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HomeMy WebLinkAbout0424 NYE ROAD - Health (2) 412. Nye Road Centerville A= 148 — 099 i �I i No. 2 o ll Fee Q C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS s Nplication for Misposai *pstem Construction permit Application for a Permit to Construct( ) Repair(j() Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. L//2 t1JYC 1Zj o},( Ce,•,6, tLf Owner's Name,Address,and Tel.No. ` Q_Vwx"�-_— Cook-k ` Assessor's Map/Parcel 1laa- /N-Sh o O Installer's Name,Address,and Tel.No. L T 3 Designer's Name,Address,and Tel.No. &-o_j eC Type of Building: Le__ Dwelling No.of Bedrooms J Lot Size 4�(" sq.ft. Garbage Grinder( ) Other Type of Building S�(n, AlIt,Ll No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 55-0 gpd Design flow provided S�`f gpd Plan Date �'t�1 - 2t7 l 1 Number of sheets Revision Date Title N L j 6- Size of Septic Tank 00o Type of S.A.S. Z,��tejj •� Description of Soil 3 o Nature of Repairs or Alterations(Answer when applicable) e ID Date last inspected: ( )dl Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Sig a Date S ) - ZoI Application Approved by U Date -20 Application Disapproved by Date for the following reasons Permit No. 6 1 /„C� Date Issued -l d r , Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: — PUBLIC HEALTH DIVISION -TOWN -�.OFI ARNSTABLE, MASSACHUSETTS s tt application for -Misposal i�pstrm Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or tot No. qj 2.�tjyf/Z,;I C.!f ,�;;�l e Owner's Name,Address,and Tel.No. T Q_�nn,(e- Cook ,�,V^f" Assessor's Map/Parcel " 1 4 8//O O 64r ,t Installer's Name,Address,and Tel.No. 1 f 3 C or"n,4.0 4<- Designer's Name,Address,and Tel.No. 6-w_7 eC�. LCAP&,J, ✓y �C,1' s�5 S!rYtm3 5�,�wt ►v� Type of Building: .r Dwelling No.of Bedrooms S Lot Size It, + sq.ft. Garbage Grinder( ) Other Type of Building 5,(11 4w, L7 No.of Persons+ Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �5�C7 gpd Design flow provided gpd Plan Date S'1 7 - ZO�c 1 Number of sheets `�.�5 a �J Revision Date Title cl CL tj (( t; Size of Septic Tank o0o Type of S.A.S. J/���,� Description of Soil 30 ( r cc Nature of Repairs or Alterations(Answer when applicable) t Date last inspected: Agreement: --� The undersigned agrees to-.-ensure-the construction and maintenance of the afore described on-site sewage disposal system in r e k t _ - _ accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of i G Compliance has been issued by this Board of Healt . Sig a Date - ) - Z.o l Application Approved by Date Application Disapproved by Date L for the following reasons Permit No. a G 1 / Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ¢ Il Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by �ll[�{ t�'�e� (_L L at 0 NT( lam , A-( t t has been constructed in accordance -L with the provisions of Title 5 and the for Disposal System Construction Permit No. a U 1 J dated Installer ! IL1JloA�JL JQ-e tk C S LLQ Designer Gil ( t C.,-1 #bedrooms 57 Approved design flow s -5-0 and The issuance of this permit shall not be construed as a guarantee that the system will fu ct'on a desig en �✓ Date Inspector �--- t i - -------------------------------------------------------- ' No. tl �— l� Fee Zoo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction J)ermit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at I ON P y L� 11.q 4�_j X,v� and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permi Date �, ���� Approved by_(, )� Y « Cr J, /? f Town of Barnstable Regulatory Services s i Thomas F.Geiler,Director Public Health Division ' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 5-Z`1' To`\ Designer. �AIJ I Q C006H W OW IZ Installer: (fA-Pt4Z cL C4f:C/pr,'s cs Address: 43 7'41 A-W6 L C e(R Address: _ o 13oK 7L 3 '5AVDWICIA MA 6 Z. fr s R) was issued a permit to install a (date). (installer) septic system at Z- �� based on a design drawn by (address) DRu tD V. CDvr HI�NOV K, dated 5- 1'1 - 20 ci (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 refere:aeed above was installed with major changes (i.e. greater than 2 0' lateral relocation of the SAS or any vertical relocation of.any.component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF MAssgcti �o DAVID 1 o D. llel s Sig attire) CONo.H1093 R In GjSTS�L SgNI TARkPa .(Designer's Signature) (Affix Designers Stamp Here PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CE�CATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIYISION . THANK YOU. TOWN OF BARNSTABLE LOCATION 12J SEWAGE# 2 0 11- Sb VILLAGE e v2 ASSESSOR'S MAP&PARCEL /qb - /UJ—ao INSTALLER'S NAME&PHONE NO. �",ei—ea(, SEPTIC TANK CAPACITY \t�0 %-t y c sfwJ LEACHING FACILITY:(type) (1 b) R'M (size) (?) X tv NO.OF BEDROOMS S OWNER ,j Q Aw,,Wk. PERMIT DATE: 6' 11l 2ai COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility wa a 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 e4 jew Je f 13 I 1 Y yi �91. 3 ,. �321, 3f 3V,y 52 L12 0 PA Vel) DRIVEWA Y GARAGE 0 7M' 111DER -'L W�]Dr . D G 41 V, ry No A U. 0%4 (j BENCH MARK EST ' J') ' ��.,— LE� TOP OF FOUNDATIOF�\,g L A LEVATION 19 SCALE: I in = 20 ft ,�y (BARNS 1995 /.,1 US DATUmll goo 0 '9()_ 20 0 43 TRIANGLE C!!: -6a6� 0 10 20 SANDWICH MA 0,' �o- 506 364 -01 cp -joa - E T E3. - Town of Barnstable P# Department of Regulatory Services &UMSUBM : Public Health Division Date Q MASS. t6J9 �� 200 Main Street,Hyannis MA 02601 Date Scheduled r �� Time Fee Pd. �o Soil 'tability Assessment for Sewage Disposal a Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address Owner's Name H 11- NYE P.�� LENT'Ei2V l ll..t 12C1V LObKF Address Let,rE q Q t L..L.E, A4 R Assessor's Map/Parcel: (t(g(' Engineer's Name b Aal 1® M A S OI L NEW CONSTRUCTION REPAIR Telephone# `' • t Land Use Slopes(%) Surface Stones Distances from: Open Water Body"ft Possible Wet Area � Q Drinking Water Wer::�::i ft Drainage Way fitProperty Line J ' �0 7ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 1 l r Parent material(geologic) t Depth to Bedrock i: too IS — Depth to Groundwater. Standing Water in Hole: J7 Ifs � Weeping from Pit Face Estimated Seasonal High Groundwater .j" i DETERNUNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _ __in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment i't. Index Well# Reading Date: Index Well level Adj.factor- Adj,Groundwater Level,n PERCOLATION TEST Date , 'l hne Observation Hole# Time at 9" r Depth of Pere Time at 6" Start Pre-soak Time @ , ,I Time(9"-6") End Pre-soak Rate MinJlnch L 3. 