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0275 GREEN DUNES DRIVE - Health
275 Green Dunes Drive Centerville A= 245-03Q /N. SMEAD No. 53LOR UPC 12543 smead.com • Made in USA J,�Cc 2 No. �O — �YJ .. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppfieation for Misposal 6pstem Construrtion permit Application for a Permit to Construct( ) Repair( ) Upgrade(A Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 017; C 2t X) DUNF—S DR Owner's Name,Address,and Tel.No. Assessors Map/Parcel a4 03c) .�v�— P� uiu oie. s Installer's Name,Address,and Tel.No.50 9—147-' -9 8-7-1 Designer's Name,Address,and Tel.No. 15dR.;'73 -03'j CA PGW I Pe GAJT4G*1V Q SVC "C- ZC- e9CWf&)6-0oiivc= IxLoc, 1:53Go T s4-S P EC 2254 <AAM f;tk)V 61WAWNAM Type of Building: Dwelling No.of Bedrooms 4 Lot Size 414CIf 7( _sq.ft. Garbage Grinder( ) Other Type of Building RCS 1 jgWTjA-(-.o No.of Persons Showers( ) Cafeteria( ) Other Fixtures L Design Flow(min.required) o gpd Design flow provided Ef �$ a gpd Plan Date 77—11— Number of sheets Revision Date Title ia5 6LA66-yy D'u'AJ45-5 0k r Size of Septic Tank 1 ,500 Type of S.A.S. (3) -500 GO SJ Q4DW9G23 Description of Soil 44 ED 1 0 4 5�� 301/ al-z (." Nature of Repairs or Alterations(Answer when applicable) Ab b CiQ) Ne,,<) 5-0 o "d t"—(O d 4 11i q f 0 6- p- �csl avr.�!jJ 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 of Healt �G Signed Date 3..'[ ' /2P16 Application Approved by Date j 'l t% Application Disapproved by Date for the following reasons Permit No. S L ((� --ate(_ Date Issued No. Fee. IM THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS { 01pphcation for 30is'posal Opstem Construction Permit Application for a Permit to Construct( ) 'Repair( ) Upgrade(A Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. A 1$ GkEz� DVNFS bO ,Owner's Name,Address,and Tel.No. Assessor's Ma /Parcel YVR S PEI<T-ORY p a(+5 ©30 ,/W. 2-1 & tact! 0 W 814 OL-r ' Inst filler's Name,Address,and Tel.No.rj V g—�{ •$$�7 Designer's Name,Address,and Tel.No. sag..z773_Q3 7 Type of Building: Dwelling No.of Bedrooms T` 's Lot Size , Z -sq.ft. Garbage Grinder( ) Other Type of Building Q C-51 P45P JA L o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �Kai gpd Design flow provided 4 -.55f X gpd Plan Date -'—11— Number of sheets Revision Date Title t;'7!5 6t_q a_lU O UN65 op" Size of Septic Tank 1500 Type of/S.A.S. �3 5QU GMA4.4,p pa CkAae'b tges 'Description of Soil 446D I c_J 44 5A&)b ca � / "5;Er— P4" Nature of Repairs or Alterations(Answer when applicable) 6 liew S00 ag"-ad H-t o dtf+4&(,-7, to hj PC1R aJ _ 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 of Health. Signed }} Date Application Approved by. �^� l Date Application Disapproved by Date for the following reasons Permit No. a C) D b C% Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded // (k) Abandoned( )by L..� 106c._)1 aE &, C.©e l� 44C. at ��^� ( �V�/ ��i) has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.,70 10" dated -� --' Installer Q*WC--Q1b1= 6_7N70 PX1SEC UCD Designer #bedrooms L4 Approved design flow { and The issuance of his iermit shall not be construed as a guarantee that the system will o designed. Date Inspector Ml- -----------�— ---------------------------------------------------------------------------------------- ----------`- N Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( Abandon( ) System located at [4 voeQ"j"' P 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. Provi d nstruction must be completed within three years of the date of this permit. / Date Approved by lam` GL f TOWN OF BARNSTABLE LOCATION ;;t-K ;(�R —:9 Duors �. SEWAGE# 010 16RC o�(� 1r; ta— VILLAGE �� v� ASS��ESSOR'S MAP&PARCEL2�S INSTALLER'S NAME&PHONE NO.��C°6W40c ' k0T—_S LLJ�• 4'i 1-F l SEPTIC TANK CAPACITY 1 ,Soo G A-LL Aj c LEACHING FACILITY:(type)(3) j cx> etA(_ (size) J A e fS(k 33,,,5 NO.OF BEDROOMS 4 OWNER YUPy Sj>6K-r6 Off/ PERMIT DATE: 1 COMPLIANCE DATE: Separation Distance Between the: ,+' Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NIA Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) IJ 1,4 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �IA Feet FURNISHED BY CAPC W 10C &nF_VQJ Q-�16 a7,S Greer Du,,es S - C3a < b-2- 146.4 i 6-3 a-s ■®■1�3i18/2016 14 :40 5082730367 :4380 P. 001/001 �® Town of Barnstable Regulatory Services Richard V. Scali, Interim Director b � Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form i Date: 2^16 Sewage Permit# 204 Co ;LV( Assessor's Map\Parcel' Designer: Installer: Gaee.Wi4e- �nr4rec(seS Address: Address. 155 Covoi v,ec'cCal slree:F EQst P+e�nam N ft ezS�S Mas��ee 1 ptP 021o`I i i. On 9" 5-i �,c,Pevtticle Li1Fu pr..5es was issued a permit to install a (date) (installer) septic system at 7- GfeGn D Utn,e. 5 Df . based on a design drawn by (address) -S G E�nyt�neetin the , dated 3uly l 2016 / (desig er) V/ I certify that the septic system referenced above was installed substantially according to the design, hich may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 0' lateral relocation of the',SAS or any vertical relocation of any component of the septic ystem) but in accordance;with State & Local Regulations. Plan revision or certified as-b ilt by designer to follow. ;Strip out (if required) was inspected and the soils were founds itisfactory. .1 certify that the system referenced above was.constructed ' e with the terms of the IAA approval letters (if applicable) c, JOHN L. F o CHURCHILL JR N C ( sta 's Sig at e) NO Igor i �j,°fiF� IS E �7esigner's Si natur (Affix Des' er amp ere) ASE RE UR O BARNSTABLE PUBLIC HEALT DI SION. CERTIFICATE OF C MPLIANC WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD AR RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:1SepticlDesigner Certification Form Rev 8-14-13.doc i i f Town of Barnstable P# 16083 of*� �Y Department of Regulatory Services BMtNffAaL: Public Health Division Date t� � 679. �� 200 Main Street,Hyannis MA 02601 ;r i0reo tom+" ld Date Scheduled +' � Time 0 M Fee Pd. � Lt? Soil Suitability Assessment for Sewa Disposal Performed B �/Awl l / t io)M���� 4 i�/ a ef' � y:_ Witnessed By:bb��--bb ✓ I�t_in r tr LOCATION&GENERAL INFORMATION / Location Address ^ (kkr r�l sAl Owner's Name��l Lu,9 ,+ �^t� Address t'►v{C.. 1WW 1 "r71 I`lt'JI r1^� 5 Ic a llJJtt"" Assessor's Map/Parcel: q� ' O'�0 Engineer's Name Pq) NEW CONSTRUCTION ;< REPAIR Telephone# -. b03 21�F Land Use RaApn4o y Slopes(°o)--0k Surface Stones r" A Distances from: Open Water Body / ft Possible Wet Area!ioo ft Drinking Water Well ?