Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0020 NEWSPAPER ROAD - Health
20 Newspaper Road, Hyannis A= I 1 ITI TOWN OF BARNSTABLE LOCATION-`Z®°= EWSPA L°- SEWAGE#.. ZOZO ^ 3 11 VILLAGE ASSESSOR'S MAP&PARCEL L53 -- l2-Z INSTALLER'S NAME&PHONE NO. F,65m'r 8.Ou.e-Co. CSoB)Q-r - T3811 SEPTIC TANK CAPACITY (000 LEACHING FACILITY:(type) 500 a°1'1-C40kmSMS (size) ZS*/ (Z .83 NO.OF BEDROOMS I OWNER V -d l C t-► �, �G- PERMIT DATE: 10 It I ZD COMPLIANCE DATE: k O 1 (o ZO 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 I�Q6Ee7( n(00-4 `0 , d Js- � o W c °D N c P � N No. L%"�/o r I Fee 4 40 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS RppYitation for Misposal Opstem Construction Permit Application for a Permit to Construct( ) Repair(�4 Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7.G Qc 4A Owner's Name,Address,and Tel.No. Assessor's Map/Parcel a `Z "Z 5�� t 2�e - ��S(,Lt kaS Installer's Name,Address,and Tel.No. �c� -cE� 'l'i Designer's Name,Address,and Tel.No. Type of Building: I j Dwelling No.of Bedrooms Lot Size t -7o`( sq.ft. Garbage Grinder{ ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) d gpd Design flow provided g gpd Plan Date A�-�- �2`=2 Number of sheets l Revision Date 1e V1-3 o ^ZC I,- j Title -� l�-e,w S ;2 p� Size of Septic Tank I e Ct 0 Exs ii tcl Type of S.A.S.�Z� 1 w�% �d� Cjs. Description of Soil G Nature of Repairs or Alterations(Answer when applicable) e,-3 -`3 k (�2_ 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. S� e Date ( Z Application Approved by Date i!O 49 Application Disapprove Date for the following reasons Permit No. go Zfo / Date Issued �� � 3Vo. $ Fee �� THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: 00, Yes PUBLIC HEALTH DIVISION:- TOWN OF BARNSTABLE, MASSACHUSETTS { 4plicatibn for MispoBal 6pstetl�Yl� onBtrLUtlon Permit Application for a Permit to Construct( ) Repair( (f Upgrade( ) Abandon( )1 ❑Complete System ❑Individual Components Location Address or Lot No. Z O Res Q� A A Owner's Name,Address,and Tel:No. , Assessor's Map/Parcel 2 j '�. 2« �,C (2. Installer's Name,Address,and Tel.No. yt'� c4-1 1"7 Designer's-Name,Address;and Tel.No. d t r '�o�t"', �.����.�.�,�,vrsc.• a�3 tom.�'z} +Par�1 ��ti� t!,,.n_,.�, Cht�..,. Type of Building: r Dwelling No.of Bedrooms ^+",_ Lot -7oq Size A 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 ?"O O Number of sheets ( Revision Date -3 o —to -o Title 't Size of Septic Tank 10001 \Exs Type of S.A.S.L.% Description of Soil Nature of Repairs or Alterations(Answer when applicable) `j0 Date last inspected: fi=&� 6 Z 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 andfnot to place the system in operation until a Certificate of Compliance has been issued by this Boardof Health. � ! Signeitf ,�+ :" �.. / Date f " �,• :` ..� b": 10, Application Approved by Date fri/s /r ,,_ a,-F Application Disapproved b' Date for the following reasons j Permit No. 70 .- ' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS j Certificate of Compliance ; -THIS IS TOO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(k) Upgraded( ) Abandoned( )by at o f'A has been constructed in accordance r B with the provisions of Title 5 and the for Disposal System Construction Permit No.�,_y ,►�/� dated /oir Installer r{ p(r p:(t 1` b O X L-)• � Designer #bedrooms $ Approved design flow 7_70 and t The issuance of this permit shall not be construed as a guarantee that the system wi41`functionaa's,nesigned.Date , ,f/vr Inspector l�r ..,t _ - - - - _- . No. Fee pr THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION=BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction 3permit Permission is hereby granted to Construct( ' ) Repair O Upgrade( ) tAbandon! ( ) .. " System located at C> A.) em S d2 lly-0_42 1 f n,r. .1 C __1 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 6 N I t b71) Approved by - __ ^' Town of Barnstable �T"E'O�ti Inspectional Services Public Health Division Msa Thomas McKean Director1639. ' = 200 Main Street,Hyannis,MA 02601 , Officer 508-862-4644 Fax: 568-790-6304 Installer& Designer Certification Form it l2_2 Date: l� (0 �d Sewage Permit# ZOZO- 3 Assessor's Map\Pareel 53 Designer: Down Installer: IZ0 g U Ur Address: q3C COW, (OA Address: 3�3 w R tTeS A �0Mb ih Poyi MA- 02tR5 S iA•Kn_oc93A C-)2ce( pp � � On i0 1 to l 'C 0,,e Co. was issued a permit to install a (date) (installer) septic system at 2-C) Nti VG Gl`LPL P—OG(Cf, based on a design drawn by (tr dre s) {� A, 0' a. b_. dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. V I certifythat the septic system referenced above was installed with major changes (i.e. p Y 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. Fe v i S e d plan c0fat h¢d , I certify that the system referenced above was constructe 4c-sQitx�p ce with the to rms of the 11A approval letters(if applicable) 3 �` �� DANNIELA: OvkLA N�.46502 taller's Signatu sg� N L o/ (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE L6 OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Woa\depts\HEALTH\SE,WER connecdSEPTICOesigner Certification Form Rev W-11DOC 4 *, �<<c;�►e� =l'� ' -� Abl�>�l `try 010 ems.} �r� L [ .