HomeMy WebLinkAbout0024 HOUGHTON ROAD - Health 24,Houg4ton Road
Hyannis_
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A=.306 7 025,4N
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No. 310 10 1/ , Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for -Disposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon e) ❑Complete System ❑Individual Components
Location Address or Lot No.,;?q +()n Owner's Name,Address,and Tel.No. 'I�7�/•�/��-• `�aC�
`1 J70�kn NiJ)o 15 -y
Assessor's Map/Parcel CXp-p'XS '
Installer's Name,Address,and Tel.No. 6ZA-S/ -�f 90��0 Designer's Nre,Address,and Tel.No.
/
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
A Pon.
Nature of Repairs or Alterations(Answer whe licable) ba J,-�o
O
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mainten ore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environme ode and to place the system in operation until a Certificate of
Compliance has been issued by this Board of Hea
Signed Date
dJ
Application Approved by KNKA L-� Date -j 4c)
Application Disapproved by Date
for the following reasons
Permit No. �� ) Date Issued 131
No. Fee r
THE COMMONWEALTH OF�MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for MispoSal *pstrm Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade(R) Abandon k) ❑Complete System ❑Individual Components
Location Address or Lot No. (' C�,u q �U t Owner's Name,Address,and Te/l;No. 'i)71/• 11 ?(5 a`�20
Assessor's Map/Parcel 3 {, - p'�'�:: �
Installer's Name,Address,and Tel.No: Designer's Name,Address,and Tel.No.
/
/)
y--)—_Tj-k4 A!4e1 I•G A -)
Type of Building:
l_
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons . Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date i
Title r"
Size of Septic Tank Type of S.A.S. » y_
Description'of Soil
,a s
Nature of Repairs or Alterations(Answer when pplicable)
iU T ( t
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance-of th&.af"re described on-site sewage disposal system in _
accordance with the provisions of Title 5 of the EnvironmentaPCode and_not'fo p al ce the system in operation until a Certificate of }
Compliance has been issued by this Board of Health-'
Signed Date. r
Application Approved by- KrI NO(/,/�/�-�.ds!_ A Date
Application Disapproved by Date
for the following reasons
Permit No. a. � Date Issued
- - _
r
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS,ISiTA`CERfTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandone'd!Q/)by/ r6Y'#r>�/ � c Est K?Y��'± lGF'I . h f. �.�._
at o �/T�r/�.�fj j�,.r �_i/ +jow/v 5 has been constructed in accordance
s
with the provisions of Title 5 and the f/orDisposal System Construction Permit No. dated
Installer '"Xa!-fb�r`�/A/ . bI�Str'CiG�4C117i'JC Designer
#bedrooms Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system will functiotr a des ned. �--
Date p/ Inspector
No. V r
oZ�j Fee c ..
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
MispoBal *pstem Construction permit
Permission is hereby
rygranted to Construct( ) Repair( /) Upgrade( ) w Abandon,(
)Y
System located at r'�/ 1"7ouoA 4:, -y �f J��driy .4,Z1j0_)
V r
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 permit. /�
Date A / �0 Approved by 1kY1t cr/..f.-e,..'7
{
No. ;I-C) � Fee /w
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftpritation for Misposar *pstem Construction Vermit
Application for a Permit to Construct( ) Repair 0� Upgrade( ) Abandon( ) ❑Complete System �dividual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No. Jp$-SZP6- 120
Assessor ap/Parc� pro 1`��GtY)Ill s d7 UWit {_ �Sa1e{W Sf-
alc0/
Installer's N e Address,an Tel.No.�$-y`�FS- 13Qo�o Desi er's ame,Address,and Tel.No.�5— a,
G�oY)4r�_m 2.r4, gF1Yt1 UA4 y&)• stun ln�r,�n Inc Q 2(44"7$7`.
(� Off' S
Type of Building:
Dwelling No.of Bedrooms Lot Size /®,DDl3 — sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) -330 gpd Design flow provided 33(_a gpd
Plan Date 'ao Number of sheets Revision Date
Title
e �. ,
� -
Size of Septic Tank °i_)Li S�`��a Type of S.A.S.. �X��j
Description of Soil " J 1
Nature Re airs o Alterations(Answer when applicable) /U /U
la 'i-X
Svcs
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 e and n place the system in operation until a Certific to of
Compliance has been issued by this Board of Health.
Signed - Date
Application Approved by z; Date "�--
Application Disapproved by Date
for the following reasons
Permit No. PLO � d �'�� Date Issued
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es+°.
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Rpplication for -N-S osal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair `( Upgrade( ) Abandon( ) ❑Complete System [Individual Components
Location Address or Lot No. $� $Q�, -Fr�_� Owner's Name,Address,and Tel.No. �a(a- y�
Assessor's Map/Parcel 1 p A A,,A, R;, 4 a /
Installer's Name,Address,an Tel.No. � 4 FS' coo Designer's Name,JAddress,and Tel.No.��S- a,,p P-[/1-
.t_r►1G• ��`�L1:.�`�t��� i�,tcr+l � Fj'%r'1�eor•'���C Y1�jC��i
Y`� S 111JJ)S �JA it God[ �'n.�a�.�//,P J� � _ �/V Cif /7
Type of Building: 1
Dwelling No.of Bedrooms Lot Size /D,Qoe!� '- sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3-30 gpd Design flow provided 3Cn gpd
Plan Date Put,. 1'4 pv�,'Ao Number of sheets Revision Date
Title .l i-I-le .5- xr) ,g 50Lrw) e, - gL/.il 1)1 A
�. Size of Septic Tank X1}S5�['tt�u 1�1X74` Type of S.A.S.a�g//h) �h olle Z�aCfa
� . f
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)`f!J,„ AIZ'11� .1r_�-T�ir 13'ky - 4/ r:r^ii
J �irF�l r !��'��J�11;i./i..�ar�a ,� �r� J�X ri'-� /.�) ,�S/-.,r ��rr�;�'►�,./lc.�:..�' r r,�?.,��� � ,s�r7 ��C/Sr••��
Date last inspected: /
Agreement: /J'f
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal systt'
accordance with the provisions of Title 5 of the Environmental Cod-6 annot-to-place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed //y1� r --a---�_,. Date V / OTC/
Application Approved by `•,/ � . Date 2
1
Application Disapproved by Date
for the following reasons
Permit No. 9.0 �D ' � �% Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired) Upgraded( )
Abandoned(�)by tt 16r.f%J6 :
at � lr n ro sr"O j�ylt t v� ,'S has been constructed in accordance
with the provisions of Title5 /and the for Disposal System Construction Permit
'No.
