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0032 SOUTH MAIN STREET - Health (2)
32 South Main Street Centerville A=228— 137 UPC 12534 0.2-153LO i I P E tE r Commonwealth of Massachusetts Title 5 Official Inspection Form a�s Subsurface.Sewage Disposal System Form-Not for Voluntary Assessments 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name / information is CENTERVILLE -+/ required for MA 02632 5-10-15 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:When filling out A. General Information forms on the �• l O� computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that 1 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 v ' 2-7 5=10-15 Insp s Signature Date he 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 god or greater, the inspector and the system owner shall submit the j 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. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityfrown 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: SYSTEM METT ALL PASSING REQUIREMENTS AT TIME OF INSPECTION B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You.must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M '< 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °7M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-16 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® 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? ® ❑ 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? E El Was the facility owner(and occupants if different from ownerprovided 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND A 3 BEDROOM S.A.S CONSISTING OF 3 500 GALLON CHAMBERS WITH STONE Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: N.A DID INSP ON A SUNDAY Sump pump? ❑ Yes ® No Last date of occupancy: 5-2015 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: SCOTT FRANK Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? TANK SIZE Reason for pumping: MAINTENANCE Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments wM 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name , information is required for CENTERVILLE MA 02632 5-10-15 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: 3-11-2007 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 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: 1.5 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Sludge depth: MODERATE t5ins•3/13 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 M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness MODERATE 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? WOODEN POLE 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 WAS PUMPED AT TIME OF INSPECTION FOR MAINTENANCE Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 32 SOUTH MAIN Property Address CURRAN Owner Owners Name information is required for CENTERVILLE MA 02632 5-10-15 every page. City/Town 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.): BOX LEVEL NO LEAKAGE OR SOLID CARRY OVER Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 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 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is TERVILLE MA 02632 5-10-15 required for CEN j every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): CHAMBERS WERE FUNCTIONING PROPERLY WITH NO SIGNS OF CARRY OVER OR FAILURE Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 32 SOUTH MAIN Property Address CURRAN Owner Owners Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityf town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t. . <t , y t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts a v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityfrown 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 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GSM , 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 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: 132" 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: 5-2015 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: DESIGN PLAN Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 a Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 SOUTH MAIN Property Address CURRAN Owner Owner's Name information is required for CENTERVILLE MA 02632 5-10-15 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION 3:2 Sr,U/h /I C,,,a S t- SEWAGE# VILLAGE_C&4t e(U a 1)a ASSESSOR'S MAP&PARCEL _906 137 INSTALLERS NAME&PHONE NO. rS 4 Bin,�rJ r,Cpj tj r 1115��I SEPTIC TANK CAPACITY _L� N('� `` _ LEACHING FACILITY:(type)3 Sri a 1 t`""(size) ►X o20 12 S X a NO.OF BEDROOMS OWNERa+v�P°� PERMIT DATE:.3,1110P COMPLIANCE DATE: 3I_3j Separation Distance Between the: p ty Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /.�:2 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 fat of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ,a a- 'y r( L -•B 1-51'C'/ 3 (�o� Nose 3 4_30'g11 a i C 3-tig, http://www.townof bamstable.us/AssessingiHMdisplay.asp?m4ppar=22813 7&seq=1 5/14/2015 TOWN OF BARNSTABLE L :.ATION ` iZSw h /I k;v--� St SEWAGE# 'AMT-1'-/0 VILLAGE ASSESSOR'S MAP&PARCEL 99 137 INSTALLERS NAME&PHONE NO. -Q x as A SEPTIC TANK CAPACITY / ZQ OC'j `i LEACHING FACILITY:(type) ` S( 1> -, 1 dYalYI1 s(size) A J9 A S X a NO.OF BEDROOMS '3 OWNER PERMIT DATE: 3T�OP� COMPLIANCE DATE: If Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility / r2 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 4 Dr J` i-3�'�.I'� - "y'/ r LI -30`Sri h 5- 99' ��331611 y L3- c� r r' �N.. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for Dtgoza.Y 6pmem Cott$truatott Vermtt Application for a Permit to Construct Repair( ) Upgrade( ) Abandons) ❑Complete System ❑Individual Components Location Address or Lot No. S�j,F,� ( CAA4k 4 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Z 2,je, 41A' oC 77-7 Y—g3& o:a��Icy U�c -- IOC? 71 I stalier's ame Addre s,an e.No. Designer's Name,Address and Tel.No. �J�l4J� tJ �4 V Wt, Type of Building: Dwelling No.of Bedrooms Lot Size ,( l Z sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons LA Showers( Cafeteria( ) Other Fixtures Design Flow(min.required) �6 gpd Design flow provided JSDd gpd Plan Date Ab Q. 7-QQ Number of sheets Revision Date Title � p5w 51te Flo— Size of Septic Tank f 50 0 - Type of S.A.S. Description of Soil Nature of Repairs or Alter trons(Answer when applicable) (9.4d -5 G 0&d (' � a CAI><'W Date last inspected: 2-00 5 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 Boa a th. Sig 4 lloqDate Application Approved by Date Application Disapproved by: Y6J- Date - 0 / for the following reasons N..eed w,` -rj q� -r Ale e � �.iw,& - b� 'G r J r e. s o T"�/l2. U•'n I Permit No. Date Issued —————————————————————————— Fee l THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for �Mpogar *raem Con.5truction Permit Application for a Permit to,ConstructX Repair O Upgrade O Abandons(! ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No: t ( e 'ter.-n,e s rrr;<-T 32.S•01"3y Assessor's Map/Parcel Z Z 'Lv'{ ( �' ) (1 c -7-7(�-G-3 •, -2 y VovSlas rcac R x� sog-,ic -71 S-j t ll �-y Installer's Name Addre s,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: 1,5 Dwelling No.of Bedrooms 3 Lot Size 0$ I Z sq.ft. Garbage Grinder\( ) Other Type of Building No.of Persons L Showers(2,) Cafeteria( ) Other Fixtures I Design Flow(min.required) LP(y d gpd Design flow provided �5�d gpd Plan Date U V, ,7_006 Number of sheets Revision Date i Title mpb5 fa !t0-71 Size of Septic Tank I SD Or, Type of S.A.S. (mil i Description of Soil L 00-4 l d { --- � re Nature of Re airs or Alter tions(Answer when applicable) r C � c� (/►u y u Date last inspected: Z 00 5 ;{ 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 Bo o Health,,, Sig dY /Ie. -, Date Application Approved by m v �,/ /�T/✓ Date /�4'7 ' Application Disapproved by: qA_,• Date for the following reasons NR PJ (n.TN?IJvc� ni f Ne� 5 , ar. , ,b', A,..� .SA�'Ay ('„_,-, � „ Lam'7 L. 26A0; ro-e-i t ro /e f 'rk' Mum Y,G4 4 alt r f4Q. e v,,7 • " Permit No. / Date Issued —————— f` ———.———————————— ————— ——————————— ,l THE COMMONWEALTH OF MASSACHUSETTS �✓ BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by at 5cv (p rN st /0��,J;e- ell f� has been con t cted in accordance with the provisions of Title 5 and thefor Disposal System Construction Permit No. dated Instal le E �A 41. l c �"`�(OWN-,# Designer (,-eek 4"� #bedrooms Approved design flow Ii gpd The issuance of this permit shall not be const bed s.a guarantee that the system i I unncti n as designed. v Date ( /L Inspector �► / —V--r/— or—=----- — No. —� / —� --------------- Feet ^ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS ligponl *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at 2. 5 r>,li`V: Nk i O S t e1,"t0_JK t_(t,l%X`Y &J G t 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 t :s e it Date ) ` -C� Approved by PIZ tl Town of Barnstable� Regulatory Services • BAMSTnBLE, Thomas F. Geiler,Director 9 MASS. Public Health Division i639• ♦0 ArFDMA'�A Thomas McKean, Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3 3 0g Sewage Permit# 2601. -I�0 Assessor's Map\Parcel Designer: •2S Installer• lt,�4 zv&J Address: o, ,S oY -21 Address: 2` - Z On "�0v4 69_6w� was issued a permit to install a (date) (installer) septic system at. J_-f,A--1 ST based on a design drawn by (address) dated 0 07 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Re lations. Plan revision or certified as-built by designer to follow. OF STEPH A. �.. CHA�L s aller's Signature) No.35461 cAt ,B-sigam's Signature) (Affix ma's Stamp Here) �IuSPc—C�7av`S svS��Ta�S PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH. THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Revised.doc AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION -3;2—C aWf SEWAGE#� 7 - VILLAGE V t ASSESSOR'S MAP&PARCEL '/17 INSTALLERS NAME&PHONE NO. YV c, A SEPTIC TANK CAPACITY / LEACHING FACILITY:(type) 3 ,� ��-�� },� (�y S(size) I1A-90,L2 S)(d NO.OF BEDROOMS '3 OWNER �1t:(iut�l l PERMIT DATE: 3111TOpj 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 1" J-Hit way 1 39'4+1 B I -S I'Co'/ Al s-LIq' s �J_L12,6,� � 3 � 5-5�3 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=228137&seq=1 3/9/2015 TOWN OF BARNSTABLE =C LOCATION S/51., 5,r SEWAGE # 9j= 3p9 VILLAGE_ e4 re,ry. //e, ASSESSOR'S MAP & LOT-Llj,—/� INSTALLER'S NAME&PHONE NO. L.V-P-v Consr, C;, . sre.. SEPTIC TANK CAPACITY coo 0 LEACHING FACILITY: (type) P1 r (size) 4cam NO.OF BEDROOMS 3 BUILDER 01i6WNER� PERMTTDATE: COMPLIANCE DATE: 3 —It �9y Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Wat&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 c �3j � " No. C�Lffi I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS ZippliCAtton for OiopooY bp!6tem Conotruction Permit Application for a Permit to Construct( )Repair(1!)Upgrade( )Abandon( ) ❑Complete System R�;dividual Components Location Address or Lot No. n Owner's Name,Address and T No. 3z ���/ V>oLa ��� Assessor's Map/Parcel /*�p� lel�1n le Installer's Name,Address,and Tel.No. (/ / G Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size f li 00 sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 11,15 gallons per day. Calculated daily flow �Jj. .57— gallons. Plan Date Number of sl1pets Revision Date Title !?,- -1116 5 0�7 Size of Septic Tank 14590 ° %7Y Type of S.A.S. 7- �®��° C /�,wb�'!