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:\SEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. y on isten % vel 0 DEEP OBSERVATION HOLE LOG Hole# Depth from SoifHorizon ' Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling' (Structure,Stones,Boulders. Consistency,% ravel 3 t ItT DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten I Flood Insurance Rate Mai): / Above 500 year flood boundary No_ Yes Je Within 500 year boundary No t�.-Yes Within 100 year flood boundary Nov Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi us trtal exist in all areas observed throughout the area proposed for the soil absorption system) If not,what is the depth of naturally occurring pervi us material? Certification T I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environm tal Protection and that the above analysis was performed by me consistent with . the required training,expertise and erience described in 310 CMR 15.01, Signat Date 01 Q:\SEVn(-VERCFORM.DOC C) COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION 1AAP 4 PARCEL. .I 0 8 LOB' 'Z- _ N TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 412 Nye Road RECEIVED Centerville Owner's Name: Ken Cooke Owner's Address: FAPR 2 6 2004 Date of Inspection: 4/5/2004 TOWN OF BARNSTABLE HEALTH DEPT. Name of Inspector. (please print) ' Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O.Box 371 Sandwich,MA 02563 Telephone Number: (508)888-6055 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 Needs Further Evaluation by the Local Authority Fails Inspector's Signature: `� , i��- Date• 5' o 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 Bow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DER The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments J\� ST--v, --S ""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. Page 2 of 11 f OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 Inspection Summary:Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" need to be replaced or repaired The system,upon completion of the replacement or repair,as approv the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the for the follo g statements.ff"not determined"please explain. The septic tank is metal and over 20 years old*or the sep' tank(whether metal or not)is structurally unsound,exhibits substantial i�ltration or exliltration or tank ure is imminent System will pass inspection if the existing tank is replaced with a complying septic tank as app by the Board of Health. *A metal septic tank will pass inspection if it is sMwhwd (sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is avarl�ble. ND explain: // Observation of sewage backup or br7100� f or high static water level in the distribution box due to broken or obstructed pipe(s)or dud to a broken,settlneven distribution box.System will pass inspection if(with approval of Board of Health): pipes)are replaced obstruction is removed distribution box is leveled or replaced ND explain: /74 The system required p g more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with app of the Board of Health): broken s)are laced 1n1�( � obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 C. ftrther Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of th 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' rdance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will public health,safety and the environment: _Cesspool or privy is within 50 feet of a water _Cesspool or privy is within 50 feet of rdering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Pub/hceSupplier,if y)determines that the system is functioning in a manner that protects the public ty and rooment: _The system has a septic tank and soil absorption sysand a SAS is within 100 feet of a surface water supply or tributary to a surface water supp The system has a septic tank and SAS and the SAS Zone 1 of a publicwater supply. The system has a septic tank and SAS and the SAS feet of a private water supply well. The system has a septic tank and SAS and the SAS 100 feet but 50 feet or more from a private water supply well**. Method used to deterniz distance **This system passes if the well water analysis, nmed at a DEP certified laboratory,for colifonn bacteria and volatile organic compounds indicates the well is f1me from pollution from that facility and the presence of ammonia nitrogen and nitrate nitro en is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the anal must be attached to this form. 3. Other. Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 D. System Failure Criteria applicable to all systems: You must indicate`eyes"or"no"to each of the following for all inspections: Yes No _ -Z Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ Z Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _fi�f- Static liquid level in the distribution box above outlet invert due to and 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 _ _Z'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. _ _,Z' 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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] 1` (Yes/No)The system fails. I have determined that one or more of the above 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 esign flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the cti a above) yes no — _the system is within 400 feet of a surface drinking ter supply the system is within 200 feet of a tributary to a ce drinking water supply the system is loud in a nitrogen sensitiv area(Interim Wellhead Protection Area—IWPA)or a mapped Zone Il of a public water supply well If you have answered`yes"to any question' on E the system is considered a significant threat,or answered `yes"in Section D above the large system fair.The owner or operator of any large system considered a significant threat tinder Section E or fail under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should con the appropriate regional office of the Department. i Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 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? -Z _ 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 than 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: Yes No _ 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)P 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3 Number of bedrooms(actual): DESIGN flow based on 310 CUR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: C",_ Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):.