��V� 71 dated 2�
Installer V Designer X.,��t on (/I a;a.P roc 1 nie—eg')1?r •�l C
P #bedrooms Approved design flow 1 _� �, j ✓ r gpd
,,. -
The-issuance of thi p it shall not be construed as a-guarantee that tInspector
s m wiill fiznction�as designted.
f r .�, d/
Date
lz' 9
No. O;XC) Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) �^rRepair( U grade( ) Abandon( )
System located at S
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 permit._.,; •,� �(
Date (" Approved by 4
i -
SEP-23-2020 00:46 From: To:15087906304 Pa9e:1/1
Town of Barnstable
E inspectional Services
ri O r� l•
Public Health Division
.aJo a Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: SOM624644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: 21 ZD Sewage Permit# -?1*040 Assessors Map\Parcel 8
Designer: Installer: MtDlUM COMf OU
Address: qM mum MAddress: 4f I
Hatoo M(w9r, MA° OZ(046
On 9-a- oZU J /i� a as issued a permit to install a
(date) (insta ler)
septic system at based on a design drawn by
(add tress)
dated AU4. 12 202o. .
e igner)
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. Strip out (if required) was inspected and the soils
were found satisfactory,
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State&Local Regulations, Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that th referenced above was constructed in compliance with the to rms of
the M veil ers(if applicable) \ �jA of I�,csyc
DANIELA �n
OJALA
' CIVIL
nst er's Signature) i No.415 02
p► 90�R�Q!S T
_ 1 )tA/eL0 19SIONAL
(Designer's Signature) (Affix Des tiers Sump Here)
PLEASE RETURN.TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF rn PLIANUE WILL NOT BE ISSUED UNTIL BOTH THIS FoRm AND AS-
ARE RECEIVED BYJHE BA TABLE PUBLIC HEALTH DIVISION.
?HANK OU.
WoAdcotAHEALTMEWER coonetnEPTICOcsigna Cenification Fonn Rov W-I3.000
COVIiVIONrWEAi;TEI OF M-�_SeACE-IU SE��.�-r--�---
f- EXEcumE OFFICE OF ,E ZRo-\a iA
IE _ =F I c
DEPARTMENT OF ENTVIRON'1vrrlv-T_AL PROTECTION
0 6 o a�
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS-NIE_tiTS
SUBSURFACE SEWAGE DISPOSAL SYSTEI FORM
PART A
CERTIFICATION
Ci`7o
Property Address: lc�_ / Ire. d
Od 6®/
Owner's Narne:,C ., oh ^v)CQ �O''•C� 'Qi
Owner's Address. 2g �;� .{,
Date of Inspection:
Name of Inspector (please print)
Company Name: '
Mailing Address: O OvY /
/ '4 Od ,6 �foL
1,Telephone Nu4iber
LID Lrj -
CERTIFICATION STATEMENT
I cemfy that I have personally inspected the sewage disposal system at this address and that the mformanon renOrLed
below;is true, accurate and complete as of the time of the inspection.The inspection was performed based on m
c.;3 train dig and experience in the proper function and maintenance of on site sewage disposal systems.i am a DLP
api5roved system inspector pursuant to Secfi 5.340 of Title 5(310 CtifR 15.00_0). the syster_:
r Passes
ff{ Conditionally Passes
s Needs Further Evaluation by the Local Approvmg Author_:.-
Fails
Inspector's Signature: ��� = Date: Id- o
The system inspector shall sub 't a copy of this inspection report to the Appro��fg Author z-(Board of Health or
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10.000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of d=e
DEP. The original should be sent to the system owner and copies sent to the buyw,if applicabl . and-he ann
authority. e -oV� ,2
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.
Title 5 Inspection Form 61,512000
page l j
r
Paae 2 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SENVAGE DISPOSAL SYSTEM INSPECTIO\ FORM
PAnT A
// /J CERTIFICATION(continued)
Property Address: 2 7 �'7 e,,4 h` gcj
Owner: /Jp yC1,61 "
Date of Inspection: /oZ Is Q,6
Inspection Summary: Check A,B,C.D or E/ALWAYS complete all of Section D
A. Sys Passes:
I have not found any information which indicates that any of the failure criteria described in 310 CNI tR
15303 or in 310 CVIR 15304 exist.Any failure criteria not evaluated are indicated belor"T.
Comments:
B.'System Conditionally Passes:
wj 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,wiill pass.
