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HomeMy WebLinkAbout0062 JOAN ROAD - Health 62 Joan Road Centerville A=228 -078 5 M EAD® No.Z•153LOR UPC 12534 smead com • Made to USA t TOWN OF BARNSTABLE � LOCATION 01 `man SEWAGE#OW9 +//9' V'•LLAGE gn-4 tt^g lI �� ASSESSOR'S MAP&PARCEL 3 J INSTALLERS NAME&PHONE NO. ,3 fja►t/cx� on �f77' OLS SEPTIC TANK CAPACITY 4 �, ISDo 9c i �E9 LEACHING FACILITY:(type)`13433 ac — "' ( 9)cta� c>�ar►�3cc'S NO.OF BEDROOMS ' .._ OWNER 'Torn L� rarGr PERMIT-DATE: COMPLIANCE DATE: Separation Distance Between the: MaximumAdjusted 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 Bi-ZS 3z•:Lo; .,; A3_Cil f U?. (D AS.gq •s-® `fir;'; � ' .i Y Ti '• r + No. f�l/ Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLotion for NopoBAY *pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade K) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. TUCI n �d0 Owner's Name,Address,and Tel.No. -1-15-6 5 7 2 cc�+er., ,Il� T m o Cetrnbare.ri Assessor's Map/Parcel 22 Cg 0-7 on? t i Installer's Na e, dress, d Tel.No. Designer's Name,Address,and Tel.No. "I V 9 -6 4 8 3 �Dbet-+ I oy— t 8 X _CAVC4 00; ( C4nn0n Ern ► neer 1 Z 94-Jc, Type of Building: �-,21/— of3 G— n 7FT— t Dwelling No.of Bedrooms Lot Size 4 9 Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 4 L4 O gpd Design flow provided gpd Plan Date y 1 15 k 17 C1 Number of sheets I � Revision Date Title r O pOSerj S tLA 1J r,1,l sP b 6n I ^t' I a r) Size of Septic Tank 50 0 oni Type of S.A.S.�hGt m E1CC S Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issue is Board of Health. Signet Date Application Approved u Date 5 . Application Disapproved by Date for the following reasons Permit No. q� — //� Date Issued L5 p V ; Af No. QoWFee THE OQ THE COMMONWEALTH OF MASSACHUSETTS #, Entered in computer: PUBLIC' HEALTH DIVISION -TOWN.OF BARNSTABLE, MASSACHUSETTS Yes ;r 2ppflcatlon for MsposaY)pstem Construction i3ermit 1 Application for a Permit to Construct( ) Repair(' ) Upgrade`(° ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. & ;z Owner's Name,Address,and Tel.No. 7-7 5 - 5 'S 7 2 Assessor's Map/Parcel 22 ()-1 f,-a T r)ri Installer's Name,Address,and Tel.No. Ill I 1�� Designer's Name,Address,and Tel..No. 7 "3 I'A ,s cxto Ic 11GC'1 1nL (_GC}f)U('1 (CYIt�` 1,E,Cd i '­' Type of Building: ��- 3(r,- d 6 Dwelling No.of Bedrooms Lot Size U, �` 'I U sq.-ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ( � gpd Design flow provided gpd Plan Date f� ' 5 t(�`I Number of sheets 1 Revision Date Title��'(�JU�F'rl CDPI I r'I( C 1 )'lsn2 . ..,rI C1 r) Size of Septic Tank 61 0 0 03,I 0 Type of S.A.S. r ri r-, I �fn S Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe .� Date S 1 `1 U Application Approved _ Date 5 0PA Application Disapproved by Date for the following reasons Permit No. J� Date Issued 5 It-lb THE COMMONWEALTH OF MASSACHUSETTS ` BARNSTABLE,MASSACHUSETTS QCertificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by _T�1 L-� �A 4 C I 4 I/, C:) at ?� ,ri f1 �, f 'r'1 I P t �I f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N e dated J4 Installer �;�;F' r j (-7 i �i� Designer #bedrooms Approved dessignnflow(\ � gpd The issuance of this permit shall not be construed as a guarantee that the system will functio as desig4el Date C ( 0 0" Inspector ,a ---------------------------------------------------------------------- No. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem (Construction i9ermit Permission is hereby granted to C—o�n'struct( ) Repair(V Upgrade( ) Abandon( ) System located at (D Z ►/, I l f'; F'' i I , and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction in st a lcompleted within three years of the date of thisape Date ! Approved by- —,---.. MAY-09-2009 17:51 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.2/e R t APPLICANT: M Ma ez- -ADDRESS: Pt of 44 Oa 6.7 2 D:ESIGIY FLOW: S • gpd REVIEWE. BY: ,DATE: oil N/A OlK NO Legal boundaries denoted 310 C-MR 15.22 4 a Street,Lot,tax parcel number and lot number noted on plan [3107 CMR I5.220 4 u X Locus Provided Q10 CW 15.2204 t Plan proper scale?(1"-40'for plot plans, 1 20'or fewer far 7 corn vents 310 CMR 15.220 4 basements shown 3l0 CIvIR 15.22 .4 System located totally on fot served [310 CMS 15.405(I)(a)for u mdes -i not, a variance is required 1310 CMR 15.412(4)] X Location of impervious surfaces(driveways,parking areas etc.) 310 CMR 15.220 4 d Location all buildings existing and proposed 310 CMR 15.22Q 4 c X Location and dimensions of system com 310 CMR 15.220 ponents and reserve areas 4 e _ } Isystern Calculations 310 CMR 15.220 4 daily flow y se tic tank ea aci (required andprovided) $ p, soil abso tion s stem(required and rovided whether system designed for arba c grindet North arrow 3I 0 CMR 15.220(4)(01 gxong and MLjosed contours L310 CM11 .L5.220 4 Ucation and log of deep observation hoics(existing grade el. on each test)1310 CMR 15.220 4 Names of soil evaluator and BOCK representative j310 CMR 15.220 4 and i ' Location and date ofpercolation tests(performed at proper elevation?) 