�[if yes separate inspection required] Laundry system inspected(yes or no):= Seasonal use: (yes or no): y`j I' c„-�Z . Water meter readings,if available(last 2 years usage(gpd)): Sump Pump(yes or no): , Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sgft,etc.); Grease trap present(yes or no):_ Industrial waste holding tank present(y or no):_ Non-sanitary waste discharged to the tie 5 system(yes or no):— Water meter readings,if available: Last date of occupancy/use.- OTHER(describe): GENERAL INFORMATION Pumping Records /� Source of information: �we.z� ,-- .• ..u� 5�� �r z;t�,.. r �., a5 - �,�,•, 1��` �ca zi Was system pumped as part of the inspection(yes of no): 61,::� If yes,volume pumped:+gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM -,ZSeptic tank,dioo"en-bex,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) —Tight tank Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: 4 �T'�L1L w�\ `J l� l -urc +'�.rY �'� <i'U-d S""S `tea _+.'\ C/�L���.'c- •."�'Ov Were sewage odors detected when arriving at the site(yes or no): r� Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 BUILDING SEWER(locate on site plan) Depth below grade: 3 Q" Materials of construction:oast iron_Z40 PVC other(explain): Distance from private water supply well or suction line: ,4.-1/4 Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: locate on site plan) Depth below grade: Q S." Material of construction: concrete_metal_fiberglass_polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: . x - -u 41._5 Sludge depth: 3 l Distance from the top of sludge to bottom of outlet tee or baffle: Q 9" Scum thickness: Lj " Distance from top of scum to top of outlet tee or baffle: 7 Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined:" Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): b•��� .�+,�4.. —3raJ—' �:..J—��� ink �Q`=�' JL� i r^�.� �(v,.��w�rJ 1 •-.e'—C'��, •T' �=�xs� C�.. _�,ice.... �'-�'. �. c.�:a l GREASE TRAP:____(locate on site plan) /, Depth below grade:_ / Material of construction: concrete_metal fiberglass i/ lyethylene_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 r baffle: Date of last pumping: Comments(on pumping recommendations,inle outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage etc.): Page 8 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 TIGHT or HOLDING TANK: (tank must be pumped at 'e of inspection)(locate on site plan) Depth below.grade: Material of construction:_concrete_metal fiberglass_polyethylene_other(explain): Dimensions: Capacity: gallons Design Flow: gallons/d/(0vves Alarm present(yes or no): Alarm level: Alarm in working 9no): Date of last pumping: Comments(condition of alarm and t switches,etc.): DISTRIBUTION BOX: (if present must be open (locate on site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, on of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 SOIL ABSORPTION SYSTEM(SAS):__k��-(locate on site plan,excavation not required) If SAS not located explain why: Type �eaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Typetname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): l-r.LAC`� ca:�' xt` ` rc�> •vv m�, r= 'S`C r— i"�" �s C.lc� � �'G. kl ice.� ^ rt S �`�'^•` s�. :c �r `� i� �t,'.�r�u3 iV'�'J^Y.+T\ �Cr4�. Ii"C7 �+�i �` T,(d�a_i.a..e �a:.+��7 .� lO`� �4e�1©a.> v�v✓�.r\ ', !�-�'C] i Ch� ((�� �`�.!'� CESSPOOLS: (cesspool must be pumped as part of' n)(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: IX Indication of groundwater inflow(y or no): Comments(note condition of soil 'gns 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 aulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) I(l, Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. 3 1 - Q Q Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 412 Nye Road Centerville Owner: Ken Cooke Date of Inspection: 4/5/2004 SITE EXAM Slope Surface water Check cellar,,-'— Shallow wells Estimated depth to ground water�Q feet Please indicate(check)all methods used to determine the high ground water elevation: --ZObtained from system design plans on record—If checked,date of design plan reviewed: YU Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: M��.. —s r � J�Y, You most describe how you established the high ground water elevation: ��� �"y T'G�vv�=Q a„;-/i`�,r- 'y,�;r-u�`�.. `"vim`;ca � \�--•,r'" t-�-G�t� -ti�!�- 3C w.:v��a \ `�.r��a�Inc-3�z..�'.- �x�„�v�� �S t��.mc°� ti 'R�':•.\ No. ` THE COMMONWEALTH OF MASSACHUSETTS FEE �✓v rBOARD OF HEALTH' --Tb\Ain OF -R Urn-s+aJnlf . APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System []Individual Components y a N e 21D C-enit°r I l l e Ken Cook--Q-- ocation Owner's Name 10 orceI I DO 41,Z Aly-C-2-0 Cena2t-y Me MA Map/Parcel# Address of Teleph ne# �Dber-t G IIfvy-Vt) CXw�r +ton -DauIn rJS�n DBE �n,4tronme)4oJ Installer's Na Des gner's Name IyTeC�he�r�L(It�- e�+cAn� Fn,} Sanda)lr Addr ss Address Telephone# Telephone# Type of Building: T!�C5 i Cam C--Q— Lot Size Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(mi .r gt red) 55o gpd Calculated design flow S� gpd Design flow provided 5(°b gpd Plan: Date A "oZ U Number of sheets Revision Date Title I 1 Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signet� Date a 1510' InspecZZ= FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 pY .