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Home My WebLink About0147 YACHT CLUB ROAD - Health 147 Yacht Club Road Centerville A= 211 -025 3 llll UPC 17534 No.2_ 1_53COR KASTINGS.YN G4l � s� I Town ,Of Barnstable OF THE 7p� Re.gulatory Services t 4 Richard V. Seali, Interim Director l/sRNSTABLE, Public Health Division Thomas McKean, Director 200 Main StreQtf Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 1 Installer & Designer Certification For Date: / �� Sewage Permit# i Assessor's Map\Parcel ��1-er-,ate�v►i-ee 1�t Designer: Installer., 'D,;A . . coven Address: t'L U3, Crz�s.S) 't @)d -fW Address: P 0. X I Lt I- �tires�—cPa:C� Y"�� e9 2 C�y y �.��•.+efv. I l� IMF �Z 6 3 2 on Q-yG 1�l ��"`�n C was issued a permit to install a (date) (instaYl;ex) septic system at� Z �,�— C, y2jzk; based on a design drawn by (address) a j�Fer'✓Ltee dated y (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. Ship out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the 'SAS or any vertical relocation of any component of the septic system) but in accordance kith State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory, I certify that the system referenced abov':was constructed in compliP. � � ith the terms of the IAA approval letters if applicable) pP ( Pp ) �Z g �t. ' �1CCf�1TE- rn (Installer's Signature) esignex's Signature) x Designer's z PLEASE RETURN TO BAR.NSTABLI✓ PUBLIC HEALTH DIVISION. CERXIFICATE Ol{? COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH TBIS FORM AND_AS BUILT CARD ARE RECEIVE..BY THE BARiNSTABLE PUBLIC 1vIEA '.TE(DIVISION.. THANK YOU. QASepticTesigner Certification Form Rev 8-14-13.doe i No.O' O1 "1 — Lq Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes —L� PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS apphration for Misposal *pstem. Construction i3ermit Application for a Permit to Construct( ) Repair.(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./,'-f/ tick r- C l"b 1Z i Owner's Name,Address,and Tel.No. Assessor's Map/Parcel f,2(/ -C� � ;Pt) I et? Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. cxr�,lc�s .4 Ice 71 Gc1 j,0C cam.-; ✓ ir.'lC S -S 3f' Type of Building: Dwelling No.of Bedrooms 3 Lot Size !9 7'3 3 sq.ft. Garbage Grinder( ) Other Type of Building jPr,�,i VP;v�rlc k No.of Persons 7, Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) sue. 3 0 gpd Design flow provided 3-S tj_, i gpd Plan Date Number of sheets '4- Revision Date Title Size of Septic Tank x.si i.�y� Type of S.A.S. .j! OtC,, f . Iit 'k.sr',D r f<ea�niN✓/rl1y`ltty Description of Soil Nature of Repairs or Alterations(Answer when applicable) n/�,r��/ �J� _A. � �'�, ��l �J��.✓ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signey—Dlielf Date � /g.o/��— Application Approved by Date K % Application Disapproved by Date for the following reasons Permit No.(XU ��/ Date Issued� ` No. Fee TIE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION =TOWN_ OF BARNSTABLE, MASSACHUSETTS Nplitation for Disposal *pstrm Construction Permit Application for Permit to Construct( ) Repair/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./,'/-17 Giti Owner's Name,Address,and Tel.No. LEnf�rU (� _ Assessor's Map/Parcel a 1( -Q;Z Pa leo Installer's Name,Address,'aHd Tel.No. Designer's Name,Address,and Tel.No. 10W A).l rJ G 'S J 'VCV- 7/ WUdlI St7 - 3/ } Sl�CYvr✓ Type of Building: ., -� 'Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder:( ) Other Type of Building re,,i 3e jv .,\ No.of Persons Showers( ),Cafeteria( ) Other Fixtures Design Flow(min.required) Z 3c1 gpd Design flow provided 3-3,2 _ gpd Plan Date 8-7-/6/ Number of sheets 'L- Revision Date Title Size of Septic Tank £xi4;,,,� Type of S.A.S. q 40z&0-ba '412S �k Description of Soil r Nature of Repairs or'Alterations(Answer when applicable) ��$IGII /1I1°rJ 5.A , rj95D e/ d J6/,/ Date last inspected: =' Agreement: ` The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Z Signe Date Application Approved by / ► I Date Application Disapproved by '' . � ;_ Dade for the following reasons ;: Permit No. Id 1( 3 y!