1`310 CMR 15.220(4)(i)] Percolation test results match loadin rate? 310 CMR 15.242 X'Certification statement b Soil Evaluator 310 CMR 15.220 4 Observed and Adjusted groundwater(method far adjustment given or indicated) [310 CMIt 15.103(3)and 310 CMR 15.220 4 n ,Location of every water supply,public and private, [310 CMR 15.220 4 k M A Cr' Sheet I ot'7 MAY-06-2009 17:51 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.3/e i within 400 feet of the proposed system location in the case of surface water supelibs and gravel packed ublic water!2PRIL within 250 feet of the proeosed system location in the cafe within ISO feet of the proposed system location in the case of erivate water suRpIX wells Location of all surface waters and wetlands located up to 100 ft. Beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 fk 310 CMR 15.220(4)(1)] Water tines and other subsurface utilities located[310 CMR I5.220 4 m (if water line cross see 310 CMR 15.211 1 1 Profile of system showing invert elevations of all system com onents and the bottom of the SAS 310 CMkl 5.220 4 0 Stamp of designer 310 CMR 15.220 ] and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 fit.of lot I in92 310 CMR 15.220(3)] 'rest holes adequate(two in each of the primary and reserve unless trenches as permitted in 310 CMR 1,5.102(2)or as a roved for ati u redo under LUA at 310 CMR .I 5.405 1 k Test hole adequate to demonstrate four feet of suitable material? ✓ 3]0 CMR 15.103 4 Tdst Holes adequate to confirm adequate groundwater separation? 310 CMR 15.103 3 Benchmark within 50r75'of system 010 CMR 15.220 4 iViaterials speaifcattans noted?(various sections of 310 CMR 15.000 System components not>16"deep(unless Local Upgrade jAeeroval or LUA,r uested)f310 CMR 15.405 1 Ub Address 0.Pa cGl r F ,d rl1e- Sheet 2 of 7 I MAY-06-2009 17:51 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.4/8 _ Size OK7 310 CMR 15.223 1 Inlet tie located ten inches below flow line 310 CMR 15,227 C3utlet tee 14"or 14"+5"per foot for increase ft depth [310 CMR 15-22ZMI Outlet We with gas baffle or approved filter 310 CMR 15.227 4 Note tegarding installation on stable cornpacted'base[310 CMR. 15.228(l)] x Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227(2)] !` InlettOutlet elevations at least 12" above high groundwater (except as described 310 CMR 15,227(5))or permitted for upgrades under LUA r310 CMR 15.4-05 l k Minimum cover 9"(Tanks buried more than 9"must have risers on all openings and on the d-box)[310 CMR 15,2228(1)and 310 CMR 15,23 3 1 'Three access covers(inlet and outlet must be 20"or greater)- middle access at least 8" 7/07 310 CMR 15.228 2 Access to within G"of grade -one port for systems<]000gpd, x two for stems>1000 310 CMR 15.228(2)] All at-grade covers,secured to unauthorized access? [310 CMR I S.228(2)] /4/if I 10 ft fi om buildin foundation 3[0 CMR 1 S.21] f Duo an calculation Re uired/Done 310 CMR 15,221(8)] H-20 Where a ro riate7 310 CMR 15.225 3 Setbacks from resources '310 CMR 15.211 Required when other than single-family dwetlingor flow>100Q 310 CMR 15.223 1 First compartment 200%daily flow; Second compartment 100% daily stow 310 CMR 15.224(2)Lind 3 ' "U"pipe through or over baffle,outlet of each compartment with as baffle or approved filter 310 CMR 15.224 4 Address (� -.�- PC- ,� Sheet 3 of 7 MAY-06-2009 17:52 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.5/8 Located at least ten feet from any water line?[310 CMR77 15,222 2 � Disposal piping at least 18' below water line(when water and /'T sewer cross,see 310 CMR 15.211 11 Cleanouts required/provided?Q10 CMR 15,222 $ Thrust blocks s ctfled in force mains?310 CMR 15.221 b c Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 310 CMR 15.222 G Proper pitch on all runs?(,005 within gravity-distributed trenches and beds) 310 CMR 15.251 9 and 310 CMR 15,252 2 c Si honproblem/ leaehfield below Purn2 chamber ndcaps or vent manifolds cifed? Size and orientation of discharge holes specified?