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0020 OLD POST ROAD (CENT.) - Health
20 OLD POST RID. CENTERVILLE A= 209 068 2 i No. 42101/3 ORA ESSELTE 10% IS 9 0 O 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Grad DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION e Property Address: 20 OLDPOST RD. CENTERVILLE ®L'� �fC��VEO Name of Owner JULIE RABTOY S EP 2 Address of Owner: SAME - 4 TowNoF 19gg NZ Date of Inspection: 9/8/99 IckN VS Name of Inspector:(Please Print)JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) /�� 4, Company Name: n/a �' y Mailing Address: n/a Telephone Number: n/a C.FRTIFICATION 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: X Passes The Inpection Is based on criteria defined In Title V _ Conditionally Passes code 310 CMR 15.303.My findings are of how the system is _ Needs Further Evaluation By the Local Approving Authority performing at the time of the inspection.My inspection does _ Fails not imply any warranty or guarantee of the Ionggevlty of the septic system and any of its components useful life. Inspector's Signature: Date:919/99 The System Inspector sha submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)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. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2/98 Page 1 of 11 _..------- rayr c Ui i i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9l8/99 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection B. SYSTEM CONDITIONALLY PASSES: nLa 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. nLa 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 complying septic tank as approved by the Board of Health. Wa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced nLa The system required pumping more than four times a year due to broken or obstructed pipe(s).The system-will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced _ obstruction is removed revised 9/2198 Page 2 of 11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8199 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 the public health,safety and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nLa_(approximation not valid). 3) OTHER Wa revised 9/2/98 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8/99 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped nta. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water,analysis for coliform bacteria,volatile organic ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X 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 part of this inspection. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste Flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material 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: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 11 5.302(3)(b)] X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:918/99 FLOW CONDITIONS RESIDENTIAL: Design flow:-0 g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual):I Total DESIGN flow: IQ Number of current residents:2 Garbage grinder(yes or no):MQ Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):M Seasonal use(yes or no):DLO Water meter readings,if available(last two year's usage(gpd): nLa Sump Pump(yes or no): NO Last date of occupancy: nta COMMERCIAL/INDUSTRIAL Type of establishment: nLa Design flow: nLa gpd(Based on 15.203) Basis of design flow: nLa Grease trap present:(yes or no): pLQ Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):DLO Water meter readings.if available:n& Last date of occupancy: n& OTHER: (Describe) n& Last date of occupancy: n& GENERAL INFORMATION PUMPING RECORDS and source of information: SYSTEM HAS NOT BEEN PUMPED IN THE LAST TWO YEARS. System pumped as part of inspection:(yes or no):KQ If yes,volume pumped nLa_ gallons Reason for pumping: n& TYPE OF SYSTEM XSeptic 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.