� No. tiTH ,,COMMONWEALTH OF MASSACHUSETTS '' ~FEE �- BOARD OF HEALTHY T APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components Location Owner's Name C('',•)IC ,Iir ,c4 Map/Parcel# Address Lot# Te ne lepho # 1�hC rl Cy It , II c. I Installer's Na e- -/ Designer's Name Li �k � 1' (Il I(, �l1„ L(; Ci��` il 'iLit.P.Ilt' it 1 Ad/dress Z y_ L 4.1 1 _1 / 56A -;Z I -1 ry Address Telephone# Telephone# Type of Building: F'S I C i t , 1 L c=- Lot Size Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures r Design Flow(min.required) 550 gpd Calculated desi n flow 550 gpd Design flow provided�(o� gpd Plan: Date j(� f v'� Number of sheets g Revision Date Title_ �I �� `�>� 1n U Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions,of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed , ! �`�-"-f Date L;� ,51 u� C 5/d'� Inspectiogts FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. C09'-0a-5 THE COMMONWEALTH OF MASSACHUSETTS FEE /d� BOARD OF HEALTH RTIFICATE OF COMPLIANCE Description of Work: QIndividual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired(Upgraded( ),Abandoned( ) �? C by: `� I !n L C. (\\1 r'A � i/C- has been installed in accordance with the movisions of 310 Cj R 15.00 (Title 5) and the approved design s/ s-built plans relating to application No. dated Q, I�f Ap roved Design Flow (gpd) Installer -Dow I (� C5c InspectorDesigner:The issuance of this certificate shall not be construed as a guarantee that system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. _ QG 'I "�� THE COMMONWEALTH OF MASSACHUSETTS FEE �G� h<ti c.t -j1 BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair (✓) Upgrade ( ) Abandon ( ) an individual sewage disposal system at � ) I ' i t as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of thf'is p r i'`t��1 cal conditions must be met. Date /D r� Board of Healt � Y FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN rM PUBLISHERS- BOSTON Town of Barnstable Regulatory Services ., Thomas F.Geiler,Director + BA'ItN.rAftE, + ' a Public Health Division aT° °' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: oZ 1910 9 Designer: Installer: Address: . �, �J �G� Address: � w _ pn o2 5 to F-A( -V4. 1 was issued a ennit to install a (date) I (installer) P septic. tern at I 2 �`{ P � based on a design drawn by ,,AA 11 lnG (address) dated (designer) V 1 certify that the septic system referenced above was installed substantially accnrdiri g to "%e design, which may include minor approved changes such as latest relocation T the distribution box and/or septic tank. I certify'that the septic system referenced above was installed with,W*r.changes'(.tie, greater than.`l0' lateral relocation of the SAS or any vertical relooati �n of airy compondnt of the.septiC system)but in accordance with State&Lc ons. Plan revision or certified as-bunt by designer to'follow. r 6� (Installers Si ture ., B• �. WSW rn 0Ind "66 (I3 er s Signature) Affix .e er's Staid Here. ( P PLEASE RETURN TO BAITNS�t'AB�1JE PUBLI.0 HEALTH DIVISION., �CERTM TE OF COMPLIANCE W[L1r. N® := SSUED: z BOTH�.3T�IS.- BUII�T LARD ARE RECEI=VED$�'���`$E:B. S ABL]E PUBLIC 001SI4N THANK Y0U. Q:HealtiVSeptic/Designer Certified— Fora TOWN OF BARNSTABLE LOCATION Ll 12 AlVE Rol- SEWAGE # ano9 - OPS VILLAGE c-ru c— ASSESSOR'S MAP & LOTJ—q3J Loo INSTALLER'S NAME&PHONE NO. Q Excawoj;on . SEPTIC TANK CAPACITY /000 gc;,-I LEACHING FACILITY: (type) _-009n) ckot y6 (so (size) _13 x qa. x 2. NO.OF BEDROOMS S BUILDER OR OWNER _ PERMIT DATE: 0 -S - 09 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 'Al Az - IT B2 - za.5 ' I - A3 - c3 - 3z' � A 4 - ZT cy - 36 'pp O© FE AS- J-1 T 7 -0 C K IC5 - Of GA�A�E Frond s V CERTIFIED SEPTIC SYSTEM REPORT J U L 2 8 1995 LOCATION HEALTH DEpT. 70l,"�d OF BARNSTABLe. 412 NYE RD . CENTERVILLE, MA MAP 148 PARCEL 100 LOT 20 PREPARED FOR SELLER ✓(�� `�� MR. & MRS . PAUL MERCANDETTI 508 MAIN ST . 4� Iy,9 CENTERVILLE, MA 02632 v BUYER MR. & MRS. KENNETH COOKE 127 PLEASANT ST WHITMAN , MA 02382 PREPARED BY HILLIARD HILLER, JR. P .O . BOX 250 CENTERVILLE, MA 02632 508-778-1472 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property ql;l owner's name POivG /­ �9yo soivoefi iy�,QGfly O�TTi Date of Inspection V/Y/9.S PART A CHECKLIST Check if the following have been done: y Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspectiorn. As built plans have been obtained and examined. Note if they are not available with N/A. r/ The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, eluding the SAS, have been located on the site. L,l The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. y The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. i 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential S number of bedrooms number of current residents NQ garbage grinder, yes or no, VXS laundry connected to system, yes or no A.,49 seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: 1717Y i8a K kiJ3 P/P�S,E�/l Ly Last date of occupancy GENERAL INFORMATION Pumping records and source of information: {,',WAco io/aa/73 A10 System pumped as part of inspection, yes or no if yes, volume pumped .Reason for pumping: Type of system L,-,'� 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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: r/ (locate on site plan) depth below grade: q� material of construction: ✓ concrete metal FRP other(explain) dimensions: sludge depth distance from top of sludge to bottom of outlet tee or baffle y " scum thickness .5" distance from top of scum to top of outlet tee or baffle lam" distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) 7-4 TF-Ls xee-t' a T oviZ 4if}_S L L<'T_ /// PL/IG/_r,, TifA , RzE , Sv fI5 Tv L c T TiY/_-' DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no i Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan,. if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits and number leaching chambers and. number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) All Ta /YitdX Ir T1/-.z vTf/,ZX CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc. ) 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: Vl,,l IV YZ /-ID include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' gvcKyE�a li o-. oR/Gives%. DEPTH TO GROUNDWATER depth to groundwater method of determination or approximation: 117 5-S 7-A, dJL l /S // �S ' THE /]/�S,tR✓ifi,, Cy/9%[!2 T/I/�L.