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HomeMy WebLinkAbout0024 FAWCETT LANE - Health 24 FAWCETT LANE Hyannis A = 290 - 011 - 001 , A e o a YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00.for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-.it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the_Business Certificate that is Take the completed form to the Town Clerk's Office, required by law. 1 DATE: Fill in please:p APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: y A7l u ct n n i S M a4 TELEPHONE # Home Telephone Number , � i1sv" i�13� n aFxau:+::ri yr8. ;s +td 5SN or EIN � ' d NAME OF CORPORATION: O1 . NAME OF-NEW BUSINESS TYPE OF BUSINESS Ch;i IS THIS A HOME OCCUPATION? Y NO 1 ADDRESS OF BUSINESS: m.L Y1 n i /tt A MAP/PARCEL NUMBER � ( l �,sse'ssing) When starting anew business there are several things you must do in order to be in compliance with the rules and regul'ations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth' Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ZSIO ER'S OFFICE This individu ha' e infer-me y er it re uire exits that pertain to this type of business. At ized Signatur COMMENTS: 2. BOARD OF HEALTH - This individual has b=jaiajpjprmed oft e permit requirements that pertain to this type of business. Aut o tze Si nature** r\�� VJ •S COMMENTS: r �Ma u �- S FC( 3. CONSUMER AFFAIRS.(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type''of business. Authorized Signature** COMMENTS: � 11 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Address Roger Takessian Owner Owner's Name information is .required for every Hyannis MA 02601 08/08/13 , page. Cityfrown 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. 4 Important:When A. General Information filling out forms 31 ' ' on the computer, v/► U ' use only the tab 1. Inspector: key to move your cursor-do not Michael.Kellett use the return Name of Inspector key. Aardvark Environmental Inspections ffi Company Name PO Box 896 Company Address East Dennis MA 02641 Cityfrown State Zip Code 508-385-7608 S13742 Telephone Number License Number 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 08/12/13 y Inspector's Signature Date = The system inspector shall submit a copy of this inspection report to the Approviltg Authority(Boa of Health or DEP)within 30 days of completing this inspection.If the system is 41 shared s�istem the' 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. q11 t5ins-11/10 Trite 5 Official inspection Forth:Subsu ce ge Disposal System• ge 1 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name - information is required for every Hyannis MA 02601 08/08/13 page. Cityfrown state Zip Code Date of Inspection B. Certification (cont.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: t 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): 1 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r< 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. City/rown State Zip Code Date of Inspection B. Certification (cunt.) B) System Conditionally Passes(cunt.): ❑ 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 13irt3+11110 Me.f+�^n6i.w�1z�e�on Form:Sul)Turftce Sewage Deposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. Cityfrown State Zip Code Date of Inspection B. Certification (font.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow t5ins-11/10 Title 5Official inspection Form_Subsurface Sewage Disposal System-Page 4 of 17 sA Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is Hyannis MA 02601 08/08/13 required for every page. Cityfrown 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 east 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•11/10 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 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. City/Town 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: 0 ❑ Existing information.For example,a plan at the Board of Health. ® Determined in the field (f any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)P10 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15203(for example: 110 gpd x#of bedrooms): 330 t5ins•11/10 Title 5Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form & Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. Citylrown state Zip Code Date of Inspection D. System Information Description: r Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[f yes separate inspection required) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date , Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.1,etc): Grease trap present? ❑ Yes F1 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-11/10 Idle 501ficial Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is Hyannis required for every y MA 02601 08/08/13 page. Cityfrown - State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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) (f yes,attach previous inspection records,if any) ❑ Innovative/Altemative 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every y H annis MA 02601 08/08/13 ` page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components,date installed(d known)and source of information: 11/23/07 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: �2 et 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.): 4 Septic Tank(locate on site plan): Depth below grade: 1.4 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: 1,000 gal Sludge depth: 3a t5ins•11110 Title 5Offiicial Inspection Form:Subsurrace Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 't 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is Hyannis MA 02601 08/08/13 required for every H y ` page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 2„ 6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): The tank was sound and tight with tees in place and liquid at outlet invert. 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•11110 Tide 5 Official Inspection Foun:Subsurrace Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. Cityfrown state Zip Code Date of Inspection D. System Information (cunt.) 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•11/10 Idle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r< 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page, City/Town State Zip Code Date of Inspection D. System Information (font.) Distribution Box(d present must be opened)(locate on site plan): Depth of liquid level above outlet invert even 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.): The box was level and tight with no sign of carryover. 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.): The pump chamber and all appurtenances were in woking order. Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located,explain why: t5ins•11/10 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. Cityfrown state Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number. ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): This system has 5 infiltrators in a 13'XL6'stone field.There was no sign of ponding or failure in the stones. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. Cityrrown state Zip Code Date of Inspection D. System Information (cunt.) 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.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. City/Town 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 rear 20 30 31 31 51 49 45 50 t5ins•1 V10 Title 5Official irtspection Form Subsurface Sewage Disposal System-Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. City1rown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 7.3 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: I angered to 8.0 feet and found no water. I adjusted to 7.3 feet. Bottom of leaching is at 2.7 feet. Before filing this Inspection Report,please see Report Completeness Checklist on next page. ` t5ins•11/10 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 24 Fawcett Property Address Roger Takessian Owner Owner's Name information is required for every Hyannis MA 02601 08/08/13 page. City/Town state Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C,D,or E checked I ® 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 r s t5ins•11/10 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 HIGH GROUND-WATER LEVEL COMPUTATION ,( Date: Site Location: p2� (��C� ` Permit: Owner: Phone: Contractor: Phone: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. (depth is in feet below land surface) Date: 06166 , 0 mm/ yy feet below s STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well we� B) Water-level range zone STEP 3 Using monthly"Current Water Resources Conditions" determine current depth to water level for index well. mm/yy STEP 4 Using Table of Potential Water Level Rise for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment. D r 0 STEP 5 Estimate depth to high water by subtracting the water-level