� Date Issued Co/-- a---------- - -- - -------------------- , - ---------------- 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�yc 5 A �5(cw l xt/r— at /L/7 )1k df f t-'k h J 6wl- elf fl e has been cons u)ct d n accord ce with the provisions of Title 5 and the for Disposal System Construction Permit Noy /� dated Installe,:Zty)45 `T R(Ou;� Designer�I„iz.,-%p.i/e W,,.,l #bedrooms `�y Approved design flow gpd The ije sqane of this permit shall of bei onstrued as a guarantee that the syste nction a designee Date ' / �/ Inspector lq RIM,--- -------------- --- — ---- ------------------------------------------------- -----------�------------------------ - Niib �I 3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal Opstem Construction Permit Permission is hereby granted to Construct( ) Repair / Upgrade/ ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided*Cron tructi /muustt be completed within three years of the date of this permit. Date / T( "T Approved by � Af A- rnw1C1ot iIiLa]l�]il star e pf�NElgfY Regulatory S e1"N1 Ts Ny tio�, Richard V. ueatli, iutcriui Dircetor Public .1401th Diyisiolt erns. ,� �6g9• n,� Thotitns McKean,Director �Eo Nw� ,-- 200 Malin Street,1~[y'aui►is,11'!A Q?.tiUl : rax: SOS-790-63061 office: Sog-662.4644 1~>Eo111eow,aei,CcrtiCti;sofiou IF fort -Itca'aasltir�S scer��s � - 1'rciperty Address:_.. 1 plc-1 �(u,c.44- C1•►1�___��c�-,— — -----w Assessor's MapTarcel: Property Owners Name: __... 011 « ,>> fa accordance with Massacliusetts 171':,l' alter cord, sTlie owner of rectord ahusto Place n�, e\ific'1tthe information is required by the Owner of Ve applicable box next to each line certifying the information. Yes N\A / ❑ I have been provided a copy of tine Title 5 VA teclwology Approval'letters. Lt.J (i 5 page Standard Conditions letter and the specific tecluiology letter) -C1 j have been provided with the Owner's Manual n l!, f have been provided With tSte Operation and Mai»tenat1ce Manual g'� j agree to hlltill lily . ❑ � 1 ur Systems insta�!!ed raider a Remedial Use Approval, responsibilities to provide a laved Notice as recluiretl by 3 10 CMI� 15.287(1 U) and the Approval ❑ LY'Fur Systems installed raider a Remedial Use Approval,I agree to fullll atzy responsibilities to provide written notification of the Approval to any new Owner,as reclaimed by 310 CMR 15.287(5) Fe,/ ❑ if the design does lot provide for the»se of garbage griatders,the restriction is understood / and accepted L� ❑ Whether or not eovered by a warranty, I understand the requirement to repair,replace,ittoclit' or,take any other action as required by the Department:or the LAA, if tlu: Department or the LAA detL-rmines the System to be failing to protect public health and safbty and the environment,as defined in 310 C N4R 15.303 agree to comply with•all terms aril conditions above. Property Owners pcinfedi111ie al— Property Owtters Sr�'lltmhll'e Dote: This form roust be sitbluittecl 81ou I''ith the septic ss'stem clisuosal works -ncr► lit application Wing new constrtletiol7, re�?rs\11 a made_, ivith Mid sti'ithtntt a*jr-mate stone sad�vit11 con�'e <lesi;xn_criteriti or credited_ destgrx criteria , 10/10 39dd 9090 XGW30IA30 0888L8£L1:9 80:11 DIOZ/81/80 L TOWN OF BARNNSTABLE LOCATION SEWAGE# 0"-:509 VILLAGE Zlpg ykez,il)h,o ASSESSOR'S MAP&PARCEL 211 _Q ' INSTALLER'S NAME&PHONE NO�93 ce5 A t k3w%J _(SX_ SEPTIC TANK CAPACITY e x15EI J% LEACHING FACILITY: (type) A.ic- 3a H C (size) NO. OF BEDROOMS OWNER PERMIT DATE: 6-2G`I 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"' ;, Z-• 21 T G 0 — 11 aJY Ci f a-sf op-3'1 0 yy ti� Y��M t Clob t-- 19 '�(aNS g..It J/ Iy-24 C Ckewaoh LI'3 - t'6JT wail Town of Barnstable P#_ Department of Regulatory Services MUMSTAB1 : Public Health Division Date Z i639. ,e� 200 Main� Street,Hyannis MA 02601 Y - ;Date Scheduled; � Q O � Al 2" q Time Fee Pd. i Soil Suitability Assessment for Sewage Disposal Performed By:-_� � Ci Sl'- U�_z- Witnessed By: �p/1 12_� KvrdF�v s LOCATION& GENERAL INFORMATION Location Address �J� Y�4 it � Owner's Name Iry e6� P -ri,-- Cf- Ili AddressAssessor's Map/Parcel: `�`er'A MA ,�62f �� - C9 Z S� Engineer's Name NEW CONSTRUCTION REPAIR _ Telephone# .5-CF-= 'Z-7 Land U i se r Slopes(%) 7to Surface Stones Distances from: Open Water Body 72 ft Possible Wet Area"Z�r�-�- ft Drinking Water Well �l ft Drainage Way-A?