£ J!/�/� /q`7'� b/�%i�/.�/G S�/oG.-c- i7 H 1E 40�-e r114 _ i%��� /2 T 3,;2'. Tt/y 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) V Backup of sewage into facility? A,O Discharge or ponding of effluent to the surface of the ground or surface waters? J,V Static liquid level in the distribution box above outlet invert? P Liquid depth in cesspool <6" below .invert or available volume< 1/2 day flow? Required pumping 4 times or more in the last year? number of times pumped /-V Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is .any portion of the SAS, cesspool or privy: 1 below the high groundwater elevation? within 50 feet of a surface water? /LO within. 100 feet of a surface water supply or tributary to a surface water supply? /e within a Zone I of a public well? ,O within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? i within 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysi for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. L TOWN OF BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION. -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 4119 NYC /?0 eelJT�/1y�GG E' h/a ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME hR. Y 'Z45 PART D - CERTIFICATION NAME OF INSPECTOR ��'lLG//fits l�/GG.fiC ,%f'C COMPANY NAME COMPANY ADDRESS �O. .QyX �Sy C %II2y/L4-4r- Street Town or City State ZIP COMPANY TELEPHONE FAX CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system a! this address and that the information reported is true , accurate , and complete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : y System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails tc protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature ALl�i� Date 7 o� �S One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doc l , i KEY NUMBER <5370 > NAME <MERCANDETTI, PAUL > B-C 1 B-C 2 B-C 3 B-C 4 ZOC STREET 508 MAIN STREET CITY CENTERVILLE ST MA ZIP 02632-2918 REF 1 REF 2 PHONE (508 ) 790-1185 REF 3 REF 4 METER NO. < 4971> DATE READING CONS STREET <NYE RD NO. 412> 06/30/95 655 53 CITY CEN J L20 ST LOC 12/31/94 602 133/9a PHONE ( ) - 06/30/94 469 49 12/31/93 420 134 ROUTE NUMBER 28 06/30/93 286 57�- SERVICE DATE 12/02/76 12/31/92 229 59 METER DATE 11/29/90 06/30/92 170 55�� y CAPACITY 7 12/31/91 115 63 STYLE T10 SIZE 1 RATE SCHEDULE KEY PIT PLASTIC NOTE RR RIGHT REAR IS A RENTAL! ADDITIONAL CONS 0 ALTERNATE MIN 0 NO.._fe:.A2 0 THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH TOWN OF BARNSTABLE Allp iration for lliipuua1 Works Tonstrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair) an Individual Sewage Disposal System at t 1.� (je'��Y '� ` OO........................... ................ AL, - •- ... ............................. Location-Address �q� or Lot N = Z �- �._V._ .i.......�Q............................•---- ` Own dress Installer Address dType of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—T e 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 v Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by---_---------------------- ----•-•--------------------------------------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ --------------------------------------&L - Description of Soil----------------------- __ L._....�j�. x -------------------------------------------------------------- - - ------------- ..----............---•...-•-•-•---------•-----......------....- - - . .-•---. -- -•-• .. -- V' --------------------------------------------------------------------------------•------.....------------------------------------------•-•••- .......... ¢ ---------------------•- U Nature of Re airs or Alterations— swer when applicable.____ ( 1..................... ;...... Agreement: The undersigned agrees to install the described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State E iron ental Code—The undersigned further agrees not to place the tne Sigsystem in operation until a Certificate o g e as been issued by the board of health. . ... -------------------------- �-�°?-�-�----.0 M Date Application Approved By ` ---- Date Application Disapproved for the following reasons: - ----------------------------------------------------------------------------------------------- ---------------------------------------------....... .....................................-------------- ---- ------------------------------- te Permit No. ........ � ' ���---------------------- Issued .....-.... --'--- Date No.... 1�. ! �.0 . Fins 'THE COMMONWEALTH OF MASSACHUSETTS BOARD 'OF ,HEALTH TOWN OF BARNSTABLE App iratiun for Biupuua1 Works Tonstrnr#iun ermi Application is hereby made for a Permit to Construct ( ) or Repair -(<) an Individual Sewage Disposal System at• `� ...n.. �: 1�1 ''l.� (�� .........�_.�.......��---•---•••-•...............•................ Location'Address / N Lori t No.(7 !1 .................... ... .._... -.-.•---•-•-------•--. e....----•--------------..... .............................. Own A dress ................... P-�.:...��.� ell). nrt --- Installer Address Type of`Building Size Lot............................Sq. feet U Dwelling—No. oftiBedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building.............. ....... No. of persons...._.._....._..._...__.____ Showers ( ) — Cafeteria ( ) d , Other'fixtures =•• --------------------t"a-----------------------------------------------•---------------------..........--•---......--•- W Design Flow...........................................gallons.per person per day. Total daily flow............................................gallons. , xSeptic Tank—Liquid'-dapacity............gallons Length.:n............ Width................ Diameter................ Depth....._\...__. , 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........