adjustment (STEP 4) from 731 measured depth to water level at site (STEP 1). NOTE* Tables 1-9 "Potential Water-Level Rise" are attached as worksheets to this file. month) index well data: www.ca ecodcommission.or wells.htmi Y p /9 TOWN OF BARNSTABtE i�AT ON d Y Fo7 w Ck l T /e--� SEWAGE# JO-0 7 Cr/ VILLAGE 1�ya n n f ASSESSOR'S MAP&PARCEL 0170 0/ / -_CG) 64STALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY 10()n J— (DO U r,-6-A LEACHING FACILITY:(type) f(size) I a(p NO.OF BEDROOMS 3 OWNER PERMIT DATE: /A /� COMPLIANCE DATE: J/7 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -7 r 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 tr` I , PP cep P � No. Fee 190 r ; THE'CO.MMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplicatiou for Mi5po5al *p.5tem Chou.5tructiou Permit Application for a Permit to Construct( ) Repair Upgrade( Abandon( ) [:] Complete SystemXindividual Components Location Address or Lot No. t_ ' Owner's Name,Address,and Tel.No. �.�Ar4"ASS -VT%, KIESS1 AfA Assessor's Map/Parcel 29 c,` oo I S,WN1 G Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. E"JT L%.0 S�+AY F"Q .S"CS Z 539— Type of Building: Dwelling No.of Bedrooms Lot Size 13 1,500 sq.ft. Garbage Grinder W" Other Type of Building �Clt1P No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3o gpd Design flow provided C� �r..( gpd Plan Date o Number of sheets Revision Date Title '5j\08\1 CkS Size of Septic Tank Type of S.A.S. !-�� oZ:�: dIQ\QSS 11CC Description of Soil '�l"O %i5 Nature of Repairs or Alterations(Answer when applicable) r , 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. Sign Q ate I l Application Approved b d :Date._ Application Disapproved by: -Date -for-the following reasons Permit No. - `i Date Issued �j -•w•,,..r6;,,�..,f....;" ..� :r« __ .;r,� ...� >. ..�..�,..w.v.,«,T.,:...y.;..y.,vyCsw..-+w.-• -".Yn,.....,, -..-.m-...-.-_. ,,�,.u,r•,.-. , ,..�w,.r t y _ D2 01 No. tf� '.-l�� = $ Fee THE;`C'O" M'N11ONWEALTH OF MASSACHUSETTS Entered in computer: 7 PUBLIC HEALTH DIVISION .- TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for Zigozal �§p!5te.11i Con5trUction Permit Application for a Pemiit to Construct( ) Repair '� Upgrade( Abandon( ❑ Complete Systerry Individual Components Location Address or Lot No. 5�L} Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Zg 0 J �,i` �..- r:, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No._ �ni�EW +D t�.� L�.0 +-1�,Y 1 av .s Type of Building' Dwelling No.of Bedrooms Lot Size I sq. ft. Garbage Grinder (A) 4 Other - Type'of Building 5�`12 No.of Persons Showers( ) Cafeteria( ) Other Fixtures LQ�} .U�" , C�'�n Design Flow(min.required) ,-.) 7� gpd Design flow provided , gpd Plan Date � � �l (� �� Number of sheets Revision Date Title ����. Size of Septic Tank L>C i`�T f , QQo c, G� Type of S:A.S. .� X � `j�Cv�PyeSS Description of Soil '� C� 4 C�y�< �: Q U t1 t�S Nature of Repairs or Alterations(Answer when applicable), '�Z? ����• i Date last inspected: £ _ Agreement: F 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 theasystem in operation until a Certificate of Compliance has been issued by this Board of Health. Signed //., ��� �`. Date (� l 4� — Application Approved by i fII, ,1 © vi` �i'! L/it s✓` Date Application Disapproved by: / ! E Date for the following reasons Permit No. ( Date Issued 1%J0 {• THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (�) :p Abandoned( )by CApp,,0'Ak C 1Cd 01 I'.SeS Lk—r— t s at Z, 1 4wc &,* �"*�- ��A no,i has been constructed i. a cordance / �r with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer eA sw;eL 'Cd..i L�Lc_ Designer bedrooms Anmroved desien flower � _ gpd The issuance of this permit hall not bbeJconstrued as a guarantee that the system will fun tion as designed. Date / Inspector, ------�—f�-----------=------`--==-- ---- Fee —/�—�— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �Digonl i§pgtem Con5trUction Permit Permission is herebyranted to Construct ( ) Repair ( ) Upgrade ) Abandon ( ) g p System located at Z,q i g,,L f±�n 141 A,,A, s and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be comp,eted within three years of the date of thi ermit. Date lJ 1/ ,`'-,Approved by i / Town of Barnstable Regulatory Services Thomas F. GeRer,Director Public Health Division i e0 Thomas,McKean Director 200 Main Street,Hyannis,MA 02661 j Office 5 -862-4644 Fax: 508-790-6304 Instiller & Designer Certification Form Date 1 S Desi e : Shay Environmental Services,Inc_ Installer. 