-,!A-- ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) r, G 1 1 Q C= /may Parent material(geologic) 61k 6 0. /QcJ"-wC Depth to Bedrock. Depth to Groundwater. Standing Water in Hole: ' p g o Weeping from Pit Rece A Estimated Seasonal High Groundwater �S d f � 371 / i S L /V 6-VD DETERNIINATION FOR SEASONAL HIGH WATER 'TABLE Method Used: Depth Observed standing in obs.hole: in, Depth to soil mottles: Depth to weeping from side of obs.hole: in, t3roundwater AdJusfinent _,tea fr. Index Well# Reading Date: Index Well level,.:� Adj,factor Adj.Grvutidwater]level e Observation PERCOLATION TEST bate Thno,_� � Hole# Time at 9" _ Depth of Perc 3 d q Time at 6" Start Pre-soak Time @ 4 Time(9"-6") End Pre-soak ;r Rate Min-Anch. - Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)_ Original: Public Health Division Observation Hole Data To Be Completed on Back-----•------ ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:1S EPT10PERCFORM.DOC -- I DEEP.OBSERVATION HOLE LOG Hole# `1-e- Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, Gravel) fl—I Z— �►�C q SL lII'1!►'Lyl ,'ee_ Yz- $ Ls �o Ynsjb Za �� G,,uv-t yz-l3ti c Iw-c Sa.,�l Z.SY�f za� Gs�,.Kl 6b , DEEP OBSERVATION HOLE LOG Hole# �' Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) b -tz 5L e -l,Zo ^ L fA-e. .5q,'-j Z e,.Y 1 • DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, o Gravel) DEEP OBSERVATION:HOLE LOG t Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) i (USDA) ', (Munsell) Mottling, (structure,Stones,Boulders. o n + • _ _ t _ it Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes .?(___ Within 500 year boundary No Yes :. Within 100 year flood boundary No Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious-material? Certification I certify that on It (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required tr ' ing,expertise and experience described in 10 CMR 15.017. Signature Date r� Q:\.SBPTICVBRCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 147 YACHT CLUB RD Property Address PULEOMINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN J cursor-do not Name of Inspector use the return key. DOUGLAS A BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 'soon Citylrown State Zip Code 508-420-4534 S14297 f Telephone Number License Number k' y` B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10/10/12 Inspector' Ignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the . report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority, ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. VcriForm. �t5ins-09/08 Title 5 Official urface Sewage Disposal System•Page 1 of 17 1 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM MEETS MINIMUM PASSING REQUIREMENTS AT TIME OF INSPECTION , HOUSE WAS OCCUPIED BY ONE ELDERLY MAN FOR MOST OF THE TIME, FUTURE PERFORMANCE UNDER THE SAME OR INCREASED USE CAN NOT BE PREDICTED 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•09/08 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 147 YACHT CLUB RD Property Address PULEOMINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will, pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ 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•09/08 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 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 '/Z day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 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 M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 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? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 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 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: ACCORDING TO AS-BUILT CARD SYSTEM CONSISTS OF A 1000 GALLON SEPTIC TANK D- BOX AND 3 4X4 GALLEYS Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available last 2 ears usage d SEE BELOW 9 ( Y 9 (gP ))� Detail: 2010-----87 2011----93 Sump pump? ❑ Yes ❑ No Last date of occupancy: UNKNOWN Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 7 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owners Name information is required for CENTERVILLE MA 02632 10/10/12 ' every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: UNKNOWN Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared,system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1991 ACCORDING TO AS-BUILT 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: 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: 1000 GALLON ACCORDING TO AS-BUILT Sludge depth: LIGHT t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 r� Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12- every page. Citylrown 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 TRACE 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 LOOKS SOUND AT TIME OF INSPECTION 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•09108 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 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown 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•09108 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 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owners Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown 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 01, 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 SIGNS OF FAILURE AT TIME OF INSPECTION Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °r 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. City(rown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 4-4X4 GALLEYS ❑ 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.): NO SIGNS OF HYDRAULIC FAILURE IN AREA OF GALLEYS 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 I. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 147 YACHT CLUB RD Property Address PULEONVINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityrrown 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 t5ins-09/08 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 �M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 every page. Cityfrown 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: BELOW BOTTOM OF GALLEYS 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. 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: AUGERED IN AREA OF GALLEYS Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 147 YACHT CLUB RD Property Address PULEO/WINNER Owner Owner's Name information is required for CENTERVILLE MA 02632 10/10/12 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 p Assessing As-Built Cards Page 1 of 1 TOWN OF BARNSSTABBLE LOCATION./ 2 � a,,4_ SEWAGE VILLAGE 'C�,+ti../� ASSESSOR'S MAP & LOT INSTALLER`S NAME & PHONE NO. V If�iu_ SEPTIC TANK CAPACITY /ddQ 1i4 LEACHING FACILITY:(type) NO.OF BEDROOMS PRIVATE WEL OR UBLIC W BUILDER OR OWNER "Am DATE PERMIT ISSUED: _�i - 2��.•,�_� FJ DATE COUPLIANCE ISSUED: VARIANCE6 _TED _ Yes No .�... ."�' 17 TM E http://www.town.bamstable.ma.us/Assessing/HMdisplay.asp?mappar=211025&seq=1 10/30/2012 TOWN-OF BARNSTABLE LOCATIONZ�2 ;SEWAGE VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 4 + SEPTIC TANK CAPACITY Aawv 64 '+ ' LEACHING FACILiTY:(type) NO. OF BtDROOMS PRIVATE WE L OR UBLIC;W �'>/, ? � ``�" �1 gip.;• ,,,rt� ,•.• BUILDER OR OWNER ':�AiAt YA+ DATE PERMIT ISSUED: �i � DATE COZSPI:IANC:E ISSUED: 1= �a Y ,VARIANCE G A1TBD.r Yes a� r rNo Y ` x::KJ +..,.. �, . �. _ ,. ..,.>.�r.,.-.,•.�v.+.rNM^e�"d,b++ i erA 49 s z j . * r 1 y � 1 r • r l t N. }d 1 THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonst:rurthin rrmi# Application is hereby made for a Permit to Construct ( ) or Repair (' an Individual Sewage Disposal System at: —/ ..-. �/ --•.-.--- -Ad e$s or Lot No. r? ... --------------------------------------------- --Location r rca-----.:.•.................... /...c ,..... �s..�.� ..... ?CLOCK -7� caner // e ddress Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.............. ."0--------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----•-•-------------------•-------------------•....------...------------------------.....-----------....................................-...... .. Design Flow......... gallons per person per day. Total daily flow............................................ W g -----------------•-••---g P P P Y• Ygallons. WSeptic Tank—Liquid capacitye�_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........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ O Description of Soil--------------� ° ---------------•--...