Answer ves;no or not determined(Y.N,1NiD)in the for the following statements. If"not determined"rlease
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 ex-filtration or tank failure is imminent. System will pass inspection if ;
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 Cer ificate of CoTimpliance
indicating that the tank is less than 20 years old is available.
tiD explain:
Observation of sewage backup or break out or high static water level in the dis=rbuion box due to broken or
obstructed pipe(s) or due to a broken,settled or uneven distribution box. System will pass inspection if,(v-:ith
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
vD explain:
T he system required pumping more than 4 times a year due to broken or obstructed pipe'sl. ! e s -=
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
NTD explain:
Tit]- S Tnc,.ort;nn 17 r, �lt:l�nnn
Paae 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR NI
PART A
CERTIFICATION(continued)
Property Address: �� Aee,�/n �Q
2 G /
Owner: lJ p,/
Date of Inspection:
C. .Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determnle if 1h e 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 CINIR 1-4.303(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 whin a Zone 1 of a public,rater sup-Div.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water sure .lv well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or mare`rom a
private water supply well".'Method used to determine distance
"This system passes if the well water analysis;performed at a DEP certified laboraton. for colhform
bacteria and volatile organic compounds indicates that the well is free from pollution from hat faci_z and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprr.prGyi �d hat no o;aer
failure criteria are triggered.A copy of the analysis must be attached to this form
3. Other:
Page 4 of l i
OFFICIAL INSPECTION FORiVI—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORNT
PART A
CERTIFICATION(continued)
Property Address: 1 47L g7 i v7 �i
ni
Owner:./.So ie'2
Date of Inspection: /d- O
D. Svstem Failure Criteria applicable to all systems:
You must indicate "Yes"or"no"to each of the following for ail inspections:
Yes No
B ckup,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
ogged SAS or cesspool
v dStatic liquid level in the distribution box above outlet invert due to an overloaded or cloaced SAS or
f��spool
�/ Lj,quid depth in cesspool is less than 6"below invert or available volume is less than;!day-iiov
Required pumping more than 4 times in the last year NOT due to clogg obstructed
ed or obsucted pipe(s).Number
/�f times pumped
V Any portion of the SAS; cesspool or privy is below high ground water elevation.
_V--Anv portion of cesspool or privy is within 100 feet of a surface water supply or mbutary to a surface
water supply.
Any portion of a cesspool or privy is within a Zone I of a public weL.
_ y 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 f et 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
�f are triggered.A copy of the analysis must be attached to this form.]
�V (Yes/?io) The system fails.I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10_.000 gpd to IS.000
gPd-
You must indicate either"yes"or"no"to each of the following:
Xe
eria apply to large systems in addition to the criteria above)
m is within 400feet of a surface drinking water supply
m is within 200 feet of a tributary to a surface drinking water sTippiy°n is located in a nitrogen sensitive area(InterimWellheadProtectionArea--e?7PA) cratea,Leif a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant or=n__sv,-e-,..
"yes"in Section D above the large system has failed.,The owner or operator of any-lame st stem com�idered
significant threat under Section E or failed under Section_D shall upggade the system i n accordar:cp w t'r= (i`I f:;
15.304. The system owner should contact the appropriate regional office of the Department,
n
Page 5 of 11
OFFICIA.I, INSPECTION FORM—NOT FOR VOLUNT_AIRY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL, SYSTEM 1?V'SPECTION FORM
PART B
CHECKLIST
Property Address:
Q-vvner: V o✓C'2 't�
Date of Inspection:
Check if the following have been done_You must indicate"yes"or no as to each of the folowna:
Yes o
Pumping information was provided by the owner,occupant or Board of Health
V 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?
Ll Have large volumes of water been introduced to the system recently or as part of this i- pec=on
Were as built plans of the system obtained and examined?(If they were not available note as 1%A)
v 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?
t/ Were the septic tank manholes uncovered;opened,and the interior of the tank inspected for he condit on
of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
`l/— Was the facility owner(and occupants if different from owner)provided with information on the-proper
maintenance of subsurface sewage disposal systems?
Tile size and location of the Soil absorption System(SAS)on the site has beer deteriu.ed based on:
Yes . no
xisting 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 approxarior cf d;.-ance
is unacceptable) f310 C_�2 15.302(3)(b)]
c
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS--NIENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION EORAI
PART C
�( SYSTEM ENTORMATION
Property Address:
Owner:
�or e f'
Date of Inspection: 79
OW CONDITIONS
RESIDENTIAL,
Number of bedrooms(design): Number of bedrooms(actual): /�U
DESIGN flow based on 310 C� 15.20 (for example: 110 gpd x_of bearooms): T- 7"'o
Number of current residents:
Does residence have a garbage grinder(yes or no): /j/O
Is laundry on a separate sewage system yes or no):/!V �ifyes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use: (yes or no): do
Water meter readings; if avail le(last 2 years usage(gpd)):
Sump pump(yes or no):
Last date of occupancy:
dr
C0-NEti1ERCI_AL/IPNTDUS TRIAL
Type of establishment:
Design flow(based on 310.C),M 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:
r
OTHER(describe):
GENERAL n-FORMATION
Pumping Records G�/ r /
Source_of information: /fie JPt� /t/v /�r r ✓`' C- — /J
Was system pumped as part of the inspection(yes or no):
If yes;volume pumped: gallons--How was quantity pumped determined?
Reason for pumping: y
TYP F SYSTEM
Septic tank, distribution box, soil absorption system
_Single cesspool_
Overflow cesspool
Privy
—Shared system(yes or no)(if yes, attach previous inspection records;if any)
_Innovative/Alternative technology.Attach a copy oft e current operation and maintenarlc--ce _act f o
obtained from system owner)
_Tight tank —Attach a copy of the DEP approval
Other(describe):
Approximate age of all components dat installed(if known)a d source orinfo aon:
Were sewage odors detected when arriving at the site(yes or no):/VC2
T41- G Tncr cnfin. L ,
Page 7 of l I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM PNFOR.MATIO (continued)
Property Address:
Owner:iYo
Date of Inspection:
BLII.DING SENVER(locate on site plan)
Depth below grade: 40.