�ft Drainage Way >JO ft Property Line )'I6 ft Other "` ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) see Parent material(geologic)o �� Depth to Bedrock •��// 'J v/ - - Depth to Groundwater: Standing Water in Hole: > 130 �/3 Weeping from Pit Face \ Estimated Seasonal High Groundwater /)r']�X 13 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: t/,f e6 N�eyr/Q4on Depth Observed standing in obs.hole: > W in. Depth to soil mottles: >13) in. Depth to weeping from side of obs.hole: 7/ e in. Groundwater Adjustment ft. Index Well# — Reading Date: Index Well level — Adj.factor Adj.Groundwater Level PERCOLATION TEST Date jd`7"03rime Observation Hole# ^' Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6') End Pre-soak r perk lv4 COh d t.,c4� by Rate Min./Inch 0- Fn in@e(In of) IQ-9 2003 Site Suitability Assessment: Site Passed Y12S Site Failed: — Additional Testing Needed(Y/N) /V Original: Public Health Division g 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 A. DEEP OBSERVATION HOLE LOG Hole# — Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consist ave O-6" Lit G-30" L a JOW % - 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) DEEP OBSE_R_VATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 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) Flood Insurance Rate Man: Above 500 year flood boundary No, Yes Within 500 year boundary No V Yes Within 100 year flood boundary Nov Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring perviyu s material exist in all areas observed throughout the area proposed for the soil absorption system? o If not,what is the depth of naturally occurring pervious material? Certification I certify that on 10-27-9 9 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection a d that the above analysis was performed by me consistent with the required training,expertise and exp a ce described in 310 CMR 15.00117. Signature Ajk - Date Q:\SEPT[C\PERCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owners Name information is required for Centerville MA 02632 May 10, 2012 every 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: A. General Information When filling out 14 forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not use the return Name of Inspector key. Septic Inspection Services Co. Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508-428-1779 S1 12855 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 May 10, 2012 Job#=1,2-80 ;::w• ' I pector's Signature Date s The system inspector shall submit a copy of this inspection report to the Approving Authority.:(BoaRY 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 si'all submit the report to the appropriate regional office of the DEP. The original should be sent to''the systeinvaowne and copies sent to the'buyer, if applicable, and the approving authority. ° r '1 ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Di osal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. Citylrown 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: Tank was pumped 2-3 weeks prior to inspection and had liquid only. Leaching chambers were empty with no sidewall stains. 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): l5ins-11/10 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 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. Citylrown 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).- El 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 E 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 l5ins•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 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. Cityrrown 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 l5ins-11/10 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 w 275 Green Dunes Drive Property Address Spektorov Owner Owners Name information is Centerville MA 02632 May 10, 2012 required for y every page. Cityrrown 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 CM 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a 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): 330 t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts 9 _ Title 5 Official Inspection Form Subsurface Sewage Disposal g p sal System Form Not for Voluntary Assessments 275 Green Dunes-Drive Property Address Spektorov Owner Owners Name information is required for Centerville MA 02632 May 10, 2012 every page. city/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ 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 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown 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: 15ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for Y every page. CitylTown 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: Tank was pumped 2-3 weeks prior to inspection. 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 F Title 5 Official Inspection Form c Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Compliance date: 11/13/03 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' 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.): Septic Tank(locate on site plan): Depth below grade: 14"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: 10.5' long x 5.8'wide- 1500 gal. Sludge depth: 0" t5ins•11/10 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 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. Cityrrown 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 Scum thickness 0" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? 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.): Tank had liquid only, no solids. Liquid level was at bottom of outlet invert and tees were intact. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for y every page. Citylrown 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.): No solids or high stains present liquid level was at bottom of outlet pipe 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: t t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owners Name information is required for Centerville MA 02632 May 10, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: Two 500 galdrywells. ❑ 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.): Leaching chambers were empty at time of inspection with no sidewall stains 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Y required for Centerville MA 02632 May 10, 2012 every page. Cityrrown 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.): a t5ins•11/10 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 275 Green Dunes Drive Property A ----ddress --------" -- Spektorov Owner - -- ------ ._.. ---- ---- ---.—._....- ...