� IIA 9 0 O - � � , - � c mom* "• � � 1ay20fi509:17p �/� D.1 \ t Commonwealth of Massachusetts � / Title 5 Official Inspection Form ��� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information is Cert rie GLh n 5 MA 02632 5-20-15 required for every page_ CkfNown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information ` ���ZH unrrrruir o on the computer, use only the tab 1, Inspector: key to move your _�: JAMES u' cursor-do not = James D.Sears =o. use the return -- •-��� key_ Name of Inspector Capewide Enterprises,LLC �'i;:°FQT,F��°•'o�, Company Name 153 Commercial Street su INS P �,,§N Company Address Mashpee MA 02649 Cityrrown State Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification 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 Evaluadon by the Local Approving Authority d-' 5-20-15 spectors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection_ if the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and,the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at:that time.This inspection does not address how the system will perform in the future under . the same or different conditions of use. t9ns•3/13 Title 5Oftldal tnspedion Fenn:Subsurface Sewage Disposal System•Page t of 17 ,May 20'15 09:17p p.2 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments _20 Newspaper Road Properly Address Rita Thorton Owner Owner's Name information required for every Centerville MA 02632 5-20-15 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: ® l 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: The system is a 1000 Gal Tank D Box and Pit. 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 ❑ M . ❑ ND(Explain below): • 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pape 2 of 17 May 20'15 09:18p p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name Information is required for every Centervilie MR 02632 5-20-15 page. CitytTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumpstalarms are repaired. 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 saft marsh t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal Syslem•Page 3 of 17 May 20'1509:18p p.4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2D Newspaper Road Property Address Rita Thorton Owner Owners Name information required for every Centerville MA 02632 5-20-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 loan overloaded or clogged SAS or cesspool Liquid depth in essapeisl is less than 6" below invert or available volume is less than day flow P/7' 15ins•3/13 Tile 8 OFidal Inspection Form:Subsur'ace Sewage Disposal System Page 4 or 17 May 20'15 09:18p p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form '' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information is required for every Centerville MA 02632 5-20-15 page, Cityrrown State Zip Code Date of Inspection B. Certification (cont.) . Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of amrnonla nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be, necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection_ Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or"answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Ofridal Inspection Form:Subsurface Sewage l)Isposal System•Page 5 417 y May 20'15 09:19p p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information required for every Centerville MA 02632 5-20-15 page. Citylrown State Zip Code Dale of Inspection C. Checklist Check if the following have been done. You must indicate ayes"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? f ❑ ® 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 NIA) ❑ 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? ❑ 0 Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)J D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x.#of bedrooms): 330 t5ins-3113 Title 5 Official Inspection Forth:Suhswfece Sewage Disposal System•Page 6 of 17 May 20'15 09:19p p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner owner's Name information is required for every Cef-rtterville AAA 02632 5-20-15 page. Citylfown State Zip Code, Date of Inspection D. System Information Description: The system is a 1000 Gal.Tank D Box and pit. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes 0 No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? . ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): NA Detail: Sump pump? ❑ Yes JZ No. Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/personslsq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ihs•3113 - Me 5 Of ial Itspeclion Foam:Subsurface Sewage Disposal System-Page 7 of 17 May 20'15 09:19p p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thcrton Owner Owners Name information required for every Centerville MA' 02632 3-20-15 page, Cityrrawn State Zip Code Date of Inspection D. System Information (cunt.) Last date of occupancy/use' Date Other(describe below):, Genera! Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping. ` Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy [] Shared system(yes or no) (if yes, attach previous inspection records, if any) . ❑ Innovative/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 Q . Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): 15ins-3/13 Tlde 5 Offcial Inspection form:Subsurface Sewage Disposal System-Page 8 ar 17 .May 20'15 09:20p p.9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information required for every Centerville MA 02632 5-20-15 page. City[Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: 198B Permit#87-646 5 -2015 New D Box Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain) Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage,etc.): Pipeing is 4" PVC SCH 40. Septic Tank(locate on site plan): Depth below grade: 13 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: 1600 Gal. Precast H-10 21' Sludge depth: t51ns•3113 - -. Tills 5 Orridel Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 May 20 15 09:20p p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information Centerville MA 02632 5-20-15 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle NA Scum thickness 1 r, Distance from top of scum to'top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA How were dimensions determined? Asbuilt-Tape Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Tank at working level. Tank and cover's at 13" below grade. Inlet tee, outlet baffle. Out let cover under deck step. No sign of leakage or over loading. 