(not smaller than 3/8"not larger than 5/8") [310 CMR 15.251(9)and 3 1.0 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5)specifies various pipe types allowed Stable compacted base[310 CMR 15.22](2)and 310 CMR 15.232 a Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer)[310 CMR 15,323 3 a Riser if dee r than 9" 310 CMR 15,232(3)(0] Inside minimum dimension 12" 0 10 CMR 15.232 2 Minimum sum G" 310 CMRIS.2M2(3 Ue Watertight cover if<2000gpd);waterproof manhole if>2000gpd 310 CMR 15.232(3)(D Capacity(emergency storage above working=dcsign .flow)?[310 CMR 231 Q1 Proper setbacks Q10 CMR 15.211 same as se tic tanksg 7 7p, 7 Watertight 20-in minium access manhole at least 20"MUST Far TO GRADE 310 CMR 15.231 5 Service components accessible(not too deep with piping, A t disconnects accessible) I" Alarm floats-alarm on circuit se crate from purnes specified? Exceeds two units must have two pumps operating in lead-Ing mode. f 310 CMR 15.23 1 b and 8 'Stable Compacted Base F310 CMR 15.22)(2)] -Buoyancy calculations needed ?.Provided? 310 CMR 15,221 8 Address,..6?— 1 l d- C& "(V/- Shoot 4 of 7 MAY-06-2009 17:52 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.6f8 Calculations correct? 4 feet of naturally occurring material demonstrated?[310 CMR 15.240 1 Re uimd separation to roundwater? 310 CMR 15.212 A&Mgatc s 6fied as double washed 310 CMR 15.247(2)] System Venting►required/provided7(system under driveway or >36"dee 310 CMR 15.2411 /q- Inspection ports specified and within 3"final grade?(310 CMR 7)c7 15.24 13 Breakout requirements met?(No violation of breakout elevation within 15 A of SAS unless barrier)[310 CM'R 15.211(1)[41 and Guidance Document Chambers and Gal. in trench configuration supplied with inlet every 20 R. 310 CN.M 15.253 G Each structure with one inspection manhole(if>2000 gpd must be to ado 310 CMR 15.253L2)) !1� Aggregate I'minimum-4'maximum. 310 CMR 15.253 ] b 2'sidewall credit maximum MQ CMR 15.253 1 a In bed confil2ration, inlet eveU 40 s .f.010 CMR 15.253(6)] Width 2'minimum X maximum 310 CMR 15.25.1 1 b 100 feet-maximum len i 310 CMR 15.251 1 a Minimum separation 2x effective depth or width whichever eater Ox if reserve between trenches 310 CMR 251 1 dD M [Situated along contours 310 CMR I5ZI 2 JBrc&kout0K7f310CMR15,21l 1 4 and Guidance Document .minimum 2 distribution lines 1310 CMR 15.252 2 tr Maximum se aration between lines 6' 310 CM R 15.252 2 d Maximum separation between Iines and outside of hed 4' j 310 7 CMR 15.252 2 e ] hJ /�- Aggregate depth below discharge pipes 6"minimum, 12" maximum. 310 CMR 15.252 2 44 Se ration between beds IW minimum. 310 CM12 15.252 2 t Bc►ttdm area used in calculations only 310 CMR 15.252 2 i Address _ e�, ('ek+I 1 V(i lCr '" Sheet 5 of 7 MAY-06-2009 17:53 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.7/8 Nam Pressure Dasrd System P Provided pump and piping calculations as re uired 310 CMR 15,220 4 r Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2)and I/A Remedial Use Approvalo. / If used in gravelless system •make sure jet is directed as not to ' scour soil interface Guidance Document !� Inspections once per year(systems<2000 gpd) or quarterly 2000good to note on plan 310 CMR 15.254 2 d Construction In fill -Did the plan specify that the fill shall meet the s ecification of 310 CMR 15,255 3 ? Tm envious barrier and/or retainin wall ?(Guidance.Document Impervious barrier installation must be supervised by deli er f310 CMR .15.255 Retaining wall mustbe designed by Registered Professional tan ineer P 10 CMR 15.255 a O lh- Side slo a not exceed 3:1 ? 310 CMlt 15.255 2 • Breakout requirements met?[310 CMR 15.252(2) and Guidance Document At least 511, &o,n impervious barrier to edge of SAS (10 ft. recommended 310 CMR 15.255 2 e Check DEP Approval letters for-credits and desi n conditions If used with pressure dosing do not allow pressure discharge r to scour soil interface I" Was DEP Approval setter provided and/or have you reviewed the letter for conditions? t y lA- Is the technology being properly applied and does it meet.all DEP A royal Conditions? N �' Ts there a note on the plan regarding the requirement for perpetUill maintenance a moment? Any alarms involved on se crate circuits Did the applicant submit an operation and maintenance manual? /1J Has applicant submitted a copy of a maintenance F NIA Are the variances listed on the plan?