---- -- ------- Owner's Name information is required for Centerville MA _ 02632 May 10, 2012 _._ _ eve a Cit /Town ------ ----------------------------- every page.e. y 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 40 Front Yard 42 48 65 ,y ti ya,tir d�E�t�ssYeS`�r r>� f w e Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is Centerville MA 02632 May 10, 2012 required for Y every 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: 10feet 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: 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: Elevation of marsh at rear of property is lower than SAS. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Spektorov Owner Owner's Name information is required for Centerville MA 02632 May 10, 2012 every page. Citylrown 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 15ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 1� _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . wM 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is W H annis ort required for y p Ma. 02672 5/07/2007 every 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. Important: When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC Company Name r� P.O.Box 763 Company Address Centerville Ma. 02632 remm City/Town State Zip Code (508)428-4028 Telephone Number License Number FJ B. Certification E `a I certify that I have personally inspected the sewage disposal system at this addg,&s and tfiat the_,., ^- information reported below is true, accurate and complete as of the time of the irSs*pection.5e inspection was performed based on my training and experience in the proper function and Aigintenance of on',site sewage disposal systems. I am a DEP approved system inspector pursuant t�`-'i ection 15.3407-of Title 5.(310 CMR 15.000).The system: cc r`3 r- ® Passes ❑ Conditionally Passes ❑ Fails rn ❑ Needs Further Evaluation by the Local Approving Authority 5/7/2007 Inspector's Signatur 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. 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form w». Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M s 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is p required for y W H annis ort Ma. 02672 5/07/2007 every 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: The septic system is in proper working at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank (whether metal or not)is' structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water.level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 275 green dunes dr.•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is W H annis ort Ma. 02672 5/07/2007 required for y p every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): .. ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: . C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 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. 275 green dunes.dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15,__._�, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 275 Green Dunes Drive Property Address - Susan Donovan Owner Owner's Name information is required for W Hy p annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria 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 a; than 1/z day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form "s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for W.Hy p annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.El m ® 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 El ❑ 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. 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for Y p W H annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® El available 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? m.. ® ❑ 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)] 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is P required for y W.H annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection 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). 330 Number of current residents: 1 Does residence have a garbage grinder? ❑ 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 2006: 7,0000 g ( y g (gpd)): 2006:97,000 Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ N6' ; Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for y p W H annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) -- General Information Pumping Records: Source of information: Capewide Enterprises,LLC Was system pumped as part of the inspection? ® Yes ❑ No If yes,volume pumped: 1500 gallons How was quantity pumped determined? measured Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool i ❑ Privy a.' ❑ 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) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: New systen installed 11/10/03 Were sewage odors detected when arriving at the site? ❑ Yes ® No 275 green dunes dr.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 '"'"� Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 275.Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is W H annis ort Ma. 02672 5/07/2007 required for y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 10'+ feet Comments (on-condition of joints,venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. r 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: 1 0'6"x5'1 0"x57' Sludge depth: none Distance from top of sludge to bottom of outlet tee or baffle na Scum thickness none Distance from top of scum to top of outlet tee or baffle na Distance from bottom of scum to bottom of outlet tee or baffle na How were dimensions determined? Tank pumped 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for W.Hy p annis ort Ma. 02672 5/07/2007 every 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.): Pump septic tank every 2-3years.inlet and.outlet tees are in place.No evidence of leakage.Tank �- appears structurally sound. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal El 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 w 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): 275 green dunes dr.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 110 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is H annis ort Ma. 02672 5/07/2007 . required for W y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert no 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.): Box is Ievel.Box has one Iateral.No evidence of solids carryover.No evidence of leakage into or out of box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No �- 275 green dunes dr.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GM , 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for W Hy p annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: „- Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: / ❑ overflow cesspool number: ❑ innovative/alternative system w Type/name of technology: n_"..... Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No evidence of hydraulic failure. Leaching chambers were dry at time if inspection. 