HomeMy WebLinkAbout0961 PITCHER'S WAY - Health 961 Pitcher's Way
Hyannis
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TOWN OF BARNSTABLE�C'APRS Way SEWAGE# b0-1" 0� 1
VILLAGE ASSESSOR'S MAP&PARCEL c 7;Z 1 4/e-/
INSTALLERS NAME&PHONE NO. j'N V l X Spy eft r
SEPTIC TANK CAPACITY t�,5,0 0 d 0 k ( QQ
LEACHING FACILITY:(type) �oc�r�i RbodA�Ab,,(size)o Q4/
NO.OF BEDRROOMS
OWNER . 0 ((JR I�
PERMIT DATE: O'7 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching facility Facili 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 _�^-
ft?0 fG�,
n �� - C
'~ Commonwealth of Massachusetts
Title 5 Official Inspection Form o � o�
Subsurface Sewage Disposal System Form Not for Voluntary Assessments f_
961 Pitcher's Way s V
Property Address
Jean Clark Realty Trust
Owner Owner's Name
information is Y
required for every Hyannis MA 02601 4-1-2010
page. Citylrown 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 fortes A. General Information
on the computer, 17#
use only the tab 1. Inspector:
key to move your
cursor-do not Joseph R. Smith
use the return Name of Inspector
key.
Stevens Construction, Inc.
�y Company Name
P.O.Box 71
Company Address
Marstons Mills MA 02648
City/rown State Zip Code
(508) 776-9054 S14994
Telephone Number License Number
B. Certification
LU ::j- I certify that I have personally inspected the sewage disposal system at this address and that the
Era �_' information reported below is true, accurate and complete as of the time of the inspection.The inspection
c_W 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
Cl-
Title 5(310 CHAR 15.000).The system:
tx�
M ® :;Passes El Conditionally Passes ❑ Fails
= :_ ❑-Needs Further Evaluation by the Local Approving Authority
4-5-2010
rs 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 witf perform in the future under
the same or different conditions of use.
tsins-osros rile s Otfidel Inspection Form:Sutaface sewage; system• t of 17
>v � Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
961 Pitchers Way
Property Address-
Jean Clark Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 4-1-2010
page. Cityrrown 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:
X ! ,lave 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.-
At the time of inspection none of the failure criteria described in 310 CMR 15.303 through 15.304
existed.
B) System Condidonalty;Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
4placed 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
pease explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
:•.•.•.. ;: " ..��,::^+iaj infiltration or sxfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with-a--,—,.mpiy1n 9.septic tank as a;,p.;; c. y-U, ;u�._
Health.
..�_s•. ___r.•t_.._...�-..__. rcu eaa :•^_ariaeuvn.0 it iu sL uci;..emu,:sound, not ieEIlU(Ig.d(IQ li i3 L....r JiicaLE.-' ut
Cornpiiance indicating that the tank is less than 20 years old is available.
Y ❑ N [] ND (Explain below):
t5ms•09/08 Title 5 Official Ins
pection Form:Subvirface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts.
Title 5 Official Inspection Form
' Subsurface Sewage Disposal System form-Not for Voluntary Assessments
r 961 Pitchers Way
Property Address
Jean Clark Realty Trust
Owner Owner's Name
information is
required for every Hyannis MA 02601 4-1-2010
page. Cltylrown State Zip Code Date of Inspection
S. Certification (cont.)
B) System Conditionally Passes(coat.):
Observation of sewage backup or break out or high static water level in the distribution box due
:,b vk r, or absirucied pipe(s) ur due io a Lmoken, settled or uneven distribution box.,System will
pass inspection if(with approval of Board of Health):
broke„ pipe,'s) are replaced Y N ND (Explain 114l ):
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 i _ ND (Explain below):
_! obstruction is removed Y ❑ N r] ND(Explain below):
-C) fur- r EvaluatkM is Requiredby the Board of Health:
Conditions exist.which.require further.evaluation by_the Board of Health in order to determine.if
M' .system,is,failing.:to{�rotect.public..health, safety or the environment.