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 151ns'•3l13 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System-page 10 of 17 May 20'15 09:20p p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton ' Owner Owner's Name information is Centervide A MA 02632 5-20-15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): • S Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: i 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 t5irrs•Y13 Tille 5 Official Inspection Form.Subaurface Sewage Disposal System-Page 11 of 17 ; May 20'15 09:21 p p.12 Commonwealth of Massachusetts WI' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information is required for every Certtervili!e MA 02632 5-20-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): D Box under deck wi'trap door opening. D Box is new 5-2015 Box is 16"x16rt-25" below grade wlcover at 6". One line out. 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.): " If pumps or alarms are not in working order,system is a conditional pass, Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3n3 • Title 6 Official Inspectlon Forth:Subsiefaee Sewege Disposal SyMsm-Pege 12 of 17 May 20'15 09:21 p p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owners Name information is required for every Centervf1le AAA 02632 5-2045 page. Cityfrown Stale Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ 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.): Leaching is a 1000 Gal.Precast Pit. Pit at 3' below grade w/cover at 18". 30"water in pit. No sign of over loading or solid carry over. No high stain line 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 15ins•3113 Title 5 Olfiaal fn speeban Forts;Subsuface Seweae Disposal System.Page 13 of 17 lay 20 15 09:30p p.1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton ' Owner Owner's Name information is required for every Centerville MA 02632 5-20-15 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovativelalternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is a 1000 Gal.Precast Pit. Pit at 3' below grade wlcover at 18". 30"water in pit. No sign of over loading or solid carryover. No high stain line Cesspools (cesspool must be pumped as part of inspection)(locate on site plan)- Number and configuration Depth—top of liquid to inlet invert s Depth of solids layer Depth of scum layer ' Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3l13 Title 5 Official Inspection Fwm;Subsu Lace Sewage Disposal System-Page 13 0117 May 20 15 09:30p p.2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name Information is required for every Centerville MA 02632 5-20-1 5 page_ Cityffown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 May 2015 09:31 p p.3 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name Information's required for every Certteryille MA 02632 5-20-15 page. Gtyfrown State' Zip Code Date of Inspection D. System Information (corn.) 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 F -:3 = , t t5ins•3M3 Ti1Fe 6 Official Wpadion Fww.Subox%c a Sewage Oispow system-Page 15 of SF May 2015 09:31 p p.4 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owners Name information is required for every CenterWile MA 02632 5-20-15 page. CityrTown State Zip Code Date of Inspection D. System Information.(coat.) Site Exam: ❑ 'Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20'+ 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 propertylobservation 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: Area and abutting roe dro 's off some 20'+. Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15ins•3113 title 5 Official Inspection Form:subsurfeoa sewage Disposal system-Page 16 of 17 May 2015 09:31 p p.5 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Newspaper Road Property Address Rita Thorton Owner Owner's Name information required for every Centerville MA 02632 5-20-15 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D,or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file isins-3113 Tdle 5 Official Inspecdon Form Subsurface Sewage Disposal Syslem-Page 17 of 17 No. ®1 5 —///A Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 10101 Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Disposal *pstem Construrtion Permit Application for a Permit to Construct( ) Repair(�) Upgrade( ) Abandon( ) ❑Complete System 061ndividual Components Location Address or Lot No. ;.0 NCcv—SBA-pe?L 'RD Owner's Name,Address,and Tel.No. p 3 ola oo ��TN6,x D Assessor's Ma /Parcel c2` Installer's Name,Address,and Tel.No. signer's Name,Address,and Tel.No. QAPEc,�cvE ���Sc3 u-c. 