'L Addi esi P.O.Box 627 Address: 1763 East Falmouth M' 02536 1. 6 2-" Z On S was issued a permit to i stall a at ) (installer) i• i septi sy stem at ��� based on a design drawn by (address) Slay nvironmental Services' Inc, dated -- (designer) I xxtify that the septic system referenced above was installed substantially a-,cording to tic design,'which may i4clude minor approved changes such as lateral relocation of tie tribution box and/or septic tank. i p I certify that the septic system referenced above was installed with major changes (i e. 4`E lateral relocation than 10' late relocation of the SAS or any vertical relocation of any component offthe septic system)but':in accordance with State & Local Regulations. Plan.revison er c rtified as-built by designer to follow. j CARMEN '�,� ler's Signa e) y SHAY I No. 1181 � Q V� SANITAR,Pa (D igner's Signature) (Affix Des p Herd PLE S RETURN TO BARNSTABLE PUBLIC HEALTH DIVI ON. CER �IFICAIE OF O LIANCE WILL NOT BE ISSUED UNTIL BOTH THISFORM AND As- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH IVISI01v. T '[you. Q:Hea tic/Designer Certification Form i f Town of Barnstable P# °f •� Department of.Re! ato Services ry Public Health Division Date -AWL $ 200 Main Street,Hyannis MA 02601 f6J9• �6 Fee PdLi�Date Scheduled Time Fee Pd. 0 ----ter i • ,foil Suitability Assessment for -cadge Duo l Witnessed.By: Performed By: LOCATION& GENERAL INFORMATION , a C2 ttd Owner's Name Location Address 24 t�-G� C:tY t-tv�ae�tl\S 1 M� i Address . V J13� Engineer's Name S� , SevcS- /' Assessor's Map/P4rcel. 0 /Q i NEW CONSTRUtf'nON REPAIR I Telephone# � Land Use ► 1�i A Slopes(`') Surface Stones ft Drinking Water Well __ft Distances from: Open Water Body� ft Possible Wet Area - .---- 9 ft. Property Line _�--ft Other R Drainage Way . SKETCH:($treat name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) i i i. i ! \ Bedrock ' C' Uv Depth W � �� Parent material(gedlogic) t �� Q` �" 1 tom . Depth to Groundwalar. Standing Water in Hole i Weeping from Pit Face M Estimated Seasonal;High Groundwater i tTERARN R SEASONAL IiIGIE WATER TABLE DATION FO i Method Used: CD Fe�c i r n J1 I — �! . Depth to Sall mottles: In. �_ 3, Depth dbgerved standing in obs.hole: , ��* in Groundwater Auetmentco Depth toiweeping from side of obs.hole- Depth _^_ Adj•faetor,4 A Adj.dr0undwatex LeV I •$-= Index Well# ta��Reading Date 11T Index Well level Date 1 074ney,b 4 PERCOLATION TEST Observation Tune at 9" J 1 -•- - Hole# - u Time at 6" 11 . e Depth of Perc M n j lime(911•61 Start Pre-soak Time.@ End Pre-soak Rate MinAnch 1 L AMP Site Suitability Ass0sment: Site Passed Site Failed; -= Additional Testing Needed(YIN) Original: Public He"dlth Division Observatiot Hole Data To Be Completed on Back---- ***If percola >itin.test is to be conducted within 100 .of wetland,you must first notify the Barnstable C4 nervation Division at least one(1)we&prior to beginning • •DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil ! Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConslitencLGravel) O- l 3 MA �Deb Q r1e&-S" 2.5 Y. -6 Is - 1 oho DEEP OBSERVATION HOLE LOG. Hole# "a Depth from Soil Horizon Soil Texture Sol Color Soil Other Surface(in.) (USDA) i (Munsell) Mottling (Structure,Stones,Boulders. nsistenGravel) fn c.J i e5 a -, . • ll`(�\-sad �-s� �� � c.ma _ logo . . sue• PEEP OBSERVATION HOLE LOG Hole#_�— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consist Gravel) ;DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistrn Flood Insuranie Rate Man: Above SI)O year flood boundary No— Yes ----_--- Within 500 year boundary No Yes within 100 year flood boundary No Yes Depth of Natutally oecurring Pervious Material Does at least f0fir feet of naturally occurring pervious material exist in all areas observed throughout the area proposed f r the soil absorption system? If not,what.is the depth of naturally occurring Pervious material? Certification I certify that on. 1 (date)I have passed the soil evaluator examination approved by the Department of> nviro ment tection and'that the above analysis was performed by uke consistent with . `the required traini ,e e e perience described in 310 CUR 15.017. Signature Date �� " Q WEMC1PERCl ORM.DOC �1 d r � � N 0 3 �° N A N ell m A a2w N � 28 � A C I�1 i �v l„ w s N n a • �S�cy+tr -s 41 i 3,6 No:....y.._...