Materials of construction:— ast iron _t-40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments (on condition of joints,venting,evidence of leakage;etc.):
SEPTIC TANK:_(locate on site plan)
Depth below grade:
-Material of construction:_concrete_metal_fiberglass_polyethylene
_other(expla n)
If tank is metal list age:_ IIss age confirmed by a Certificate of Compliance(yes or no):_(attach a cope of
certificate)s �
Dimension
Sludge depth:. aZ 9 </
Distance from top ofs judge to bottom of outlet tee or baffle: R
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottoy of outlet tee 0 baffle:
How were dimensions determined: a e �( -4?
Comments.(on pumping recommendations;inlet and out tee or baffle condition-s*u uct rrai inter itt. liauie levels
as lated to outlet invert. evid nce of leakage'etc.):
h \ GIN //� Q Oh
GREASE TRAP:&(,ocate on site plan) J
Depth below grade:_
Material of construction:_concrete_metal_iberalass �elyeftzylene 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 nte�t.,iouid, le,-
eh-as related to outlet invert, evidence of leakage,etc.):
T;rto C tncnorr;nn �,..-.., �i�c»nnn
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS-TENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORRN-s
PART C
SYSTEM INFORMI ATION(continued)
Property Address: If eA4 .7 ��
Owner: o i�
Date of Inspection: /d2 3eJ
TIGHT or HOLDING TANK: /y (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: concrete metal_fiberglass_polyethylene o her(e plain):
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.):
DISTRIBUTION BOX: �presentmust be opened)(locate on site plan)
Depth of liquid level above outlet invert: YI ol-V-7 Gi
Comments (note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of
leaka ae.into or out of box;etc.):
�-e 1, Alec
PUMP CIELAI1'IBERA (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.):
Titlo Tncn artinn Gn+rn (/7 S/^nnn S2
Page 9 of 11
OFFICIAL. INSPECTION FORM-NOT FOR VOLUNTARY A S S E S S I-VIE N-T S
SUBSURFACE SEWAGE DISPOSAL SYSTEM I1-SPECTTO\ FORIT
PART C
SYSTEM INFORMATION(continued)
Property Address: ?,-.,A 2d
Owner: �Owner: Qv
o✓ ?
Date.of Inspection: /02 3o O
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Type / �—
leaching pits;number:_ 10 Z h
leaching chambers,number:
leaching galleries,number:
leaching trenches;number; length:
leaching field >s; 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.): �®n a -? L. / �/PG!mil Gi �► C C�r
CESSPOOLS:—&( esspool must be pumped as part of inspection)(locate on site plan)
\Turnber 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 or no):
Comments (note condition of soil, signs of hydraulic failure;level of ponding, condition of vegetarian
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 veget_- o- e c.:;:
Titles T.c.orfinn t "� �lt:!)nnn 0
Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM I\"SPECTTO-N-' EOR11
PART C
SYSTEM INFORMATION(continued)
Property Address: c?,—T li eG�j611 1�2d
Owner: do i'j{
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the se«-aae disposal system including ties to at least two permanent reference land narks or
benchmarks. Locate all -wells within 100 feet. Locate,",here public water supply enters the budding.
1
R1S2r
S s��ylr
r
0
S '
nN 0/-t Y-e
1`
x - V9
Z/7 - l�
Ll
ti-e 41,47 - ��
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOI UT' rT RY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR-VT
PART C
SYSTEM INFORMATION(continued)
Property Address: 02 ly-2a+-'��t
Owner: �e
Date of Inspection:
SITE.EXAM
Slope
Surface water
Check cellar
Shallow-wells
Estimated depth to ground water ��Sfeet
Please indicate (check) all methods used to determine the high round water elevation:
Obtain from system design plans on record-If checked,date of design plan reviewed:
en,ed site (abutting property/observation hole wit 1150 feet of SAS)
Checked with local Board of Health-explain: >Va h
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must de cr. e ho,, y u establl hed the high ground water elei�ati n:,
c
K.� ..-fir cf�
14
�o
+
T'
. tio G Tncnortinn T.'nrm !,/7 Ghnnn i
O V&OWN O BA.RNSdT�ABLE
LOCATION �� SEWAGE# 0 3
VILLAGE /`V 1) ef M^ L , ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. `i� ;.�;o A.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) F kJ (size)
f!O.OF BEDROOMS 5 f
BUILDER OR OWNER if A2
PERMIT DATE: 7!%�--e' J COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Fa/ility Feet
Private Water Supply Well and Leaching Facility (If any wells e-4 st
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
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i
e
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No. �V U 3 0 V / Fee�0 ls��(O
t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: a✓
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZIpprication for 33igpogat *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair(>KUpgrade( )Abandon( ) ❑Complete System ❑Individual Components
,.�cation Address or�Lot No.
Owner's Name,Address and Tell.No.
_ 'A"ssessor's Map/P elA/�J _r Ca i s t/, nce_ Ag a✓'o-eq
Installer's Name,Address,and Tel.No. Designer's Name,a�ddress and Tel.No.
ltz le 7-kd b l it o'n SV/jC- Iry � � � h CJ r�
P v 1941-K if igoq
Type of Building: f /
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder.('V��
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) / S f�II /d o 'i,� ; t/� s
5Zp tic. is 7077" 7!:6 C, 2 Shoo-7—
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this d o ealth.