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: n& APPROXIMATE AGE of all components,date installed(if known)and source of information: 1978 Sewage odors detected when arriving at the site:(yes or no): NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8199 BUILDING SEWER: (Locate on site plan) Depth below grade: i Material of construction:_ cast iron _40 PVC X other(explain) Distance from private water supply well or suction line: TOWN Diameter: nla Comments: (condition of joints,venting,evidence of leakage,etc.) n/a SEPTIC TANK: X (locate on site plan) Depth below grade: E Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) nLa If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ Wa Dimensions: L B'6"H 5'7"W 4'10" Sludge depth: r Distance from top of sludge to bottom of outlet tee or baffle: L" 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: Jr How dimensions were determined: MEASURED 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.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING EVERY ONE TO TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) n& Dimensions: Wa Scum thickness: nLa Distance from top of scum to top of outlet tee or baffle:-nLa Distance from bottom of scum to bottom of outlet tee or baffle nla Date of last pumping: nta 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.) n& revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/9/99 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n& Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) nLa Dimensions: nLa Capacity: n& gallons Design flow: nta gallons/day Alarm present: NO Alarm level: n/a Alarm in working order:Yes_No_: MQ Date of previous pumping: nLa Comments: (condition of inlet tee,condition of alarm and float switches,etc.) Wa DISTRIBUTION BOX: _ (locate on site plan) Depth of liquid level above outlet invert:n& Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) nLa PUMP CHAMBER: MQ (locate on site plan) Pumps in working order:(Yes or No): MO Alarms in working order(Yes or No): NQ Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) Wa 9� revised 9/2/98 Page 8 of 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Wit Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers,number: -a& leaching galleries,number: 1l(a leaching trenches,number,length: Wa leaching fields,number,dimensions: Wa overflow cesspool,number: n& Alternative system: Wa Name of Technology: -nla Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALL SOUND AND FUNTIONING PROPERLY THE PIT HAD I'OF LEACHING LEFT AT THE TIME OF THE INSPECTION. CESSPOOLS: _ (locate on site plan) Number and configuration: nta Depth-top of liquid to inlet invert: it& Depth of solids layer: nta Depth of scum layer. nta Dimensions of cesspool: nLa Materials of construction: nta Indication of groundwater: n& inflow(cesspool must be pumped as part of inspection)n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Wa PRIVY: _ (locate on site plan) Materials of construction:nfa Dimensions:n& Depth of solids: Wa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nta revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 OLDPOST RD.CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8/99 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) n/a It ILI rtiC l� � Eff A00 931 Q 3) revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 of-nPoST RD,CENTERVILLE Owner: JULIE RABTOY Date of Inspection:9/8/99 NRCS Report name: nLa Soil Type: n& Typical depth to groundwater: n[a USGS Date website visited: nla Observation Wells checked: NO Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record _ Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions _ Checked with local Board of health _ Checked FEMA Maps _ Checked pumping records _ Checked local excavators,installers XUsed USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS revised 9/2/98 Page 11 of 11 No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for M!6pogal *pgtem Congtructton Vertu Application for a Permit to Construct(*X Repair( )Upgrade( )Abandon( ) ($Complete System ❑Individual Components Location Address or Lot No. -b 0( Q g. Owner's Name,Address and Tel.No. 13&v4C(A Bywt C��. Assessor's Map/Parcel Z PC s Z R LN•i-A Ct5 62G3 Z