__....... F�s......:2......... . THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH o2- G bQ Appliration for Disposal larks nnstrnrtiun ramit Application is hereby made for a Permit to Construc -9 epair ( } an Individual Sewage Di s osal System at: 0? ............... .__...... - . ----.._.. 5 - .......................... I, .':� • --•--- _. .....- . -.. Loc ,ion-Address r Lot No. -------------D f*—( . � :C: W ,-1 1 Owner Address � ._..._. 5 ..........................•----•-•---.....-•---•-- ------.....------------------------_ .....------------------•-----------•--•---- Installer Address Type of Building Gov FaZ4lln� Size Lot....... _S_t�?C'0....Sq. feet Dwelling—No. of Bedrooms......a.................................Expansion Attic (AD) Garbage Grinder (trts) P4 Other—Type of Building ________._: No. of persons............................ Showers ( - Cafeter-ia--(_� Pq Other fixtures --------_ .. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity/A49_4O.gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length...... . Total,leaching area....................sq. ft. Seepage Pit No........o/-------- Diameter.Z! ......... Depth below inlet.... ......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ..................................................../-...................................................................................................... 0 Description of Soil.................. -W ....................••-•....•• . .....--•-•- -----------••••- 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 'I'LL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee,, sued by th pard of health. � / �-�a:�.�--------- •------•----- -------/--------------------•-- Application Approved By------- � �! �, .: ....-- Dat Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------_ --.....---•---•----------------------------------------------------------------------------•-------------......-•••••---•••••-•-••-•-••--•-•-••-•-----•-----••-•-•-•-----•-------•---•---•-•--------•--- Date PermitNo......................................................... . Issued....................................................... Date Fs5....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF \ql Appliration for Uiepasaal Vorkg Tnnaitrn.rtiaan Famit :i Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..............•--................................................................................ .......••----....------..-----•---------------.......----•--------•-----------•--.....--•---..---- Location-Address or Lot No. ......................»............_............................................................ ..........................-••-----_._..................---------................................_ Owner Address W 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............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capaco5VQ.....gallons Length................ Width................ Diameter._______-_____ Depth................ x Disposal Trench—No..................... Width.................... Total Length.L ._........... Total leaching area--------------------sq. ft. Seepage Pit No._Jr______________ Diamete/Z................ Depth below inlet.........._... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by--_------------_----.................................................. Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... rX, Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ x -------------------------------------...........y........................................................................................................... 0 Description of Soil.......................... x ............... --•----•----•----•--•------•--•-••-•--•••-••--•-•--••---•---•---•••-••-•••••-••••-••----•-------••------•----------•-•••---••••-----••••••--•------••---•-••......-•••-••-••-•--••-•.••- 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 TITIZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................... --'�•/--------------------------- ZkyApplication Approved BY �..- , --------------------------------•••--• --••--`"�--. .........----- Date Application Disapproved for the following reason .--••-••-----•-••-••-••••-•-•••--•-•-•--•----•-•-••-••••...••••••••--•••-•••-•--•••-••-••.............•-••---•--- --------------------------------------------•------•----------•-.--------•----------------------------------•-•-----------------------•---------------------------------..