Signed zZ Date v�
Application Approved by — Date S— —�)
Application Disapproved for the rollowing reasons
v —
4 Permit No. �u 3 �� Date Issued ��'I� U 3
• rl�. � � r r� ;elk
' � W
No. U y 3�; l!? ' Fee
Entered in computer: I
...� - THE COMMONWEALTH,OF MASSACHUSETTS 1 Yes
PUBLIC HEALTH DIVISION -TOWN OF:BARNSTABLE;.-MASSACHUSETTS
2pplfration for �Dizpo�ar *pot m' �Congtruction 3permit
i
Application for a Permit to Construct( . )Repair Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
r-ocation Add ss or Lot.No: j Owner's Name,Address and Tel.No.
Ass
yn�/
'is a /Pazcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
��A,obtn4 oil5-elfrG
Type of Building: ' /
Dwelling No.of Bedrooms "7 Lot Size sq.ft. Garbage Grinder({J
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) //1 S X4// /7 0 g) // x
F„ 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 Env conmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this d o ealth. ,.
Signed /1 .�IEqf Date
Application Approved by 4, - 0 Date S-
Application Disapproved for the following reasons
Permit No. u o 3 391 Date Issued
—————————————————— ————— —— —-———————
�6,,- n THE COMMONWEALTH OF MASSACHUSETTS �Qn
BARNSTABLE, MASSACHUSETTS
Rd (Certificate of Compliance
TI'S IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (X Upgraded( )
Abandoned( )by LL/4 . &o b/A7247 n .57eo fj�, &P"& Ic 0__
at caZ f° V -A 1 IS has been constructed in accordance'
with the provisions of Title and the for Disposal System Construction Permit No.r U 0 7—3LI —dated _G 3
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the s6lstw will functi iZ
desi ned.
Date V"�' 3 Inspector h..� 4u_ � �-
---------------------------------------
No. Fee
3a r pen THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION,- BARNSTABLE, MASSACHUSETTS
Mi5pozar *pgtem Con5truction Permit
Permission is hereby granted to Construct( )Repair(,Upgrade( )Abandon( )
System located at 01 Ll
/l/. wlMs
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this k j
Date:_ r�'— 1 —0 3 Approved by
U
TOWN OF BARNSTABLE
C
LOCATION ✓-c.� � c' 1 i " C'. G� SEWAGE # l a J `"
VILLAGE If `"" ASSESSOR'S MAP & LOT 30L D ,z
INSTALLER'S NAME&PHONE NO. A,
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) , v l I' a;. S (size)
AO.OF BEDROOMS v}
BUILDER OR OWNER L, i
PERMIT DATE: ,'%= COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Fa/ility 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 i
Furnished by
j,.
OA
Now
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63
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fit
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No.. ..........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.......................T-own.........OF........BarnS.ta l? ........................................................
Appl ration for Uhgp sal Works Tonstrartiun Vamit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
......Q26QL..............................................•---------------•--------------........---------
Location-Address or Lot No.
Borden ... ...... K�s.t a ng.did:_�._�iy�.nl��.s.► + Q26Q1, ..._...
Owner Address
a ...._......&__B_Ces . ...................................... 12$ F3isho�s--Terrace,-•I yann $•,.--MA...-02601,......
Installer Address
� Type of Building Size Lot............................S........ q. feet
Dwelling—No. of Bedrooms.......3..................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons......... ................. Showers ( ) — Cafeteria ( )
Otherfixtures ------------------------------------------------------....--------------------._...---------------•--...----------------------....-----------=-------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
~' Percolation Test Results Performed bY___________________________ -------....__..._...._. Date........................................
a ------.....
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-__________-_---.--_.__.
(i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------------------- ----------•------•------•--•-------•----•-.....-•-------------•-•--••--•---.....--•---••-•------.....-----------..........-•---------
ODescription of Soil--------....S.and.................................................................................................................................................
x
w
x --------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------•--------------•-•----
V Nature of Repairs or Alterations—Answer when applicable_Ainstall.ati-ort_.Of..e.._.6OQ...L..P ... tQne---packad
........ overflow) ---------------••--•----•--------•-•---------------------------------------------------------------------------------•--.....__.....----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance I.. e =issuedy the b d f health.-
Signed........................ . --.._........---......... ....`...=-----------' --11APA1-------•--
Application Approved By___. Dat
/ � .. ,� 11�10�8..
Date
Application Disapproved for the following reasons-------=--------•---------------------------------------------------------------------------------------------•-
---------------------•-----------------------------------•--•------------•-•••--------.......------.........-----------...------.---------------------------------------------------------•-----------•-
Date
Permit No.81.-------------------------•-••-•••-------•-•--•.. Issued-...... 11 ---
1O181 .
--- ----------------------------
Date
..t
No..f31- '. .. FEz$....S M.._........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...................---.Town.........OF........ ........................................................
ApplirFatiou for Disposal Morks Toaastrortiou rrmi#
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
.......In #----_...Ketaa.t. F1,yen1L1js+--.FA.....02602.................................................................................................
Location-Address or Lot No.
-.......................................................................... ....o2!�oi... - --..............
Owner Address
a A_Vic•E Cesspool_Service...................................... 128-.Ejrho s-TPrraceA il►annis-,--'"A 02h01
.. . ...
Installer Address
Type of Building . Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms....... _..................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of ersons._..__..:_________________ Showers
a YP g ----•---•---------•--------- P ( )--- Cafeteria ( )
Otherfixtures -------------------------•----...-----...-•-•---------------•-------------------•--•--•----•---•---•....•••-••••••. ..._..
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
0:` Septic Tank—Liquid capacity............gallons Length................ 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........................................
W
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........................