-•---------•-------------------------•----------•-. ------ -----•---.-....-------•--.. W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•------••-•------------------------------------•----------------------------------••----...--------------....----------------------•------------------•------------•--•-----•--------------.._......... 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 b ssued by t boar f health. Signed ....... ------ - . .......... ---------------------- �• to Application Approved B ...................... Date Application Disapproved for the following reasons:' -------------.................................................................................... ----- ----------- ------------- --------------------------- .- ---------------------- ---Q --------- X 3 Permit No. q..1 -- ......... Issued ........... -- ..- ..---- Datte IV .../....... / _ FEs. THE COMMONWEALTH OF MASSACHUSETTS -- _BOARD OF HEALTH TOWN OF BARNSTABLE rlirat#ilan�,for DhiposFal Works C�nn�#ra�r#iun rani# Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: f � � � /�v' f / __• LnAdTss orLt . ................... .................. n / be W Owner Add ress L ............T.... --------------- .. .. ............... Installer Address Type of Building Size Lot............................Sq. feet I—I Dwelling—No. of Bedrooms...................•--_--•-••------__-•__--Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ---------------------------------------- W Design Flow.........2;� .......................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity`.°U.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........................................ r Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fit Test Pit No. 2................minutes per inch Depth of.Test Pit..................... Depth to ground water........................ O Description of Soil...............j�`? Z` V ---------------- ------------------ -------------- ------------------------------------------- •-------------------------------------------------------- -............................................... W V Nature of Repairs or Alterations—Answer when applicable.....................................................:_....._._......._................._.__... ----------------------------•------------------------'----------------------------------.......------------------------------------......------•-----------------------......------------......•-•------ 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 bee sued by t e board of health. 4 _a r J Signed .... u— :..... R -r--- " A lication Approved B ..v..l:.,- l.- PP PP Y ---.. ............----- ---�-- ---------...--- ...:.........----------=........�--................................. Date Application Disapproved for the following reasons- ------------- -----------------------...............................................................------------------------- . .--- ----------------------........................------------- - -------- - ------------- -- Permit No. ..-_ � / ------------- -- Issued --- -------- �e 't ----. .... r .,,Dare l,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CIJelr#iftrate of Contyliance THISs TO Y, at the Individual Sewage Disposal System constructed ( )TI or Repaired ( ) by ------------- ��. r`at UAInstaller ,�j `1 ---...... ...... .. - has been installed`in accordance with the provisions o TITLE 5,pt The State Environmental Codes desc ibed in the application for Disposal Works Construction Permit No. ............�."'....��....... .. dated .. 1._... � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE ONSUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION-SATISFACTORY. DATE..................................----- -- ------------------------------------------------------------ Inspector ----- ............. -----------------------=-------------------- -----------'---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �-- No....e..1......... FEE."s .......... Disposal Workv Tongtrnr#' n Trani# .Permission is hereby granted_ ..... ....� a ...................�. ... u r- ........................................ to Construct ` ) or e-a r ( ) an I• lividu 1 ewage:Disposal S s at No.. - _ f� __ � `� ��11� � �,, =r�V/- / .0�,- ----_l l :- i I � t r I Street � -�p, /1 f� �.. as shown on the applicat on for Disposal Works Construction P rmit No ___f74 Dated.._.__. ....__._....._.... ... ............... ................................ ` -_ ter ... G� Board of Health V DATE.................. ..- :...... �• �' FORM 36508 HOBBS♦!t WARREN,INC..PUBLISHERS JJ 1 2 LEGEND N Locus / x 100.98 EXISTING SPOT GRADE ® a � Wequaquet - 45 -- EXISTING CONTOUR Lake EXISTING LEACH' P/T vs- PROPOSED CONTOUR TO BE REMOVED-THE OWNER IS -W EXISTING WATER SERVICE o RESPONSIBLE WITH ARRANGEMENTS -G EXISTING GAS SERVICE 0g G P9 j03 WITH THE ABUTTER AND APPROVING U oR. UNDERGROUND WIRES dins All `moo CL 6 AUTHORITIES. co Plan V/ Bk 124 -O.H-.W - OVERHEAD WIRES cor�eta', o EXISTING SEPTIC TANKTEST PIT " Wilcox �� rt TOP OF TANK, EL'.=43.03f- BENCHMARK o SLEEVE SEWER FOR 10' EACH SIDE INV.(OUT), EL.=4.1.70t OF WATER SERVICE CROSSING I TAKE/TACk " " -n J 4 STAKE/TACk Great Marsh Rd 44,82 POLE 45.68-_ 45.06 j HEDGE S 13'28 30 -W- 43.63' 43.40 13.90' " " ° 49. SHRUBS 43,07 LOCUS MAP 45,44 NOT TO SCALE \ w u + 45„�9 S2 GENERAL NOTES: \ \ {� 3.66 + 43.6 Cj 5,13 INSTALL 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ❑ G, CL STALL W, DECK DE K BOARD OF HEALTH AND THE DESIGN ENGINEER. `-43,$_4-- 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 04/3 85 LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: .r' p 45.25 � SH 44 53 -310 CMR 15.405(1)(b): �• \ r7 "pQ C :' 1. A 10' variance, S.A.S. to cellar wall, fora 10' setback. + 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �\ 5,38 EX/ST/NG (A TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE a kn m \\ HOUSE(#147) X.\45 G � DESIGN ENGINEER. T•O.F.=46.0± 1� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 0 1 \ cJ� J FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN x ENGINEER BEFORE CONSTRUCTION CONTINUES. '0 45,33 DECK w 5. ALL ELEVATIONS BASED ON NGVD. pt-1 \� \\\ 45 p GAR,gG�- O 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 4 / x U^i0 rn (LOT 32 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF O � 43_9 _ � � _ _� 44,42 EQ ` HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 38,48 ,.•:.. x 44,77 q 1 \ 4 __ � 25, 43.99 M BLU 2 1 1 -025 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. LAMP T21 P- - ��L /S'r4 S. / 9,733 S.F.t 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 43,21 -�"L _I 44,11 " REL J v.., 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS /*'ET, dygt 56.2' x ;;: 3 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 42,35;s,;::• INSTALL A 40 MIL POLY LINER THE APPROVING AUTHORITIES. :...: ..: . .. .. .... : A -- DIRECTED BY E G �..,t.;: :.:: �v •.: 43,00 4r.,��;-:..::` e� TOP OF LINER, EL.=41.5 41,94 `> BOTTOM OF LINER, EL.=39.0 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY DRIVEWAY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING "-•" � CONSTRUCTION. O' F� 41.84 QO• 41.64 ° +� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS (� 41'. ".93.26 . IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND vPK SET 2830 40.73: 99- REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 41 i-0• w A W. - - --0., .:•`O:H: ; --0.H.W. M 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE - , j t U R \�� ASS9 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. U.P. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 40,56 .'. .:.:. PETER T. IS NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 41.23 / , F o McENTEE N 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED OR ------� `` v CIVIL BENCHMARK SET 40,13 No. 35109 UNPERMITTED SEPTIC SYSTEM COMPONENTS THAT MAY EXIST ON x O THE PROPERTY. T HOUSE IS � VERIFY THAT ALL SEWAGE EXITING THE R HALL I L GE E G,o TRACTOR S- 15. CON f E S GI Z I S MAGNETIC NAIL SET �•, EL.=41.66 edge of pavement 39.93 40.02 ��FS L CONNECTED TO THE PROPOSED SEPTIC SYSTEM. 