-----------------------.---... 4 Date PermitNo.......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...................­*........... .............................. Tatifiratt of aaanla THIS IS TO CERTIFY, That the Individual Sewage Disposal Systerll constructed ( ) or Repaired by ---- ---------------I----------nstaller .....................'.......................................................................... at.. , •. -- ..--•--•--•---. has been installed in accordance with the provisions of TITLE The State Sanitary. Code as described in the application for Disposal Works Construction Permit No......... :_.., .JfAet.... dated_______._._____________________________•-----•I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED GUARANTEE THAT THE SYSTEM W FU SATISFACTORY. DATE---...... ....... . ............................................. Inspector ....-----------------------------------....------ -------- THE COMMONWEALTH OFTS BOARD OF HEALTH •••..............•-..... ' No.......ffly ,yd L FEE....................------ Pis marl Vorkv TI-Inotrudion r taltit Permission is hereby granted•-••••-----••-• �� -•------------ •--- -=--------------------------------------------------------------------------- to Construct Re air a Individuate--e Dis osal S stem ( ) P ( ) n �,�/� atNo. ,`'' / Y 405K• ............................................................... .. �. Street as shown on/theali ion for Disposal Works Construction Permit No.............. .... Dated........____.__........................... ;, - - --- - ---------------------------------Board ofHealthDATE--••••-• j....... FORM 1255 A. M. SULKIN. INC.. BOSTON )I1.1GLG- FAMILY - :3 BCOROoM No GaQOA�� 621NDEcz t . �,o - w ICU X 3 73oG Po - F _ jEPTIG TP►.�K = 330x1 A976-P. _.- U T D15PGtiSl�L PIT- USE ez)o GPI. w-3'STaNc- -�5I DO-WA► L AZZA = 13Z- s. F /,SoD�f97 r 13ZX. Z. S = 33o6.P �. 0 98, 9 ooT-rnAA aeEa 1 t 3 s• r 113 Tcrr� roc-'SIGN = 4143 6-F. D. N s.7 DES 1G^I R=P-GDL.AT"14N RAC: t'' 1 Ki 1►d 4 Lts S �; . 97. z r-� �U'r t,, �<,� H Of Af WILLIAA4 DAVIDC. lop THULIN � �7.9 Diu N Y E �'1 v No. 2� 76 Z HoL.F o/ T'T,�:A14 loon INS• . GAL. Goo INS. 5EP`r�C- v K Z � GAS• K �.� TAN o W-3.3 r v 93- IN INV. Y. -� srr�ivE I o e / q�G �7 F3 �Ea 13' �—G--{ 3• �--7 y t Sawa. I�{ ,Cone 44,P B y ZoN�G _ 9 I C P P 1.oT P 1..A1J i PR UPILr== 'TIoN Y/,a,NJKk l LoCA ql �,r j N o `'_q p 't N a.T 'f N E P-m� _ \ r' . 1 CERTIFY P ; NEc2EoN GoMPL.�S YJITNZHE S1o�L_IN � \L_.G>-t� �3 A i fi p.uo SET�.GK 26QuIR-EMENT`> oF 'tN� L .C.C. ZZBZ -To w N op: 1340(sra:RtS; a N v I t,1r�T- L.00p°TED •WITH►�1 TNt~ L-oo� PLAIN ` DATE -AT,Ecze "fu1S Pt-o•N ► 5 Norr (3n5�D o� AN OSTE2VILL� - ,1 •SS. ; IN5••T-R.uMENT 5v2vt�`( �'TNE n_ I=FSETS Suoul,U NoT DE U5EOT0 OE-TEW^1►�� L..oT �. 11.,1�5 APPL-ICP.NT DALE Gk-_��c-c)DE� I PERCOLATION TEST 3-24•DIAM. ACCESS MANHOLES 3-24•REMOVABLE COVERS Date of Percolation Test: JANUARY 12, 2007 P111597 B -a• { ;, a 4• Test Performed By: CARMEN E. SHAY, R.S., C.S.E. :'+' t '_• ��±.,C •:' .'t 3 mti�ol.eren« ��, B' min.T 2 min. Inlet to outlet .+ Results Witnessed By. DONALD DESMARAIS ( BARNSTABLE B.O.H.) ;� r INLET- ��_ _r mti. cfl Excavator: Shay Environmental Services, Inc. '� (; �' NLE 1 to•mh. Loral ,a outtE7 ' Percolation Rate: Less Than 2 MPI 0 24" / -`1 /'� a'-o• *, INLET 4'-0•mM. l „ E r ' 11 NLET `/ `/ •� J b r eawt. Uqukl depth \\ 98.61' 1� Test Hole Test Hole ' � r�.�•aq; .,� -.Ta;, ,•rra•.,^'r,•,,:' '. ,r ra'•i• •,., �'••t• . w 1 N o. 1 N o. 2 DEPTH SOILS ELEV. DEPTH SOILS ELEV. STEEL REINFORCED PRECAST CONCRETE D 97,Do CROSS SECTION END-SECTION G 94.00 PLAN VIEW � 1 Sandy Loom Sandy Loam \ ( 10-M 3/2 10YR 3/2 TYPICAL (EXIST.)l000 GALLON SEPTIC TANK Ae 98.50 0"-6" Ae 93.50 Sandy Sand THE ACCESS COVERS FOR THE SEPTIC TANK, ` 1 Loam Loamy NOT TO SCALE DISTRIBUTION BOX AND LEACHING COMPONENTSHALL . IOYR 5/6 lo`tQ5(t, (H-10 LOADING) FINISHEDEGRAD RAISED TO WITHIN 6" OF Note: Remove soil down to el. 95.00 or C-1 Layer & replace with 6'- 24" Be 95.00 6"- 24' B 2.00 INSTALL TUF-TiTE GAS BAFFLES OR EQUALS \ \ i clean coarse sand w/perc. rate less than or Mod Sand Mad Sand ALL OUTLET PIPES FROM THE \ \ ► or equal to 2 min./in. before & after placement 2.5 Y 8/3 DISTRIBUTION BOX SHALL BE 1 i L5 Y 7/4 SET LEVEL FOR AT LEAST 2 FT. 12" -' CONCRETE COVER 1 \ I 1 24 132 C, 24"- 120 Cn r••a,. 