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is W H annis ort Ma. 02672 5/07/2007 required for y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): 275 green dunes dr.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 a Commonwealth of Massachusetts W Title 5 Official Inspection Form a a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is required for W.Hy P.annis ort Ma. 02672 5/07/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks-or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i � y i 275 green dunes dr.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M .° 275 Green Dunes Drive Property Address Susan Donovan Owner Owner's Name information is W H annis ort Ma. 02672 5/07/2007 required for y p every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: .µv ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to ground water: 20'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: 10/24/2003 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used:Gaherty& Miller model 12/16/94 ground water elevations.Used:Technical bulletin 92-000-01 plate#2 annual ranged of ground water elevations. 275 green dunes dr.•08/06 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 A . . No. —" Z.- ' Fee$5 0. 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for Ziopozar *ps�tem Con!aruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ), /TJComplete System O Individual Components Location Address or Lot No.2 7 5 92 e e n Owner's Name,Address and Tel.NoJ?a.t h D O n o v a n llensor�s t,s arse nnli,6/zo2il, (7ah,3. 27�5 G2een [�une� [7a ive se Gle�t 245- 30 f1yann.i,6/2o2.t, Ma6.6. 02672 Installer's Name,Address,and Tel.No.5 0 8-7 7 5-3 3 3 8 Designer's Name,Address and Tel.Nos 0 8-2 7 3-0 3 7 7 I. %. Macom e2 & Son Inc. a0 Cng.inee/ting 2854 C,,zange22y Box 66 Cen.teAv.iiie, Ma.6.6. 02632 Highway Ea,3t ldazeham, t7a.6,3. 02538 Type of Building: Dwelling,YX No.of Bedrooms 3 Lot Size i sq.ft. Garbage Grinder( ) Other 'I�pe of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Natu a of Repairs or Alterations(Answer when applicable) O m i.t.t.i n Q c e Z Z/2 o o.9 z and 1- 10 0 0 gai.eon /z.i.t" InZ.taieing 1- 1500 gaeeon ze/zt.ic .tank. 1-Diat2igu.t-ion Sox and two 500 rgaiion 1/v_nr•hiny rhnrnaoPA aar_&ed--6ra 4 ' o;e IL" ilono Date last inspected: 25 'X12. 9'X2' 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 Co a and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi °B dJ o Health Signed `� J`' Date 1 0/ 1/0 3 Application Approved by Date .3 Application Disapproved for the following reasons Permit No. U 2— Date Issued 111101,03 c �+ No. ' Fee$5 0. 00 Entered in computer:THE COMMONWEALTH OF MASSACHUSETTS P PUBLIC HEALTH DIVISION -TOWN�OF BARNSTABLE., MASSACHUSETTS Yes 2ppY cation .for MiopogaY *potem Construction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( )Y', Complete System ❑Individual Components Location Address or Lot No.2 7 5 q 2Ie e n D a a n 4 D z.i vP75 ner's Name,Address and Tel.No./?u t h Donovan, I�Je�st 1/ 2nn.is/2oat, Nas.e. gzeen Dunes Derive Assessor'sMaVarcel !i/e st Hyann.ij/2oat, Ma s,3. 02672 245-30 Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.5 0 8—2 7 3—0 3 7 7 �. P. f7acom9e2 9 Son Inc. �O Eng.ineeAing 2854 C2an&eaay Box 56 Centeltviiee, Na.6,s. 02632 ll.ighway ,East ldaaeham, Naiss. 02538 Type of Building: Dwelling XX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title5 Size of Septic Tank Type of S.A.S. Description of Soil Natup of Repal o Alte ations,(Answer when applicable) 0 m.i t t-i n g c e,6,3 R o o.2 6 and 1-10 0 0 ga .ton pt?. � at1 ng 1- 1500 ga.QQon ze/at is tank. 1-Diet2.i17u.t.ion Sox and two 500 oa-Q-eon ieachina ch2 te,7_6 nnrkor/ ;n 4` o- 1�" .s.tone 25'X 12. 9'X2' Date last inspected: - Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board oHealth. Signed </ �` Date 10131103 Application Approved by �'f.� •_ Date 11 fC,1L 3 Application Disapproved for the following reasons Permit No. Date Issued y� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed Repaired U rade&(' X/y .a g P Y ( ) P ( ) Pg ( ) Abandoned( )by • 7)• P;acomaez Son Inc. - at 275 C/2een [7uneh [72.ive /Just 11gann.i,6/2oa2 _, Mass. 'has beer,ccnst:aeted i.. .:cer�dance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 ?—�� Z dated l I (G�6 Installer .7. %. Naeomfe2 X .Son. Tnr. Designer X Engtnee2inq r � The issuance of this permit rhall not be construed as a guarantee that the system,,will function a dtes/igned. ^ Date f l �U Inspector (���C T7i�% .`4` . — -- - -- --------------------------Fee$50. 00 —THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Miopooal &potem Conotruction Permit Permission is hereby granted to Construct( )Repair( )UpgradA(X )Abandon( ) System located at 275 r/aeen /5une.6 172 veldezt H.yann.i3/2oat, Na.6.s. 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: Constructi n mus I be completed within three years of the date of this pe t� Date: � /U �/ Approved by i i TOWN OF BARNSTABLE LOCATION Zlf X ee Al z?t/Ales SEWAGE VILLAGE YAA/A//44 0re7' ASSESSOR'S MAP & LOT 245'030 i INSTALLER'S NAME&PHONE NO. /YI C 0 g d C R, 5- SEPTIC TANK CAPACITY i LEACHING FACILITY: (type) _- 1,�/?y t&& S (size) NO.OF BEDROOMS •� BUILDER OR OWNE PERMITDATE: 11 10 of COMPLIANCE DATE:, l I 03 Separation Distance Between-tht i 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 V 30a.7J 4\ 1_` I a TOWN OF BARN-STABLE LOCATION G g P e w d v.ves SEWAGE #"UD3 3;,A X VII ?.AGE ASSESSOR'S MAP & LOT .5'o3O INSTALLER'S NAME&PHONE NO. ,� 019 C O,,0 /9 f R, S 0,A1 SEPTIC TANK CAPACITY -/- fO O LEACHING FACILITY: (type) /7/?V LUeLL (size) NO.OF BEDROOMS .3 ' BUILDER OR OWNE PERMIT DATE: I 1 1010 COMPLIANCE DATE: it 1 .3 03 Separation Distance Between the: _ Maximum Adjusted Groundwater Tab.e 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 -. _ .! t` C d // 30� �`� \ Y � d � � � ,,� \ \�,�. /'9 ym� � � � � � � �� 6 3— �p a 1 REMOVE i EXISTING n �rr ADD RIDGE VENT I CHIMNEY 1 N Y �4 67 ADD RIDGE VENT d ADD RIDGE VENT 12 i NEW ASPHALT NEW ASPHALT NEW ASPHALT 3E ` ARCHITECTURAL STYLE SHINGLES ARCHITECTURAL STYLE SHINGLES ARCHITECTURAL STYLE SHINGLES oil ;Rt 4 _______________________________________ _____________________________________________ ______________ __ _________________________________________________________________I FM pa _ ® 0 ® o - f CNIY 101 i D D 0 ® A 2836 ® REPLACE C315 O EXISTING00 '-••-�®1 [E I 'REPLACE REPLACE 0 �+ REPLACE WINDOW • REMOVE' REMOVE EXISTING EXISTING W g� EXISTING W/NEW ® EXISTING EXISTING WINDOW EXISTING WINDOW a WINDOW WINDOW MAIN HOUSE WINDOW WINDOW W/NEW W/NEW Zi EXISTING V W/NEW MAIN HOUSE 0 Qi t (d FRONT ELEVATION x 1 DENOTES WINDOWS k CHIMNEY TO BE REMOVED E4 a I REMOVE I t CULVP "a'�q t Hw�yy (x,)^ 1 1 EXISTING s"Nv ADD RIDGE VENT I CHIMNEY 1 �bw m ADD RIDGE VENT NEW NEW ASPHALT ARCHITECTURAL STYLE SHINGLES ARCHITECTURAL STYLE SHINGLES ADD RIDGE VENT t/✓tiv," ^G NEW ASPHALT _._..._.