•---••--•---••--••••••••--•...•••-•-••--•..._.._....-•••••-•••-......••••••-••....................•..........................................................
0 Description of Sol...............Sand..........................................................................................................................................................
U •-•--•-••••••-•-•-•----••-••-••-••••-•--•-•--•-••---•••-•-•••••----••-••••-----••-•••---•._...----•-••-••--••••--•-••---••-•--•-•••••••••--••--•--••••-••_--
W
-•-•- ------------------------------------------------------------------------------------------------------------------t------------------------------------------------------------------•--•-•-••--
V Nature of Repairs or Alterations—Answer when applicable.__lnstal!ation--of a 600 L.P. stone packed
•- --
.......................over ° �'-•-••••••...--•....•-••••-•-••••••--••-••-•••••••-•--•...............•••••••••••-•------•-----•••-••-•-••-••-•--•- ---•••••-•-•-•••••••--••-••••••••-•••----.....-•••--Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of ,T:'LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance i�L ped by the b d, f health.-
Signe ............................ C-_.....•••-•-••. �'`",'-�` = 11/10/81
••.::.�-� 11 1D�tyy81
Date
Application Approved BY --------••-• ••........................APplication Disapproved for the-following reasons-------------------------------------------------------------------------------------------••---•--•---..._...__
._:......-•--•--------------------•-•----....-----....---------------.........--------........-----------•••-•-••---•••-••-••••----••---•---•---•---•-•-•••-•---•••••-••-••••---•---•••••••••--••-------
PermitNo......................................................... Issued.......................................................
Date
i
d , �
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............�.°�.................OF...............Barnstable............-...............-..............
Trtifiratr of TompliFanu
AHJSJ. TOpCE fY That t�j; ivifluoals a&e )ispoWl Seem co str ( ) or Repaired (X )
ess oo erlt'ice •sn--•-•p `e ce, , L s, l� � ?
by ---- ----
Keating Rd., Hyannis, FA 02601 — EorWer
at---------------------------------------------------•---------------------------___---------------------------------------------
has been installed in accordance with the provisions of �l_LL; C of The State Sanitaryllo .0a`described in the
application for Disposal Works Construction Permit No...-_:._.___�D__ ___________________ dated .....------ ._--.....-._-_-.._._.____-_:
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
11/10/81 -' j
DATE...................•---..._.._......................._..._...._•-•-••----•_----- Inspector........-- �.: L�_ !_..._....................'.........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
81- , ..................Town OF............Barnstable
N ..... FEE----•-----`•••-:5..00
Disposal Works %Toaas#ra ion umi#
Permission is hereby granted........ $ CeSSD001 Service. Bishops
to Construct ( ) or Repair X ) an Individual Sewage Disposal System
pp ( ..._..
Keatin Rd. annis MA 02601 Borden
at No..... .._..Y.._.........t........................•.....................................................••-••-••••••••--•.........................................................
Street
as shown on the application for Disposal Works Construction ,it No 8 ........ Dated.._.__11/1 / 1
tI'+ `-,/- 7 •------ ----•---
l1/10/81 Boar Health
DATE. ---- ..............--------
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
ALL. SHALL
TE
SYSTEM PROFILE MARK DS WITHC MAGNETIC TTAPE OR BE NOTES
NOT TO SCALE) Rd
PROVIDE MIN. 20" DIAM. WATERTIGHT � COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS NAVD 88 ' ���e
FIRST FLOOR EL. 36.3' ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE Goo`
2" PEASTONE OR GEOTEXTILE 2. MUNICIPAL WATER IS EXISTING
FILTER FABRIC OVER STONE
2% SLOPE REQUIRED OVER SYSTEM 37.0 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST
MIN. 2" WALL THICKNESS 4. DESIGN LOADING FOR ALL PROPOSED PRECAST
PRECAST H-10 BLOCKS OR "UNITS TO BE AASHO H-10
RISERS (TYP.) PRECAST RISERS
20 37.0' 4"bSCH40 PVC MORTAR ALL H-10
PIPES LEVEL 1ST 2' �ENDS
4, COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. To ey
(TYP') !S EL. 33.38' SIDES jj
Locus
1 C" EXISTING 000vee 34.21 ' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE
TEE SEPTIC TANK*JTEE
TO
° ° WITH 310 CMR 15.000 (TITLE 5.) d35.6f'* o -- o°o°o°o° Croigville Beach R° ®�®®®®®®®® ° ®®����®®®®® '°°°°°°° 7 THIS PLAN IS FOR PROPOSED WORK ONLY AND00000 ° °° ° ° ° ° °0000,000000o o ° ° ° °GAS BAFFLE:: o °g^ N °goo o ° ®Do®®�Do ®®oOOo NOT TO BE USED FOR LOT LINE STAKING OR ANY33.67' 33.5' 00
31 .38' OTHER PURPOSE.>°°°°° O7°0°7 O O O O
L i I T 7.7
6" MIN. SUMP 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
LH-10
12" MIN. INT. DIM. 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL.
3/4"-1-1/2" DOUBLE WASHED STONE (2) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30' X 9.83' CONCEALED WITHOUT INSPECTION BY BOARD OF Nantucket ros
COMPACTION. (15.221 [2]) to HEALTH AND PERMISSION OBTAINED FROM BOARD
ti q OF HEALTH. Sound
to
( 9 % SLOPE) ( 1 % SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR
CALLING DIGSAFE (1-888-344-7233) AND ^� /� /� p
FOUNDATION EXIST. SEPTIC TANK 20' LEACHING D' BOX 14' VERIFYING THE LOCATION OF ALL UNDERGROUND & y
FACILITY 26.33' BOTTOM TH-2 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF LOS 'V'ASCALE 1"=2000'±
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT
NO GROUNDWATER FOUND WORK.