YnAP Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ,t�l c3 Xi=, � f e yHQ AWI,�&/// �Of�'cS/� i2 r1'l�i� S�: CSS�c�cy i I le 0!I/� �2G SS Type of Building: Dwelling No.of Bedrooms Fmvu r- Lot Size S4,S&0 sq.ft. Garbage Grinder A14 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 166 c ra4llodian gallons per day. Calculated daily flow 9-A gallons. Plan Date Number of sheets ®nc- Revision Date Title CA 2m ®ia 0:&± Rc Size of Septic Tank [[ s Type of S.A.S. L-caz-eLu!j Ciammhem 12`x 35 r- e ofe� k 1 Description of Soil ®-Z 04t 9 m 3 '^2 -a Z 07 C i G aQ�sP Kati®a � ^►vE1� " .91 iD r�i C/ertn /777 sks1 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 Certifi- cate of Compliance has been issued b�h' Signed Date Application Approved b Date ` Application Disapproved for the following reasons Permit No. ItK`` Date Issued /` T WN OF B STABLE LOCATION Z0 Ole SEWAGE # VILLAGE /�c` ASSESSOR'S MAP & LOT Z®,';�-068' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY al LEACHING FACILITY: NO. OF BEDROOMS (size) BUILDER OR OWNER PERM ITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by Feet a i o© 4 --3 3 �� .. No. �!7� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLES MASSACHUSETTS. Yes ZIPPricatton for Miopaar *pgtem Congtruction Permit Application for a Permit to Construct(X )Repair( )Upgrade( )Abandon( ) Complete System O Individual Components Location Addressor Lot No. ,gyp 0ld1 Posl~ Owner's Name,Address and Tel.No. Cea.+krui 64 s�c.QA �u��cfi �• Assessor's Map/Parcel l�/ c ZOT PCL. -7- l?o &W jt5 ,, ,J,/� �l�I ' -a'Zt3 Z_ Insstal/ler's Name,Address,and Tel.No. 41;4+-377"Y Designer's Name,Address and Tel.No. ' 1 1 �1 •r/ Type of Building: f Dwelling No.of Bedrooms.Su r- Lot Size 541540 sq.ft. Garbage Grinder A40 Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 eQ beQ gallons per day. Calculated daily flow ��}•0 gallons. Plan Date 7 ZD f Number of sheets G etc- Revision Date Title 24D Old t RcQ Size of Septic Tank 1 ool(aY.s Type of S.A.S. Ckn. Gem IZ`r,3-$ ,XZ c ^ ' (Deescription of Soil 0-Z" ' a�` "B e y o Nature-of Repairs or Alterations(Answer when applicable) Date last inspected: f 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- 'f �I.,�cate of Compliance has beeti issued by�thj,, 00 eat //� /fe �/ �,• ' ,�� � Signed Date Application Approved bne Date - �" Application Disapproved for the following reasons 1z 1'tt ' Permit No. '' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Dispo�aIS ystem C nstructed(V)Repaired ( )Upgraded( ) Abandoned( )by" � "'°"�jf r9 � &Df/—DL®7�i� ?©�S,/�, at av 0C-b 10657' If f-) CFzyT,�4V CL(F has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. " dated Installer Designer I ft,/ 0 The issuance of this permit shall not be construed as a guarantee that the sy tem w'll function as deg/ned. ( ( � ` � Date ! )j/ G Inspector 11t..jyL 7-,--eq q� -t� I ( l — ,— ——————————————————————————————— — Fee Z THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS migogal racm Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at a d 0/6 b ?057 Ab. GeIU-f 6e✓/&C-(:_ 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 a completed within three years of the date of thi it. qq / Date: 6��tr 9/` Approved by - L/2- o?ip T WN OF B STABLE LOCATION Ole SEWAGE # 00;;�� VILLAGE �v�� ?� ASSESSOR'S MAP &LOT ZO/`-06Re INSTALLER'S NAME&PHONE NO. �i�90?6 ��s�` �7 SEPTIC TANK CAPACITY .�� C-IJ. LEACHING FACII.ITY: ( ) c L-I �� (`�) (size) 12,�C 'S��c Z, NO.OF BEDROOMS BUILDER OR OWNER /y PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom cf 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 ' got" tat 3-3 �� a i TOWN OF BARNSTABLE LOCATION® SEWAGE # VILLAGE ( \lam ASSESSOR'S MA$ & LOT L� INSTALLER'S NAME&PHONE NO. / SEPTIC TANK CAPACITY l �� LEACHING FACILITY: (type) P (size) NO. OF BEDROOMS _ BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ` Feet Furnished by `�tC� �tC� TOWN OF BARNSTABLE /41 ���c LOCATION v s`� 12 S Z—9A • SEWAGE # VILLAGE C ASSESSOR'S MAP&LOT 1-7- ZIQ a INSTALLER'S NAME&PHONE NO. SEPTIC TANK.CAPACITY f V l LEACHING FACII.TTY: (type) (size) NO.OF