`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 Certifi- cate of Compliance has bee issued h' of ealth. _ .gned Date Application Approve Date Application Disapproved for the following reasons Permit No. ,ram© � Date Issued 6.5 h-_.. -., �`t ry"....nM..,-�--.... .. .r. - „�,,1.. cr..ti -.. ;.,- ..,�• , �., �,.,,., ly-".N •-.' ...vr.. -_ No. P'<sLJ ` tI Fee,. Dv ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Otopogal bpotem Con.5truction Permit Application for a Permit to Construct( )Repair( V)Upgrade( )Abandon( ) ❑Complete System gKdividual Components Location Address or Lot No. ' ame,Address and Tel.No. 3Z �rl _�1gi�r sr Owners N%�Gais� Ass Map/Parcel cel e.# C11,11 1e Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size'®D sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers,( ) Cafeteria( ) Other Fixtures Design Flow j gallons per day. Calculated daily flow *134 5— gallons. ` Plan Date 2 Z Z S_ Number of sheets Revision Date Title ©f O D 1- S 1; S S . I. Size of Septic Tank Type of S.A.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 piovisions of Title 5 of the Environmental Code and not to place the system in,operation until a Certifi- cate of Compliance has bepsued of blealth.LSlgned Date % IeG 3y Application Approvedl�b• Date Application Disapproved for the following reasoris Permit No. 5 Date Issued S THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that thy On-site Sewa a Disposal System Constructed( )Repaired (Z-/)Upgraded( ) Abandoned( )by at 3 Z- 01G/ has been constru t•dKar�dance with the provisions•of)Title 5 and the for Disposal System Construction Permit No.-_OS 13 dated i Installer to 4 Designer " The issuance of this permit shall not be construed as a guarantee that the ste 11 u ti m as designed. Date i �? Inspector THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwf6pogal 6p5tem Con!5truction permit Permission is hereby granted to Construct( ) epair(✓)Upgrade( )Abandon System located at J 2^ 5�L✓� ��//� 5 `—i2"��" G'G��l �Ui�!/� 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: Const`rruuc ^on ust be completed within three years of tht date of this p 1 Date:_. � �� Approved by r 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems.Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, S'o fiV ,hereby certify that the engineered plan signed by me dated c4 JA9,1 OS ,concerning the property located at # 3� � �►VV mac i.Y Sr. Cer)-Wcu (,_ meets all of the. following criteria: • This failed system is,connected to'a residential dwelling only. There are no.commercial or business uses associated with the dwelling. t The soil is classified as,CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests at-the site without a health agent present. • There is no.increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will-be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) C- GC) B) G.W.Elevation r- +adjustment for high G.W. DIFFERENCE BETWEEN A and B .9- • SIGNF,D : DATE: ' 6� NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percex=T.doc it Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: C UL_�A tk M►)i>IJ �,�� �Sl ;\� Lot No, Owner: Address: `l'IY1c� Contractor: ISkC u Qi�:^-. '\C `� Address: I MAI �-{ Notes: � STEP 1 Measure depth to water table to nearest 1/10 ft. .............................. Jo's Is ................................................ .Oats month/day/year STEP 2 Using Water•Level Range Zone and Index Well Map locate site:and determine: Mtu? O Appropriate index well.................................................... 0 Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... A))/�3$ -� mo tth/year/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water•level zone (STEP 28) determine water-level adjustment ........................................... STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) from measured depth to water levelat site (STEP 1) ................ ...........;.;................................................ �i ..................... a Figure 13.