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP � PARCEL
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE BE REMOVED BENEATH AND 5' AROUND THE
CONDITIONS IF NOT SUITABLE PROPOSED LEACHING FACILITY. -7 0
12. EXISTING LEACHING FACILITY SHALL BE PUMPED
AND REMOVED OR PUMPED AND FILLED WITH CLEAN
LEGEND
99- EXISTING CONTOUR SAND.
\ VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY
BE IMMEDIATELY GRANTED BY THE BOARD OF
X 99.1 EXIST. SPOT ELEV. o \ HEALTH AGENT OR BY HEALTH INSPECTOR
-[99]- PROPOSED CONTOUR ENCHMARK PAPERWORK AND HEARING REDUCTION PROPOSALS
MAG APPROVED BY THE BOARD OF HEALTH REVISED
DURING A PUBLIC HEARING HELD ON DEC. 10, 2013
198.41 PROPOSED SPOT EL. EL. = 36.7' \ SYSTEM DESIGN.
TH1 p 1) ALL SYSTEMS THAT HAVE NO INCREASE IN
TEST HOLE �j FLOW - SEPTIC SYSTEM COMPONENT TO
FOUNDATION SETBACK (NO MORE THAN 50% GARBAGE DISPOSER IS NOT ALLOWED
SLOPE OF GROUND ' REDUCTION IN REQUIRED SEPARATION DISTANCE) DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD
UTILITY POLE 10o.o USE A 330 GPD DESIGN FLOW
LL
FIRE HYDRANT
° O SEPTIC TANK: 330 GPD (2) = 660
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING y
**RE-USE EXISTING 1,00 GAL. SEPTIC TANK
RIVE � � ., < �^
LEACHING:
TEST HOLE LOGS ' x SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD
ABUT HOUSE BOTTOM 30 x 9.83 (.74) = 218 GPD
ENGINEER: DANIEL E. GONSALVES, SE #13587 0
TOTAL: 454 S.F. 336 GPD
WITNESS: DON DESMARAIS, RS o x
8/11/20 1 EXISTING DWELLING o USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
DATE: FFLR EL = 38.1' �< 2 MIN/INCH � >
PERC. RATE _ 1 o X WITH 2.5 STONE AT SIDES, 4 AT ENDS AND 5
1 BETWEEN UNITS
CLASS I SOILS P# 20-154 00 LOT #14 \�
ELEV. ELEV. PORCH 10,000± S.F.
1„ 37' 37'2 (SLAB) _1 x
4
A A TH2
LS LS C�j x C, MA
10YR 5/2 10YR 5/2 H1 ,,,--';,,-�`' I� APPROVED DATE BOARD OF HEALTH
_ TITLE 5 SITE PLAN
B B SHED 0 \
LS LS OF
� -'' o - � ( � �N OFMgss�.' ann,t„�,
c �v\OF
10YR 7/6 10YR 7/6 �6 DANIELAa
�� y` � �DANIELs 88 ISALENE STREET
26 4.83 28" 34.67 100.00 �s
O � tip:°�
CIVIL - o A. a
�No 4�502� �� oJALA � HYANNIS, MA
No.40980
PREPARED FOR
FS��OPJAt Q)\ a�
C C �,
PERC ` �Yp SURVEY ;
°F- OF� `SS�0ORTOLOTTI
S
-BERKOWITZ
," ti
MS PI s cy� ,o/ E ^al��L
DAIS
n! I .1- DATE: AUG. 12, 2020
io OJALA u i �, ,,LA ��
1OYR 6/4 10YR 6/4 CIvS�5o2 J`, ���N 0
�, 6 �� off 508-362-4541
fax 508-362-9880
?! to � � downcope.com
down cape engideering, inc.
126 26'.5' 128 26.33' � �r civil engineers
Scale: 1"= 20' �-<'�I ' � "�a �--_-, •� � •�.._.-,�� __><.�.. land surveyors
NO GROUNDWATER ENCOUNTERED
939 Main Street ( Rte 6A)
0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
BI CE #20- > 89 20-189 BORTOLOTTI-BERKOWITZ.DWG
i
I
BENCHMARK 20 FT. MINIMUM FROM CELLAR SOIL TEST
TOP OF FOUNDATION
100 00 10 FT. MINIMUM 0 FT, MINIMUM FROM SLAB OR CRAWL SPACE DATE SOIL TES" ��Q3___.