1.-. System-will pass.untess Board ofHealth deteeeCffef{ra ::i}y{,ry�Vil�`••r _�_••% Je�3
15.303(1)(b)that the system is not functicmina in wi.t_t t .,:►__. . _Y. ._ .:_::_..
_- > _ -- ..5VSfvIiyb'iii:
Cesspool or privy is within 50 feet of a surface water
�.)'Qrwl ul ri ivy i WiUMl ,00 feel d a bordering vegetated wetland cr a-suit marsh
t5ins•o9m Title 5 Official Inspeclkxi Rum:Subsi [ac>-:Sevaye Disposal Sysiwe f•Pa.�.."r1??
t 4 Commonwealth of Massachusetts
Title 5 Official Ins
! . — Subs;.rf ice swage Dismal System Form-Not for Voluntary Assessments
- 961 Pitcher's Way ---- --
--------------....___... --------------------...---------
ProperFy Address.
Jean Clark Realty Trust
Owner Owner's Name
information-is
.equim fo.every aYInis - — -------. -- ItiIIIA 02601 _ 4-1-2010
page. Cityrrown State Zip Code Date of inspection
B. C-edification (cunt.)
2. System.wiiI fail unIess,the.1:.m:- X:-s:2�t
determines that the system is.functioning in a mannQ Z
safety and environment:
system {SAS} and Me SAS is within
hn F__66 _f— e.:.d 1 +. r olmnry nr tr lbu+wn,to a
surface water supply.pply. .
tank and SAS and the SAS is within a Zone 1 of a public water
3 h� SyStF has a septic ian1C and SFI end 'i?P_. 1' _ . :,i, ! f er _system!
supply,well.
i l7v;e ii vrii c7 Lii-;vat�'v'r'uwr uuppiy'ir�iiR�.
'�ethud used to determine distance:
.. Thie evetzm Y1ar Qeae± 4 0-r,
bacteria indicates absent and the presence of ammonia nitroc en :;;d
less than 5 ppm, provided that no other failure criteria are tr iy; F,
..,.6-4 «r,;.. 4C,,.....
3. Other.
D) System Failure Criteria AD licable to All Systepm,
You-must indicate="Yes"or"No"to-each of the_followring for. alE_inspections-
"yes No
backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
i` 'Y` t 71Rf'{'i F C fib iL{Tt;iiiTl LJt ei!!�j `i'1l (.1!.!-'!C 1!'!�i:_V!.!!!C 3i�S::UIIU Ui v,i! t= ',i* ._._
UVG lV GlI VVGIIVOVGV V1 t,iVyl,GV Jr1J VI -vQQOPUUI
® Static liquid level in the distribution box above outlet.invcrt due.to a^El
cr clogged SITS - i_pccl
;Ll
quid depth in cesspool is less than 6"below invert or available volume is less
Phan t/rdav flaw
t5ins•09D8 Ttle 5 Official Inspection Form:Subsutiace Sawage Disposal Spslam•Page 4 ct 17
Corn. mon-Arealth of Ma&sacjh-jG1_e=
N,
T,itle 5 Offic-lat Inspection Fortm
Sy 'C'm, 1"Ict for Vol,-n+ ry Asse-s—ments
Y M
961 Pitcher's Way --------
Property Addiess
Jean Clark Realtv Trust
Owner Owner's Name
information is R&A
ukl= is _% 02601 4-1-2010
tufjvned for every __1'y_ in, Ivi-1 7' -----
page. cityi—i own state Zip Code Date of inspection
B. Ce tification (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-_.
Cj' z Any portion of the SAS, cesspool or privy is below high ground water elevation.
r_1 Any portion of cesspool or privy is within 100 feet of a surface water supply or
z
tributar,i to a siurface water suq-,Ey
Cj- Z Any portion of a cesspool or privy is within a Zone 1 of a public well.