—Reproducible computation form. 15 10/30/2015 02:,32 FAX 1a001/001 Town of Barnstable Regulatory Services Thomas F. Geiler,Director MAW* � Public Health Division �ao►Ku+' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 f „,, Office: 508-862-4644 Fax5%00 b-6304 x7, Zf Installer& Designer Certification Form ini v c :a Date: 7/7/05 N) Designer: Shay Environmental Services Inc Installer: Bortolotti Con tructio�:i=� '_ Address: P.O. Box 627 Address: Route 28 East Falmouth, MA 02536 Marston Mills MA On Bortolotti Construction was issued a permit to install a (date) (installer) septic system at 32 South Main Street Centerville based on a design drawn by (address) -- Shay Environmental Services Inc. dated March 2005 (designer) XX I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the eptic system) but in accordance with State & Local Regulations. Plan revision or Zc ' ie as-b ' t by designer to follow. N of MaSSgc o� CARMEN y°s (I staller's Signature) E. SHAY N No. liB1 FGrsT�asc S i" esigner's Signature) (Affix De p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q;Hcalth/Sepdc/Designcr Certification Form TOWN OF BARNSTABLE �TION S• in S'v SEWAGE # v "L..gGE .,��i sery,��� ASSESSOR'S MAP& LOT-SAS' INSTALLER'S NAME&PHONE NO. t��ci�y (eons Ck 5 i&TIC TANK CAPACITY /,©o® - LRACHING FACILITY: (type) P f•r (size) A c� r� NO.OF BEDROOMS BUILDER O WNER /Gera c-, ca r� PERMTTDATE: v 95- COMPLIANCE DATE:�T y 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 i � - S �j' f\� 1 \.� t � t, t i � _ `� �you �.3� � 32� �,� �� �r `3/ `j�� Trm) OF BARNSTABLE ON od1J74 SEWAGE #�S'Z2,_ AG ZP r il/i ASSESSOR'S MAP & LOT Ti4STALLER'S NAME&PHONE N0. �Xi �aa37`iu y �14 b 71C SEPTIC TANK CAPACITY �i0®O G�L LEACHING FACILITY: (type) mB CrC CS,e a hg-, QJ (size) /a�J-s .2 NO. BEDROOM BUILDER OWNER PERMITDATE: 'LDS' 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 Ede of Wetland and Leaching Facility If an wetlands exist g g ty( y Feet -within 300 feet of leachingfacility)ty) Furnished by Q ,4) Rea', 7ear tv S r� 0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE . ppliration for Dispoiial Works Tomit.rnrtion .erntit Application is hereby made for a Permit to Construct ( ) or Repair �m an Individual Sewage Disposal System at: Locatio Address or Lot No. _ `2 ? t .. - ��--= •. ...P—.....:-•..................... `z .... ...._...__.... owner Address ---'---------------------=------------------------.-------------------------------------- ....... Installer Address dType of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms__________ _____Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ' ) Cafeteria ( ) Q' Other fixtures . -------.•--•--••---------------•---- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------------------_ Diameter_--------------._.-- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water......................... G14 Test Pit No. 2................minutes per inch Depth of Test Pit_:.................. Depth to ground water........................ 9 ------------•--•-------•---•---•--••----•-•--••----•---••--•---------•--•-...-•••••••---••--•------•......................................................... 0 Description of Soil...............................................................................-----------------------•--------------------•-......................................... W w ---------------------------------------------------------------------------------------------------------------------------------------............................................................... U Nature of Repairs or Alterations—Answer hen a plicable uw - - 1 1� _S u�_- �5c�S j iv ` - Q� �------------ 1 � ... - .......................`�--�14--------__.. E- - -------•- �_.... Agreement: The undersigned agrees to.install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. Signed ----- a - --- - -- - -------................................ ------------ ./ J .. Dare Application Approved By ........... Application Disapproved for the following reasons- ----------------------------------------------------------------------------------..................................................... ........................................................---".................----....--------......--------------------------- ---- -------------------------------------------------.....-------- ..............------------------.... Dare Permit No. 3 --......... - cL�/ ------------ Issued - j-" - 1�'Dare ------------- THE COMMONWEALTH-OF MASSACHUSETTS - BOARO OF HEALTH TOWN.OF BARNSTABLE Appliration for Disposal Works Tnnstrnr#ion Permit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: • , r Location-Address or Lot No.. Owner Address a t_cc IC t=4 CEO 1(J Ste' �� �S ,c ...... ., f r �r� .................................. •- �' Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms---_.__ .....Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) G.I r Other fixtures ----------•-----•-••--•-•--••-•. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length_................. Total leaching area_.................._sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water-___------_-____•-_-_-_. G ( Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 0 Description of Soil...............................................................................:........................................................................................ W V .....•-••--••-••---•--•----•-•••--•-•..............•--•-•-•-..__.........••----••---•-----•-----•--•-.....-------•••-••••--•-•------••-••...----....--•--••-••--•-•-----...