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 Nature of Repairs or Alterations(Answer when applicable) RGP44< D`13DX/ 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 Hea Si Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ON `r Date Issued y • ty, 3. a. No. 5 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes d 40lication for Misposal .pstem (Construction Permit Application for a Permit to Construct( ) Repair('k Upgrade(j) Abandon( ) ElComplete System Individual Components Location Address or Lot No. AD Owner's Name,Address,and Tel.No. Assessor's Ma /Parcel P_rcA -Tb�O�f�V r p 3 o E r L4_8_ Installer's Name,Address,'and Tel.No. �jpg..t f -�.gS•�+ \ signer's Name,Address,and Tel.No. Ec,v CAPcvE GPTetP4jses r - 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 Nature of Repairs or Alterations(Answer when applicable) Q G h-(10(<_C_ 1)—Bp>!� 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. Sig Date 5-(g-.ZOI. Application Approved by Date Application Disapproved by Date for the following reasons Permit No. C_ / �" Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS x l�u VtrP� BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned.( )by �,A ew t D e at a&cX FAP." P') < V[c.c_cs has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No--'-k,/J/ dated Installer Q)-M/0 jR lg j5 LA,( C. Designer iv LA #bedrooms A Approved design flow gpd The issuance of this �rmit hall not be construed as a guarantee that the system will func ion as geed. Q Date �f�(r Inspector U --------------------------------------------------------------------------------------------------------------------------------------- No. ��i 15 /� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction 1ermit Permission is hereby granted to Construct( ) Repair()``Y) Upgrade( ) Abandon( ) System located at RO N f-:4US MP_ZA 1� 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 co pleted within three years of the date of this pe Date '! t Approved by II,. _ 125.00a rya N ca CO Go LOT A n LOT B � N 18,074 s.f. 6.0 f ( 0.43 ac.) / S.8' EC90 .0 •r 6 N 4O EXISTING ' s.o. DWELLING / M g / t 5� LOT C z . uilf N� 85.00 ' TY,sp,PER RO.Ah . JOB # 00-035 _ CERTIFIED PL 0 T PLAN (SHOWING PROPOSED ADDITION) LOCATION 20 NEWSPAPER ROAD PREPARED FOR: BARNSTABLE, (CENTERVILLE) MASS. SCALE 30' DATE : MAY '5, 2000 RITA THORNTON REFERENCE PLAN BOOK 231 PC 17 ASSESS. MAP 253 PCL" t2-2 'I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE ���N OF MRS� GROUND AS SHOWN HEREON. ` o�� ARNE oft 508-362-4541 c OJALA fax 508-362-9880 " y 4 Na 28Mc� down cape engineering, Inc. CrVrL ENGMEERS $ S LAND SURVEYORS 939 main it yarmouth, ma 02675 DATE REG. LAND EYOR COMMONWEALTH OF MASSACHUSETTS vi EXECUTIVE OFFICE OF ENVIRONMENTAL AF RMEI EP �® DE AR__TE�'MENT OF ENVIRONMENTALR STREET, o >2sPROTE N MAY 9 1997ONE , d TOWN OF HEALTH BARNS ABLE WILLI"F.WELD TR Governor ` tart' ARGEO PAUL CELLUCCI Z STRUHS Lt. Governor Commissioner t , i SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART A,- CERTIFICATION Property Address:& A;Z,—,SA , _ �Kam, Address of Owner: a:.� ;'-e�•mo o c,.��:5 c Date of Inspection: p /��( Z/ (If different) —Vo �� X Name of Inspector: _,. �,o J� _ Company Name, Address and Telephone Number: " G` 'RTLA.sT1c. E.tJv�ec�+.�.v,+��:ham.t�t•O�ox oZ�r$y� 't"�. S�ntx�t Mrs. oZ�yq GS�`C+� "117—1yZa 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 inspection. The inspection was performed.based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: . Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority, F 'Is Inspector's Signature: CL . I ..,. Date: Z� �I The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection_ If the system is a shared system or has•a design flow of 10,000 gpd.or greater, the inspector and the system owner shall submit . the report to the appropriate regional office of the Department of Environmental Protection. The original should be.sent to the system owner and copies sent to the buyer, if applicable,.and the approving authority. INSPECTION SUMMARY: w lr Check A, B, C, or'D: "t , A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. _ B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired., The system, upon completion of the replacement or repair, passes inspection. , Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic'tank as .. approved by the Board of Health. (revised 1-1/03/95) 1 i�! Printed on Recycled Paper � r E� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address? •Ldys �/�P� �o( / �4 K"� 4 - Owner: a ,`Date of Inspection.0�J B].SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distributi box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system wi pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is remover' distribution box is levelled or replaced _ The system required pumping more than four times a year due to br en 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 C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board o Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETE NES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAF • 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil'absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and 'soil absorption system and is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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• 3) OTHER f f (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:—.?0 /pJee4s). Vc� ,p /EW_ �/ �C�> Owner: _ �/ ) . O rC " !�!C'J c.