2"1 2B' �I LOT #41 w... t 6KNOCKOUTS- 5' UTLET �� ,,;o.b•,5 , 1 / I �+' i W OBS 0120' or ELEV. 87.0) yt OBS 084' or ELEV. 87.00 D-Box /// i 15.5" OUTLET 12" INLET - TEST HOLD #1 1 ,5.5' 1.75" 1 I ELEV.= A7.00 PLAN-SECTION CROSS SECTION Failed ' I O LEACH PIT 0 ;' � CIS � 6 HOLE DIST/ RIBUTION BOX LOT #44 1 1000,6ALLON Perc Ili Test Hole #2) EXIST. 0 Pymp Chamber I Depth to Perc: 30" to 48" NOT TO SCALE Perc Rate= Less Than 2 MPI 1 / SOOT GALLON / OBSERVED H2O Elev. 120" ® TP1 2-W DIM.ACCESS MANMM \ / SEPTIC TANK I TEST HOIjE �2 1 i 1 ELEV.= 94.00 OBS. H2O Elev. 87.00 MANHOLE MOVERS WITHIN ABILE PROJECT BENCH MARK 2-20•MANHOLE 1 AIW230/ZONE D - INDEX = 23.6 for 12/06 B•OF FINISHED GRADE. TOP OF FOUNDATION 1 i/ 1\ ADJUSTMENT = 4.1 FEET or ELEV= 91.10 r-.• ELEV. = 100.00 (Assumed) I DECK OBSERVED H2O Elev. = 120" Or E.=V. 84.00 00 RESTOPE TO FINISHED GRADE ELEV. rE!�. +:�:.t..► F: :.i., B U OA N C Y CA L CUL A Tl ONS urr OUT CHAIN �' 1 1 �r THE ACCESS COVERS FOR THE SEPTIC TANK, 1 1 INLET INVERT ` '1 DISTRIBUTION DEEPER TM AN AND LEACHING COMPONENT I 1 F �->i'S OUTLET INVERT ELEV- 95.50 I I EXISTING \ CHECK VALVE .,•-. } FGRADE1ESHALL t LLL BE RAISED 70 WTHIN 6. OF I Weight of Septic Tank(Exist): 8,240 lbs. R FCHECK _P,v,a STEEL REINFORCED PRECAST CONCRETE HOuSE I �� ,9`t Weight of Soil Above Tank 2,220 lbs. Go. PLAN VIEW I : --� #24 ; Total Weight Down: 10,460 lbs. a'" 2= 3-M'FM07Mm I I I I LOT #40 a.4• r r I i Weight of Water Displaced: 5,064 lbs. ,6, ,� _ , - r-��.,to eua., a mk aMorvi- I' '4• uer r 1 * No Ballast Required For Septic Tank R PUMP CHAMBER ELEV.- 01.5o IM , O17Ef LJ 12 of 1 ASPHALT i Weight of Pump Chamber(H- 10: 8,250 lbs. / 2 Rone �« / b DRIVEV�AY 1\ _ Weight of Soil Above Tank 2,750 lbs. 1 PUMP DETAIL .•. 6 ; I ► I I -- --9 Total Weight Down: 11,000 lbs. Seale '-°' l I I ` __ CROSS-SECTION END-SECTION 1 I 17,500 Oquua a Feet +/-���--_- Weight of Water Displaced: 5,264 lbs. PUMP NOTES & SPEC/F/CA TIONS 1000 GALLON H-10 SEPTIC TANK USED AS PUMP CHAMBER No Ballast Required For Pum `'Chamber NOT To SCALE 1 I 1J I �, 1. PUMP SHALL BE INSTALLED IN STIP/CT COMPLLWCE NOTE., PUMP PHAMBER TO BE FACTORY WATERPROFFED PRIOR TO SHIPPING. design calculations s, ALA"�Nc�sr OF�DBLE SFI e Number a!Bedrooms: 2 Equivalent to 220 Gal. - ' I I ► , q /Day (330 Gal./Day Min. per Title V) � � RED WARNING LIGHT fn BE/NSTALLED IN Buu.aNG 102.01 Garbage Ginder: No AND POWERED RY SEPARATE CIRCU/r FRI PUMP SPECIFICATION CALCULATIONS _ Leaching (bpocity Proposed: 330 Gal./Day Minimum (Min. Per Title V) C►RCU17S TO P;:IfP. Septic _Taro : _- ,2 .x 330MGal./Day_=_660_USE�XIST;1 L)�Q GAL._Seotic_7ank..---- _ D - - �-�`""`-"` 44o c4ttoNs/4 DOSES- t to c4ttoNsjbos£ STA 17C HEAD CAl_CULA AON __� - - SOIL ABSU2PTiON AREA: Using percolation rate of f2 min./inch Bottom Area: 0.74 gal/sq. ft. x 490.88 sq. ft. - 363.25 gallons _ 1 9 r.00' - Ebvmt/on of Bottom of Pump Chamber g7,f7' Elev of 0-Box In CE 6 T ` .T I Sidewal(Area: NOT USED FLOAT LOCA TION CAL CULA TIONS , r Providing: = ,' 97.17 =91.00' - 6.17' Static Head • , . (4U' FOOT g: 363.25 gallons ', , \ OT RIGHT OF W '� I 110 Galion/ 7.48 c4L../Cv Ft - 14.7 Cu Ft Use: 4 ROG OD 6-OUICK4 STANDARD CHAMBER UNITS WITH NO Areo of Bottom of Chombe: - 6'x 5' - 40 Sq. R. DYNAMIC HEAD ~�-`- --_ _J STONE FORAN SAS HAVING THE DIMENSIONS: 12.7' x 26.0' Height of Water for One Doi@ (H) - f4.7 Cu. R. /40 Sq. Ft. -•` -------- • H - O.J7 Ft. - 4.44' Friction Hood For 2'SCH 40 PVC Pipe 100 ��� _ _ Bottom Ara: (General Use Approval for 4.72 SF/LF of INFITRATOR _ 010 GPM - 0.005 Ft/1o0 R. - -- Pump On - 11.44' '---98 6 UNITS + 2 END CAPS per ROW = 26.0 FT P ' 050 GPM - 0.01 Ft,/too Ft. use Gould Model J8B7(WS0311BF) Pump 230 volt Phoie / 4 ROWS x 26.0 x 4.72 SF/LF = 490.88 Pump Off - 7.0' Or00 GPM - 0.40 ft/too Ft. 1/2 HP 2'Solids Handling DESIGN FL(W PROVIDED: 0.74(490.88 S.F.) = 363.25 GPD Alarm - 16.0' Total Dynomie Hood - 6.57' 0 100 GPM OR EQUIVALENT EXISTING LACH PIT THE PROPERTY LINES ARE APPROXIMATE AND PUMP! RF MANC DATA O 2O 4O 5O COMPILED FROM THE SURVEY PLAN ENTITLED PU E OR E DA _ TO BE PUWED DRY AND REMOVED PLAN OF LAND OF MELANCY C. WHITE GENERAL NOTES NOTE: THE STRIPPED OUT SOIL CONTAINING LEACHATE CENTERVILLE, MA, DATED JULY, 1951,PLAN BOOK 99,PAGE 125 BY EBEARSE & KELLOGG of CENTERVILLE, MA SCALE: 1"=20' � FROM THE EXISTING SEPTIC SYSTEM TO BE DISPOSED AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN 40 1. Contractor is responsible for Digsafe notification and IT SHOULD BE USED FOR NO PURPOSE OTHER THAN LOCATION, VERIFICATION AND PROTECTION of all underground utilities and pipes. OF AS PER BOARD OF HEALTH SPECIFICATIONS. THE SEPTIC SYSTEM INSTALLATION.