-•--•---..._--••--••-••------- W VNature of Repairs or Alterations—Answer when aapplicable h�_•_ --f.....f:l.._...1-U) - !S _ ......._ ---•--k•t-n0"p = --------•---� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ......% -'' - --- -------------------------------- ---------- �Da[e/ ApplicationApproved By ......... ---------------------------------------------------------------------• ------.-! _ ----.F/ _ Application Disapproved for the following reasons- ----------------------------------------------------------------•----.---........------.---...----.--........------...........---- -----------......------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------- Date Permit No. ..............r,. .' ................. Issued ........... �� .-.-"1�� .•--��-��`�.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Teztifiettte of C�umplianee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ) by ........- --- COW S� Installer/ atZ- - S '� c'rJ S ............. c~ vt ��� ..... ----....... ...........--...... - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .....�...�— .., .AG........... dated ......�--:.....?...... -.. .. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B�CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ��t .-:-`.:....- `.................:.. Inspector .�------`.:.-..-............---........---.---........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ TOWN OF BARNSTABLE No......j.. FEE Disposal Works Tons ur#iorn ;permit Permission is hereby granted.----- A'-•--...... -----....---••----...--••--------------•-----•---......---................... to Construct ( ) or Repair ) an Individual Sewage Disposal ystem atNo.. L 5 = `�r�-^� s -----ems----- l - -+ ------•--•--•------•--•--•-••-•-------------------------------- Street as shown on the application for Disposal Works Construction Permit No.,F�--6..-�--7-- Dated.._._ ... ..: ...... .............................0................................................................... DATE.................. .-_ _. ?__..�:!..GL_ Board of Health a --------•--•----.----- FORM 36508 HOBBS h WARREN.INC.,PUBLISHERS t I . .... . .....!LLLN-u FM- 91 R 5- F . ®r L-T-Till (1 -- Il f►1 _ ul. Ril -- l � � rA .I;IA Al, 3a aN*OyG.�R S7G d coe APPROVED By: OMfYM M DATE: 3 a 9-ys�o •• �. .�, � 1i�t.,��d.Rs?�.r_.�Rt.aai�-SQitA�L��d.-..�d��za-6��r WING MU04"m _ -- 1T FFIJ III i IDOI .� I- • S/ oi .. .f• t Y� 4: •'v t. r (f : t r. 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ItKa - d —A —.- -- oc . Pa2i z_ y T. T. stnt. GLL ;tJ[ v o LA Dx8 P.T LC G-EP- -r io" L..'/ oX t3PD >C I H-fl/GN T/1 tE D �� 13t LOtJ /1/11D£ GAK AG E - IDAM P i'Kcx7= I fare LELGtO GRr1045" rued'/v" �INGttOR OOvT AE2c.vtY - I nx 3U"x30"x/a"�oAlt. Pony - ._ tU-NDOw' EXT'ERtOR yCC>Oe et�ULE _I tirET. .7 a lYbg --- --------�-------•---------t .----------+-'—i--•--- ------- 1_�--_._.—__•__ry /3 3 xC, 4: 3t DE -------J- -------.1_...- --- ------ -- - --_ ------------ ._. _ .... -- -- c ANY& -2 _... _.._....._._._._ D yc.L —..—.�_._.--._.._.. ....._.� I ' ' (c°X 4S 5t tDt:IC I + I u • ' pA ."; u i O?xa� gT•eEt_ hook � 1 . . --------- --------- --- - --- SOIL TEST TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR OR CRAWL SPACE - - __ T �• ! DATE OF SOIL ES I FEBRUAR 3 20t�__ ELEV. = 100.00 - 10 FT MINIMUM 10 FT. K11NIMUM FROM SLAB i D SOIL TEST DONE BY CARM�N_SHAY1 R.S.___ ------ - I CLEAN SAND WITNESSED BY WA V D____---_______ CONCRETE COVERS -, LOAM AND SEED 4" SCHEDULE 40 PVC PIPE �; OBSERVATION HOLE 5 ELEV.=__-_-- 98.50 -T--------- ; MIN. PITCH 1/8" PER FT. - 1 2" LAYER OF ; I \OR 1/8" TO 1/2" PERCOLATION RATE _._<__3_._ MIN./INCH AT J4___ INCHES - WASHED STONEX. � FILTER rABRIC i DEPTH THORIZ TEXTURE COLOR MOTT. OTHER 98.50 MAX. VENT ` 4" CAST IRON PIPE q 1, T D / --�- -; --- 96.25 MIN. NOT REQUIRED I-0-'0" A LOAv r SAND 10YR3%2 NO (OR EQUAL) MINIMUM \ --�_ - - --- --•-.. --- - ` . PITCH 1/4" PER FT f-r z�/ I10-24" �B LOAMY SAND 10YR5/6 FLO' j \1 ` 24-120" C1 MEDIUM SAND__ 2.5Y6/4 W LINE rLl ' -- 1- ( i95.50 �---�{ o - -- -- -------- - ELEV. _ _�4� c % � �L ELEV. -�5= - LEVEL o/ C ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ �o °I ELEV. _ -Adt--' GAS � ELEV. _ _ -� 6" SUMP `ELEV. = 94.93_ o of .0 � __ NO WATER ENCOUNTERED AT ,20 � = 88.50 BAFFLE _ 95.10_ ------ ELE\ DISTRIBUTION a o o! ❑ ❑ � ❑ ❑ ❑ ❑ ❑ ❑ cc �020 01 -- _- CLEJ. _ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ C 92.75 - LIQUID ODjTL-ET BOX o _ ° ° °' ELEV. _��-�� E� ---- TEE TH (TO BE PLACED ON FIRM BASE) 3 500 GALLON GALLEYS 'WITi - 4 FEE 19 INCHES IF MORE THAN ONE OUTLET TESTED rT 14 INCHES TO BE ,HATER 5 FEET i 'TLET STONE IN AN ! I 6 FEE 24 INCHES 15W GALLON L7 FEE' 29 INCHES j (TO BE PLACED ON FIRM BASE) %I 11' X 2&125* X 2' TRENCH FORMATION z I WELL N/A 8 FEE' 34 INCHES I SEPTIC TANK � �- M 18.25 ZONE ----- ------ 3/4" TO 1 1/2" CLEAN SOIL ABSORPTION �, ' INDEX _ _-- DESIGN CALCULATIONS DOUBLE WASHED STONE SYSTEM SAS � ADJUST - GNUMBER ARBAGEODIS DISPOSAL FREE OF FINES & SILT J (J J, _L SEWAGE DISPOSAL SYSTEM PROFILE _--_-- USGS PROBABLE WATER TABLE ELEV. = TOTAL ESTIMATEC FLOW OBSERVED WATER TABLE ( / i ) ELEV. _ _ _ ( 110 GAL/BR./DAY X _.3 8R.) _�4_ GAL./DAY NOT Ti) BOTTOM OF- Q.TEST HOLE ELEV. = _Qk- REQUIRED SEPTIC TANK CAPACITY _ GAL. ) S SOIL TEST P 11 fi9fi ACTUAL SIZE OF SEPTIC TANK _) ___ GAL. DATE OF SOIL TEST APRIL 5L 2007 SOIL CLASSIFICATION SOIL TEST DONE BY S'JEE?SER ENGINEERING DESIGN PERCOLATION RATE <_.5 MIN./IN. WITNESSED BY _'7_, aFMAR& - EFFLUENT LOADING RATE W-4- GAL./DAY/S.F. j LEACHING AREA 472�75 SQ FT. OBSERVATION HOLE ELEV.