___..._.....---.- _._._._._..�.........._._ ARCHITECTURAL STYLE SHINGLES FMI NEW DEG IXSTGC D K ry O FED DORMER O SZE M W x z�z z�z SEG S W.__- WIN W,-__ A W 2N6 .-2M6 2446 W W. EXISTING DORMER •;w -------------------------------- ------------------------------------------------------ ---- --------------------------------------- a i ❑ � ❑ F I © F EXISTING EXISTING EO j MAIN HOUSE ��t0 wlo pg.�b zew ze�v I Z GARAGE 9 ®® _ O 6' S � � ING TE RED - TEMPERED � -� RED \ ' OOR GLASS mm a EXISTING Z W MAIN HOUSE p W F R' a � 0 REMOVE EXISTING WALL ® PORCH REAR ELEVATION O ADD HEADER k COLUMNS Z �� 3 c REMOVE REMOVE , •�I EXISTING EXISTING CHIMNEY { i CHIMNEY N Y�d - - - _. in 0 ee V g NEW b _ DORMER g EXISTING D , EXISTING DORMER EE /NEW DORMER �= t IEG 1 1 � e� �� z4zslN Wzizs R REPLACE DUSTING all I' ll WINDOW W/EGRESS WINDOW , 1 1 REMOVE { ❑ REMOVE i I I REMOVE EXISTING W w EXISTING EXISTING 1 EXISTING GARAGE U P O WINDOW r O WINDOW ; WINDOW �^ z ----- 2846 ---- 1___ % w fwZZ se 6 E A "g P LEFT SIDE ELEVATION RIGHT SIDE ELEVATION F g aU< M CONFIRM ALL WIN a�1 �a E IwT4 U TYPES. AM WINDOW SCHEDULE DIMENSIONS PRIOROTO ORDERINGOUNTS k WINDOW NOTES: PERFORMANCE DATA WINDOW SIZES SHOWN WITHIN AREA BASED ON GENERIC SIZES UNLESS OTHERWISE SPECIFIED. THE MK NO. TYPE MANUFACTURER SIZE NOTE: RESCHECK MUST BE RE- OWNER AND/OR GENERAL CONTRACTOR SHALL CHOOSE THE WINDOW MANUFACTURER. WINDOW SIZES CALCULATED FOR ANY SUBSTRUTIONS SHALL BE VERIFIED BY THE GENERAL CONTRACTOR PRIOR TO ORDERING. THE WINDOW MANUFACTURER SHALL PROVIDE ROUGH OPENING SIZES. OA ANDERSEN OR 2836 U-31 SHGC-.32 1 DOUBLE-HUNG SIMILAR WINDOWS SHALL MEET THE FOLLOWING CRITERIA FROM THE MASSACHUSETTS STATE BUILDING CODE: A) GLAZING CLOSER THAN EIGHTEEN (18) INCHES TO THE FLOOR AND EXCEEDING SIX (6) SQUARE U W FEET IN AREA MUST BE TEMPERED GLASS ao Z OB 1 CASEMENT CN12 U-.30 SHGC-.34 B) EMERGENCY EGRESS: SLEEPING ROOMS SHALL HAVE AT LEAST ONE (1) OPENABLE WINDOW OR r] EXTERIOR DOOR TO PERMIT EMERGENCY EGRESS OR RESCUE. A REQUIRED WINDOW MUST BE W A © 1 CASEMENT C335 U=.30 SHGC=.34 TO}P{Er 0 OWROM THE INSIDE WITHOUT THE USE OF SEPARATE TOOLS AND SHALL CONFORM TO - >Q pq W N QD 2 DOUBLE-HUNG 24210 U=.31 SHGC=.32 1) SILL HEIGHT SHALL BE NOT MORE THAN FORTY-FOUR (44) INCHES ABOVE FINISH FLOOR w a OE 1 DOOR SLIDING GLASS 6068 U=.32 SHGC=.28 2) THE RECTANGLEWHAVING MINIMUM A CLEAR OPENING NET CLEAR OPENING REA OF 3.3 DIMENSIONS OFUARE FEEr TWENrY (20mINCHEs WIDE f 0H A CUM a u rn DOUBLE USED,TWENTY-FOUR DIMENSIONSCHES IGH. IF A TO THE BOTTOM DOUBLE-HUNG HALF OF ITHE WINDOW �+'•_ LL 2 CASEMENT CW26 U=.30 SHGC-.34 �l © 1 PICTURE P5060 � DOUBLE .) 0 1 DOUBLE-HUNG 20310 U=.31 SHGC=.32 - - TRIPLE 2846,2846,2846 U-.31 SHGC-.32 to OI 1 DOUBLE-HUNG 0 OJ 2 DOUBLE-HUNG 2846 U=.31 SHGC=.32 10 � W 0 3 DOUBLE 244-6,2446 U-.31 SHGC-.32 \ J DOUBLE-HUNG ,r w © REPLACE W/ 1 DOUBLE-HUNG U=.31 SHGC-. W W EXISTING SIZE 32 c N REPLACE W/ U=. -.31 SHGC32 MO 1 DOUBLE-HUNG EXISTING SIZE 6 - N 3 DOUBLE-HUNG 2832 U=.31 SHGC=.32 Z C9 3 c I. I 10 - rVol l e l n A N Y J 0.-. 1FL,PF72ED TEMPERED SEAT 1 ? ? LVLs HEADER 1 REMOVE EXISTI G WALL I I a b n REPLACE EKIsnNc slNctE WINDOWS REPLACE EKISIC WINDOW I I �i O © O O � I I COVERED W/RIPLE WINDOW O W/DOUBLE WINDOW H I Q� QO Q° I I PORCH a os' COVE D \ Lw NFIDflt ----- --- $ Y$ I 2- 1 3/4-XI 7/8- �3 13'_5" WtXcs - O °FREESTANpNO TUB 6 d ADD Lw BELOW WALL U a N z Oj d 6' S IDER 12 0 cA� 0 5 2z3 _ �TM wi���;,ON'OFG3.l FAMILY i O o , �0-1 a m SHOWER/TUB PERIMETER ; ROOM ',1; E ae ; FIREPROOFING NOTE: F+ C%� io B FOR LED DOWN-.UGHiI H o ; $ ANY COMPOSITE OR STEEL COMPONENT MASTER I I N c IN &SEMENT OR GARAGE SHALL Z " WMN BEDROOM " cus _ z BRKFST FIREPROOFED TO CODE W cb�m P 0 13'x15 —4" I' NOOK Q E- ODQ� F GARAGE R� F'WS.--ED Lw ATE —i N g J t 5 ►•VI tl iv ° W8x31 FLUSH—FRAMED STEEL BEAM a �' .?� QO " W " ; 3 1 75"x9 25 LVLs 2 1.75"x9. 5 _ _ ; WBx28 FLUSH-FRAMED STEEL BEAM .I 3 REMOVE EXISTING WALL `° LVIn -i+ REMOVE ISTING FP 1 RE OVE EXISTING WALL W8x31 FLUSH-FRAMED STEEL BEAM REMOVE EXISTING 6x8 BEAM " �z3 J 6�----' - � F+•�I F a I T--_" S I 2o6 8 (Go-cxNn' 90—,-+ �I' ------ U CUBBIES S1 — ------ n Wd128SF---------------- MUD 1I II «DSET 1 a WALK-IN WORK 26 ISLAND c1 RMW7A �DOW 6sR00M_ 6n L I I FS }� D D CONFIRM HEADER SIZE CONFIRM HEADER SIZE I um,=a KITCHEN �a W s 14'-2 1/2" A0 Zq DW Z 00 REMOVE CSIv r REMOVE • 0 004 ` EXISTING WNE S EXISTING 04 N WINDOW WINDOW 6'-10" 9'-2" 3' 6'-8" 13'-2 1/2" 8'-5 1/2" 3'-10" 3'-4" 3'-4" 6'-1" 9' S' p� 19' 28'-4" 31'-2" i FIRST FLOOR PLAN �� g IL DENOTES WALLS/WINDOWS TO BE REMOVED OS DEONTES SMOKE DETECTOR 4 w ® DENOTES HEAT DETECTOR CuLvw O DENOTES WALLS TO BE CONSTRUCTED ® DENOTES SMOKE & CARBON MONOXIDE DETECTOR OINK 2 —-— DENOTES STRUCTURAL BEAMS TO BE ADDED 7YVw'By Y EZ F a._ F N oM G Z V'J 3 c �p ao C 1 n III � N � Y I � V t O I 1 m JE � �0 . 2 8 26'-4" 6'-2" 23' 2' �Ig 3'-11 3/4" 8'-1 1/2" 8'-0 3/4" 2'-10" t W FIXTURESKQ 3 XTURES © W M O ADD SHED DORMER ID n z EXISTING 9'-4 1/2• 13'-7 1/2" O w EAVES z BEDROOM '� � � _ //yy 1-�" ----- W------------------ = icy .N tSL.PED CEILING I�I Sz3 a I W M n ALK-IN BEDROOM 1 OSET 8 c d- ---- y0 15'x15'-2" 1EEXISTINC SHELNNG : A�F��� ~sn VAULTED CEILINGW Z I N S e 0 8'-8• CEILING HT ram+ c ----------I I oi= I e L_VL RIDGE_W/RIDGE VENT _ 14 ----------------------- ----- T - - - SLOPED CEILING II LOFT i OL REMOVE EXISTING CHIMNEY C+�y • [- c'E'Z 7' 8 1/2" 1 EXISTING%n%ING t i �►s O M BIFOLD6 IFOLDF+1 ►�•�i ---IL Hi _ S 6' BIFOLD 6' BIFOLD CLOSET CLOSET SLOPED CEILING --------------------- -- --- --- -- SLOPED ILING CLOSET "I I SLOPED CEILING SLOPED CEILING 8-3 3 4 7-2 3 4 15-7 1 2 iq EAVES Tn W 3 U.° o z z i EAVES 1 0 U a ou Be wIn EAVES EAVES x IN m cn Wuj . a 28'-4" 31'-2" 78'-6" ♦ 0 O SECOND FLOOR PLAN sp;�' Z 0 c� W•• W N IL G C O 3 o i I c - N of � • N � ]C C U lie 59'-10" � WW 0 FIREPROOFING NOTE: O W o O ANY COMPOSITE OR STEEL COMPONENT g B �^ IN BASE ENT TO CODE. OR GARAGE SHALL BE q4 1 FIREPROO "j o zae U f9 X O W rJ2 n STEEL SPAN ABOVE O 1ST FLR CEILING A + S tl� eo c� O �� z ,�3' O op � % �A dt 0 18'-10 a U S d p i Pert---� 'jti�=- _Q9°off 5, �` i' N phi ►�-� a IXISTG 7x153{� - I I I IXISTG 7k15.3 II I IXISf 7x15.3� L L 3-1.75"x5:5 L ''3 I__ 1 I v� I W x -—- �- t--_!