Loading...
HomeMy WebLinkAbout0021 HARRINGTON WAY - Health 21 Harrington Way Hyannis F/R t A = 288 091 I' I n No. 'Lei FFee$5 0 .0 0 / e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es t/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipphratton for �Digpotal bpgtem ConfStruction Vermtt Application for a Permit to Construct( . )Repair( X)Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 7 7 5—8 5 8 4 1 'Sharon Freitas/Wanda Carter Assessor?I ap*,gXrington Way, Hyannis 21 Harrington Way, Hyannis 288-91 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name;Address and Tel.No. 3 9 8—8 31 1 Wm E Robinson Sr Septic Craig Short PO Box 1089 Centerville PO Box 1044 S. Dennis Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install Title 5 septic system for 3 bedroom to plans of Craig Short #1 -994 Date last inspected: Agreement: The undersigned agrees to ensure the constructi n and maintenance of the afore described on-site sewage disposal system in accordance with the�vi sions of Title 5 o e ironmental ode and not to place the system in operation until a Certifi- cate of Compliance hase iss6d by ' oar Health. Sid Date Application Approved by Date Application Disapproved for the following reaso --- Permit No. Date Issued No.. _ �G'l 1 ` r R Fee$50.00 � \.. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. ✓' PUBLIC�HE TH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS Yes 01porici ion for rh5potar.- ip$tem Con5truchon Perm Application for a Permit to Construct( , )Repair( X)Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 7 7 5—8 5 8 4 Assessor?laprn�lrin.gton Way, Hyannis Sharon Freitas/Wanda Carter 21 Harrington Way, Hyannis 288-91 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Nihee.Address and Tel.NNo—3 9 8—8 1 1 n.f Wm E Robinson Sr Septic Crai jj f ; PO Box 1 089 Centerville PO Box 1044 S. `D s .- `� Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(qo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets o Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer*when,applicable) Install Title 5 s e a t i c s v s t Pm for 3 bedroom to orins .' AJ Craig Short #1-994 - Date last inspected: Agreement: The undersigned agrees to ensure the�construcUOn and'mamtenance"of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 o e Environmental C de'and not to place the system in operation until a Certifi- cate of Compliance has been issued by th.i�s/sfBoazd of Health. / rL) s Sign �ilr`� Date/" 'o / Application Approved by -Date3/� Application Disapproved for the following reasons Permit No. 400 L4 -- M I Date Issued j --�h,� ------ ---------------------------- ------ THE COMMONWEALTH OF MA SACHUSETTS Freitas BARNSTABLE, MASSACHUSETTS Certificate of Compliance I THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( ) Abandoned( )by Wm E Robinson Sr Septic -Service at 21 Harrington Way, Hyannis has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ',_-�®0 - P1 dated L/ 3 /1 C/ Installer Designer . h I The issuance of thi`permit shall not be construed as a guarantee that the s tem ill qfu/nction as I-esigned. Date `� , Inspector rnX _ S ��I No. /k'.Z'}`� l�l I Fe%5 0.0 0 Freitas THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE., MASSACHUSETTS Mi5pooal *pztem Con5tructtou Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 21 Harrington Way, 14aannic 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 bcompleted within three years of the date of�thisp 't. Date: ,r?/�9:31G Approved by TOWN OF BARNSTABLE � t LOCATION SEWAGE # 6 f� VILLAGE ,f�&,142 44 4 ASSESSOR'S MAP & LOT W o1/ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACTI'Y LEACHING FACILITY:. (type) d-- C- (size) 13� NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE•DATE: Separation Distance Between the:" .Maximum Adjusted Groundwater ble to the Bottom of Leaching Facility Feet Private Water Supply Well 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 6 G� Town of Barnstable Regulatory Services Thomas F. Geiler,Director BAMMBM 9�p MASS.9 � Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Designer: Craig Short Installer: wm E Robinson Sr Address: PO Box 1044 Address: PO Box 1089 S Dennis �'entprsi> > e • On Wm E Robinson Sr was issued a permit to install a (date) (installer) septic system at 21 Harrington way, Hyannis based on a design drawn by (address) Craig Short dated 10-10-03 (designer) X _ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. �.a*ui 3 J6 l V 41 (� f Installers Signature) Will `W ( ) � . (De igner's Signature) (A esi'gner's Stamp ere) r PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form f f 6 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS b DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEiVE APR 15 Z003 TOWNAF LTH UEPT. TITLE 5 LE OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: / rri r► �� ,� �, MAP /fJ 01) CE ICY PAR L Owner's Name: �i` �.l 'SOT ` Owner's Address: ;-;L/ Date of Inspection: a Name of Inspector: (please print.) Company Name: L/d✓p / FAILED INSPECTION Mailing Address: Telephone Number: Si D Z) 2 — i 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 Further Evaluation by the Local Approving Authority Fails Inspector's Signature: 4 v Date: �2 3 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection- If the system is a shared system or has a design flow of 10,0oo gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The orig;irtal should be sent to the system owner and copi authority. es sent to the buyer, if applicable,and the approving Notes and Comments ****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 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: ] �%+/✓I•� fah r;✓�%� Owner: vj Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Sys m Passes: I have not found any information which indicates that any of the failure criteria described in 310 CNIR 15.303 or in 310 CNIR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. Syst�rn Conditionally Passes: iOne 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. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined" please 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced N"D explain.- 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 obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART A J CERTIFICATION (continued) if Property Address: / c;r/l h ��v) I've, 1.7C0 Owner: h&2 Date of Inspection: �;, t7 C. Further Evaluation is Required by the Board of Health: —&—'Conditions elist which require further evaluation by the Board of Health in order to deter mine if the s}-stem is failing to protect public health safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CN1R 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 2. System will fail unless the Board of Health (and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank:and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria 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. 3. Other: f Page 4 of 11 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: , 7 Y/-t� Owner Date of Inspection: 3 0 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no" to each of the following for all inspections: Yes No ack of sewage into facility or system component due to overloaded or clogged SAS or cesspool i/ Discharge or ponding of effluent to die 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 _ _ squid depth in cesspool is less than 6"below invert or available volume is less than 1/2day flow 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. V Any portion of cesspool or privy is within 100 feet of a surface utter supply or tributary to a surface 'water supply. _ r/ 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, N1-rformc­' DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates t::.:. one 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.] 3(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large sv�tem the system must serve a facility with a design flow of 10,M0 gpd to 15,000 gpd• You must indicate either'-yes' or'-no" to each of the following: (The following criteria apply to large s}-stems in addition to the criteria above) yes no _ — the system is within 400 feet of a surface drutlang 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 1;--e 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. Page 5ofII OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: r► V7 Owner: Date of Inspection: Check if the following have been done. You must indicate`dyes" or"no"as to each of the followin Yes o Pumping information was provided by the ow—ner, occupant, or Board of Health L' Were any of the system components pumped out in the previous two weeks H .the system received normal flows in the previous two week period _ v Have large volumes of w b ater been introduced to the system recently or as part of this inspection Were as built plans of the system obtained and examined?