F"A 5C fnef nf n nriI
v-te sunp!v,,vell
L Any porflon of otzssnool or privy is less than 100 feet but greater than 50 feet
. ; . ! if U, I V
trf)m P nrnipitp mtqtpr Q!
system passes if the well water anal,
... ........
laboratory,for fecal coliforrn
.... .;;;-:ot Uached to this form.]
d
T h c 31 Y s V e-
1 U t' T
A r,
uonzaci une ooaru o P y - aim touk -Le1 ine',Ain
necessary to correct the failure.
desian filow,of io.000and to 15.09opel
addluori to the
r -I V�- I 1U W k' I U U R� 19M.)W11 it, 111
que,__uuns fri 6eution i-).
Yes No
Ff Fi mithin AM foot f%f
the system is within'200-feet of a tributary to a sUrfacediifikin4water suboly
n4krr,,n�� kF-rrqitrj- q (Infizirir Prnfiom.inn
A 1'VVPA) nr a mannPri Zone 11 of oublic water suoolv well
Q,
system considered a significant.threat under Section LE or tailed utrird:_,. -d ion C. sh'-:1
svSt-en.- in accOrdanca ...th
I �f U 1c vC;PVA.Ul ICl
15ins-OWN Tale 5 C) dnf Ingaechan F,-m SubsurfaceSewame DiSMial Svslen•Pane 5 nt 17
.1 nf Unc
Title 5 Offildal Inspection Forat
961 Pitcher's Way
Property Address
Jean Clark Realtv Trust
vYrncr Owners Name
information is
ranuired for every Hyartrils it Al. iv,
M11% 4r!-2010
page. �•Iiyl I UWi I Jletc f-Iij k'UUa Lia1v U1 III!,pa"UU11
C. Checklist
Check if the foilowino have been done. You rrust indi t •VeS or 171.-n" a-qtoeac.hofthefoilowina:
Yes No
NO F-1
P-11inq information%A!2's crovide.., h-v the ti !jr)-Ant, nr Rri_qM'nf Hapittl
ei _ha nn
El M Were any of the system components pumped out in the previous two weeks?
F-1 Has the systern rereiveri pormal flows in the nr vi-I IS Nyo week
El M Have large;volumes of water been introduced to the system recently or as pat L Of
th.;G in G D G c t On.?
avaliabie nuie as NiAi
Was Mile"Ictcaivy-or Uemnq
VW unitj IfFIVC1_tCU 101 StWIS Selrlr?%�kitjt:UCK,&Up-!
Li Was the site inspected foi-signs of break out?
'W rp q I —
idinn qAq !frpt fj nn cAp_?
❑ Were the septic tank manholes uncovered, opened,and the interior of the tank
inspected for the condition on of it e baff;
dimensions, depth of itc:uid. ceptn tOr ISNUC.,- -cirld Cip-ICIrl lot SCUM"'
AA/mcz the f:irifitv nwnpr(=nrt nr.ri inqntq if rfifferpnt fr(-.m
VN nwnr�F� pf-nviel_�-r4
- ------
---nnn nf z:
r1itzrIncn! q z111Mnt-_?