40,65 40.13 40,00 9 x tCWq PROPOSED SEPTIC SYSTEM UPGRADE PLAN CNVENTIONL S.A.S.FOR IILOLUSTRATIONAONLY-DOFOOTPRINI NOT INSTALL ANNABLE POINT ROAD 147 YACHT CLUB ROAD, CENTERVILLE, MA 5 LC-6 PRECAST CONCRETE UNITS W/4' STONE ON SIDES Prepared for: D.A. Brown, Inc., P. 0. Box 145, Hyannis, MA 02601 AND 2' STONE ON ENDS FOR AN 11' x 34' S.A.S. FOOTPRINT OWNER OF RECORD Engineering by: SCALE DRAWN J08. N0. BOTTOM SIDEWALL TOTAL AREA AREA AREA PULEO, WALTER & WINNER, WENDY Engineering Works, Inc. 1"=20' P.T.M. 196-14 374 SF 90 SF 464 SF 60 FULLER STREET 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. TOTAL CAPACITY = 0.74 GPD SF 464 SF 343 GPD 4 VERETT, MA 02149-4213 (508) 477-5313 8/19/14 P.T.M. 1 Of 2 k NOTE: TO' PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL.41.0 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOXi AS. . INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT PROPOSED SINSTALL 1 INSPECTION PORT(MIN.) OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE AT END OF S.A.S.f T.O.F.=46.Ot F.G. EL.=44.Ot F.G. EL.=44.Ot EX/STING EXISITNG F.G. EL.=43.7t F.G. EL.=44.Of HOUSE(#147) f f MAINTAIN 2% GRADE (MIN.) OVER S.A.S. ^ T.O.F.=46.Of a �°5 DE T, INV.=41.70± = 92' L 8' INSPECTION PORT ^� � G S=1% (MIN.) ® S=1% (MIN.) ONE (MIN.) O ' ,ARAGE SCH40 PVC 4"SCH40 PVC 1 _' 0560 (/AjDER ° ' P -58 s" 7.13" TO ' �+y EXISITNG 48�L`I�OLID INVERT r � � $,,q S E� �� '►�' GAS BNV.=40.75 PROPOSED INV.=40.58 (4 ROWS OF 7 UNITS AT 5.0'/UNIT) + 1.2' (1 COUPLER) = 36.2' 3s Z`,�� ^ � SOIL ABSORPTION SYSTEM (PROFILE) EXISITNG SEPTIC TANK EXISITNG INV.=40.50 S.A.S. LAYOUT ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR )-= 15'5 -i " - 2"PERC SAND TO TOP OF CHAMBERS (3) 5 DIA.OUTLETS BREAKOUT=TOP NOTES: El 12" TOP ELEV.=41.0 15.5" 8" INV. ELEV.=40.50 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE e" INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=39.90-~ H-10 LOADINGT 2) D-BOX SHALL BE SET LEVEL AND TRUE TO L=. 3' D-BOX 2" GRADE ON A MECHANICALLY COMPACTED SIX 5' MIN. ABOVE BOTTOM OF INCH CRUSHED STONE BASE, AS SPECIFIED IN T.P. EXCAVATION OR G.W. EFFECTIVE IWIDTH=11.3' 310 CMR 15.221(2). EXISTING SUITABLE Note: Arc 36 SIDE PORT COUPLERS ARE TO BE 3) INSTALL INLET & OUTLET TEES AS REQUIRED. ESTABLISHID G.W., EL=34.8 - MATERIAL ALSO USED WITH THIS DESIGN. 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE ESTABLISHED HIGH GROUNDWATER, EL. 34.8 (LAKE WEQUAQUET) AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. CURRENT WATER SURFACE AT EL.=33.5 -63.5" USE 4 ROWS OF 7-ADS Arc 36HD UNITS + 1 COUPLER PER - - ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE SEPTIC SYSTEM PROFILE TYPICAL SECTION /13" N.T.S. l 33.8" DESIGN CRITERIA SOIL LOG NUMBER OF BEDROOMS: 3 BEDROOMS DATE: AUGUST 8, 2012 (REF#14,451) TOP VIEW SOIL EVALUATOR: PETER 'McENTEE PE(SE#1542) SOIL TEXTURAL CLASS: CLASS I WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT 60" DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH END CAP END CAP DAILY FLOW: 330 GPD 44.6 0 44.5 0" FRONT VIEW SIDE VIEW END CAP S 0all - DESIGN FLOW: 330 GPD FILL FILL REAR/TOP VIEW 43.6 12,. 44.0 A 6•' GARBAGE GRINDER: NO-S.A.S. IS NOT DESIGNED FOR GARBAGE GRINDER A SANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW SANDY LOAM 10YR 4/2 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 43.1 10YR 4/2 18 S 43.5 12" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. B Ir 4640 TRUEMAN BLVD .74 GPD/SF SANDY LOAM SANDY LOAM � 10YR 5/6 PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED 30 a HILLIARD, OHIO 43026 Arc 36 DETAIL a EXISITNG SEPTIC TANK: 1000 GALLON CAPACITY 10YR 5/6 PERC 41.1 ' 41.5 36° aoVnNceo orsnance sysreMs.INC. UNITS MUST BE STAMPED HD 40 42 C USE 4 ROWS OF 7-ADS Arc 36HD UNITS + 1 COUPLER PER C PROPOSED SEPTIC SYSTEM UPGRADE PLAN ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE M-C SAND M-C SAND 147 YACHT CLUB ROAD, CENTERVILLE, MA 2.5Y 6/4 2.5Y 6/4 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) / 20% GRAVEL i 20% GRAVEL Prepared for: D.A. Brown, Inc., P. 0. Box 145, Hyannis, MA 02601 (Arc36 Units) 28 UNITS x 5.0 LF x 4.80 SF/LF = 672.0 SF ✓ & COBBLES h & COBBLES SCALE DRAWN JOB. N0. (COUPLERS) 4 COUPLERS x 1.17' x 4.80 SF/LF = 22.4 SF Engineering by:1� TOTAL AREA = 694.4 SF 33.6 132" 33.5 120" Engineering Works, Inc. N.T.S. P.T.M. 196-14 DESIGN FLOW PROVIDED: 0.74 GPD/SF(694.48 SF) = 513.8 GPD PERC RATE <2 MIN/IN. ("B" HORISON) 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. ACTUAL FOOTPRINT AREA = 11.3' X 36.2' = 409.1 SF NO GROUNDWATER ENCOUNTERED (508) 477-5313 8/19/14 P.T.M. 2 of 2