(If the .were not available note Y as N/A) X7 X7 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 0 on site _ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of thhee baffles or tees, material of construction, dimensions,depth of liquid,depth of sludge and depth of scum t/ — 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: Yes no i Existing information. For example, a plan at the Board of Health_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CNIR 15.302(3)(b)] I Page 6 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSTEM INFORMATION Property Address: / 7C,PrO.i Owner: /g ; Date of Inspection: 3 D RESIDENTIAL FLOW CONDITIONS / , Number of bedrooms(design): Number of bedrooms (actual): L+ DESIGN flow based on 310 CMS 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: / �/ Does residence have a garbage grinder(yes or no): /d v Is laundry on a separate sewage system yes or no): ,d/q f yes separate inspection required] Laundry system inspected(yes or no): &IJ Seasonal use: (yes or no):_,!!�I/O Water meter readings,if available(last 2 years usage(gpd)): /v Sump pump(, es or no): r7 Last date of occupancy: 0//e,v9 CO1rII 1ERCIALAND USTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):— Water meter readings,if available: Last date of occupancy/use: OTHER i, ;)e): GENERAL INFORINIATION Pumping Records ,� Source of information: /41 'yf'r/ �' -1 h, ® ter ,Si ,, cam, - l f�Zt Was system pumped as part of the inspection If yes, volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM —Septic tank,distribution box, soil absorption system (D� — fL — <:�-,�54 —Single cesspool ,y _Overflow cesspool AO S yJ _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 instalTled(if known)and source of information: .57 Were sewage odors detected when arriving at'he site(yes or no)://6? Page 7 of 11 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C /SYSTEM INFORMATION (continued) Property Address: /0P7 Owner: e f Date of Inspection: 0 p BUILDING SEWER(locate on site plan) Depth below grade: 'Z/',' Materials of construction: t/cast iro11----4DTFVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK:/(s'(locate on site plan) Depth below grade: 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: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: 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.): GREASE TRAP: (locate on site plan) Depth below grade:— Material of construction:_concrete_metal_fiberglass_polvethvlene 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: 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/day Alarm present(yes or no).- Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): DISTRIBCTI (if present must be opened)(locate on site plan) Depth of liquid level abov invert: Comments (note if box is lc-.cl acd distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.): PUMP CHAMBER:Zv/(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: r Ac,rl /,'75 7 v./ IV`� Owner: 7i e,�G���r1cZtL .'"/� '/Z2 roCJ/ '/ 7 Date of Inspection: 1- 9.o/ �j SOIL ABSORPTION SYSTEM(SAS): (locate on site p n,excavation not fequire If SAS not located explain why: n Tye iva -k-, �c S o��C 'o S Sri v, leaching pits,number: / � leaching chambers, number: ��/4�vC b^ �°n ,n .-- /3'-' �'e�,c ,� 3/ �`J Fell . ,n leachinggalleries,number:`"' (� leaching trenches,number, length: 9®ncj,+ c J 0-41 1 OVer %;,�� _ to ��/��i n leaching fields, number, dimensions: /V, ,n c:l �- overflow cesspool, number: �.41,J_ i yver j innovative/altemative system Type/name of technology: Comments note condition f soil, signs of hydraulic failure, lev 1 of ponding,damp oil,condition of vege Lion, etc.): 1/ C •'L-t to 1 CESSPOOLS: (cesspool must be pumped as part of i on)(Iocate on site lan) Number and configuration: Depth—top of liquid to inlet invert: L;cepm of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, le I of ponding, Condit on 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,condit.on of vegetation,etc.): I� Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: / ' G,,-, /'ova (NGi Owner: ►^e l-1 C. Date of Inspection: %� 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. F�o✓� 0 140L/ re / /-92 � e3 ^ d-y , C4 - 4o � /3 - 3Y .4 �t - � Page 11 of 11 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS • - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / SYSTEM INFOR'NIATION(continued) Property Address: / 7c' "Ih Owner: !G� Date of Inspection: SITE EXAM Scope Surface water Check cellar Shallow wells Estimated depth to groundwater /feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked date of design plan reviewed: served site(abutting property/observation hole within'n 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach.documentation) Accessed USGS database-explain: You mus sc ' how you establis ed the hig�ground w• ter elevation: TIC � v d ra LeS4 .TOWN OF BARNSTABLE CC LOC!'