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--_-_--_-____-_--_.--.- Pi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------------------•----- 0 Description of Soil........................ - - -- - --- - -- V ---•-----•--•--•-------•---•------------------------•-------------.........---------- 6..----•-...--------------••--------.-------....-----------••------------••------------------------------- U Nature of Repairs or Alterations— nswer when applicable:_..__ �� ................. ,...__. Agreement: The undersigned agrees to install the afor..edescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State En� fv ronmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com pfian�e has been issued �by the board of health. Signed {f -M - 'i-�+5Z._?tA. ..._ o2.� �n ....................................... llate.......--.-....-- Application Approved By .................. -------- --.. b-•-� cam.. : ....... ...... �'� .................... ....... Application Disapproved for the following reasons- ---------------------------------------------------------------------------- ---------.------...... ------------------ "I Date Permit No. .......... Issued --- �' ........................ R..._ Date ' - W� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of C ontylianre THIS4S TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�) by................... :r.-\.... ..........k -..a.r. ... .-c.....-.......... ' tq Installer at .. -. -. ".----------i" '... '^' `...5....... 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. ............ .-�... 3.. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......(--- 0- \ _ � O ......................... - . -- Inspector .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � `TOWN OF BARNSTABLE o, FEE...... ............... �t��u �,� urk��un�#rur#iun rrntt� Permission is hereby granted...._ _.�._.._..__.`'v_.._.._ . ............................................................... to Construct ( ) or Repair 'C7�-,n Individual Se�wage Disposal System f at No........................(J A NI..�-t. •. 1� C °C', ✓ l� . Street as shown on the application for Disposal Works Construction Permit No -'��.3... Dated.._....G...' ._.�!:_.... G� .................................... .. ...r------------------.---•----•-••-•----••-------•------ co , /� Board of Health DATE........ -�-•-•------•--------•---•-I-•-- FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS ~' TOWN OF BARNSTABLE LOCATION y/a VYZ 160 SEWAGE # c90^a R3 VILLAGE fXXM!/IG ASSESSOR'S MAP & LOT 1 8iekv LTao INSTALLER'S NAME&PHONE NO. G�9.QG�Dry fi' D.C/GiS �/77 o?&3S SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS 4WMDER-OROWNER /1/? PERMTTDATE: �A/��y COMPLIANCE DATE: ,--� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility c2 r/5 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 leeachhiinng facility) Feet Furnished by �. ��. ,. 13v�ki���1a U G �— � I i G,� �� L� `�- � -�� o, ,t/�cd PST � � \ PiT TOWN OF BARNSTABLE LOCATION p.1 N SEWAGE # 7V [t� y"C ✓ILLAGE ens r� Q1��. ASSESSOR'S MAP & LOT��� INSTALLER'S NAME & PHONE NO. art SEPTIC TANK CAPACITY ( DOC) LEACHING FACILITY:(type) ' f"0 (size) NO. OF BEDROOMS 10 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER p��.�.\ W\°�r e-.�,�, `. t3 C DATE PERMIT ISSUED: �'�. �— l b DATE COUPLIANCE ISSUED: L ;L i v VARIANCE GRANTED: Yes No 41 'a Q a• n� IV-70" t 4 4'-1 1/2"�T-0"�3'-71/4" T-8•�6•_5" _3•_O„ 4•_," 5,_4° 9-6° I.Fo L_� FHA d' relocate existing n 4"stack p 6' I I existing 4"stack — I —�'-' 0 F { KITCHEN BATH O y BEDROOM O BEDROOM ! DINING Tilefl°or . I Vny floor `� FAMILY Lp cU� 1 Tib floor ;� Oak floor II !1L existing FHA to be 1 N a � L j •_ rolocated FHA return N _ Oak floor I 16 3 4* O i O DN— 7 eoeo co 1 B" O BEDROOM BEDROOM goaooxae� QQ o 57UDY i^ Oak floor uP LIVING Q[ Oak floor - W Z LO 0 9 O 5299 w EXISTING SECOND FLOOR PLAN GENERAL NOTES 11'-111/2" 3'-a v2" 16-B" Seale:l/4°-1'-O" 1.ALL DETAILS,SECTIONS AND NOTES 3'-4 7/16" 4'-,t" 2'-0" SHOWN ON DRAWINGS ARE TYPICAL I'-ll 1/4° 6-0112" 7-61/2"—� 10'-1° AND SHALL APPLY TO 51MILAR CITUAT10N5 ELSEWHERE OTHER- W15E NOTED. 12-211/16°—(*-) 32'-0" 2.THE CONTRACTOR SHALL VERIFY ALL EXISTING FIRST FLOOR PLAN DIMEN510N5 AND CONDITIONS AT S1TE PRIOR TO (� COMMENCEMENT OF CONSTRUCTION. - 3.BLOCK OVER ALL CARRYING BEAM5,BEARING WALLS,AT ALL 5TAIRWAYS,&WHEREVER ELSE NEEDED FOR FIRE STOP OR NAILINGto i� N 4.PROVIDE 51MP50N gH2.5 HURRICANE TIES® Y ALL RAFTERS THAT DO NOT ABUT CEILING J015T B AND AT ALL TFU55 LOCALS i4•_S,/.y'—(�_) °Q, N + U LQ C) '5.CONTRACTOR TO VERIFY ALL ENGINEERED (+) W-1112° 3'-,1" 2'-2" 32'-0" c�1 1" 022 Q LUMBER WITH REGARD TO 51ZE AND APPLICATON WITH am- WITH THEIR RESPECTIVE MANUFACTURER AND 6'-0" 4'4" 11'-7° 72'-id' T-T' new FHA register locations SUPPLIER existing door z N 611/2" relocated _ T-2" td-td' existing window b —' new T1YL432 window � new _ casing to casing 3'-101/2" windows vdoor relocated h K-1 •� z-eb•ers um� I rwH so.se O � �}' N line of soffit bel east i aff center '- �- --I - accommodate BATH 'Z'22 �.--- ---- -O- --- ---- - 0� 4'plumbing v nt .offit/chese below p f/ Fal.e cabinet for reiaceted I p _ - cdeGbg 4'eteck. ID U KITCHEN rdoceCe to cab/chnx BEDROOM ti Demo Note.: �8B a m I' � DEN 1 Entire first floor Is to be existing relocated ­ L BEDROOM ) 4 3'-10" g U demoed down to the rough framing ! _ _ V-4" existing FHA to I 1 F zsss g g ca I t o be relocated ZD Exlstln heat ro Istere 2 Rorn—ell kitchen IL'-` a to be relocated binetry and appliances _ -) 6'-3„ -at u ow 3)Remwe all plumbing fixtures `' r - ze.e £' ( WBx15 steel beam(flush) - __= WBx21 steel beam(flush)C!