[310 CMR 15.220 4 1 LS Stamp necessary on plan if a component is within five feet of pro2crty line 310 CMR 15.412 4 New construction or increased flow proposed-[Refer to 310 _ CMR 15.414] Address_tp Z OG� 1 r �'�' Sheet 6 of 7 MAY-,O�-2009 17:53 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.8/8 • i Is the system to a Designated Nitrogen Sensitive Area(Zon-e-If o a public supply well)?C310 CMR 15,214, 310 CM.R 15.215 and 310 CMR 15.216-also refer to Policy regarding upgrades of such existing stems Is the system proposed on the same lot as served by private we117 ' 310 CMR 15.214 2 . Are the nitrogen loads proposed in compliance? [310 CMR VIA Pumping to se tic tank? 310 MR 15.229 Shared S stem 1.31 Q CMR 15.290 Address" a d� �� ui �I{� � Sheet 7 of 7 MAY-18-2009 18:35 From:CAPE COD COMMISSION 5083623136 To:15084770768 P.2/2 ' 'own of Barnstable Regulatory Services Thomas F.Geiler,Director $ Public Health Division t0sa a Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Offica: 508-862-4644 Fax 508,790.6304 Date: ¢ Sewage Permit# OO - /8 Assessor's Map/Parcel Zz>3 U ip to er&I)gSigner ertification,�)f'or�m Designer: [��N o�a�� i e, � Installer: c! Address: N Address: / (Z., ¢ �- - d r-b �3Y16 on sl- g _p • eN T as issued a permit to install a ate (installer) septic system at 40 „"Casa 04 ,� _Ire h,f It based on a design drawn by (address) dated iper I certify that the septic system referenced above was installed substantially accordin to the design, which may include minor approved changes such as lateral relocation of the pa inspected and the soils if Stri ut required) was distribution box and/or septic tank. ( q were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. eater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations, plan revision or certified as-built by designer to fallow. Stripout(if required) was inspected and the soils were found satisfactory. Hato er's igna ore IM. IF III esignees �ipature � (Affix p .ere PLEASE- RET O B AB PI)BLY HE H D IO C T I , E T-IL BOTH O COM k-, OT S U TAl9 1 P><JH C T A .ON. C D E D T OU. q.W fiiw fnrmownigneroardfialtinn form doo 9 P 7f/ S No. Fee f 1 r ­-' Entered in computer: THE COMMONWEALTH OF MAS SACHUSETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0imitation for �Di_qpaat *Potem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ;!5Complete System ❑Individual Components Location Address or Lot No W W &0G . Owner's Name,Address and Tel.No. Assessor's Map/Parcel ����`� ►v`t� U�d Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ip-GI��P�s�p�nkc II,, YY( Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures t 1 Design Flow �a gallons per day. Calculated daily flow `'1;, gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank v Se ,6 (. Type of S.A.S. Description of Soil SI`� Nature of Repairs or Alterations(Answer when applicable) 1 S o k , . ' (L w v— 10—6-�K 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 to place the system in operation until a Certifi- cate of Compliance has be is Signed Date Z9 Application Approved by Date Application Disapproved for the following reasons Permit No. �Q4 7 71 Date Issued TOWN OF BARNSTABLE LOCATION G1 oa SEWAGE # �( VILLAGE '1 .M7.ra-m�1 1��.,.. ASSESSOR'S MAP & LOT 219 - D INSTALLER'S NAME&PHONE nnNo. M ", re-'A-e SEPTIC TANK CAPACTTY !"4_A/ If Se LEACHING FACILITY: (type) '451"/it 6K/fe4 S (size) NO.OF BEDROOMS ` BUILDER OR OWNER11 c � PERMITDATE: . - 17 -` 15 COMPLIANCE DATE: 11.- V • S' - Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet I Furnished by I No. / F— 7?Z Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS A 01pprication for Mfigpoal *p5tem Construction Permit Application for a Permit to Construct"(" )Repair( )Upgrade( )Abandon( ) ;5Complete System ❑Individual Components Location Address or Lot No Q GNr �ll� Owner's Nam ,Address and Tel.No. Assessor's Map/Parcel ��� ,Q� I� l�cl l i Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ,N1.1 `G to V Se P1 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank � Se Type of S.A.S. Ct (✓ Description of Soil Vlh- — rf/�� Nature of Repairs or Alterati6ns•(Answer when applicable) S 0'D V'o J 1 se(h 1 C- 71:54- '-,4 Et�fL�%�"�r r.D Gt r-L L�-Z,C:1 S Gcj� I W STGw•e_ L � l Orr/ Date last inspected: Agreement: r. 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 to place the system in operation until a Certifi- cate of Compliance has be A�. t d- ; is Signed" Date Application Approved by : Date Application Disapproved for the following reasons Permit No. "M Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS QCertificate of (tompliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(P< Abandoned( )by ( t 0—C.0� at /4 C - __; o►a" dW 0 C_e^ -y C2 V,Wt has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. --',`Z dated Installer „,V_ br� Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector --------------------------- — No. 1 -� 7/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migogaf *potem Con0truction Permit Permission is hereby granted to Construct( )Repair(' Upgrade(Abandon( ) System located at t40-- a� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this it. Q Date: 2` 7 —�� Approved by ✓J - 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only: CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works construction permit signed by me dated CC5 , concerning the property located at (o D � 0�J L meets all of the following criteria: (� ere are no wetlands located within 100 feet of the proposed leaching facility the proposed septic stem There are no private wells within 150 feetof p p p y There is no increase in flow and/or change in use proposed There are no variances requested or needed. �lf the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the proposed leaching facility will=be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. Please complete the following: � t � A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) 1 7 B)Observed Groundwater Table Elevation(according to Health Division well map)c;;,er` I 3S0fi SIGNED : DATE: 7 l LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder.cert {�n/ nn� 1���� v �� TOWN OF BARNSTABLE `L LOCATION Y1 ©u ut SEWAGE # �" 7 �/ VILLAGE _ __ ►n - - ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. 0&je t SEPTIC TANK CAPACITY .f o o LEACHING FACILITY: (type) /il 1641-le4 0'S (size) NO.OF BEDROOMS BUILDER OR OWNER 11 PERMTTDATE: — I;7 -29 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by A 3- 3-9 COMMONWEALTH OF MASSACHUSETTS �' � �'�'. EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAI°RSA DEPARTMENT OF ENVIRONMENTAL PROTEC rON � s,19 ry ONE WINTER STREET, BOSTON MA 02108 (617) 292-5500 < � �T�q, WILLIAM F.WELD ',� ti •;� 1qTRUDY CORE Governor oFJT; Secretary a ARGEO PAUL CELLUCCI ` DAVID B. STRUHS Lt. Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Qt� xl-c PART A J CERTIFICATION ro �Z OaN� Q� < ���.�, Address of Owner: Property Address: ����� 1 Date of Inspection: (If different) 7 C11 -rtli Name of Inspector: ici-. �.1�.L.k,(� ' I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: 'r LL Q ®2Z Mailing Address:—D.S—) Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: XPasses _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any. failure criteria not evaluated are indicated below. COMMENTS: Tt C Twa o� •�e..Q cYo\ ►�'\l t� e k 1 qu-e\e, rtwl 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. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection. or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 r' A r W_! Pnnted vn Recwlecl Paver SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distrib ion box is due to broken or obstructed pipe(s) or due to a.broken, settled or uneven distribution box. The system will pass i spection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to bro en 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 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HE Conditions exist which require further evaluation by the Board of alth in order to determine if the system is failing to protect the public health. safety Y and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DE ILNVIINES THAT THE SYSTEM IS NOT FUNCTIONING IN A . MANNER WCH WILL PROTECT THE PUBLIC HE TH AND SAFETY A.N'D THE ENIIZ VONMEI�"T: HF Cesspool or privy is within 50 feet of a surface w ter _ Cesspool or privy is within 50 feet of a borderin vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF ALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETEIMUNES THAT THE SYSTEM IS FUNCTI G IN A MANNER THAT PROTECTS THE PUBLIC HEALTH A,1D SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil abs rption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil a sorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil bsorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soi absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well wa r analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facili and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distanc (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: DI SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as define in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine w at will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clo ged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface water due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overl aded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clo ed or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is b ow the high groundwater elevation. _ Any portion of a cesspool or privy is within 100 feet of a surfa water supply or tributary to a surface water supply. _ Any portion of a cesspool or privy is within a Zone I of a p lic well. Any portion of a cesspool or privy is within 50 feet of a ivate water