=__98.70 (11HING s CAPACITY x2) LEACHING CAPACITY (AREA X RA'E) T. GAL./DAY PERCOLATION RATE < _2 MIN./INCH AT 57 INCHES 472.875 X 0.74 j --- --- -'----- _ _ RESERVE LEACHING CAPACITY Mil GAL./DAY �DEPTH HCRI' I TEXTURE COLOR MOTT. JOTHER (283.62+164.64) X 0.74 0-$" A" ii LOAMY SAND 1OYR4/1 NO ROOTS 8-24 B OAMY SAND 1 OYR6/4 '317 6 24-120" c - jMEDIUM SANG 2.5 8/6 _^- NO WATER ENCOUNTERED AT 120 ELEV. 88.7G NOTES• --- -_ 1. ALL WORKMANSHIP AND MATERIALS SHALL_ CONFORM TO D.E.P. OBSERVATION HOLE 2 ELEV.=__98•49 TITLE 5 AND THE TOWN'S RULES AND REGULATIONS FOR SOIL / __ __ _ TES - - THE SUBSURFACE DISPOSAL OF SEWAGE. T DEPTH i HORIZ TEXTURE CO,-OR Ii MOTT. - JOTHER --� 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO I E,, 0-9� !A LOAMY SAND 10YR4/1 NO ROOTS WITHIN 6" OF FINISHED GRADE. I IL 5a / 7� 0-25" B LOAMY SAND i0YR6 '4 I 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF \ 9 �ST 2 , � 0 1c� ✓ ---- - I WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN /p 25-120" C _ MEDIUM SAND 2.5Y7/4 10 FT, OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE LOT AREA -- 5.�2 SOIL OIL 120" $8.40 USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. T 1 NO WATER ENCOUNTERED AT ____ ELEV. _ v c c T' T.. I lvr 11, 112 SQ. Fr f E�-3 O 21. EST 5 �9g 2 4. AN MASONA`?Y )NITS USED O BRING COVERS O GRADE SHALL SOIL 7-$ 2�S t� 99 OBSERVATION HOLE 3 ELEV.= 98•10 8E MORTARED IN PLACE. T / � 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH \ TES 4 4 / / D. / I PERCOLATION RATE _ < -Z-- MIN./INCH AT 62_- INCHES DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY, 99 0 99.2� DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 6.9 /ice x 16 1`0 \ - IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS "7 0-9" A LOAMY SAND 10YR4 1INC) ROOTS _ ,500 GALLON / 12 cM� „- - / _-_ _ _ I PRIOR TO COMMENCING WORK ON SITE. 97.2 SEPTIC T DE �' Q 9--22 B LOAMY SAND 10YR6/6 ! 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS // a\ 2 SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION /r 0 N 2-120" C MEDIUM SAND 2.5Y7/4 ( iS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER // 8 9.2 NO WATER ENCOUNTERED AT 120" ELEV. _ _ 88_10_ IMMEDIATELY. / OBSERVATION HOLE 4 ELEV.�__97_5a_ - 8. PARCEL IS IN FLOOD ZONE C____. �- y8 9. LOT IS SHOWN ON ASSESSORS MAP _�- AS PARCEL -__137 . DLI�G 99 " 99 3 DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 10. EXISTING BUILDINGS, UTILITIES, AND SEPTIC SYSTEM ARE TO BE REMOVED i 0 INCLUDING ANY POLLUTED SOILS ENCOUNTERED, AND REPLACED WITH NEW 97.3 5E0 �pN1' �, y 0-10" A LOAMY SAND 10YR4/1 NC ROOTS SERVICES, SEPTIC, AND BUILDING. 98'S ,."� 10-31" 6 LOAMY SAND 1UYR6/6 11. THE INSTALLER IS TO GIVE THE ENGINEER A MINIMUM OF 48 HOURS 0" 1 (2 WORKING DAYS) NOTICE FOR THE FINAL INSPECTION (NUMBER BELOW). 97' /�, 9 8 I 31--132" IC MEDIUM SAND 2.5Y7/4 1 98.9 ,i 91 / NO WATER ENCOUNTERED AT 32_ ELEV. _ 86.50 99.2 / - APPROVED: BOARD OF HEALTH 98.7 8.9 99.1 r 9 7.4 Ile 98.C, 97.6 C4T AGENT i o z //.x; 98 4 §7.7 PROPOSED SITE PLAN ----' • 9e.5 9 8.8 ,�► 98.8 9 � I JAMES CURRAN rZUSH 98.E MAC• NAIL SE LJ23. 1 IN U_POLE pa-,31 I ---- Loc EL= 99a (Asuc; . 32 SOUTH MAIN STREET 100.2 T A. BARNSTABLE, MASS.-It I OCUS 99.0 9 9 a , �.�Ia I �� I I - _ C E N T E R V I L L E ----_� r' 6 I 98.8 5OU� �w° P SWEETSER ENGINEERING ----- 99.2 �/ �98.8 32 Sq~ta� i Q gi41 `�~ 235 GREAT WESTERN ROAD ! / l 508- P. 0. BOX 713 j I SOUTH DENNIS, MASS. � c 398_3922 02660 LEGEND: f 4qc EXISTING SPOT ELEVATION 00,0 / L/� ATE SCALE ; " ' EXISTING CONTOUR ----DO---- / NOV. 3, LCi j = 2V FINAL SPOT ELEVATION �99.2 FINAL CONTOUR- RED ApP. 1 o, �oo7 j ; JOB No. 6360-00 SOIL TEST LOCATION '� 'QO UTILITY POLE O , ------ -- --� L- TOWN WATER =W-=- v^d-- - a c.Y di { CATCH BASIN fl � - �--- i 1 GAS LINE --G -- -- = r; > .. LOCATION MAP • RE`✓. CLEAN OUT C.O. -- -- - -- I LSNEE - OF � I CESSPOOL C.P. C; ' S T � I "? q � n �, C 2��06 SWFETSBR EtJG. C: S..' ' Prcv�. o�6� 0,7 dw E360-sasl. �W� i TOP OF FOUNDATION I -__ 20 FT. MINIMUM FROM CELLAR OR CRAWL SPACE _ _ SDiI TES DATE OF SOIL TES' FEBRUARY 3 c005 ELEV. = 100.00 10 FT. MINIMUM 10 F?. MINIMUM FROM SLAB CLEAN SAND SOIL TEST DONE BY CARMEN-SHAY. R.S.__ ------ III WITNESSED BY WAIVLJ------------- I CONCRETE - � 4' SCHEDULE 40 PVC PIPE LOAM AND SLID OBSEf� Y/1 ON HOLE ELEV.=-_98•50 � MIN. PITCH 1/8" PER E?. � 2" LAYER OF �/ -�-- \ ` 1/r," TO 1/2" r-� PERCOLATION RAT_ _ < _3 MIN./INCH AT -54___ INCHES r--- WASHED STONE - UAY \ 98 50 MAX. OR FILTER FABRIC VENT DEPTH, HORIZ ' TE TURE COLOR MOTT. OTHER !3.5 ! 4" CAST IRON PIPE 96.25 MIN. I NOT REQUIRED 0-10" A LOA Y SANO 10YR3 2 NO (OR EQUAL) MINIMUM \ -----�- -- - - __ / - --- -._ PITCH 1/4" PER FT. \ Z42 - t (10-24" 9 LOA Y SAND10YR5/6 Z 24 120' C1 MED UMSAND 2.SY6/495-50 FLOW LINE - 'ELEV. ffi �__ 0 I ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ M IN. - -I oo --ELEV. 95. 