�.a4 L Date of Inspection: � u , D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as d ined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to de rmine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface w ters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to a overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available v ume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or priv is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 'f a public well. Any portion of a cesspool or privy is within 50 fee'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. If the well/has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. F` E] LARGE SYSTEM FAILS: The following criteria apply to large system in addition to the criteria above: The system serves a facility with a desi flow of 10,000 gpd or greater(Large System) and the system is a significant threat to Y Y g public health and safety and the envir nment because one or more of the following conditions exist: the system is within 400 eet of a surface drinking water supply the system is within 0 feet of a tributary to a surface drinking water supply • _ the system is loca in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a public water su ly well) The owner or operator of any ch system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5. 0 and 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 r ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: �0ci>S�ct , C _ AG,ck K c�`, Owner: �Ge�. 7fa 2 o = ,�-,.�c_ l Date of Inspection: ?�. Check if the following have been done: X_Pumping information was requested of the owner, occupant, and Board of Health. I None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. .tPAs built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper ma'ntenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property A7ddess: �0 ct,5 c� /V. Ce w44-zL'Owner:Date -- of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: allons Number of bedrooms: 03 Number of current residents: O Garbage grinder(yes or no):� Laundry connected to-system (yes or no):ti RA Seasonal use (yes or no):-Vb t Water meter readings, if available:_tJl i r Last date of occupancy: COMMERCIAL/I ND USTRIAL: Type of establishment: Design flow:_gallons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS andn mation: su Sc—U14, S A System pumped as part of inspection: (yes or no)_ NA If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: _�"V Sewage odors detected when arriving at the site: (yes or no) a' (revised 11/03/95) 5 SUBSURFACE SEWAGE DiSPOSAL SYSTEM INSPECTION FORM PART C �pp SYSTEM INFORMATION (continued) Property Ad7dess: ovOwner.- Date of Inspection: SEPTIC TANK%�n) (locate on site tit Depth below grade: Material of construction: concrete _metal _FRP —other(explain) Dimensions: Hr Sludge depth: tt Distance from top of sludge to bottom of outlet tee or baffle: J� Scum thickness:_ tt Distance from top of scum to top of outlet tee or baffle:_ tf Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping, condition of inl t nd outlet tees or baffles, depth of liquid level in relation to ou et invert, structural integrity, evidence of leaks e, etc.) ix UIA OJ)gm: GUM (V b Vll �3 GREASE TRAP:P_O (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP —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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 11/03/95) 6 r w SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C pp SYSTEM INFORMATION (continued) Property Address:dOo Owner: // 7 Date of I s ection: 0�13o�q�- TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: Material of construction: _concrete _metal FRP —other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.), DISTRIBUTION BOX:-M. (locate on site plan) Depth of liquid level above outlet invert:w(cuj�T TpVQa—, Comments: (note if level and distrib tion i equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) A V PUMP CHAMBER:_ (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:ag® X2?c,t_!'s�%�io� Owner: a---",646� C_ Date of In ection: 0�-_/ l� — SOIL ABSORPTION SYSTEM (SAS):4— (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type leaching pits, number: leaching chambers, num er:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: omments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of ve ation,etc.) o � o CESSPOOLS: _ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspecion) 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.) (revised 11/03/95) 8 f r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address Owner: �cz`.,'�� �% Date of Inspection: `2 �"�eS ZZ],e- ®L��?-p ?L a SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' z o r • Ell y+1 • , 7— `ON - )Z c� K4L\- VA= 32(- DEPTH TO GROUNDWATER Depth to groundwater._120 jeet method of determination or approximation:"'-'w Q,,P© c, 1 + rtT \N c—[t tit 2 (revised 11/03/9S) 9 a , op TOW OF BARNSTABLE LOCATION SEWAGE ��� VILLAGE '� ASSESSOR'S MAP LOT,.J-�..- d/ INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY �0 LEACHING FACILITY:(type) 2s L (size) /,POO'Al'Ale— NO. OF BEDROOMS—PRIVATE WELL OR PUBLIC WATER ,� BUILDER OR OWNER Cr DATE PERMIT ISSUED: ._ 7 DATE COMPLIANCE ISSUED: - VARIANCE GRANTED: Yes No e ASSESSORS MAP NO: PARCEL NO: No.... THE COMMONWEALTH OF MASSACHUSETT!� BOARD Off` ,HEALTH ....oF.............G` .......................... Applira#ion for Dispas al Works Tonstrnrtiun lirrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at . �'...... ............ . r�- �; •------------------------1.. `" ----------------------------------------- Locati ddress or Lot No. .... .. .C.t � ----� Owner Address W _ Installer Address U Type g l Size Lot............................Sq. feet T e of Building a Dwelling—No. of Bedrooms................................;....