supply well. Any portion of a cesspool or privy is less than 100 fee but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has bee analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, am nia nitrogen and nitrate nitrogen. E]LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the followi The following criteria apply to large systems in additi to the criteria above: The system serves a facility with a design flow of 1 ,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because on or more of the following conditions exist: Yes No the system is within 400 feet of a s rface drinking water supply the system is within 200 feet of tributary to a surface drinking water supply the system is located in a nitro en sensitive area(Interim Wellhead Protection Area -IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system sha bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. PI ase consult the local regional office of the Department for further information. r (revised 04/25/417) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: ►-1,t i\4VJ4_, Date of Inspection: rely 1 L Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as pan of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. X _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, naterial of construction, dimensions, depth of liquid, depth of sludge. depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/25/97) Page 4 of 10 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: b Z 3—t%-,S Owner: Q'(,kkKTl�,-, Date of Inspection: %l,y`rl FLOW CONDITIONS RESIDENTIAL: Design flow:44 0 g.p.d./bedroom for S.A.S. Number of bedrooms: Number of current residents: C) Garbage grinder (yes or no):-Q Laundry connected to system (yes or no): Seasonal use (yes or no): t--3 Water meter readings, if available (last two (2) year usage (gpd): &D Sump Pump (yes or no): tJ Last date of occupancy: ve COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: Gallons/day Grease trap present: (yes or no)_ ' Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readines, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUbEPING RECORDS and source of information: System pumped as pan of inspection: (yes or no)_ If yes, volume pumped: Gallons 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: + 3Stjat- Sewage odors detected when arriving at the site: (yes or no) NL7 (revised 04/25/97) Page 5 or to SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) 'SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethyle _other(explain) If tank is metal, list are_ Is age confirmed by Certificate of Compli ce _(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping. condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity. evidence of leakage. etc.) GREASE TRAP: (locate on site plan) Depth below grade: Material of construction: _concrete _metal Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of/nof or baffle: Distance from bottom of scum to botlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity. evidence of leakage, etc.) (revised 04/25/97) Page 6 of to SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: % Date of Inspection: TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Capacity:_gallons Design flow: gallons/day Alarm level: Alarm in workine order _ Yes. _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches. etc.) )ISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryov r ,evidence of leakage into or out of box, etc.) PUMP CHAMBER:_ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pu/and purtenances, etc.) (revised 04/25/97) Page 7 or 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Sri Z, 53A..b S Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):!`' (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields. number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (n a condition of soil. si ns of hydraulic failure, level of ponding, c ndition veg tion, etc.) CESSPOOLS:.. (locate on site plan Number and configuration: Depth-top of liquid to inlet invert: c�` b" Depth of solids layer: \->v Depth of scum layer: n`t Dimensions of cesspool: Materials of construction: Grxsc Te e loe- Indication of groundwater: P-'Icp inflow (cesspool must be pumped as part of inspection) Nje---511 Comments: ote condition of soil, si ns of hydraulic failure, level of ponding, condition of v�ege n, e . +l QIS Nca S i Spa a �.