ELEV. _ � 24" HEAVY DUTY �-- CLEAN SAND SOIL TEST DONE BY A�{ R=�Sti Z.P. _
(ASSUMED) C.I. MANHOLE F do C OBSERVATION PIPE WITNESSED BY
LOAM AND SEED
4" SCHEDULE 40 PVC PIPE OBSERVATION HOLE 1 ELEV.=_Ag•7_
I � SET TO GRAD � _ �
\ MIN. PITCH 1/8" PER FT. 4" PVC PIPE PERCOLATION RATE <_ 2 _ MIN./INCH AT __ 42-'.�4 j
2" LAYER OF PAINTED FLAT DARK INCHES
�- 1/8" TO 1/2" GREEN OR BROWN LEGEND: !I TEXTURE COLOR MOTT. OTHER
WASHED STONE WITH CARBON FILTER
I 102 MAX. I EXISTING SPOT ELEVATION OOXO
i 25' 4" CAST IRON PIPE H2O 99.0 MIN. IS REQUIRED _ I
(OR EQUAL) MINIMUM H2O __ EXISTING CONTOUR -----00--- j
PITCH 1/4" PER FT. FINAL SPOT ELEVATION
5.5' 0-9' ' A LOAMY SANG 10 "3 1 NO
ZABEL FILTE --� ! H2O 1 ! MAX t SOIL TEST OCATION
-
FLOW LINE 96.5
I UTILITY POLE -O-
PLUMBING ELEV. - 97.75_ 10" TOWN WATER -W w
_TMIN 0 0 0 o CATCH BASIN F9-24' LOAMY SANG 10YR5 8 N
TO BE RAISED LEV. _ __96.50_ diff.5-121,
AND RE-PIPED BY _ ! - 7' EL V. _ _95_5GAS uNE
ELEV. - 96�7s5_ GAS ELEV. - 96_33 - SUMP �-ELEV. _ _4��16_ CLEAN OUT C
LICENSED PLUMBER BAFFLE - CESSPOOL C.P. 0
AS NEEDED H2O DISTRIBUTION ELEV. = H 2OMEDK)M TO
6 STANDARD INFILTRATORS WITH
LIQUID OUTLET �"� \ BOX -�'Df-I DEPTH TEE STONE IN AN Z 4 1 C COARSE SANG 10YR6/8 NO
4 FEET 14 INCHES I (TO BE PLACED ON FIRM BASE TO BE WATER TESTED - 5
5 FEET 19 INCHES 1500 GALLON IF MORE THAN ONE OUTLET 11' x 49' x 7 TRENCH FORMATION
6 FEET 24 INCHES '� WELL MIW 29
7 EE 34 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION ZONE A WATER ENCOUNTERED AT _ 1d5_ ELEV. _ __$Q,2_
s FEETI 3/4~ TO , 1/2" CLEAN SYSTEM (SAS) INDEX 76
DOUBLE WASHED STONE ADJUST 1.3
FREE OF FINES SILT DESIGN CALCULATIONS
NUMBER OF BEDROOMS _ 4
JSGS PROBABLE WATER TABLE ELEV. _ _90 5__ GARBAGE DISPOSAL UNIT NO_ NOT ALLOWED
SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV - _88.2_ TOTAL ESTIMATED FLOW -
NOT TO SCALE BOTTOM OF TEST HOLE ELEV, = _58z7_- ( 110 GAL/81R./DAY X _4 BR.) _44Q_ GAL./DAY
REQUIRED SEPTIC TANK CAPACITY _1,40- GAL.
ACTUAL SIZE OF SEPTIC TANK _.1500 GAL.
SOIL CLASSIFICATION
TIT, E 5 & B.O.H. VARIANCES REQUIRED: DESIGN PERCOLATION RATE �_,t`_ MIN./IN.
SECTI N 15.221 MAXIMUM DISTANCES: EFFLUENT LOADING RATE _QJA_ GAL./DAY/S.F.
ALLOWS ONLY 3' OF COVER OVER S.A.S COMPONENTS LEACHING AREA _ate_ SQ. FT.
' A 2.5' VARIANCE REQUESTED (11'x49')+(120'x7/12')
LEACHING CAPACITY (AREA X RATE) _59_ GAL./DAY
609 X 0.74
RESERVE LEACHING CAPACITY _tV&- GAL./DAY
I
95,6 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.
S71 FENCE 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO j
WITHIN 6" OF FINISHED GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
ST = WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
6 - 4g'- 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADINC SHALL BE
USED UNDER OR WITHIN 10 Y r. Of DRIVES OR PARKING AREAS.
BASIN
CATCH�-- 342 �r'� p 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL
98.2 " ""'? -w- BE MORTARED IN PLACE.
4"VENT 5. v0 DETER14INAT11ON HAS SEEN MADE AS TO COMPLIANCE WITH
`---- ---1 DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO
10&0 OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
6 UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR
g D.B IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS
98.3 �� 1 �SrA/RS PRIOR TO COMMENCING WORK ON SITE.
BIT-DRIVE 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
5 " SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION
O LOT 13 & 14 0, IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
98.4 AREA 14,566 f S.F IMMEDIATELY.
Qz
SEPTIC 8. PARCEL IS IN FLOOD ZONE
Z TANK .S 9. LOT IS SHOWN ON ASSESSORS MAP _ 306 AS PARCEL -_23
10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND
FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM,
" f AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15,255: (3)
j .�of / (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT.4ry, 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND
O W OR REMOVED
Q �" 90.6 �l
W 99.3 Q �,HoRT \ f
r,y,L APPROVED: BOARD OF HEALTH }
*a No- 274$� i
98.6
10 FG/,-. a3 I 2470 DATE AGENT
EXISTING IN 'DWELLING PROPOSED SEPTIC DESIGN
`s�� S
FOR
gs.e
CONSTANCE BORDEN
--- 99.4 ,� N ---
99.8 / W �UAI L°C 24 KEATING ROAD
TO.F.
99.0 100.0' 99.2 x 99.0 _ �o� BARNSTABLE, MASS
BENCHMARK _
`A 99.8 99.5 11.34 Get
S�1pLfY { C IG D SHORT, I . 0
43,
235 GREAT WESTERN ROAD
99.2 97.9 w�'I 97.9 508- P. 0. BOX 1044
97.® Locus ( 398-8311 SOUTH DENNIS, MASS. 02660
Kl_A;7V6 RD DATE SCALE " ' -�
96.6 READ , � AUG. 5, 2003 I �' = 20
KEA TING o�A�A,_- _ @
NANTUCKEr� J REV. ; LOB NO. 1 -975
SOUND
LOCATION MAP I REV. SHEET 1 OF 1
01-0975 Borden SP.dwg ®2003 CRAIG R. SHORT, P.E.