_--i_ abi _-- and cabinetry from bath s MUD ROOM - DN 'r ( BEAM E!2 BEAM Eli -- 4)Staircase and finish walls on 'IT both.Ides to remain Intact 1 11'-0" 14%71/2" 5)Existing FHA and plumbing feed. - ) 2 BEDROOM to second floor arc to be relocated w new door L to the propo.ed false cabinet he-. _ exi.tin9 DINING i LIVING I ------------- FEE] -------------------------- UP I X r D I O N 2-1 3/4'k91/2'LVL_ I 4-1N ________-_ P. X1 EW DOWS 5CH JLE NUMBER NCITY�N FLOOR ED CODE N® window seat ® B ti e�Mo PROP05ED SECOND FLOOR BATH Wo, , , Scale:i/4"-1'-0" W02 2 1 TWIH46 W03 1 1 TW2046-3 I---7-7---�—5'-O° az W04 1 1 TM432 a W05 , 2 TM452 PROPOSED FIRST FLOOR PLAN r kt 1 Approx.location of Existing lowered ceiling existing 4"plumbing stock to be proposed eabinetichase ^�, contains plumbing chace be relocated into proposed above 2x516"OC to existing second floor cabincv.hase / master bath 5impsona'LU5 h.nge- AAAAA i-------- _----- i f— ---__— --_ --- — ---'i— ------- I 112"Gab.baits OC,sterger 11 V=1^ -/ ——— 1 �1—————— I _ _ _ n, wall lines above --- 2xfiller _---- -_ _. �, 1 U ' '1-- 1 redirect second floor feed 1 i a- _ L1_ -- I 1/2°ply filler - I I I redirect existing first i l LAUNDRY ROOM to cabinaWchase(see 1 floor bath heat to toe I' i' proposed second floor plan 1 proposed new partitioning I __ gg 1 kick of new kitchen cabs R for termination) W5x_Steel Beam 1 and bath above I �' -- i ' 1 '-__ UNFINISHED I I U O existing 1x3 strapping l ___________i -___ i _ r__ __`_ BOILER ROOM I N l 1 -�----------� PE§dnew 1x3 strapping 1 _}_; I existing FHA feed 11 1 I ' existing FHA reWrn� I I o L ' 5/B"ply,glue and screw 1 1 I _ N pj ii 3 1 1.---- —� I u o —————— z DETAIL AT STEEL BEAM 2 1 __ 1assu I `n o 21 __--------_— med ' >_ Existing lowered telling I FIN15HEP MEDIA ROOM at HVAC and assumed I I I O W floor beam I i FINISHED FAMILY ROOM 3 U 0 I I I E— �-Existing Electricle service I LU O —————————————————————————— ———- r 3T-O" Newpilaster -�^ EXISTING BASEMENT PLAN New freeze boards 1T-0" 12'-0" 24'-0" C3 El CROSS SECTION z Scale:l/5"=1'-0I New kitchen window location Y Verifywith cabinet supplier � N Window to be 'P Relocate FHA register V Q Demo Wind— relocated Demo Window L a Mwe door 24" N fl[ Q Demo Door -...._�O L , O N Reverse swing I I I o O anti relocate door I New petitioning — y � _-__-_______ Existing waste pipe FHA feeds to second 7O I I from second floor BATH O floor to be relocated O Window 0 Demo bath to be relocated I g 4-1 2x516"OC , ` ——— DINING i I FAMILY V Relocate FHA register match existing 12 and add one additional I I replaced with(flush) Bearing ova outlet in new powder room 1 — I ` WINO steel beam 2-1 3/4'k91/2 LVL 1 �---- - ' i 11 11 Firsts floor FHA return air 2-2x5 ' � 1 1 ducts to be relocated in toe _y— ' 1 1 Bearing wall to be TW2046 3 ith kicks of new 161and cabinets replaced w (fluu sh) safety glass � II _I� Demo Door Wgx15 steel beam Do not demo lower sash — Demo Notes: glass height m1..15" 1)Entire first floor is to be 5TUDY above finish floor � Aemocd down to the rough UP LIVING framing window seat with storage draws , ' 2)Remove e11 kitchen i 12 cabinetry and appliances i 1 ' 1--------------------1 12 ' 3)Remove all plumbing fixtures 2xa cantilever 16"OC 2-2x8 header I and cabinetry from bath O N -------------------- 4)Staircase and finish walls on 2"HPF board suround both sides to remain Intact EXISTING FIRST FLOOR DEMO PLAN N Zx12 wrap -9 feed- -_- to se g wndf oo�are to end l r be relocated ram+ Scale:1/4°-1'-0° m to the ro eed false cabinet chace. ^ 6.�1 ' p P° Wells areas scheAuled far demo-............. ti I I r '..�. is, r ----- i proposed newpartitioning... ----- - ---------- 2 DETAIL AT BOX BAY WINDOW t e° SECTION AT FRONT BAY WINDOW a seals:a/4"=r-o° r I. Rcquiro input from T, heating contractor 7041/4" + i 611/2" Requiro input from cabinet contractor m I (Y1i r 'I"151/2"� } casing •�" C A I 6 3 Cfto 11 LO � II 3 � III 0 5CALE:115"=1'-0" ZD k IF]Ull 00 a 5/4""oak floor I I _esa=arm 40"-2x416"OC wall with LLI 1/2"rack both sides T (J Q 36" 12" 36" 33" 36" 213" G 11.1 z �- 3 W requires Input from . _ O cabinet contractor Door Casing 95° I \ lip I II II I ' c n i I 1x finish 3/4"raised panel .� � � O I I 3'-91/2" ,t3 00 II o 't °� I sheeC rock to sheet rock � l U 1/2" Scale:l/2"=P-O" 1z-O" t} F 3/ 1 _ � 0 I I requires TV specs II I I I ^°proJectwe M� 0 1 a L P" 19 I ® N ICI � ,V ♦11 � � ® C W Min. � I l 3 ia- l�/ e C�,,,� i III 0 a R g v rc N GpR G d W Z G ILO: - /52 m LOCUS O<W `�O912.E+5 P8 �. Rp O a o <o0O P NOT SCALE* in P CENTERVILLE. MA III wI IIIII 0 / RgVEO/ LOCUS MAP Illllu � OR/V�yVA�, ((�� O = IIIIIIIIIIIIIuowmu � �� Ar �V$ / MINIMAL �� zWo �IIIIIIIIIIIIInIIlllul � CONTOURS cRnolNc 2zzIlllllllllllllluuullll � W GARBAGE GRINDER W via Illlluuuuuullll'I" > IS NOT ALLOWED �LAB /`�®M , / 40_�PosEo JV Iwli- LW null IIII �_�� EXISTING —�® w� �a� "IIIIIIunnullllilllll o WITH THIS DESIGN. j��A��iq o Z NICE Illlllllllllllununn pp�p IIIIIIIIIIIIIIIIIIIIIIIII THIS PLAN IS INTENDED SOLELY FOR INSTALLATION III IIIII IIIII IIII Q \ OF THE SEPTIC SYSTEM DEPICTED ON IT.FOR ANY nnlnllllllllllll1111 v J ® / OTHER CHANGES TO THE PROPERTY INCLUDING IIIIIIIIIIIIIIIIIIIIIIIII n n n fig' PLACEMENT OF ADDITIONS.SHEDS.FENCES OR 1p IIIIIIIIIIIIIIIIIIIIIIIII U q / / SWIMMING POOLS. REGISTERED SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. tL b IIIIIIIIIIIIIIIIIIIIIIIII 000 IIIIIIIIIIIIIIIIIIIIIIIII W oa nn III IIII IIII II N / / 0 ®� �� Z Illllllllllluuuuuul ' / d / V g IIIIIIIIIIIIIIIIIIIIIIIII �® Q ® ry �� n E�/�//� D H"Iliiliiilillllllllllll �l (� eI L5 L5 u v (�J ® O Q� ����� O I� Y�P / EXISTING y b o W ` 9000 GALLON p o cue O ��/ ®� / SEPTIC Td4NIt c J @o o °� ^ ^ �i / / EXISTING LEACH k z W< Q b w ��' I PITiCESSPOOL WU LL Lu O� / / UTILITY POLE $ �� O E® \ A W g a c di / / / TEST PIT ®-SOX O �61 co m �ca 54 N o / j O TP-1 � �5�OF M4�sq M b b O r� c� °`� DAVID -2 �yGN / I AS �VILy �o / � D. / ES R -0 JL COUGHANOW - o / / �OljO� No. 1093 TERM 0 z �� 0 � < — << z �i � / role 93 J 1 �, X p d z ___-� Qk Te SEWAGE DISPOSAL SYSTEM PLAN ®. P ll(_UJ O --CID �® 52 `'s�, -TO SERVE EXISTING DWELLING � e P BENCH MAR EST. JENNIFER L. COOKE ® 0 a o owNERls) OF RECORD 412 NYE ROAD #DLAN T®p ®� �®�N®A�1®� a CLC VATI®WI ���.�� 1995 v 0 (L (�Ati�NSTA�L( �u� ®�T�o-� �� °� CENTERVILLE. MA W W W SCALE: 1 In = ZO f$ �ON � PROPERTY ADDRESS I 20 0 20 40 43 TRIANGLE CIRCLE ASSESSORS MAP 146 PARCEL 100 SANDWICH MA 02563 PLAN BOOK 261 PAGE 172 0 90 20 588 364-0894 DATE: MAY 1 ?. 2011 JOB E T E-3 4 6 4 PAGE 1 OF 2 VERSION.- k SOIL TEST L O G DATE V TEST: ?VARY 26. 