-5 --r—- Ir - -—1 D BEAM TO REP-C IXISTG 7 115.3 1 Dt I N U L°°s'°J EXISTII; 7x15A � Till I 4- _J I C�NCRETE BASE � � � L_ _J kke�yy L____ I Fil L___ ___J !REMOVE EXISTING 3'-5" '-5" 2'-8" CHIMNEY-BASE- 1 STG 6x12.5 1 1 EXISTG 6x 2.5# 8' 7' '-10 5'-8" I '"1'- 4- � - 1 I x ti NOTE NEW LALLY COLUMNS io L_ _I LJ U °< d TO HAVE 30"X30'X75" o FOOTINGS UNLESS OTHERWISE : cGo SPECIFIED e ow FF ;. Tn w N x U Z o w 0 w € .a n Z r i O A OF W l -a 04 cn () in C a P. z 29'-2" 30'-9" i� g CuLvw z � SAW FOUNDATION PLAN =__ \ __� DENOTES WALLS/WINDOWS TO BE REMOVED �O DENOTES WALLS TO BE CONSTRUCTED : Gi —-— DENOTES STRUCTURAL BEAMS/POSTS TO BE ADDED �, a O O Lo Z O 3 c o I N •II N Y a u gill INSTALL NEW ARCHITECTURAL STYLE ASPHALT SHINGLE ] 9 ROOFING O ALL EXISTING ROOF AND NEW DORMER ROOF � RL" ADD RIDGE VENTS 8 EXISTING RIDGE TO BE REPLACE W LVL RIDGE W RIDGE VENT NEW 200 RAFTERS O 16' O.C. R38 12 O DORMER AREA NOTES: W cn W 10 r -__ 2x10 71E5 1 r --- R21INSULATION - ALL NEW 2x6 EXTERIOR WALLS DIMENSIONING STANDARDS USED WITHIN THE DOCUMENTS W4 U a --1-F.i-- -- ARE AS FOLLOWS, UNLESS OTHERWISE NOTED: 0 2xlo JOISTS OATH k NAJ MAINTAIN A MINIMUM HEIGHT A) EXTERIOR DIMENSIONING AT BUILDING CORNERS ISTING AT ALL STAIRWAYS, ANDD MINI A MINIMUM WIDTH REPRESENTS AN OUTSIDE OF STUD DIMENSION DORMER OF 3'-0'ALL HALLS k STAIRWAYS. �1 W o FURR OUT EXISTING 2x8 RAFfE)t6 ` ALL WALLS & CEILINGS TO BE 1/2' BLUEBOARD B) EXTERIOR DIMENSIONING AT WINDOWS, DOORS AND TO RECEIVE R38 INSULATION Ta 1 / QO x W/SKIMCOAT PLASTER INTERIOR PARTITIONS REPRESENTS MEASUREMENT TO d W BAFFLES u 2x6 EXTERIOR WALL �. 1 �� THE CENTER OF THAT ELEMENT, FROM THE CENTER R i BEDROOM 1 .R/2'IPLYWOODNSHEATHING ACCORDING TO HEAT&MASSDSTATE BUILDING ECODEINSTALLED OF THE STUD ELEMENT, OR FROM THE OUTSIDE OF [7] R TYVEK OR SIMILAR HOUSE WRAP n BEDROOM WINDOWS SHALL MEET BUILDING W SHINGLE SIDING TO MATCH EXISTING C) INTERIOR DIMENSIONING AT STUD WALL A S REPRESENTS Ei + CODE REQUIREMENTS FOR EGRESS, SILL HEIGHT Q 8 • MEASUREMENT TO THE CENTER OF THE STUD E-I 2x6 STUDS W/SHOE h DBL TOP LATE SHALL NOT BE MORE THAN 44'ABOVE FINISH R21 INSULATION FLOOR, AND SHALL PROVIDE A NET CLEAR EXISTING 2x8 RAFTERS OPENING OF 5.7 SQUARE FEET (MINIMUM NET DESIGNER ASSUMES NO LIABILITY FOR ANY HOME ►rl �+ •..� ___- CLEAR OPENING SIZE OF 20"X24' IN EITHER CONSTRUCTED FROM THIS PLAN. IT IS THE RESPONSIBILITY F+I u x DIRECTION. OF THE PURCHASER OF THE PLAN TO PERFORM THE N 2.10 JOISTS SISTMED TO W REPLACE EXISTING 4x10 BM LVLS FOLLOWING PRIOR TO CONSTRUCTION: i NC 2.e JOISTS it O.C. W/LVL BM KITCHEN WINDOW LOCATION MAY REQUIRE E-+g aa a ULATION ADJUSTMENT IF CABINET LAYOUT IS CHANGED. 1. CONTRACTOR MUST VERIFY ALL SIZES & 0- DIMENSIONS AND NOTIFY DESIGNER OF ANY ~' W "—NOTE: ADD 13EAmREINFORCE HEADER GARAGE ALL HABITABLE ROOMS SHALL BE PROVIDED DISCREPANCIES, AMBIGUITIES OR INCONSISTENCIES �? F a WITH AGGREGATE GLAZING AREA OF NOT LESS PRIOR TO START OF CONSTRUCTION W g J THAN EIGHT PER CENT OF THE FLOOR AREA �L IF NEEDED I...L w EXISTING 2x4 EXTERIOR WALL OF SUCH ROOMS. ONE-HALF OF THE REQUIRED 2. CONTRACTOR MUST VERIFY COMPLIANCE WITH Frl u AREA OF GLAZING SHALL BE OPENABLE. ALL STATE h LOCAL BUILDING CODES V I o FIREPROOFING NOTE: THE_ ~ ANY COMPOSITE OR STEEL COMPONENT BOARD ONG TH EGARAGE SIDE HAVE 5/8 OF WALL OR INCH U FLOOR 3. PLANS INDICATE LOCATIONS ONLY, ENGINEERING IN BASEMENT OR GARAGE SHALL BE ADJACENT TO THE HOUSE, AND WHEREVER THE ASPECTS SHOULD INCORPORATE ACTUAL SITE FIREPROOFED TO CODE. ATTIC AREA IS CONTINUOUS BETWEEN THE GARAGE CONDITIONS AND THE HOUSE A FIRESTOP OF 5/8 INCH GYPSUM - BOARD SHALL BE USED TO FORM A BARRIER TO SEPARATE THE GARAGE AND HOUSE. THE FLOOR LEVEL OF ALL DOOR OPENINGS BETWEEN F THE GARAGE AND HOUSE SHALL HAVE A MINIMUM r EXISTING MOST WALL j j FOUR INCH RAISED SILL - V7 W I I L4� x I I L__J CROSS SECTION A A z � Oa � � uL 4 zo L) tO U N � VI Vl O L) ao U O Z 3 c T.O.F. EL.= 18.6't FINISH GRADE OVER D-BOX= 18.1't FINISH GRADE OVER CHAMBERS = 18.0' - 18.2'f PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM GENERAL NOTES WITH COVER OVER INLET& RISER TO WITHIN 6" OF FINISHED GRADE 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE FINISH GRADE OUTLET TO WITHIN 6" OF F.G._\ @ FIND. EL.= 18.0 t F.G. OVER TANK EL. = 18.0'± 5" DIA. OUTLET(S) 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS PLACE RISERS ON ALL CHAMBERS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY TOP OF SAS = 15.23, 9" MIN. 14.40 9' MIN. TO 6" OF FINISHED GRADE APPLICABLE LOCAL RULES. ' 36" MAX. Fr- 36"MAX. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE oREitiC^vuT cL = �.gQ ; DESIGN ENGINEER. 6 3" 3" DROP MAX ' „ 3 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL - 2" DROP MIN 3" 9 PROVIDE WATERTIGHT o 0 0 0 0 o SYSTEM UNLESS OTHERWISE NOTED. JOINTS (TYP.) !�t O �o O 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 14" 4" PVC OUT TO a U �a ELEVATION = 14.70' FOR A DISTANCE OF 15 FEET AROUND THE PERIMETER OF THE CONTRACTOR TO PROVIDE _ LEACHING FACILITY T �� �1 �� (-1 e �� (� = = = o S.A.S., UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST 5 FEET FROM S.A.S. SPECIFIED DROP BETWEEN 12„ ao L�! AND THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL 6 , 2' o0 0 o0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE MIN. 14.5 t p a p 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. AND CONDITION OF EXISTING TEES GAS BAFFLE �j�,,6" CRUSHED STONE j o 0 0 0 0 0 0 00 0 0 0 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o - TANK NECESSARY COMPACTED BASE 1i_4' I 8.5' I I 4 } I 4.0' 4.83' 4.0' I FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS ' S 33 5' _ t I NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF OUTLET DISTRIBUTION BOX h �- �I (1�,P ) --` HEALTH AND DESIGN ENGINEER. TO BE INSTALLED ON A LEVEL STABLE < 7.20' 12.83' 8. ELEVATIONS BASED ON NAVD 88 DATUM OF 18.70' ESTABLISHED ON A NAIL IN A PINE BASE. FIRST TWO FEET OF OUTLET 12.40' GROUND WATER ELEV.= TREE AS SHOWN ON PLAN, PIPES TO BE LAID LEVEL. 2- 500 GAL. CHAMBERS 5' MIN. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,500 GALLON CONCRETE SEPTIC TANK THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY "CONTRACTOR TO VERIFY EXISTING ELEVATION PRIORR TO ANY WORK& I)EPT '�" +► !>!! PROFLL I D I SI Vr%1 li.)U t C�l.�li iJ�TA I L TYPICAL CHAMBER PROFILE CHAMBER DETAIL CHAMBER END VIEW DISCREPANCIES TO THE DESIGN ENGINEER. i t,.1 M�# NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE _ NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE -- WATERTIGHT. .••" '�� �.` sue, • �, ' L• -�---- TEST PIT DATA TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING / { U„ • . ;'.� ` •{�` It 11 �' REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM / •� , •� �' •; • .• ,`, - ` • PERC NO. 15083 PERC NO. 15083 APPROPRIATE AUTHORITY. !!! • • �, • �• • .` 4k •INs * •i 'mot• DaVidv. Stanton, R.S n ..: Inr a ��i ' '`�I ���'�` �_ l., •!