0 ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ i-ELIE,. _ �_ GAS ELEV. 95.10_- 6" SUMP ELE`d _ --94�9.3_ ° _ ° ,° ' NO WATER COUNTERED AT t2C"_ ELEV. _ _ 88.50 BAFFLE DISTRIBUTION ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ° 2 ° __� ry - --- � E�V_ LIQUID OUTLET Q4,Z'�_ o 0 0 DEPTH TEE 4 FEET i 4 INCHES (?0 BE PLACED ON FIRM BASE) TO BE WATER BOX TESTED 2 500 GALLON GALLEY WIN T- 5 FEET 19 INCHES F MORE THAN ONE OUTLET STONE IN AN 'r 6 FEET 24 INCHES 1500 GALLON _ I ! 7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) J 11� X 28.125� X 2� T NCH F)�MATION z 1 WELL-NfA _ ZONE 8 FEET 34 INCHES SEPTIC 'TANK 3 4" TO 1 '/2" CLEAN - I4.25 INDEX/ SOIL A6S0 PTIC)�� .� I� DESIGN CALCULATIONS DOUBLE WASHED STONE ADJUST NUMBEP. 0r BEDROOMS 3 FREF OF FINES & SILT SYSTEM SAS` _ + GARBAGE DISPOSAL UNIT USGS PROBABL WATER ABLE ELEV. = TOTAi- ESTIMATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED 'HATER TABLE / ) ELEV. = ------ ( 110 CAL./SR./DAY X �_ 9R.) __3�4 GAL./DAY BOTTOM TEST HOLE ELEV. = _�,'�Q_ REQUIRED SEPTIC TANK CAPACITY __NQ_ GAL. ACTUAL SIZE OF SEPTIC TANK _1500 GAL. SOIL CLASSIFICATION --I-- DESIGN PERCOLATION RATE <_,'� MIN.jIN. 1-1 EFFLUENT LOADING RATE D1-4. GAL.jDAY/S.F. LEACHING AREA 47�87_3 SO. FT. (11 X28.125)+(81.75X2) LEACHING CAPACITY (AREA X RATE) 34"2 GAL./DAY 472.875 X 0.74 RESERVE LEACHING CAPACITY _3�1,7Z GAL./DAY I (283.62+1$4.64) X 0.74 f 98/$ 97.6 NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN'S RULES AND REGULATIONS FOR / I THE SUBSURFACE DISPOSAL OF SEWAGE. 2, ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO `. WITHIN 6" OF FINISHED GRADE. 58 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF 9 3A a ' WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN % 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE L07_ AREA - � 12 _ USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. � �,55. p 1 61 OIL 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL (1V ) �, �2 S0. FT.f �i 2 TEST .�g�-1 BE MORTARED IN PLACE. Irr ?�S 99 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 4 D.^ Qff J DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO 9�W{ 1 OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 0 UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 6.9 16 o `� a; I IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS 1500 GALLON i' 12 G►� O ��/ I PRIOR TO COMMENCING WORK ON SITE. ■ 97.2 OE No\ O 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SEPTIC T o SITE CONDITiONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TC BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER 9.��� 2 IMMEDIATELY i 8. PARCEL IS IN FLOOD ZONE _ C 9. LOT IS SHOWN ON ASSESSORS MAP 228_ AS PARCEL -137 99.3 I!' 38 10. EXISTING BUILDINGS, UTILITIES, AND SEPTIC SYSTEM ARE TO BE REMOVED 99• INCLUDING ANY POLLUTED SOILS ENCOUNTERED, AND REPLACED WITH NEW I \ a 97.3 �0 Gp1� 4» ��" SERVICES, SEPTIC, AND BUILDING. 97.8 5 gEOR 98.5 1 i 11. THE INSTALLER IS TO GIVE THE ENGINEER A MINIMUM OF 48 HOURS 97.5 /y / (2 WORKING DAYS) NOTICE FOR THE FINAL INSPECTION (NUMBER BELOW). 0 x 9 8 / - g� 98.9 i �'4r gg�1 1 I w 99.z APPROVED: BOARD OF HEALTH 98.7 99.1 0 8 9 f 97.4 / 98.6\f/ ��/997.6 DATE -. y .4 0. x ---- - - -- - ----..--- - ---- -- - - - D SITE PLAN PROPOSE ■ 98.5 g g { 98.8 31 �� ; JAMES CURRAN o 1o' i � /�100.1 98.7 x 8 8.9 / 'MAG' NAIL SET FLUSH ' ------ -------- -- - - -- - -------- �.* TRE� IN U-POLE r39 rLoc 32 SOUTH MAIN STREET \100.2 9.5 1 . �'_.= 99.a (ASSUMED) �r� ". :., _.. �N r ' LOCUS BARNSTABLE, MASS. 9�a c 99.4 / � _-- -- c E N_T E F2�/i L L.E DU 988 S ', SWEETSER ENGINEERING 99.2 98.8 32 c,s gibs �� 235 GREAT WESTERN ROAD `� 508-- P. 0. BOX 713 398-3922 - SOUTH DENNIS, MASS. 22660 ®99.1 - --- j LEGEND: 1 EXISTING SPOT ELEVATION 0010 / �� DATE SCALE ' - ' / �F NOS. 2006 L_ - 20--� iEXISTING CONTOUR ----00---- j - _ � � t --`�' I --- FINAL SPOT ELEVATION / `�99•2 »r Fq FINAL CONTOUR �,,•; f ,PO I REVISED JOB N0. SOIL TEST LOCATION --- 6360-00 Ik m �- I UTILITY POLE -------- TOWN WATER -W� =w=-== J41 r _ 7 7 � Y CATCH BASIN ®; r- I OCAT!QN MAP - ; REVISED SHE-LT 1 OF GAS LINE ---- l"'= ^� CLEAN OUT -�:-- �'r �ar,�Sur-,,, c ------ - ---1 � � - -- CESSPOOL C.P. �, � C: S8 ! PROJ , 6360-00 1 a'w_q ', 6360-sas.DWG © 2006 SWEETSER-00 6360-sas.DWG 2006 ENG. j *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A -A ALL OUTLET PIPES FROM THE - 10' min. from PROFILE VIEW OF LEACHING SYSTEM! DISTRIBUTION aox SHALL BE Existing Foundation house to septic tank SET LEVEE FOR AT LEAST 2 FT. 12 CONCRETE COVER Septic tank covers must be D-BOX cover must to 1 _ TOP OF FOUNDATION = ELEV. 100.00 (Assumed) withn 6 In. of finished grade I within 6 in. of findshed grade '`- KNOCKOUTS ? Anode over D-Box - 98.50 -Grade over SAS - ELEV- g8.50 �• 3 - K OUTLET ' Grade over septic Tank - 96.so� � j a/�•a r r/rt se�AM a..�.ka sk.e. �r/s•- r/IY Irrre is..d.n. KNOCICOU TS - .._ ,.- � - ; pine//J\\ St i INSPECTION cover must be 5.5• OUTLET 1 l 12• INLET 1 w'•hin 6 In, of finished grade S - 0,02 S HOLE H--10 + _ I s• Za 1�; DIST. BOX 3' Maximum Cover Top of SAS-Etev.