63 WASHE D iSTONE FlF1D AS SHOWN REVIS D JULY 2 1992 P , ER 1TLE 5 , 1 2. 5 4 12 15 10 LEACHING DATUM OF THIS PLAN IS NGVD 12 AREA REQUIRED. , 770 GPD D. 4 in / 7 104t SF S EYJ -A LL AREA. ,- 1A 75 x 2 x 2 300 SF -- c , ..TR _ _ _ __ _ -___ __ .__.___ _ _ _ _ _. _ �. tz` BOTI'dM AREA. 1 `6 v i�ED SAND TOTAL ARE A 1056 SF D -,_ ;E I �.7� ; eP-G - Tti•».J Is , a PERCOLATIO N RATE . < 5 MIN NC H EL 14.5 'TEST _ � /� , - / SOI L CLASS „ , .- 28 144 EL 10.5 i / 3 D OP ,EWEL ED PROFlt� OF PROPOSED SEP'n0 SY5'1EM ;, , . , . .N :\.�",�]j 1"­I_I-I�".�,I,lI�IrI�I I-I/III�II.-IE.I,"I'�_I II-,1 I'"�II—'r 1 I1-�:III OT TO SCALE I.�4�-,II 1.:",I.II�,I,I,II.9I I,:'.-RI I,1�1II:�I�I�I�I A.IIIII I I�I I',ITI.I.I 1I-�II,IIII,.I. \ , I,1-.I I.1I.�_�I,,I I j C I 0 . 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CB H"F , D ND = \ - - EL - 22 13 NGVD 2 / � ! .i J �\ / � / 2 4, .4 2 , 2 - J . Cl) ,r -: 2 / t ; J / 4/ \' / N / \ ---- --__ r_ ! --- -- lg W Q _ _ T, . 23 / L9 3 ' / AT / _ a LOTS 59 do 18 N GREEN DUNES 4 DRIVE I 4 Q WEST HYANNISPORT, MASS. 20 / a / FOR / / cB L . DH `FND �� : � { C / / ^ �AN, US / 19 8 ., ,0 , . T NGVD L- lle� ; e>,l_..25 i $ - co Lots 4 D�-0T#i`1�1 o F DeQc`` / ) B / o /. SCALE. 1 - 20 DE MEMBER 16, 1997 0 0 / / o / 1 BA TE X R & NYE INC. 812 MAIN STREET / 0 ST VI ER LLE MASS. 02655 - -508 428 9131 . 1 t ) / GRAPHIC SCALE ; / > - l zo ,o CERTIFY THAT THE PROPOSED FOUNDATION SHOWN .HEREON COMPLYS WITH THE SIDELINE AND SETBACK / / / / REQUIREMENTS OF 41H1 T13WN dF BARNSTABLE AND IS / t INfj_ NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD ZONE J / 1 inch 20 ft 1 DA /• - /�N FQ A9 QS 4 S' 0 �' 9 `. t� OF � O S7EPHEN y - G _ cn ALLYN '�K�bIRCi � m A .A o WILSON BAXTER & NYE, INC. 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