2009 SOIL EVALUATOR: DAVIO B. MASON. R.S. DESIGN CALCULATIONS WITNESSED BY: DONNA MIORANOI. HEALTH DEPT. PERC NUMBER: 12460 DESIGN FLOW: 5 BEDROOMS X 110 GPD = 550 GPD '-t SEPTIC TANK: 550 GPD. X 2 DAYS = 1100 G�'cLLGiNS TEST PIT 1NO PAARENOTUNDWATER MAATERIIAL EPROGLAC ALD OUTWASH NOTE: EXISTING TANK DESIGNED TO. ACCOMMODATE PRE-95 REQUIREMENTS PERC AT 30 1n - 2 MIN/INCH IN C SOILS FOR 5 BEDROOMS. GARBAGE GRINDER NOT ALLOWED. USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL CONDITION. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING DISTRIBUTION BOX: USE 3 OUTLET D-BOX. 54.06 0-10 A LOAMY SAND 10 YR 3/2 SOIL ABSORBTION SYSTEM: IN ADS HIGH CAPACITY BIODIFFUSER 607 ) 10-30 B LOAMY SAND 10 YR 6/8 16 UNITS x 6. F UNIT = 100.00 L—� '7 g9 Gvir:n� QEP �� � Cl� 51.55 100.00 L.F, x 9 S.F./L.F = 790.00 S.F.=788 30-132 C MEDIUM SAND 10 YR 6/6 790.00 S.F x G.P.D. / S.F. = 564.6 GPD S'11(2 �Pd �K_ �,�• SI($I II 43.05 USE 16 HIGH CAPACITY BIODIFFUSERS AS CONFIGURED BELOW POARENOTUMDATEREAL ENCOUNTERED OUTWASH - Vt = 584.6 GPO > 550 GPD REOU[RED TEST PIT 2 REFER TO DEP APPROVAL LETTER TRANSMITTAL u W000052 FOR CERTIFICATION PERC AT 30 1n - 2 MIN/INCH IN C SOILS OF ADANCED DRAINAGE SYSTEMS BIODIFFUSER SYSTEMS. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 54.05 0-10 A LOAMY SAND 10 YR 3/2 10-30 B LOAMY SAND 10 YR 6/B 51.55 30-132 C MEDIUM SAND 10 YR 6/6 1000 GALLON SEPTIC TAT 43.05 DIMENSIONS AND DETAIL NOT TO SOIL A BSORR T ION S YS T EM USE ExISTING H-10 UNIT SCALE )NOT TO NOTES CONSTRUCTION DETAIL SCALE SEPTIC TANK IS TO BE PUMPED DRY USE ADS HIGH CAPACITY BIOOIFFUSERS 1r1600BD1. GRAVELLESS AT TIME OF INSTALLATION AND IS TO INSTALLATION - USE DEP APPROVED INSTALLATION PROCEDURES. 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. BE EXAMINED FOR STRUCTURAL INTEGRITY. INSTALL NEW PVC OUTLET 50.00 1g a 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED TEE EQUIPPED WITH A GAS BAFFLE. FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS TAKER OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTAL'LER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. ei 5) EXISTING LEACHING GALLERY TO BE ABANDONED IN PLACE OR REMOVED. 0 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. s 7) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES eA AND APPLIANCES:" AND.: BIANNUAL PUMPING OF THE SEPTIC TANK. B) SYSTEM IS NOT DESIGNED;TO WITHSTAND VEHICULAR LOADING. DO NOT ,401� CROSS SECTION VIEW PARK OR DRIVE VEHICLES ;OVER SEPTIC SYSTEM. �t 4g _ 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL USE H-20 STABLE BASE THAT 'HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 94LC-T OUT LETER a.0 RATED UNITS SIX INCHES- OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. 16 I1.3 in pp In EFFECTIVE —� �3 NV OR FLOW LM1� DEPTH BLOAf 10 BtALDNW in n To 34 ,n 12.63 F0 68 In 15.66 FU 34 In 12.63 Ft1 DIS RIBMTI oOnM BOX DIMENSIONS AND DETAIL USE SHOREY DB-3 H-10 VELGAO' A SEPARATION OF INLET AND OUTLET TEES NOT TO tz In SHALL BE NO LESS THAN LIQUID DEPTH SCALE MIN CROSS SECTION VIEW SEWAGE DISPOSAL SYSTEM PLAN fm .- F�®M ``TANK s TO SAS PAGE 2 OF 2 0 JENNIFER L. COOKE ,r 6 STONE BASE 412 NYE ROAD9$ CROSS SECTION VIEW CENTERVILLE. MA MAY 17. 2011 1 ETE-3464 ASSESSORS MAP : TEST HOLE-_-�I�� _ _ _._.._ LOGS PARCEL: -4' NOTES. SOIL EVALUATOR FLOOD ZONE:- /�,/®/ �/=�,�'C.I� lea C... W I TNESS : 'TOW 1 C1121L1;�. REFERENCE: �° 1) The installation shall comply with Title V and Town of Barnstable Board of E:a DATE: AWL Zfo �t3� � -- Health Regulations. PERCOLAT ON RAr�E: .'. 2. ► IL—J, I y 2) The installer shall verify the location of utilities, sewer inverts and septic -"-`._ --------" "V `' w -__...__�._ --- - .i7 components prior to installation and setting base elevations. D ,may _____, ,, .�:.�� � g TH- I TH-2 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot, The first two feet out of the d-box to the leaching shall be level. l� � � 4) This plan is not to be utilized for property line determination nor any other 10+ p �� purpose other than the proposed system installation. t v e 4A O ,�Cj UVAV Wj 10 5) All septic components must meet Title V specifications. ,r �� �' f "'� 6 Parkin shall not be constructed over H10 septic components. LOCATION MAP �° ) g p 7) The property is bounded by property corners and property lines. 8) The property owner shall review design considerations to approve of total design and number of bedrooms to be considered for design. Receipt of payment for the plan and installation based on the plan shall be deemed a ro•�ai of the design flow b the owner. �r pP g Y 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean sand per Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the / SEPT I SYSTEM DESIGN water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if �' applicable.` The proposed SAS is being installed below the water service line. Th^ line is to be sleeved as aforementioned and maintained in place. FLOW ESTIMATE 11) If a garbage grinder exists it is to be removed and is the responsibility of the owner to ensure such. 5 BEDROOMS AT I ID GAL/DAY/BEDROOM -550GAL/DAY 12)The installer is to take caution in excavation around the gas line. _ . ... cp ,e 44KVS C J602,,. c,C2. � 13)The installer shall verify the location, quantity and elevation of the sewer 4 SEPTIC TANK lines exiting the dwelling prior to the installation. O 5GAL/DAY x 4DAYS - GAL USE NO() GALLON SEPTIC TANK . - - SOIL ABSORVION SYSTEM �-- .� :'�/ c3s...��` .____. _., --- ----- " Gc%';'z�/ ''� , C.,}�Tl3F+,1� �^I''�°.�i t.3+'�i° ....' �;=�. t� r'• �� K SIDE AREA: OOTTOM AREA: ' X 7 :M R � a T I r SYSTEM SECT I ON r ., C-i I ID M�y A. Iy .ys' fw, p oELLI _ 1000 GAL - nC SEPTIC TANK w � I ���'" Tl�tti.1 Pt ,liI✓3t +(.� __ �_3_q'��_�_'��� ��''-t'-'�- -_ ._ _'�s±�2U.�.,��� o �- ,1�1 : X �Z�S . _ w F t� i Vj S I TE AND SEWAGE PLAN LOCATION : I� . , • .k, ;t r r�,. ;��- ~ PREPARED FOR : '� � �ikG �!►��1l�� VIC5.1/ k_._.c O S ALE: 1 G. W DAV I D B . MASON DATE: Z GBC ENVIRONMENTAL DESIGNS EAST SANDWICH . MA 3 DATE HEALTH AGENT 508 ) 833- 2 177 W Z