• ..,d. AGENT AGENT: ►�av,d VV Stanton, R.S 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED • �.. t •: •. i; , PROPOSED INSPECTION PORT , , • * l „" _,r=' �. 6 }# •� .• EVALUATOR: Michael Pimentel, E.I.T. EVALUATOR: Michael Pimentel E.I.T. UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR f_�: •''• 6-23-16 TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. ROPOSED 1 - 500 GALLON LEACHING --='�,'. . , . • •. • • ' ' •+l •• DATE: DATE: 6-23-16 /DRI CHAMBER w/AGGREGATE TO BE ' � , ��` J• • � 3T' 13 DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. / L , . '• , . �M 18 _• -- ; •, i"�r= . TEST PIT#: 1 TEST PIT#: 2ADDED TO EXISTING CHAMBERS 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND • ELEV TOP= 18,20' ELEV TOP = 18.20'TREET MAP 245 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING EX 2 - 500 GALLON t: ••�_-�� ; ,�. / `l :t :�l;•�,• _` • :,1.INAGE PARCEL29 � -� I1� 1� ! ' ` ELEV WATER= <7.20 ELEV WATER= <7.20' FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE CHAMBERS TO REMAIN ``t 30 ;i ♦ , •w , . , ��• ��. FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 1 j • ► •t • w , N/F CONWAY PERC RATE_ <2 MIN/IN PERC RATE _ 15.255(3). �r • . � 1� r ,, �; � •, ... �;�' . co L EX. DISTRIBUTION BOX TO ,tt; Veit.',' l • .•, , . t,•t. .�.• X BE UTILIZED IN THIS DESIG !; '`:�� 1 it 1 ' r ` •• •� • • : _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN Z it .II • ( ,�1'" ! . �• DEPTH OF PERC = _ DEPTH OF PERC - _ ft ti li•r*. 0 11•i}• ��``�r ; f• • SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK g /--100-FT BUFFER TO �,,... ,:,11 I( it 4 t l,1�, . ��-,� TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 16, PROPOSED PROJECT IS LOCATED WITHIN:r, ,fir t r r: r- ,r t. A tt_-r x COASTAL BANK ��/�o p s'` • .�`• t f;` I t ;:i • •'i -�� ~� �u ASSESSORS MAP 245 PARCEL 30 •'" 0 18-20' 0 18.20' s x EX. 1500-GAL SEPTIC TANK C1) .1` '♦ . •.-' • 6", EDGE OF CREEK AS i . E: t OWNER OF RECORD: RUTH M. DONOVAN C/O SUSAN E DONOVAN TO BE UTILIZED IN THIS I A Loam Sand A Loam x TP 2 TP 4 SHOWN ON LAND COURT r``a ;' •t,, Y y Sand B.M. 18.2 DESIGN s � ''�'• 10Yr 3/1 10Yr 3/1 ADDRESS: 301 EAST 64TH STREET 18.2 PLAN 15694 H (1960) �� 1 • Nail in Pine " i NEW YORK, NY 10021 X TP 1 � r�y� .1 6„ 17.70' 6" 17.70' Elev. = 18.70' CO /I/ 1 NAVD 88 18.2 "' 335, � � - �► f., �, �'I• FEMA FLOOD ZONE X; X(<500); AE(EL.12); AE(EL.13); VE(EL.14) ' LOCUS AS SHOWN ON COMMUNITY PANEL# 25001 C0564J Loamy Sand Loam Sand T 10Yr 5/6 10Yr 5/6 TP 3 't O B B 17. PLAN REFERENCE: 18.2 \r8 "�, , L.C. PLAN# 15694H �j D h.: _� r�1 f I R L� O LL 4 30" 15.70' 30" 15.70' 18. DEED REFERENCE: S g U 3 W "' L C.C #38926 Es 0 z � 16 R , p Lo 19 ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. ell _ Sand Medium 20. PROPERTY LINE INFORMATION IS APPROXIMATE, ONLY. THIS PLAN IS TO BE USED ONLY r i C�/ i C Medium Sand FOR SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL NOT ASSUME ANY LIABILITY Q� va Rt'1 i S - - _-_ 2.5Y 6/6 2.5Y 6/6 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. - - `� 0 21. A 4" PERFORATED SCH- 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A O REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. No roundwater, © g No groundwater, �o , LOCUS PLAN Weeping or Mottling Weeping or groundwater, 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL � f / �, #275 0 / „ = 132" Observed Observed Mottling REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. 41 O '� EXISTING SCALE: 1000' �° 7.20' 132 7-20 3-BDRM / -- � DWELLING � � � C:'�,:T Q I T nDATr L E G E N C -- J y� TOP OF FOUND. , ;J / *Per Test Performed by JC : 4Y `� (1) EL = 18.6'± Engineering on October 9th, 2003 PERC NO 15083 NUMBER OF BEDROOMS: 4 (DESIGN) in "C" Soil EXISTING CONTOUR DESIGN FLOW: 110 GPD/BDRM AGENT: David W. Stanton, R.S. TOTAL DESIGN FLOW: 440 GPD EVALUATOR. Michael Pimentel E.I.T. 50 PROPOSED SPOT GRADES DESIGN FLOW X 200 % = Sao GPD TEST PIT DATA �, GO 0 DATE: 6-23-16 50 PROPOSED CONTOUR PATIO USE EXISTING 1500-GALLON SEPTIC TANK / PERC NO. 15083 TEST PIT#: 4 EXISTING OVERHEAD UTILITIES �'/� w AGENT: David W. Stanton, R.S. ELEV TOP= 18.20, V i EXISTING WATERLINE EVALUATOR: Miclhael Pimentel, E.I.T. ELEV WATER - <7.20' EXISTING UNDERGROUND ELECTRIC SAS DESIGN: INSTALL 1 NEW 500 GAL. CHAMBER MAP 245 �' = PARCEL 30 ; / / TO 2 EXISTING 500 GAL. CHAMBERS AS SHOWN DATE: 6-23-16 �� PERC RATE = TEST PIT LOCATION TEST PIT#: 3 _ 44,770 S.F ± ELEV TOP = 18 20' DEPTH OF PERC = SIDEWALL CAPACITY O O O TEXTURAL CLASS: 1 EXISTING 1,500 GALLON SEPTIC TANK / (LENGTH + WIDTH) (2 SIDES) (EFF. HEIGHT) (.74 GPD/SQ.FT.) - GPD ELEV WATER = <7.20' _ / (33.5' + 12.83') (2) (2') (.74 GAL/SQ.FT,) = 137.1 GAL LEACHING/DAY PERC RATE _ <2 MIN/IN` 0 18 20' EXISTING 4" SOLID SCHEDULE 40 PVC PIPE 14 / 0��- BOTTOM CAPACITY DEPTH OF PERC = A Loamy Sand EXISTING 500 GALLON LEACHING CHAMBER (LENGTH) (WIDTH) (.74 GPD/SQ.FT.) = GPD 10Yr 3/1 El EXISTING DISTRIBUTION BOX (33.5') (12.83') (.74 GAL/SQ.FT.) = 318.1 GAL. LEACHING/DAY TEXTURAL CLASS: 1 _ 6' 17.70' CB/DH / PROPOSED 500 GALLON LEACHING CHAMBER FND,; TOTALS: HELD 0 1s.2o' Loamy Sand ... ...... ... .. ...... PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE ( TOTAL LEACHING AREA 615.1 SQ.FT A Loamy Sand B 10Yr 5/6 1.041 TOTAL LEACHING CAPACITY 455.2 GPD 10Yr 3/1 Loamy Sand REV_ DATE BY APP'D. DESCRIPTION B 10Yr5/6 PROPOSED SEPTIC SYSTEM PLAN � 9J S�oa2 30" 15.70' G Medium PREPARED FOR: 2.5Y 6/6nd ERIC POLYAK MAP 245 LOCATED AT ARCEL 31 C Medium Sand No groundwater, 275 GREEN DUNES DRIVE N/F CAREY 2.5Y 616 Weeping or Observed Mottling HYANNISPORT, MA 02648 132" 7.20' SCALE: 1 INCH = 20 FT. DATE: JULY 11, 2016 No groundwater, 0 10 20 40 80 FEET Weeping or Mottling i JOHN L. PREPARED BY: Observed 132" 7.20' CHURCHILL JR. I v,L JC ENGINEERING, INC. a1807 2854 CRANBERRY HIGHWAY *Per Test Performed by JC G!s � EAST WAREHAM, MA 02538 SITE PLAN Engineering on October 9th, 2003 I .� f i(� in "C" Soil 508.273.0377i SCALE 1" - 20' Drawn By: SJI Designed By: MCP Checked By. JLC JOB No.561-1 TOP OF FOUNDATION = 20.94' 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS = 20.30' - 20.10' GENERAL NOTES REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM FINISH GRADE OVER TANK EL.= FINISH GRADE OVER D-BOX-20.20' 4"SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2"DOUBLE WASHED STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTIONMETHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE FINISHED GRADE 20.30, @ FOUNDATION = 20.20' 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD I; 20"MIN.ACCESS COVER PROVIDE RISER OVER OUTLET i' (3 TYPICAL) TO WITHIN 6"OF GRADE TOP OF SAS= 17.33' PLACE RISERS ON ALL CHAMBERS OF HEALTH AND THE DESIGN ENGINEER. \\\ 36"MAX. " TO 6"OF FINISHED GRADE " li 16.50' 6"MIAX. 3 BESU USED IN DISPOSALSYS SIPE YSTEM UNLESS OTHERWISE NOTEDTH WATER TIGHT JOINTS . BREAKOUT EL = 17.00 1� 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN 2" DROP MIN. PROVIDE WATERTIGHT ELEVATION = 17.