BEDROOMS 1,(, BUILDER OR OWNER l%v > c, G e-,- PERMTTDATE: 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� `�• /1 ti.. s . la-7�� i i H ,,9�g _ ' U Ov POST �- s KH - - mo ^4 . J o 1 \ v Z� v 6-- Q PLAN REFERENCE: BOOK 504 PAGE 27. N <� BEEC'HWOOD r CEMETERY NOTES ROUTE 1. THE CONTOUR LINES WERE DIGITIZED FROM TOWN OF BARNSTABLE G.I.S, MAP 209. -r 2. THIS PARCEL IS NOT LOCATED IN THE FLOOD PLAIN. RD. a �Q( JS 3. THERE ARE NO WETLANDS LOCATED WITHIN 100' OF THIS LOCUS. S.B. FND. cr y• 4. REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL OE—D j]/��r < WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT *�/ .[ t,�iV T RO" \�J MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED Q 1916 COUNTY LAYOUT ON No. 50 SIEVE, OF FRACTION PASSING No. 4, 10% OR LESS TO FASS No. 100 SIEVE AND 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. vn r 5. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS --�-- ---- nil / � PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE --__ T ` o R�'��� N DALIA PANZERA ET AL �+ THE REQUIRED NOTIFICATION TO DIG SAFE (1-800-322'-4844) AND APPROPRIATE � 1 2 , LOCUS MAP WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. S86"1S'59"E S�' Ci 1.38' SCALE 1 25,000 C.B. SET 44.79' C.B. FND. S86°34'32"E OLD METAL ASSESSORS �FF co "~ . 216.11' x ---- ,X MAP 209 PARCEL 68-2 0 ��(8P -____ _______ - ,____ _ 10-- SETBACK MNG -REQl}iREMENT..M _.�- -- ~.� S7g AQUIFER PR❑TECTIC7N Z❑NE 20 ,SETBACK in C.B. FND. 66.09t \l is Q�„ I -.,, off ZONE \ S�� r�.SS, LP. FND. 0 0 \ MINIMUMS � � p� p �00� AREA = 43,560 S.F. LOT � FRONTAGE _ 20' � �'�� �� �\,\�G .L►[l.�l � WIDTH 100' � ,� �� FRONT SETBACK = 20 \ G 54,560 sq.ft. SIDE SETBACKS 10' \ �� '� Gh� 1.25 acres REAR SETBACK 10 S.# = 18.83 BUILDING HEIGHT = 30' Fz\ 0. + c� DESIGN DATA o ,, �s�. PREP I.P. FND. SINGLE FAMILY— 4 BEDROOMS x NO GARBAGE GRINDER DAILY FLOW = 110 X 4 = 440 G.P.D. SEPTIC TANK 440 X 200% = 880 '' USE 1500 GAL. SEPTIC TANK #2 N c CULTEC LEACHING CHAMBER DESIGN _ �, � #1 � x 1-to, � C REC GER 33OR CAR EQUIVALENT ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED ' Co0 01 WITH CAPPED ENDS �: x C.B.'FND. USE 1 - 4" DISTRIBUTION LINE IN 4 RECHARGER UNITS N IN A 12'X 35' WASHED STONE TRENCH AS SHOWN LEACHING AREA REQUIRED 440 G.P.D./.74 = 595 S.F. 2(35 + 12) X 2 = 188 S.F. SIDEWALL AREA �^ (12 X 35) = 420 S.F. BOTTOM AREA E 608 S.F. TOTAL PROVIDED 357.7A � ;o _ ICY) iv fHOMAS W• PRYOR 12 FINISHED GRADE , 36"MAX.- 12"MIN. WN \' \ COMPACTED FILL 2p,- _ .................._.......... .. .......... .... • •. .. a PEASTONE C.B. SET . C.B. FND. n •. . ''y d. a °'•e ,'.' a 3/4" TO 1 1/2 " PLAN OF LOT z t 30.5 i;. ,.. 0. ;4.• DOUBLE SCALE: 1" = 20' I .4 . . WASHED STONE i SECTION NO SCALE PLAN OF PROPOSED SEPTIC SYSTEM AT #90 OLD POST ROB IN TEST I- +�LE (CENTERVILLE) m DECEMBER 8,1995 BARNSTABLE, M S. BAXTER & NYE INC. ' COVERS LOCATED TO WITHIN #P-8624 FOR F.F. ELEV. = 58.0 6" OF F.G. PIT #1 ELEV. = 56.5 PIT #2ELEV. = 56.5' o 0 13AYSIDE B tNG Co. INC. F.G.= 57 fT T F G= 57'± —2" —2 4 TOTAL UNITS 1 STARTER,1 END, Ec 2 INTERMEDIATES. F.G.- A LOAMY SAND A LOAMY SAND „ �7„ 330S SCALE: AS NOTED DATE: JULY 20,1998 \ \ \ \ .\ n LEVEL � � \ , , . . —7 Trn. 3301 330E INV. INV. _ 1500 GAL " 2' I Q B LOAMY FINE SAND B LOAMY FINE SAND IN 4 DIAMETER 7 —Z' Y 7 Syr 6.25 6.25'4.4 54 $ SEPTIC TANK INV. T DIST SCHEDULE LEACHING CHAMBERS T- 1-1.5" WASHED STONE 4o P.V.C. -4 PERK TEST -4 PERK TEST r .:• .;•:,' • . t•;,.t $AXTER & NYE INC. 54.6 INv. ffi54.4 Box S REGISTERED LAND SURVEYORS INV. =54.2 INV. 54.0 C4,COARSE C� COARSE 10.00 ,,, ::::::•::•:::.........:""- -6" STONE BASE SANDY GRAVEL SANDY GRAVEL N MIN. I T r•••: !4...,'•1 "' +' is . �.. .- .'• �: , .:i::.. CIVIL ENGINEERS OSTERVILLE, MASS. BOTTOM ELEV. EL = 52.0 ` 35.00' PLAN OF LEACH TRENCH i(7 L -9 C2 .. SCALE: 1' = 20' rOWILSOP C2 CLEAN CLBANPROk'ILL,' 00MEDIUM SAND MEDIUM SAND ENALLYN NO SCALE NO WATER `-10' NO WATER atebtr EL. = 46.5 " DAXTER No.30216 ,yo 24M WATER LEVEL N 5.0' A�'o CisTL``oa ,tr� (GROUNDWATER CONTOUR MAP, JUNE 1992) �' r � y 1-24,98 #98068