-�.t�,/�a��l^`n ! ��... c PRIVY: ,,4v—b (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.) (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: C L ;3, Owner: H,Q r*< Date of Inspection: -&I q SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) O2 (revised 04125/97) Pagc 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: �'Z �S Qjz Owner: Date of Inspection:C.1 15 Depth to Groundwater t�i(Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators. installers Use USGS Data Describe in your own words how(ou established the High Groundwater Elevation. Must be completed) Ca (revised 04/25/97) Page 10 of 10 Town of Barnstable r# /� Department of Regulatory Services Public Health Division Date 3 200 Main Street,Hyannis MA 02601 Date Scheduled 'V-2 O,� Time 104" Fee Pd. 11 U b. i. Soil Suitability'Assessment for Sewage Diso' sal Performed By: _VN a Witnessed By: S /V Y K ^� LOCATION & GENERAL INFORMATION l/VJ Location Address z Owner's Name—Rii— rn ' Address �Z f rt.� ��/ Cw ku—t k- Assessor's Map/Parcel: 2 Z G 7 Engineer's Name (S�,P,4 c, U 1 NEW CONSTRUCTION REPAIR Telephone#-Q.)v 7 e C/ Pj 3 Land Use RES/1)E'Al a,4L Slopes(3'0) 3'S Surface Stones NNE Distances from: Open Water Body 70dt- ft Possible Wet Area ✓rOOf ft Drinking Water Well• ft Drainage Way ft Property Line —ft Other ft SKETCH:(Street name,dimensions of 1%exact locations of test holes&perc tests,locate wetlands in proximity to holes) 00 cJOc�vl 1��, Parent material(geologic)ABLtJr1Qf✓ T/L�/�UTW9 Sy Depth to Bedrock • f Depth to Groundwater. Standing Water in Hole: NOT ENC,/� Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: DIRECT Depth Observed standing in obs.hole: /2 SNOT EN2'P in, Depth to soil mottles: /ONE in, Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well#&&W Reading Date: Index Well level Adl,factor— Adj.Groundwater Level PERCOLATION TEST Date 43--j 9TIMe JPAI� Observation Hole# / — Time at 9" Depth of Pere S4q'68f! Time at 6" Start Pre-soak Time @ /Q•�¢ �s uSC�. Time(9"•6") End Pre-soak /0:26 cov«'d �ofisafvrafiC Rate Min./Inch Y 14J1 /1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Divislon 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:XSEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. on istenc % ravel O L.s, /OY rR/ABLE Id Ye �� FR148Ct`r co0st, STONE 98 C'i S. 2.sY / - Y. 98=/y�/ Cz S: Z,SY�/G �oosE, N DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten % rave 4"/6 /D 34It 4 396" s 96"/W`' � 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 .f DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Consistency, • yd 'k Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes - Within 500 year boundary No= Yes✓ _ _ _ _ Within 100 year flood boundary No Yes Depth of Naturally Occurrint;Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Y �C5 -- If not,what is the depth of naturally occurring pervious material? Certification I certify that on d-t9r (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . w the required-ILaining,expertise and experience described in 3 10 CMR 15.017. Signature Date 4-3 4 9 n _ r Q:\SEPTICIPERCFORM.DOC x . f i MINIM SYSTEM PROFILE , : •• F NI S HE D GRAp` E ELEV _ 44 . , 0 ♦. • FINISHED GRAD E E ELEV 44.0 ; , I INSTALL RISERS OVER D-BOX TO WITHIN 6 OFFINISHGRADE G DE INSTALL RISERS OVER CHAMBER T .., C WITHIN . . 4 .3#1-mina 6 OF FINISH GRADE - 4 SCH 40 PVC 7: . 6 min: sloe .02 C PERFORMED .PIPE WITH IL41.55 P .. SCREW CAP T 2 min. 3 max. SE TO WITHIN 3 OF FINISH 42.00 GRADE TO SERVE AS INSPECTION PORT _ t flow .line ... 14 _. 10 min. ♦ �• ff „ '42 83 ' 1 8 T 0 1 2 WASHED STONE _ / 21.5 o 0 0 _- 1. 0 0 4 38 - . . . . , o 0 0 0 0 4 „ :. „ 1, • „ • 00 0 00 3 4_ a. TO 1 1 A . .. ... 2 min. o0 0 00 2 WASHED STONE .. . �., . .. . PROPOSED' 6 min. GAS BAFFLE L . 41.17 DISTRI uTl n >, 3 7 PARCEL 082 B 0 BOX, 91 ' F' L TO T CRUSHED STONE BE SE ON S OF SHED S 0 E 10.5 13.2 ' USE EXISTING 1500 G - AL. PLACED ON A COMPACTED .LEVEL BASE 5 SEPARATION AS REQUIRED SEPTIC TANK Y BY DISTRIBUTION BOX B TITLE V` FOR PERC < 2 MIN. IN. - 44 42 6 46 p L OUTLETS NOTE 3 NONE 0 ELEV 32.6 • PLUGGED GROUNDWATER ELcVATION PROP• OSED INSPE CTION TI C ON PO RT HA V RTIFY AEXISTINGP CONTRACTOR S SHALL E ALL E. INVERTS PRIOR TO CONSTRUCTION DISTFI�UTION BOX LEACHING CHAMBERS _ RS PROPO SED DISTRIB UTION ON BOX NOT TO SCALE, . 40 _ N T TO SCALE I PROPOSED 3 - 500 GAL. LEACHING CHAMBERS WITH 4.00 FEET F �0 STONE LEGEND W - - EXISTING CONTOUR . IN TEST PIT WATER LINE 100.00 LINE AND, TEES SHALL BE PUMPED AND INSPECTED. THE SEPTIC TANK SHALL BE CHECKED FOR WATER TIGHT EXISTING 1,500 GAL. SEPTIC TANK A EE _ - PROPOSED CONTOUR 1N TY. IF .THE .TANK FAILS ANEW 1 500 GAL."SEPTIC TANK SHALL INSTALLED. 