4-- IS A Q1 +L.,
G; kaS+
e1e;n,-Ad eased on-
Fyisfina infor ation. F.nr exAmr);_ !§.-In Rnnn❑ ,
Determined in the field (if any of the failure criteria relatOd to Part C1 is at issue
Residential Flow Conditions:
8
i,—me4 nn 1!0) rl!jp I C. I)nj 880
1 1 n nnr4 V-ff of
Minn FnrM S.thm irfnrp RF.wano omr—.4 9—t—-Perm A rif 17
�+ �: � ! ��gs��es•�a>>#!+; raf�l�cg�rFs�ego4$r,�
-- - -__r� Title � c% r �
1 l m_ -
=s. ;; iagk�.a.s! 4� 'e•_t S'_A i4t� .�' *oForm-Not for)fnli i t?r! Asses-rents
961 Pitcher's Way
_ Property Address -
jean r jlarV Realty T r:.--.t
v^wner Owner's Name
information is ;� ;,• .� w w riven
reouired for every Hyannis 410A '0260 1 '4-1-2u tv
Z1aOP. i.uYr l Owl �iN t,Giic vaLC U1 iiiDI./CLuui�
D. System Information
Description:
Septic�.;...'em that is sair.i..v.Fi.�s ur,.weirt,r C i..F.. Of n ? non .. I1v. F:..F..n1k /7\ d . xe-
v...v.i..SYJi..iii that is 3Gi�iiiy "UIJGi it i.v Vi a�.UIiV i.iQiiVil JGNU- iuii�., i.,i i,i'y.VnGJ, piiu
leaching.fields (1 Tx 34')that contain (3)-500 gallon flow chambers a piece:
linos recirrlcnre h2Vo o rrorhnno nrinr4or7 (� Voc IQI Rlr
�.. ..y„ .,....,.... . u v .,
is i..unudi-y t r, i:G yes ..il �i v_._ inn
lJ lain lul y Oii1 a separate Scwauc system',,I �n yea Scuai ale ii ISPeCtiOi 1 i euuireu] i i !as "" No
1 3undry system inspected? Fel Yes n No.
Seasonal use? ❑ Yes ® No
See Below
Detail:
2VV8 -230,d 12 ga1io,ns(3 1,9UU cubic feet) , 20U9-20 1,2 12 gallo is(26,92u0 cuuic f@et)
�UI11(j t)iii!'ly! I i 7Ca lJ�l IVV
Currently in use
Date -
Commercial1indestriai Flow Conditions:
Type of Establishment
Design flow(based on 310 CMR 15.203): Canons per day room
f3a.SiS ofdesian flow lseats/nersonslst?.ft.:.Ph,1_
Grease trap present? ❑ Yes ❑. No
inrlrletriol ,meta hniriinn t?nlr nrocant7 n Va. n M"
Non-sanitary waste discharged to the Titie 5 system? ❑ Yes ❑ No
YYgICI NICLCI iCdWIIUJ. 11 QVG!lGUIC.
65.ns Title 5 Official Inspection Form:Suburface Sewage Disoosal Svstem-Page 7 M 17 li
COrr MOrtwea . O
t e ca nspe Uon orfifit
ym I c.... _ Not for\eo!'Untary Asveocmenl-_
770
961 Pitcher's Way _
Property Address
Owner Owner's Name
information is
LJ &in iihLiiA • w hnwn
required for every Hyannis rvVIN v4uu i — �+-i-cw i v
page. Lifi WtJUG veCc vi iimpacuofi
0. System Information (cont.)
Last date of occupaneWuse:
Other(describe below):
General Information
Pumping Records:
Source of information: own of Barnstabie B.O.H.
xAtas systern oawlrrped as oart of the inspection? �? Yes No
if yes,:volumepumped: !tons
Reason for pumping: --- --
Type of System:
6?! Septic tank. distribution box. soil absorption, systern
❑ Single cesspool
O-verflow cesspool
❑ Privy
Shared-system (yes or no) (if yes, attach previous inspection records, if any)
Annovative/Aitemative technology:Attach'a copy of the current operation and
maintenance contract(to be obtained from system:owner]and a copy of latest
inSna+tinn at tkn-WX owetnm -obtained
c%igtcm nnorntnr i anrYor i,^ntrunT
Lj Tigt it tank. Attach a copy Oi tiie D&I approval.