- 2. The septic tank a j distri¢gtion box shall be set level on 6 of 3 4 -1 1 2 stone. 3. Backfill should be clean sand or gravel with no 5witchbosrdt' I ; t' ', / ' * stones over 3" in size. a FI LEGEND i 40 4. This system is subject to inspection during installation PROFILE 0 F SEPTIC SYSTEM by CARMEN E. SHAY - Environmental 1 t " I 5. The contractor shall install this system in accordance - DENOTES 4 Iwith Title V of the Massachusetts state code, the approved plan PROPOSED o i at a 8X0and Local Regulations. .� a114 SPOT GRADE x° r' ttn�I ` v 6. If, during installation the contractor encounters any DENOTES .EXISTING E soil conditions or site conditions that are different �..- 104X46 SPOT GRADE.- °C from those shown on the soil log or in our design ` {`i ;' 24 Fawcett�Ln - S installation must halt & immediate notification be - ' fir'•:' , made to CARMEN E. SHAY - Environmental *NOTE: INSTALL TUF-TITE GAS BAFFLES OR EQUALS ON ALL OUTLET TEE ENDS.I Finished grade over system-2X slope away ' PL PROPERTY LINE o ` s : - 10 7. No vehicle or heavy machinery shall drive over the Provide Risers it necessary I septic system unless noted as H-20 septic components. to bring D-Box cover Finished grade over-eystem= 98.50 ,� Y t 4 PROPOSED CONTOUR within 6• of finished grade l j 8. Install Tuf-Tlte gas baffles or equals on all outlet tee ends. �'- ,. • r .TM Yam' `' 9. All Distribution Lines shall be 4" diameter Schedule-,40 NSF PVC pipes. 10' min. from Provide Risers DBOX t x 97- -- - - -97 EXISTING' CONTOUR P P EXIST. House house to septic tank Provide Risers N necessary to bring,INLET Pump Chamber cover l -lit t' 10. All solid piping, tees & fittings shall be 4" diameter to brinqq Septic tank covers to grade and outlet cover to within within B' of finished grade 6" of finished grade r., f, t 4 DEEP TEST_ HOLE & Schedule 40 NSF PVC pipes with water tight joints. 0 20 40 60 80 100 120 140 Mi 11. Municipal Water is Available And All Houses Within '150 Feet s- ,/B per toot Top of syt«n- El.r. -e7.eo i _ `' PERCOLATION TEST LOCATION 3' Mazlmum nr 4•PVC(CAPPED) INSPECTION 'PORT TO BE T 1 r Level for 2' INSTALLED AND TO BE WITHIN 6.OF GRADE \ �'\ 5 A t fs r � +, are Connected. } p AI s i ti t STOCKADE FENCE I - e' foot S- 1 6• CF M o dh2oo6n�oroseeCi di2+snw f - _ / Per foo FOR o q Eq:aee�wwOr,tic. "r ., Capacity US G.P.M. EXT FROM EXIST, C 14 O' ' In 2 r FOUNDATION 4" Soh XIST.1,000 G4LLD 5'In °i �1_J11 O, h 0D �s' f 40 P1rC rn SEPTIC TANK ,R N 1000 GALLON t' 8oh 4 > 0) 4 ROWS OF 6 UNITS AT 4'/UNIT+ 2 END CAPS- 26.00' CONCRETE FOUNDATION II H-10 PUMP CRAM o II REVISIONS + PROPOSED FULL FOUNDATION N >y II p u PROJECT ADJ. Groundwater - ELEV. 91,.10 PREPARED F 0 R� Bottom of Test Hole 1 Elw.- 86.00 e > all> 6• aF3/4•-11/2" STONE SUBSURFACE SEWAGE DISPOSAL SYSTEM 6" OF 3/4"-11/2" STONE 6" OF 3/4'-11/2' STONE M c PUMP ESTABLISHED VEGETATIVE COVER SYSTEM PROFILE CHAMBER f NO. DATE: DEFINITION of r• a' �, „+•.. n•• i. y• ,, 1,• BACKFILL NTH CLEAN SAND ,� ;''r; :; �A• 24 FAVVCETT LANE t• , .t .. NATIVE OR PERC SAND CLAIRE C . TAKESSIAN ��i',"1','l,ti,r'I�:Y��r�•f'J+�t..ta•''�'"?�' A,; 'd;;'A...A;,•.A,r y.�1 :{�'. ,. ."� „••�}.,Ir', TOP OF UNIT ELEVATION - 27.60 u, �„ •, , . ,` ,;,.� 1 . .', ,,�,..:• :a,'+: ' ';;f.':.'.tl::: :a:' �.'`�:.u,, HYAN IN IS, MA w • ,'.,e;•'t,• ti;'%• t'; T":% %,i;.I ASSESSORS MAP - 290 PARCEL - 011-001 INV. ELEVATION - 66.65 ;,• ;'' 'r '''.. ,r{iw;' '� ;:,� I.' , #24 FAWC ETT LANE'':r:' ,'t,,,'. '�;�,i„' �n. A PREPARED BY: Jn S t• TT ELEVATION Y BOTTOM ELEV A TORY WATE RPROFFED PRIOR TO SHIPPING. - ER TO I , NOTE: PUMP CHAMBER H I A N I S, M A 0 2 6 01' �, p � �., � VEY E. ,SH�1 Y E. 5' IIIN ABOVE BOTTOM OF 4 a s S4<a U u KNVIRONAtEAT4L SERVICES, INC. EXISTING SUITABLE MATERIAL P.O. BOX 627 TEST PIT OR ESHOWT EFF. WIDTH f 2.70' 1 S❑IL ABS❑RPTI❑N SYSTEM (SECTI❑N) 0ls r�F EAST FALMOUTH, MA 02536 BOTTOM OF TI : - e6.00 INFILTATR❑R QUICK 4 (H-10 LOADING)/ GE❑RGE ❑'BRIEN NITAR\ ��y Y� (OR EQUIVALENT) 0. NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" TEL/FAX : 508-539-7966 vObs. Groundwater - Test Hole 1 Elev.- 87.00 (Adj. Per CAPE COD COMMISSION - 4.1' - ELEV. 91.10) SCALE: 1 "=20' DRAWN BY: CES DATE: JAN. 12 2007 ♦PROJECT ADJ. Groundwater = ELEV. 91.10 PROJECT#SD-1008 FILENAME: SD,1008PP.DWG SHEET 1 OF 1