100.00 SED CO OU LINE COMPLIANCE AND STRUCTURAL INTEGRITY. L BE NS LED SOIL SAMPLE G WATER LINE E 00.00 FT £0 90N WELL AND FILLED WITH CLEAN SAND BOX TO '.PUMPED L EXISTING DISTRIBUTIONB 1 .0 TD _ 40 _._._.. i GENERAL NOTES ' SOIL TEST D o - G E N TE DATA T ABANDON U ORS T A N 0 PER --TITLE V RE.G CATIONS 44 EXISTING INFILTRATORS 0 BE B D I 3 . R WELL PROPOSED DRY W 0 RO OSED ALL ORGANICMATERIAL MUST REMOVED FROM TH 0 S BEE AR EA ADIRECTLY U A 7 E UNDER AND BEYOND THE PROPOSED 0 7 PARCEL rn o 0 - as LEACHING FACILITY. ..THIS AREA 6� BACKFILLED PARCEL 0/9 A kL , SANDY K TO ELEVATIONS' INDICATED ON THESE PLANS WITH COARSE TEST PREFORMED BY. D EESE ao WASHED SAND OR CLEAN BANK RUN GRAVEL FREE OF E B N 0 DO MI RANDI. R.S. TOW 0 N-i-I N F BAR STABL z TEST WITNESSED BY. DECK . FIN AN ES D HAVING A PERCOLATION RATE OF 2 MIN. PER • /3/ 0 DATE PREFORMED. 20 9 N '4: `�--- INCH OR LESS BEFORE OR AFTER P f,C M N ,TE L E E T FOUR 1 F •A CX i� NG A T L STONE MUST W A FREE FROM _ L S BE DOUBLE AHED AND EE F 0 1 2 BEDROOM L .D Roo 4 E DEEP.: HOLE N0. DEEP HOLE to � FINES AND ANY ORGANIC I A T_ A S L N0. � 0 G C MATERIAL AND MUST HAVE LESS c ,F 1 AL .. N I � RE , THAN `0,2 PERCENT MATERIAL FINER HAN A NUMBER 00 - E T ER L INE BE 2 O Q 0 0 of of t N , c� H vl SIEVE. E E , 3 LOAMY SAND 2 LOAMY SAND 1011 7 r<C ND I+ f cN ND LOAMY S CANNONLOA LOAMY SAND HEAVY ,nITT D PASS E VY MACHINARY A NOT � IE TO SS ,SHALL 0 B P R .E E ur- � n .�4 w OVER THE,I �.Er1v''I NG 1eIL , tV a 0 MA P 22 8 o- 5 r T �t TIGHT P G JOINT (PING I � YVJ Y H Ri� TO COWS ST OFF L N L C LO OE k 00 a � a PARCEL 078 NA E PIP E P•V•C. SCHEDULE NTH RWIS `N T D LE 40 UNLESS SS E E NOTED.E SAN D SA x, z ( : ., SAND [L C) S.F. 10,890 9611 , T FOR PROPER PERFORMANCE, A I : , E E ORMANCE THE SEPTIC TANK SHOULD BE INSPECTED;AT LEAST A w , LE S ONCE A YEAR AND WHEN THE. TOTAL DEPTH OF UM AN D ND SOILS EXCEEDS 1 3 THE LIQUID I / � D P SH OULD DEPTH OF THE TANK THE TANK SHO.�G BE PUMPED. 46 1 I ,. ALL DISTURBED AREAS ARE TO BE ..0 A4,w,.,rJ, SEEDED AND SAND _ SAND _. MAINTAINED T PREVENT R 100.01 FT 3N00 ,65 50N E 0 E ENT EROSION. On. THE GENERAL CONTACTOR IS TO BE RESPONSIBLE FOR ALL 144 „ B.M SEPTIC TANK OUTLET INVERT HORIZONTAL AND VERTICAL CONTROL OF ALL COMPONENTS. 144 i _ B.M. - ELEV. 42.83 JOAN ROAD ` GARBAGE DISPOSAL SYSTEM IS NDT TO BE CONNECTED TO THEi DISPOSAL SYSTEM. 44.6: ELEV. ELEV 43.0 NONE ® 144 T�I, ' n. i � � WATER WATER Nam® 144 THE DESIGNER HAS NOT BEEN RE A:, ►E.. BY T�€ CLIENT TO NONE CONSTRUCT OR SUPERVISE THE CONSTRUCTION OF THE REFUSAL REFUSAL NONE SYSTEM. THE CONTRACTOR IS REPONSIBLE FOR MAKING ARRANGEMENTSA T FOR `INSPECTION OF INSTALLATION -0F HE SYSTEM WITH THE TOWN OF BARNSTABLE BOARD OF HEALTH. P RC TEST DEPTH ,�, E ES DE RATE GRAPHIC SCALE THIS PLAN HAS BEEN PREPARED SPECaRCALLY AS A SEPTIC „ „ p� HOLES ITE 1 50 -68 2 MIN. INCH SYSTEM DESIGN PLAN AND IS NOT TC SE USED TO 20 0 to Za 40 eo ESTABLISH PROPERTY I BUILDING K L NES OR E3U LU G SETBACKS. PROPE TY LINES AN IN LOCATIONS ARE RAPHiC R L E D BUILDING LOC G E G ONLY, PROPERTY LINES NOT HAVING BEEN FIELD VERIFIED. IN FEES ) NO REPRESENTATION OR CERTIF►CAT10 . AS TO THE �. � OP r r, !. .- I r±. p v+ l ACCURACY OF THOSE SHOWN IS MPLIc� OR INTENDED. E�.., � I I ,. 1 nch � F..� ft. .sr I i ( II _ Designed i , b GDC rn 9 I _I 1 � I •4 I t o + N 1x prawn b GDP II DESIGN CALCULyiTIIvS - NE SS jll 0 „ LY� �1 1 .M _ -�c__ _ -- 151 2009 SCALE 1 _ 20 1, �_ I--_ TYPE OF BUILDING ' .>.i; ;'.` I q A 6 RTI L'AY '� � _ RESIDENTIAL DWELLING 71, 31 �, - ,� p N0. OF BEDROOMS 4 EXISTING I1 s , ,I, gA, �^ -, GARBAGE GRINDER ALLOWED �Q_ CANNON ENGINEERING 1 • :A - �� 1500 ; � _�' � I ,,:- ;_. SEPTIC. TANK VOLUME GAL. > (2 X 4:� 110 GAL/DAY) : STA ! / I 1 i! I( '� cap DESIGN PERC. RATE_2-MIN. IN._ / 11 BRENRAE DRI4�_ �I REFEREN DRIVE ;• �•. (` -;r , a .� .� - DESIGN FLOW: MIDDLEBORO MA ., X _110 GPD BEDROOM =443 GPD MORTGAGE INSPECTION DEED REF. CT: 401245 CENTER JILLE LEACHING CAPACITY PROVIDED: (508) 946 8886 "Nt s �1`? wAr W ;;' i, - 33.5 +13.2 X 2SIDES X 2 Y. •74GPD S.F.= 138.23 GPD !I ` BY YANKEE SURVEY CONSULTANTS, DATD 12 3 98, SIDEWALLs ( / 33.5 x 13.2 X .74GP r �. �, ._�.., R _ , ��===�� Fq ' • - FOR.. THOMAS AND DEBORAH CAMBARERI BOTTOM ( ) D/.�.F.= 327.23 GPD yi WATERSIDE D w, I: ,: ,'?< '` ', �� TOTAL 138.23 GPD + 327.23 GPD - ' 465.4� GPD _ �i -- PROPOSED SUBSURFACE I USE 3 - 500 GAL. LEACHING CHAMBERS WITH 4.00 FT OF STONE Ce SEPTIC SYSTEM LOCATION TAKEN FROM TOTAL LEACHING RATE 465.46 GAL. DAY > 440 GPD SEWAGE DISPOSAL PLAN EXISTING / '� A �R,• ao �1/ ;; ==`- Ro :: _ J TOWN OF BARN STABLE AS BUILT PLAN MAP 225 PARCEL C�7$ SAR'GE(VT-L BOARD OF HEALTH USE ONLY 62 JOAN ROAD Data use subject to license. ®2006 DeLorme.Sued Atlas USA®2007. 1 o aco i000 www.delorme•com MN(15.2' Data Zoom t 4 Il CENTERVILLE, MA 02632 APPLICANT: 1 LO CUS PLAN TOM CAMBARERI 62 JOAN RO AD CENTERVILLE MA 02632