❑ Other(describe):
t5in5•09/08 'rdo 5 Off'C*incss.r+ion Fnrm-G��u eA�ro geu. n Die_+nea1 gusto •P.r_9 of t7
Commonwealth of Massachusetts
Title 5 Official Inspection Fortnt
___•�.utrftf Sevtag-e Disposal System �Orm-Not for Voluntary Assessments
fY
I W—oVA", 961 Pitcher's Way
Property Address
Owner Owner's Name
information is
requited for INIA 02601 -t- /_U I%J
'or every Hyannis
page- L;4Lyj i uwi t ozaie 'Lip i Uuc L.PCILC VS 1115yCLAIU11
D. .54"tem information (cont.)
.0
Approximate age of all components, date installed ('11 known)
11-18-2007-Town of Barnstabie B.O.H, septic permit on fiie
Au.— d,-te t d when arriving at the site? Yes No
,hen
i'ld"ng 'r-wer(locate on site plan):
2.5'
feet
mast iron "Al 40 Pvc 1 1 other iexplain',
100'+
Distance from private water supply well or suction line: feet
Comments (on condition of ioints. venting, evida..f!�;;)kaqc,
joints and venting appeared to be in working condition, no evidence or leaKage.found while
inqnpr.tinn-thphtiiirfinn-puvp.rlines
2.0'
lFeet,
Materiai of construction:
f —1 nn4vet vten.e nther fexplaiinN
M F F R%PM1q!z5z f
2,000 gallon septic tank with risers installed to final grade.
if tank is metal, list age,
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
I L. L A 0 0, VV A 0 ri
ED;.M I-_n s;,0 n s: -
4^11
Giudcie depl.R'.
t5ins-09MB Tdle 5(Wcial hiwe&ian Form-qubmjrfnrn n;_"rTnn1 em-Parn 9 of 17
rtC
Commonwealth of Massachusetts
. ite r Mt 5 '"icial InspeCA'ara 'm-i
stem F--.-i=No*,,for Volluntan.,Assessment,-,
961 Pitcher's Way
Owner Owner's Name
information is
ic:uuifed for every "Iyannis MA 4 10
pane. ;141 ium I QWLC Lip k'uuc uaic of inspeat6r-1
D. system Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle 27"
2"
5"
[)ie znr�a from f r-,nf,.zt-i irn + tin of t iflat roc e-,r 1,%on a
Lilstcance from bo-ttu-rn of scum to bo-LLU-m of outlet'Lee or baffile
Ta-
e-
p �4eaGL:--' 4Z;U-i-- i.1,4-.
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
f iA— -f I- t'-C
liquid level In the septic tank- as related
to tLe OUtle,
'I Inver, are 21 8 nnrrnnl
evidenre -if!Pn1qqr.P nr
Clre,-.Sp Tr-
n (I c c a a, on 01 4 olnn�-
Depth below grade:
Matedal of construction:
concrete El metal fiberglass
L-j- polyethylene i other(explain):
Dimensions.-
Scum thickness
Distance from top of scum to top of outlet tee or baffle
1vance from F,,- rn oll scum ,,++ -I 'JI
Uata
r pecr
Common mea" n
N, ww itle 5 Official Inspection For-a-i
U-N,= Assessrnen te
h!gi?V'
961 Pitcher's Way
Property Address
j—
Owners Narne-
information is
,'or every I iya1 -Z-V I U
—C U1 M.PCIL-1.
-------------------- --------
D. System Information (cont.)
"Or—UM—c 10n� 01.lmoi.." recommendations inipt 5irtr! nnitipt !-b,or he
-is as'Pis
..........