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS MIN.SLOPE 1% 6" 3" 3" 9" 3" DROP MAX. JOINTS (TYP.) o a o 0 0 o A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10" , 4" PVC IN FROM " O ppp �� O THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. PIPE TO BE 18.00, (PIPE "A") 14 16,9�j SEPTIC TANK 4 PVC OUT TO p cep c� 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. RE-PLUMBED ' LEACHING FACILITY oo o 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 17.16 " OUTLET TEE 16.75' WHIN. 16,rj$' 2' o0 0 0 0 o o 0 0 0 0 00 7 SYCAL YSTEM IOARD OF HEALTH S NEARLY COMPLEO BE NOTIFIED TE AND READY FOR INSPECTIOR TO ION. FILLING WHEN 48 0o O SYSTEM IS NOT TO 24.5' = = = = = o0 0 0 pO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. 22"ZABEL FILTER 60 0 CRUSHED STONE -C 0 0 8. ELEVATIONS BASED ON ASSUMED DATUM OF 21.00 MSL OBTAINED FROM A NAIL IN A TREE MODEL#A1801 HIP OVER MECHANICALLY COMPACTED BASE 4' 8.5' 4' 4.0' 4.9' 4.0' AS SHOWN ON PLAN. (GAS BAFFLE ON 25 0' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 6"CRUSHED STONE BOTTOM) 5 OUTLET DISTRIBUTION BOX (TYP.) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV= < 9.27' A 12.9' AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY COMPACTED BASE C BASE. FIRST TWO FEET OF OUTLET 14.50 DISCREPANCIES TO THE DESIGN ENGINEER. PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 2- 500 GAL. CHAMBERS 5'MIN. 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE LENGTH 10.5' WIDTH 5.66' DEPTH 5.58' CROSS SECTION VIEW STRUCTURES SHALL BE MADE WATERTIGHT. TYPICAL CHAMBER PROFILE CHAMBER DETAILS CHAMBER END VIEW 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL NOT TO SCALE ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH NOT TO SCALE NOT TO SCALE DETERMINATION FROM APPROPRIATE AUTHORITY. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS \ "A �•�•• • • ' TEST PIT DATA LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE \ / !; • 1.• ''�7r ( .• THEY SHALL WITHSTAND H-20 LOADING. CB/DH \ f i Via. ; , ail• of ' : `• SOIL EVALUATOR: Samuel Philos Jensen 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT DUST AND \ , FND, ,' �;. • • + • �l � � HELD M \ \ • ' u " '• DATE: October 9, 2003 FINES. AP 245 • � �� �. , . DISTRIBUTION BOX \ i " � �, ` M `fit + �; ' • TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND STREET \ \ r 'T~ r I •� • "'• • • ELEV TOP: 20 27, UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF \ •• y- . . •, • • LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN DRAINAGE / INSTALL TWO 500-GAL PARCEL 29 \ 4 .• r •• » l �. s•` COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN CHAMBERS \ \ • • i. � $ `/ .3Jr. '#• ELEV WATER: <9.27 N/F CONWAY �. + .� . . • ACCORDANCE WITH 310 CMR 15.255(3). LP •• �• • .• w • * • :+ : . PERC RATE: < 2 Min./In. 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN Z 1500-GAL SEPTIC TANK \ - • • • • ' i• •• • .r • " SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. ,� , .• • • • . DEPTH OF PERC= 32 -50" 11 ` • .• • .• N 3{? • .� •• • - • r • 16. PROPOSED PROJECT IS LOCATED WITHIN: U 100-FT BUFFER TO • ,�� Ey�,�y, i� • • • + •• TEXTURAL CLASS: 1 ASSESSORS MAP 245 PARCEL 30 J COASTAL BANK t \• �•lit�o *•'" " • a s • ', ---- �� EDGE OF CREEK AS / �) 'li• r.;�Cl• I� _�. __.-____ "• «• , ` +� 0 20.27' 17. OWNER OF RECORD: RUTH M. DONOVAN C/O SUSAN E. DONOVAN B M / SHOWN ON LAND COURT 'Pit •IIf if 5 • �� • ° q Sandy Loam 10YR 4/4 ADDRESS: 301 EAST 64TH ST. Nail in Pine \ o PLAN 15694 H (1960) --if ', !i p • . . NEW YORK, NY 10021 / I s 10 19.44' CESSPOOLS TO BE PUMPED \ 1" • ' . =- Elev. =21.00' 1� • '' FEMA FLOOD ZONE C, Al (EL. 11 Assumed J AND FILLED WITH CLEAN ` '�'" �� ) p SAND I , Ty ` , ' • �� �. -- g Loamy Sand 10YR 6/8 AS SHOWN ON COMMUNITY PANEL# 250001 0008 D �✓ s ��°2 1, TOP OF COASTAL - �" D 4`y ••• ' 18. PLAN REFERENCE: -o 20.27 - 1q" 1 0 '6) _ 2�?, F - BANK \ / "� • • „ 32" 1. LAND COURT PLAN 15694 H / �p ?S 0, (5 p8 4, ram.)f ,r 32 Perc. 17.60' 2. LAND COURT PLAN 156941 LO U') Ste/ / �O�tiO / �j�)'J�p l.lA a _ _ 19. DEED CERTIFIC AT 38926 C / T y Y .hF tts. ��/ /� l C Go�' / 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. TH IS PLAN IS TO BE USED ONLY E FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 0* 411 , FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. #275 � / � __.__ ----•--- _ j EXISTING )w 3-BDRM/ ��T � ' �'' C ed. and .5Y 7/4 f DWELLING LOCUS PLAN R TOP OF FOUND. PIPE EL. =20.94' / � � � SCALE: 1"= 1000' No Standing Water, (1) INV. EL. / Weeping, or Mottling 8.00' , DESIGN DATA Observed LEGEND /'\16 i / INTERIOR PIPING TO BE 132" 9.27' RE-PLUMBED TO FRONT NUMBER OF BEDROOMS: 3 O ^/PATIO/ \ \ � � DESIGN FLOW: 110 GPD/BDRM EXISTING CONTOUR TOTAL DESIGN FLOW: 330 GPD \ / DESIGN FLOW X 200 % = 660 GPD 50 PROPOSED SPOT GRADES \ o INTERIOR PIPING TO BE 1 / / USE NEW 1500-GALLON SEPTIC TANK PROPOSED CONTOUR o RE-PLUMBED ` \ / CESSPOOL TO BE PUMPED AND FILLED WITH CLEAN SAND(LOCATION EXISTING OVERHEAD UTILITIES APPROXIMATE-CONTRACTOR TO VERIFY) --A9j / / / \ \ INSTALL TWO 500-GALLON CHAMBERS EXISTING WATERLINE / / •/ I \ SIDEWALL CAPACITY EXISTING GASLINE \ I / / v / J �� / , \ (LENGTH +WIDTH)(2 SIDES)(EFF. HEIGHT)(.74 GPDlSQ.FT.)=GPD % TEST PIT LOCATION MAP245 ,moo/ / \ \ �40 (25' + 12.9')(2)(2')(.74 GAL/SQ.FT.)= 112.2 GAL. LEACHING/DAY --� / BOTTOM CAPACITY PROPOSED 1500 GALLON SEPTIC TANK PARCEL 30 CB/DH � / / )(WIDTH) 74 GPD/SQ.FT.) = GPD � � (LENGTH) )(• / 4"SOLID SCHEDULE 40 PVC PIPE FND, 44,770 S.F.t / ^ �/ / (25')(12.9')(.74 GAUSQ.FT.)= 238.7 GAL. LEACHING/DAY HELD! _ / / /� ❑ DISTRIBUTION BOX TOTALS: �O 500 GAL. LEACHING CHAMBER TOTAL LEACHING AREA 474.1 SQ.FT. TOTAL LEACHING CAPACITY 350.9 GPD WATER OBSERVED AT EL. 3.95' / AT 10:14 AM (HIGH CB/DH ° S?0 2� TIDE) REV. DATE BY APP'D. DESCRIPTION FND, 171,�'4"E PROPOSED SEPTIC SYSTEM UPGRADE HELD PREPARED FOR: \ MAP 245 RUTH DONOVAN \ "SWING TIES" \ PARCEL 31 LOCATED AT N/F CAREY DESCRIPTION HC (1) HC (2) 275 GREEN DUNES DRIVE \ \ SEPTIC COVER IN (3) 46.3' 41.8' HYANNISPORT, MASS. RESERVED FOR BOARD OF HEALTH USE \ SEPTIC COVER OUT(4) 53.1' 38.1' SCALE: 1 INCH = 20 FT. DATE: OCTOBER 24, 2003 \ \ SAS EDGE(5) 64.1' 38.7' r, � 0 10 20 40 80 FEET \ SAS EDGE (6) 65.5' 61.5' 1111000001111 PREPARED BY. \ \ 2 CHURL ILL � JC ENGINEERING, INC. JR. CiVIL 2854 CRANBERRY HIGHWAY EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"=20' i'� Drawn B SJ Designed B SJ Checked B JLC JOB No.561 Y� 9 Y� Y