___.__.Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons_-_.-__...__----_----_______ Showers (� — Cafeteria ( ) p' Other fixtures ___ _. •-•---•-----------------•-•-•-----------•-•-•----------•-•---------•-----•------ -----------••------------------------ Design Flow.......::...... ..' .._ .. gallons per person per day. Total daily flow gal �0 �cj' d -- -------•-•--•-•--------•----- Ions. W � Septic Tank—Liqui capacity,/_ __._. llons Length....C........ Width... .___------ Diameter________________ Depth___.-__-__---__. Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._r.. .._v_.---- Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by... ..........................--•-------•------••--••---•••-•----------- Date---------------------------------------- �--4 Test Pit No. I............_---minutes per inch Depth of Test+Pit.................... Depth to ground water........................ rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....................................................-...............=........................................................................................ 0 Description of Soil.................... ...... -----------------------------•---•----------------------------------•-•--•-•--_.. V ..----••••-•--•-•------•----•-•-•-•-•-•--••------------•-••--•-•---... •. - W --------------------------------.......................-. -------------•-------•-------.....•--•-•••-------------------------•-----•--••------••-••---•-----•---------••••-•••-•......-••--•--------•--- UNature 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 iI;?E j of the State Sanitary Code-The undersigned further agrees of to pl ce the system in operation until a Certificate of Compliance has been issued by e r health. Signed. 1..... •••- --•--• ------ ----.. � ... / Date Application Approved By---.... •• - = Date Application Disapproved for the following reasons--------------------------------•------------------------------•---------------------•---------•---...........--- -----••-•-----•---•----•--....---••-••----••••-••----•••-----••-----.._....••--••--•----•-----•......•----------------•--•-•...........-............................................................... ��cc, Date PermitNo......._4..7.:... .. ---------------- Issued_....................................................... Date Noe&.7_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f -OF.......... 9- Alrpliration for Uiovooal Vorkfi Tonotrurtion rrntit i Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _--f . LNo.Locat�Address /.. ..........W Owner Address Installer Address Type of Building f Size Lot............................Sq. feet 1-1 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers (P ) — Cafeteria ( ) Otherfixtures .----•-••-•-•--•-•---------------•-•-----•-•--•----•---------------•-•------------..._.._._.. W Design Flow...�1�....�71_�...��.... z..gallons per person per day. Total daily flow...../ e...........................gallons. WSeptic Tank—Liquid -gallons Length._eF_.......... Width2�........... Diameter________________ Depth................ x Disposal Trench—Nlo..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit Nod"_.?`___(:.------ Diameter.................... 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........................ 4q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gd .-•----•--•-----------------•-•----••----••---•--......--•--•--------......--••--...•-•..._---.---•••......................................................... 0 Description of Soil.....--------------�."'........ .'-��-.=�--���/.G3`-�'=`-'..".------•---------------------•------------------------•--------------------•----• U W UNature of Repairs or Alterations—Answer when applicable- -----------------•-------------•--------------------------------------------------------------------------------......._.. Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal S stem in accordance with the provisions of ?TLEIE 5 of the State Sanitary Code— The undersigned further agrees of to ce the system in operation until a Certificate of Compliance has been issued b th a d of health. Signed`,�JL. Z(. ..1.' �s Date Application Approved BY .............................. ------ Date Application Disapproved for the following reasons:---••-•••---•••••••••---•-••-••••••••--••-------•-••--••---•--•--•-----------------•-......................... ---------------------------- •-------------- --------------- •----------------- •---------------------------------------- •-----------------•-•------------•-----•----•-------------------------------- Date PermitNo.-- 7 = &-------------------- Issued....................................................... Date r` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a . ..............OF...... ...........................:fit :..... %-En ifiratr of Toutplioncr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( } by.......................................................................................................-............................................................................................ Installer at--------'�-•- /+� ....� -------------•------•----------••---------- �-V.....�...•.iEa�ivQ_. '.� C.J:�.eal_..... - - -__TTr^Y _..... ......................................... has been instailed in accordanc:4thlthe provisions of T IL i E j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----&7_..�3---y.14......... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......G`"� �n <-,.....OF.........%? z - ...c??:�eC,�................................ r Biopooal Works �ono#r tion Vanfit Permissionis hereby granted.............................................................................................................................................. to Construct ) or Repair ( ) an Individual Sewage Dis osal System at 1\�T o.......................�...a__., .2._._. {/...�,../.�„c": .�"l_ �2. ....... ---------- __ .... ....nt�J._............._._._......_....._......._._. jI street as shown on the application for Disposal Works Construction Permit NoR_:... Dated.......................................... .......................•. �.. ............................ Board of Health DATE .......... .. ... ...................................••••••....•... -- FORM 1255 HOSES & WARREN. INC.. PUBLISHERS F ZOO , ► 1 5ep o rs�w 0 pox sc' 7VP 5415W of 5j SyL s4�F� l4 ),5z4w4 4A -,IGC/ 1 i TAT v T�3T � 1� 1 �Vj I t t 1 1 � P/l-pose 1 Wl7Z G,.ve �� S nrz,v. _,n,9vez�� ` -c�_!'i�p���� /Zsa-P 40 w,D LOCATION �igf2n!ST,gBL� C !A?✓n!is� SCALE . .�.'O/' 30 DATE PLAN REFERENCE . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . P``N OF n.Ic- W�zc O g� E[ v�+ E. CDKELLEY y No. 26100 �� �F �F61 0 Q i CERTIFY THAT THE ....... .. ...... clsitI LA11�SJ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. DATE . . . . . . . . . . . f=�A�✓s� /�i4C�Cc / - /��' Tio�E:� REGISTERED LAND SURVEYOR L. . 1900 . . '.. . TOP OF FOUNDATION — - CONCRETE COVER 6 CONCRETE COVERS Ir 4s3� �, 4"CAST IRON 12 MAX. 12"MAX. OR SCHEDULE 40 4"SCHEDULE 40 PVC.(ONLY) P.V.C. PIPE PIPE- MIN. LEACH PITCH 1/4"PER. PITCH 1/4"PER.FT PIT PRECAST NVERT J LEACHING T ` e�, PIT OR SEPTIC TANK IN�3R�8 DIST. 1 NL3RSo o W : EQUIV. 0 EL..... .. . .. BOX EL...:.... ' : >_ . . ,.e INVERT �F F- 0: !� G aS /000 GAL. INVERT 6.° a 0 ;:i; 3/4��TO I V2, e; EL... ¢:...... C3G INVERT ww EL......7. ElLG3,400 u- �. WASHED w :'• STONE •' ZS-- +-6'DIA. DIA. G-NfcwulLE�p PROFILE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE . SOIL LOG WITNESSED BY : DATE .r�c�y �� iy87 TIME. !o:oo�}r-f .TG-"TL D�e�vNi�/fr BOARD OF HEALTH TEST HOLE I TEST HOLE 2 ENGINEER ELEV. .4G.oa r . . . . . . . . . . . . . . . . . . . . . . WooOlogsy W000G�q.y ,• s�Q.s 3C„ s DESIGN DATA : 3` 43.7o ``2'43.00 NUMBER OF BEDROOMS . . . . . . . . . Co�+ZSE C�oA?LSE' TOTAL ESTIMATED FLOW . !?'Z n. . GALLONS/DAY Peuc, S,s�s ev .SAs/D �?�cKs CGS BOTTOM LEACHI NG AREA 7B S0. . SQ.FT. /PITIC,/?D. SIDE LEACHING AREA . . . SO.FT./ PIT/4'7/C,P-P L2..57 So CoSE' GARBAGE DISPOSAL AREA INCREASE) COiN2SE SAW Sf}w!� TOTAL LEACHING AREA 7,pP. . SQ.FT PERCOLATION RATE 4 . .� TWo. MIN/INCH /44 �°Z.•sue 7o iyZ r C-.2.5�,0 0 LEACHING AREA PER PERCOLATION RATE .`3 . SQ.FTIr RA>, !'� WATER ENCOUNTERED NUMBER OF LEACHING PITS . �^v er • T,INI/ APPROVED . .. . . . . . . . . . BOARD OF HEALTH' o� STv�oE' vni •e}yL S/per DATE . AGENT OR INSPECTOR GF LBT' /3 0` EDW CD LEY p 26100 ,0 1ST'cP� 1'�P4 S s-. / erf gf�l$TE�E�JQ� S4H!iAP.�A� a PETITIONER 4- PINE f ARBO z�fflW.00D PRODUCTS / _ PINEHARBOR.COM 1-800-368-SHED I (of 259 Queen Anne Road H v Harwich, MA 02645 -ry f 1 : (508) 430-1 85 barns®pineharbor.com ENGINEER'S STAMP k, j PR AdF.:mHs<e.,,+'�r��i„uat'L3'� �,l✓�°"4a,' l,`. M'hF ..e v, - t � f OJECT• .rF 7 w/attacheo Garage x 22' shed CLIENT- Steve Hesl�in a Jr ADDRESS: u 5 20 Newspaper Road Centerville, MA 02632 j f , rb _ PHONE-. l ;,emu g �'s 77 -994-0649 E-MAIL: steve.heslinga@gmail.com ADDRESS OF PROPOSED WORK: 20 Newspaper Road Centerville, MA 02632 REVISION DATE: 3/24/17 DRAWN BY: GB Scale: 1/4" = 1'-0° Unless otherwise noted Page A.1 <a Floor Plan PINE FOR W.O'OD P'RODUCT..S SCALE: 1/4" = 1'-0" PINEHARBOR.COM 1-800-368-SHED _ 7 2 A7 A3 259 Queen Anne Road Harwich, MA 02645 p: (508) 430-2800 f: (508) 430-1115 ` 18-0 12-0 barns@pineharbor.com STHD10 @ all posts 'I`2-6, '�`2'-6 8 X44 Grade Beam ENGINEER'S STAMP 0 o PROJECT: 18' x 24"Garage W/attachea 12' x 22' shed a CLIENT: o Steve Heslinga Jr 3 O CIA 4 ADDRESS A4 N A4 20 Newspaper Road Centerville, MA 02632 6 PHONE: A6 774-994-0649 E-MAIL: N CV steve.heslinga@gmail.com ADDRESS OF PROPOSED WORK: 20 Newspaper Road Centerville, MA 02632 REVISION DATE: }; 3/24/17 t N . DRAWN BY: LA G � GB a 8'-0" �� Scale: 1/4" = 1'-0" �• 9_�° - Unless otherwise noted A2 Page A.5 I ' I imberpanel Frame PINE OR D WOOD PRODUCTS SCALE: 1/4" = 1'-0" .. PIN EHARBOR.CO 1.M 1-800-368-SHED 259 Queen Anne Road Harwich, MA 02645 r \, p:(508) 430-2800 f: (508) 430-1115 barnsepineharbor.com 2"x10" Ridge ENGINEER'S STAMP 7... 2"x8"TLollar Ties 1" Roof Board (4)Nails 8D 2"x8" C 24" O.C. Rafters with H2.5 A Rafter Clips 4"x4" Gable Frame ]"AT Sheathing - 6"x6" Plate Beams. 