T*1g, L Lit I or Holding Tank ftank must b U e pumped at time of inspection' (locate of-, Site plan):
()Pnth hpinw- nr->dP-
Material of construction:
rnnrrPfi= nnsmt--1 nrilvothvianin nthimr(,=yn1-qin1-
Dimnns'u
ns,
Capacity: oallons
Design Flow-
Alarm. present: Yes 11 No
A 1=.-M IpV,21-
Afnr m in wnrkin Order:
Yes Hn
Date of last pumping: Dl?te
Commenfic; fn--nditinn of q1 r.rr. and qnq trhpq. P
Attach copy of current pumping contract(required). is copy attached? L i Yes L-j No
154's-09;08 Tfe 5 Official 6,sner6o,,Form R-bsurfar�c��3—Oisoesal R�sj�-P,,.�11�f 17
,. ,'u �z' .:�'. Yam��d'd•��'t±�9s�'er .�.i AAAnv-��w4i-i ti��f'*t
--- This 5 Official inspection Forfo
eo lrm r�==_Ii4Fa!Pppnn DtS30al Ck_sin.n Form, Not for /_Iuntoni.e.c_gaLcman
_
961 Pitcher's Way
Property Address
loin r Inrx R—I", 1 n cf
Owner Ownef's Name — — ---- ----
information is
recuired for every Hyannis MA 0260 i 4-1-20 1 U
page. �nri i uvri viow ,":N�,ruuc ud�e v i(syaLuuii
0. System information (cont.)
Dil—Odbu(tion lox(if present must be nrenedA (Ioratg on cite marl
0"( formal operating heiyi;tj
Depth of liquid:level above outlet invert - -----
. �r:� tin 3
............. . ..... .. . . ... .. _ - - _ li _tz it t: i1 _ za;_ai :il(;Y "ysYrtr_.e of grlirig r�rrvnvar any
V V V LG!1J t
-id distributing flow to both portions of the leaching field equally, no evidence of solids
111Z i:7:•.ic,.:�:. 1;.i!`1...,=lms- ±....1 Qr�� iu rj• _ •'.i3 -� •F -
11:^t2-UUA.
P+rmn (_hamtw-r'(InrAtQnn ci#anlanl
Pumps in working order. Yes LJ No
Alarmc in uunrkinn nrrior Yac R!n
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
SnH c1°'rWnrn Stem (SA:SI thvr €t nn gitp nlgm gxrnt/atinn not rQcar-rirp-d1-
-f SAS not located,explain why-
tl-s-09108 Title 5(W,6i4 Inccer!+�Fr— .:, Disvosa!S;y iwn.Pape? of t7
t 4 ^�= rL+►v�w�L+ncalt.�l+h ..f 11A /c tts
1 v rsarrr "s v rare yr rtr `A1fv`e'OfY.e.b6b+d
Title 5 O iciet Inspection Fore
lz,, rrv#-nr`n Qmw Q%91M+ m Fnrm _Aln+fnr\/nllyn+nnf�caacementc
961 Pitchers Way _
PProperty Address -
_t?an Clark Reattv Tnsst
iwner Owner's Name ----- ----------- --- --- ------
information is
Hyannis MM U2l)V 1 4-i-2U 1 U
1B1)?iti Cl�iUr every � Y iy.
P:3U1'. Vilyi 1 UYYiI � 'c LIP"'ic _.'C U.il.4kcL Uil
D. System Information (cont.)
TVDE:
leaching pits number
1pnnhinn chamharc ni imhor
leaching galleries number.
lParhinn trPnnhPc rn_imhar lannth-
X leaching fields number, dimensions:
(2) 13W x 34L
n ne/orflnui racennnI niimher _----.___.____-__ - --
❑ innovativelaltemative system
Tvnelnameoftechnology -------- --- --
Comments-(notecondition-of soil,-signs-of hydraulic faiiure,'levei of ponding, damp soil, condition of
ve etation,,Ptc_)_
:I:k, -I- n f 1 !:Z :.h; C:..1,1,. f 1 T 'CAI\ t!+nt nt of/J! Cnn
o
N.. .,.
.___.... ...-_ __..��� .. -.ivy v ..{.,amn I,-
n rlci.c. I w JIy11J ul I lyw nuiii, lauul d fii CJCI ii, i iv P;-U-Ciuilly Ui CJci it'rYiii lip, i.i fC i.i iUi f iiiCi J, JUiI 'rVaJ ivi.ii iu
to be damp, normal vegetation surrounding leaching field area.