=96.90 ,' ___ 5----- o realer S- 0.010' per toot 1 ♦ ---15.5'-- 4" - SCH. 40 Te t.75' �♦ I- 30' EXIST. -- _---------- 1 0 0 o I� o o FXIcT, PIPE �, - 2' EffevtNv Depth o 4 0 o PLAN SECTION CROSS-SECTION 1,000 GAL. 20. o 0 0 0 0 0 0 FROM EXIST, FOUNDATION w � SEPTIC TANK c� 2D' n o ri II o' s„�. rn M o 2 Units 2 8.5' = 1T CONCRETE FUU. FOVNCA �, o H-10 R ED 0) 3.5' rt 4r I -T9' v u'> m R A 3. ♦J ."e. 3 HOLE H--10 DISTRIBUTION BOX - ; femdSe do 6 in.of 3/4--1 1/2" o i SYSTEM PROFILE compacted atone °' " _ 12' w Effective Length NOT To SCALE F_ _9 a r� c o Effective Width i 0100+Pxd 1t Wlv tltesei+v®.'9W NAvTEid Not to Scale - c o SOIL ABSORPTION SYSTEM (SAS) 6 in.of 3/4'-1 112' 0 500 - C H-10 LEACHING UNITS / WIGGINS PRECAST GENERAL NOTES _- compacted stone m Not to Scale 1. Contractor is responsible for Digsafe notification NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE Bottom of Test Hole 1 Elev= 88.50 _ _ and protection of all underground utilities and pipes. wObs. Groundwater - Test Hole 1 Elev.= NONE OBSERVED 2. The septic tank and distribution box shall be set level on 6" of 3/4"-1 1/2" stone. 3. Backfill should be clean sand or gravel with no _ -- stones over 3' in size. - - 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this systern in accordance \ with Title V of the Massachusetts state code, the approved plan P E R C O EAT!O N TEST and Local Regulations. 6. If, during installation the contractor encounters any soil conditions or site conditions that are different Date of Percolation Test: FEBRUARY 3, 2005 Test Performed By. CARMEN E. SHAY, R.S., C.S.E. from those shown on the soil log or in our design Results Witnessed By. WAIVER E. Barnstable B.O.H.) installation must halt & immediate notification be made to Carmen E. Shay - Environmental Services, Inc. SHAY ENVIRONMENTAL SERVICES, INC. Percolation Rate: Less Than 3 MPI 0 24" \ 7. No vehicle or heavy machinery shall drive over the Septic system unless noted as H-20 septic components. 8. Install Tuf Tite gas baffles or equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. -- --- 10. All solid piping, tees & fittings shall be 4" diameter Test Hole Schedule 40 NSF PVC pipes with water tight joints. No. 1 j DEPTH SOILS ELEV LOT #2 11. Municipal Water is Connected to The Residence and Abutting Properties Within 150 Feet. o __- - Loamy THE PROPERTY LINES ARE APPROXIMATE AND Sand COMPILED FROM THE SURVEY PLAN GENERATED BY 10 Y 3/2 0'-10' A e7.so SCOTT ASSOCIATES, LAND SURVEYOR, ENTITLED PROJECT BENCH MARK - "SUBDIVISION PLAN OF LAND IN CENTERVILLE, MA, of DOROTHY ST PIERRE Loom TOP OF FOUNDATION DATED JUNE 1965, PLAN BOOK 197 PAGE 145 Sand & THE DEED DESCRIPTION ( BOOK 11397 PAGE 169)10 YR 5/8 ELEV. = 100.00 (Assumed) IT SHOULD BE USED FOR NO PURPOSE OTHER THAN i I to'- 24" Be e6.so 9$ THE SEPTIC SYSTEM INSTALLATION. Med. Sand � 155 72' } EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE OR z.s Y e/4 G 68.50 Failed , ��, REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION 24"-120' /Leach Pit �� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE FROM THE EXISTING LEACH PIT TO BE DISPOSED _ i. t OF AS PER BOARD OF HEALTH SPECIFICATIONS. O O 12 i'. 'L ARCEA71 NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY j EXIST. 1000 gal. 98 ` Septic Tank -- ASSESSORS MAP 228, PARCEL 137 cb Z l --25'EXISTING 2 13�. LEGEND i GARAGE __ - TEST HOLE #1 Perc #1 ELEV.= 98.50 DENOTES PROPOSED Depth to Perc: 36" to 54" 104X 1 SPOT GRADE Perc Rate= Less Than 2 MPI i Groundwater Not Observed DENOTES EXISTING No Observed ESHWT i EXIS',ING X 104,46 SPOT GRADE ADJUSTED H2O Elev. = None ------ 3 BEDFOOA! N/F Town of Barnstable '-- �---- , HOU.E PL PROPERTY LINE I #32 -�our r PROPOSED CONTOUR i - - - - - -97 EXISTING CONTOUR I ASPHALT DRIVEWAY i � L07 #1 2-18' DIAM. ACCESS MANHOLES 11.70� S�!uaTe F¢6C -F DEEP TEST HOLE & I I I � PERCOLATION TEST LOCATION a i 1 cb 6 FOOT STOCKADE FENCE REV.. 04/08/05 per BOH Review Comments 1 THE ACCESS COVERS FOR THE SEPTIC TANK, I I INLET ---- DISTRIBUTION BOX AND LEACHING B COMPONENT I I PLOT PLAN OU T SET DEEPER THAN 8 INCHES BELOW FINISHED GRADE SHALL BE RAISED TO WITHIN 6- OF 1� I FINISHED GRADE. - -�� INSTALL TUf_TITE GAS BAFFLES aREQUALS so U7'H 11 fAIN �~ 7, �'F 7, OF PROPOSED SEPTIC SYSTEM UPGRADE STEEL REINFORCED PRECAST CONCRETE (40 FOOT RIGHT )F WAY) PREPARED FOR PLAN VIEW WILLIAM &. VIOLA FISH 3-24' REMOVABLE COVERS # 32 SOUTH AT STREET 3' min. clearance f 13• INLETINLET 1 m T-12_min. inlet to a�,wt „LET CENTERVILLE, MA 10'mb. Uquid-rivd ---- 1 -- te• lJ _ s -r - �$ !-- s -r Design Calculations ��N° �s, PREPARED BY:E Q ' ♦ - 4'-0' min. ba Llgowm Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) c t Garbage Grinder: No ARC N RHTN E. ,SHA Y f Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) E .•_ '"::•-.i. '-.,l-.:r.. -.- 0 20 40 50 U IAY a'-O' 4' -10" - ' Septic Tank - 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL. Septic Tank. VIRONMENTAL SERVICES, INC. END-SECTION SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch O. 1 CROSS SECTION eattom Area: 0.74 gal/sq. ft. x 300sq. ft. = 222.00 gallons GISTER�O 0. BOX 627 Sotto ll Area: 0.74 gai./sq. ft. x 148 sq. ft. = 109.50 gallons EAST FALMOUTH, MA 02536 Providing: = 331.50 gallons SANITAR�P USE EXISTING 1000 GALLON H- 10 SEPTIC TANK SCALE: 1 "=20' TEL/FAX : 508-539-7966 Use: (2) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH, SCALE: 1 "=20' DRAWN BY: CES DATE: FEB. 22, 2005 NOT TO SCALE TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES AND 4' of WASHED STONE ON THE ENDS. PROJECT#SD695 FILENAME: SD695PP.DWG SHEET 1 OF 1