7/8" Shiplap Floor PROJECT: 18' x 24' Garage 4"x10" Joists w/attachea 12' x 22' shed 6"x8" Plate Beams CLIENT: 6„x6" Plate Beams Steve Heslinga Jr 4"x4" Wind Bracing ADDRESS: 4"x6" Door/Window Posts (Fir) 20 'Newspaper Road 4"x4" Purlins (Fir) Centerville, MA 02632 6"x6" Posts (Fir) PHONE: 2"x8" Sills (PT) 774-994-0649 5/8" Anchor Bolts 4' PC, . E-MAIL: STHD10:Straps (all posts) w/ (1) #5 Rebar at Top of Wall steve.heslinga@gmail.com ADDRESS OF 9 PROPOSED WORK: a -1 20 Newspaper Road Centerville, MA 02632 a : 0 REVISION DATE: 8 3/24/17 DRAWN BY: GB ' .y.i.V'Y P�ti. Scale: 1/4" = 1'-0„ L 1/ Unless otherwise noted f Page A.6 I� - r - 4a � 1 Timber panel >=rame PINE CAR 7 WOOD PRODUCTS SCALE: 1/4" = 1'-0" _ PINEHARBOR.COM 1-800-368-SHED 259 Queen Anne Road Harwich, MA 02645 p: (508)430-2800 f: (508)430-1115 barns@pineh.arbor.com t • 2"x10" Ridge ENGINEER'S STAMP 2"x8%Collar Ties 1" Roof Board (4) Nails 8D 2'x8" C 24" O.C. Rafters with H2.5A Rafter Clips 4"x4"-Gablle Frame 1"x12" Sheathing 6"x6" Plate Beams 7/8" Shiplap Floor PROTECT: 18' x 24' Garage 4"x10" Joists w/attached_ 12' x 22' shed 6"x8" Plate Beams CLIENT: Steve Heslinga I 4"x4" Wind Bracing, ADDRESS: 4"x6" Door/Window Posts'(Fir) 20 Newspaper Road 4"x4" Purlins(Fir) Centerville, MA 02632 r 6"x6" Posts (Fir):` PHONE: 2"x8" Sills (PT) 774-994-O649 5/8' Anchor Bolts 4' OC FF E-MAIL: STHDIO Straps (all posts) w/ (1) #5 Rebar at Top of.Wall steve.heslinga@grnail.com ' ADDRESS OF PROPOSED WORK: Co a. 20 Newspaper Road co a Centerville, MA 02632 do REVISION DATE: ggag ' r 3/24/17 DRAWN BY: 17 GB Scale: 1/4 1'-0" Unless otherwise noted Page A.7 n/� NOTES SYSTEM PROFILE`OFILE MARKED WITHCMAGNETICTTAPE ORBE 1. DATUM IS NAVD 88 COMPARABLE MEANS FOR FUTURE LOCATION. (NOT TO SCALE) ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 2. MUNICIPAL WATER IS XE ISTING \ FILTER FABRIC OVER STONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 9 MINIMUM .75' OF COVER OVER PRECAST 80.0 2% SLOPE REQUIRED OVER SYSTEM 79.1' �'� •c 4. DESIGN LOADING FOR ALL PROPOSED PRECAST Qr PRECAST H-10 WATERTEST D'BOX FOR LEVELNESS BLOCKS OR �" UNITS TO BE AASHO H-M RISERS (TYP.) po MIN. 2" WALL THICKNESS PRECAST RISERS 1co 4"0SCH40 PVC MORTAR ALL =EL 1sT 2' ' COMPONENTS INVERT IN 75.32' S. PIPE JOINTS TO BE MADE WATERTIGHT. Shallow�4— NDS (TMP) SIDES 76.15' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE �'� Pollll 10" EXISTING 14" > o 0 0°0 WITH 31 C 15.000 TLE . . o 0 0 �; °o°00000° TEE SEPTIC TANK** TEE ®®®® ®®®® ®®®®— ®®® 76.3f * ° ° ° ° ° 6.. MIN. SUMP °°°°°°°° ®®®®®®®®®®® ®®®®®®®®®®® '° Locus °°°°°°°°°°°° 12" MIN. INT. DIM. °°°°°°°° ®®®®®®®®®®� ®®®®®�®® °°°°°°°° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND °°°° °° '°°°°°°°° °°°°°°°° NOT TO BE USED FOR LOT LINE STAKING OR ANY °°°°°°°° ®®®®®®®®®® ®®®®® ®® '°° GAS BAFFLE::` >°°°°°°°° °°° °°°° 75.59' 75.42' °°°°°°°° °a°o°°°° 73.32 OTHER PURPOSE. . ..< . .';;... •:••< I} 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3 4"-1-1 2" DOUBLE WASHED STONE 4' MIN. ALL 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL. p ALL AROUND PRECAST STRUCTURES (2) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR � 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' y COMPACTION. (15.221 [2]) CONCEALED WITHOUT INSPECTION BY BOARD OF �� c� vo HEALTH AND PERMISSION OBTAINED FROM BOARD pcc r� o v ( 1 SLOPE) ( 1 % SLOPE) N OF HEALTH. n 10. CONTRACTOR SHALL BE RESPONSIBLE FOR FOUNDATION EXIST. SEPTIC TANK 71' D' BOX 12' LEACHING CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP FACILITY VERIFYING THE LOCATION OF ALL UNDERGROUND & **INSTALLER SHALL CONFIRM MINIMUM 69.3' BOTTOM TH-2 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF *THE INSTALLER SHALL VERIFY THE SEPTIC TANK SIZE AT 1000 GALLONS NO GROUNDWATER FOUND WORK. SCALE 1"=2000'f LOCATIONS OF ALL UTILITIES AND ALL AND ITS SUITABILITY FOR RE-USE. 1 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 253 PARCEL 12-2 BUILDING SEWER OUTLETS AND REPLACE WITH 1500 GALLON SEPTIC SHALLOW POND EL 32t BE REMOVED BENEATH AND 5' AROUND THE ELEVATIONS PRIOR TO INSTALLING ANY TANK APPROPRIATE TO SITE PROPOSED LEACHING FACILITY. LOCUS IS WITHIN FEMA FLOOD ZONE X PORTION OF SEPTIC SYSTEM CONDITIONS IF NOT SUITABLE 12. EXISTING. LEACHING FACILITY SHALL BE PUMPED (AREA OF MINIMAL FLOOD HAZARD) AS AND REMOVED OR PUMPED AND FILLED WITH CLEAN SHOWN ON COMMUNITY PANEL #25001CO562J i LEGEND SAND. DATED 7/16/2014 99— EXISTING CONTOUR / 125.00' X 99.1 EXIST. SPOT ELEV. BEN ARK CONC. OUND SYSTEM DESIGN. ; [991 — PROPOSED CONTOUR EL. = 8 .36' ° GARBAGE DISPOSER IS NOT ALLOWED 198.41 PROPOSED SPOT EL. TH1 DESIGN FLOW: 2 BEDROOMS @ 110 GPD = 220 GPD TEST HOLE LOT USE A 220 GPD DESIGN FLOW 2q° SLOPE OF GROUND 1 ,704 S. - SEPTIC TANK: 220 GPD (2) = 440 UTILITY POLE 82 **RE-USE EXISTING 1000 GAL. SEPTIC TANK Go FIRE HYDRANT ? 1 Y LEACHING: 1 NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING I B o, Q 87 SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD 1 TH1 E BOTTOM 25 x 12.83 (.74) = 237 GPD -, 190 ' DECK TEST HOLE LOGS - J �g 180] TOTAL: _ 472 S.F. 349 GPD USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) ENGINEER: DANIEL E. GONSALVES, SE #13587 P CH T WITH 4' STONE ALL AROUND WITNESS: DAVID STANTON, RS (BARNSTABLE) DATE: 8/28/20 EXIST. DWELLING PERC. RATE _ < 2 MIN/INCH MA _ C14 APPROVED DATE BOARD OF HEALTH CLASS I SOILS P# 20-174 \ o� ELEV. ELEV. \� w L ill A A LS LS GARAGE TITLE 5 SITE PLAN 3„ 10YR 4/2 10YR 4/2 3„ \\ \ 3 OF B B LS LS ° 1� w 20 NEWSPAPER RD 3° , ` S10YR 6/4 26„ 77.8' 10YR 6/4 HYANNIS MA �\ w oc� 30" 77.4' PAVED DRIVEWAY C 3N of MA PREPARED FOR LZH OF M o`b `� Sq o� DANIEL tiG r cti� ts A �� HESLINGA, STEVE & TRACY C C o /�° DAN'ICLA �s -+T o OJALA �� �6 OJALA PERC 85 0p, " CIVIL � No.409804 DATE: SEPTEMBER 9, No.46502 � 2020 MS MS qNo. oEss\o REV: SEPTEMBER 30, 2020 (DESIGN FLOW) REV: OCTOBER 5, 2020 (TANK FOUND LOWER) a 2.5Y 7 4 OJf"I �` I �� �,: .:�;� off 508-362-4541 L } fax 508-362-9880 Sp No 4u �C�2 �a downcape.com • 7 es s�o g� V 'm down cape Apo ineefing, inc. » ' „ 3 69 A1 126 69.4 126 . ' civil engineers Scale: 1 '= 20 M land surveyors NO GROUNDWATER ENCOUNTERED �t�•x�--7-� J� S 939 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 DCE #2�-23 ' 20-231 HESLINGA.DWG