.TION A' 1,00 \) SEWAGE # 6Y— 6 VILLAGE .46 -1144 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. , f6 SEPTIC TANK CAPACITY /S,6--'o t LEACHING FACII.I'I'Y: (type) 3L- a—,e- (size) 13-2-S� NO. OF BEDROOMS BUILDER OR OWNER -A -S PERMITDATE: 7'-PL-3 OMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) _ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)- Feet Furnished by 1- N / TOWN �O/F BARNSTABLE LOCATION�! >�fJ�1R/�1��� "1I/FfN SEWAGE # VIL(AGE ///Yfs pp� ASSESSOR'S MAP & LOTeVIrg" �l 1N TALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) 'NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER OR OWNER /_cy /p" �� e, 1 4 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ' f 0 L�� I BENCHMARK TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR SOIL. TEST ELEV. - 100.00 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST 10/7/03__, CLEAN SAND SOIL TEST DONE BY O-AA R.SHORT. PP k (ASSUMED) CONCRETE WITNESSED BY WM�E.RSZ N , M._. COVERS 4" SCHEDULE 40 PVC PIPE LOAM AND SEED OBSERVATION HOLE 1 ELEV.=-_99.0 MIN, PITCH 1/8" PER FT. 2" LAYER OF PERCOLATION RATE _c 2- MIN./INCH AT ,_41--0 _ INCHES 1/8" TO 1/2" DEPTH HORIZ TEXTURE COLOR MOTT. OTHER #1 24" 9&5 MAX. WASHED STONE 4" CAST IRON PIPE " LEGEND: #2 25" (OR EQUAL) MINIMUM 98.0 MIN. -� EXISTING SPOT ELEVATION OOxO PITCH 1/4" PER FT. a EXISTING CONTOUR ----00----- 0-18" FILL ZABEL FILTER FINAL SPOT ELEVATION 0 . FINAL CONTOUR 1 98.00 FLOW LINE M EL, 95.5 °' SOIL TEST LOCATION PLUMBING TO BE RAISED ELEV. ft _2 97_•92 M!N ❑ ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑❑ ❑ UTILITY POLE -0- © 18-24" A LOAMY SAND 0YR4 3 NO AND RE-PIPED 47Y A f 95,25 VON o o o TOWN WATER -W WI LICENSED PLUMBER AS ELEV. _ LEVEL o ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CATCH BASIN ®� NEEDED ELEV. 95•50_ H2O GA5 ELEV. _ _95.10 _ 6" SUMP ELEV. _ _94.90_ 0 0 0 G ❑ Q ❑ ❑ ❑ ❑ ❑ ❑ ❑❑ ❑ o 2' o GAS LINE G EL 96.00 GRAVEL BAFFLE o ° CLEAN C.O. 24-3$ B LOAMY SAND 10YR$ 8 NO WITH GRAVEL DISTRIBUTION ELEV. _ ° ° o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o ° CESSPOOL T C.P. 0 LIQUID OUTLET BOX � �_ ° o o °' ° o o ELEV. = 92.75 DEPTH TEE (TO BE PLACED ON FIRM BASE) �� MEDIUM & 4 FEET 14 INCHES TO BE WATER TESTED 36-144*1 C COARSE SAND 10YR7L4t NO 5 FEET 19 INCHES IF MORE THAN ONE OUTLET 2-500 GALLON DRYWELLS WITH STONE 6 FEE 24 INCHES 1500 GALLON WELL N A NO WATER ENCOUNTERED AT -lZ-_ ELEV. 7 FEET 29 INCHES (TO BC PLACED ON FIRM BASE) IN AN13 X 25 X 2 TRENCH FORMATION Z 5.75' ZONE N fA 3/4" TO 1 1/2" CLEAN SOIL ABSORPTION ;�, INDEX DOUBLE WASHED STONE ADJUST FREE OF FINES & SILT SYSTEM SAS NUloMERUOEBEDR oMSIGN CALCULATiON � SEWAGE DISPOSAL SYSTEI'a PROFILE USGS PROBABLE WATER TABLE ELEV. = r1�I�A_ GARBAGE DISPOSAL UNIT NO, NOT ALLOWED OBSERVED WATER TABLE ( / / ) ELEV. = N/A_ -- TOTAL ESTIMATED FLOW NOT TO SCALE BOTTOM OF TEST HOLE ELEV. = L.SZ (110 GALAR.IDAY X 3 BR.) -Ma- GAL./DAY REOUIRED SEPTIC TANK CAPACITY 1SO GAL ACTUAL SEPTIC TANK CAPACITY lWn . GAL. SOIL CLASSIFICA 77ON __ I DESIGN PERCOLA 77ON RA 7F <5 MINI INCH EFFLUENT LOADING RA7F 0.74 GAL.IDAY/S.F. LEACHING AREA 477 SO. FT. (13'x25')+(76'x2') LEACHING CAPACITY 352 GAL.IDAY 477 X 0.74 RESERVE LEACHING CAPACITY NZA_ GAL.IDAY NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 5 . O DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPUCANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS - •9 PRIOR TO COMMENCING WORK ON SITE. ~' l /A/ / 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS rON / � SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION OH .w gj� -_ Vj� IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. - 8. PARCEL IS IN FLOOD ZONE ;,.._ C 105.00' �" - �- 9. LOT IS SHOWN ON ASSESSORS MAP �288 AS PARCEL 91__ O " 97.9 `' //; -"--- �98 97.9 �62?�_ 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND ' (C:P�7.6 � 7--__ FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM, AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) 98.E ! - N. �• (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. t 104.43' 96.3 ``tr 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND OR REMOVED. � 99.01 IOFL'`; 12. A ZABEL A1800 FILTER IS TO BE INSTALLED. 98. � #¢` ti r ^„r 1�O zc RU B r ^�r ] SEP77C 1 3.'H f T --__ j 1 " TANK x w APPROVED: BOARD OF HEALTH INVERT `t i 98.7 ,, 11, Z-4 �°� :- ELEV 98.096.8 98.8 Mom.tM$ EXIS77NG ,1 2520 DATE AGENT -� DWELLING 99.2 GARAGE D.B. k' . 97.7 PROPOSED SEPTIC DESIGN SLAB INVERT 12 �w � it /►I'q FOR ELEV 97.9 99. E. ROBINSON, SR. /FREITAJS ■ 9 .8 75 �'. 4 b • 98.0 98.e DECK S.T S.A,S OS'' LOC. r 21 HARRING TO N WAY' i i ` � `l t -� C.O. ,/] 9 7.5 ('`� G b I e } lY1 ASS 97.9 SHED 97.5 o C V S C2�GR R. SHORT,WESTERNoP.P.E. 98.5 75.68' 98.1 LOt 4 & 5 AD C2•9ic Sn^i rr,� 508- 50U P. 0. BOX 1044 18,.314.0 -1- SF. o:r.,�y-<f sr 398-8311 02660 2.b 33.6B' 10,y32' DATE SCALE " ' OCT 10, 2003 1 = 20 REV. JOB N0. 1--994 � LOCATION MAP (REv. � rSHEET 1 OF 01-0994 R-HorringtonWay.dwg 02003 CRAIG R. SHORT, P.E.