Ce"spoois (cesspool muse be pumped as part of inspection) (locate on site plan):
umbp.`r and COnfiCMIrntir -- -
Depth—top of liquid to-inlet invert
flpnth of,olidslever
Depth of scum layer
Dimensions of cesspool
I
Materials of construction
If1Uft,<ULILJII UI1uiJ11UYVLILCI itIllVvv I_J ,1�5 U iVU
.5:_•[1 108 Title 5 Oflr�ciaf Inspection Form Subsurface Sewane nis r—+_j Cvstem-Parw 13 of 17
i
,. � \; �.. !`nr»mnr+.e►ewlt� of��oc»�Fs+�s>�+9._`
V�fr_rrrvf Hf e4sv� p
- title 5 Official I stme-0 r IFFM!
Not for Vo!untary Assessments
� " 961 Pitchers Wav _
Property Address
.lean Clan; Ueathr
Owner
-----�---- - ---- — -------- ---- -----
Owner's Name
inforrnatinn iS - _ ___
r,�r
..,:....r r:f every f�7a+^�n15 MA Vcw I 4-I-lv I J
t)ACIf!. viyi i Uii1 Jin�G L•y V�uC ub=U1 iijbpCiniliil
n_ Sys`em Information (cont.)
Comments(note. condition of cnil cinnq of hydra:i6r faiil,rp., le:;.^:.^"r:;r.^cfi;:;'t nnn(Vvon or
et_ \. _
Privy (locate on site piany.
Materials of construction
Dimensions
Deoth of solids --- ---
CommerAs-tnote cor„ition:ot-sot,;signs of hydraulic failure, levei of ponding, condition of vegetation,
-etc.).
I
t5ins.69/09 Title S Official Inspection Form Subsurface Sewaoe Disoesm Svstem• 14 of 17
Common+Weafth of
you
- - Title S Official Inspe. A10,1 rofill
R-sniv—a f..'--po-sal System Form -Not forVoluntanr Assessments
961 Pitcher's Way _
Property kddress
.lean Clan, Realty,: ?^:sc
Owner — �-- ------- ----------------------------------------
Owners Name
nforrP2tion is ,t,; �; •r c n+�,
ri au+{sa i:�� Vc6J i -i-i-2v 1 v
f a1uc`eti for e1ty _._. -- ---- - ._.. -'-------
L.:,:yl,uwii Juan: Lio VUUG L.0-0
D. system Information (cont.)
Sketch of Sewaqe Disposal System: Plmvide;�i tiR--
qt least Nvo permanent ref ranne !and—marks, hen
,...-
where public water supply enters the building. Check one of the boxes he!
►,_.,�r;;e;%:�, ;,, lhr., area halrw
i i I
I
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i
I
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I
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t5ins•09M Tide 5 Official Inspection Form:Subarface Sewage Disposal System•Page 15 of 17
i 1 r1'� (`nr+�mnn�ue�l4h ^f IUfyccenhUSet
Title 5 Official Inspection Form
--. _ C»hcrirrire Sewage Distaosa! System Form _Not for Voluntary AsseSsm.ents
N®9MEW S
961 Pitcher's Way
Property Address
.lean. Glark Realty 1-rust
Owner owners Name
information is required tor every Hyannis MA 02601 4-1-2010
page. uwii oink uN_OUc vale vi umNcwivii
D. System Information (cont.)
Site Exam:
® Check Slope
M IRIirfaf`.P W;#pr
® Check cellar
1571 Shallow wells
10'+
Estimated depth to high ground water row
Please indir;_#2 ail methods us*d to determine the high ground water elevation:
Obtained"from system design plans on record
if checked, date of design Plan reviewed.
❑ Obsented:site(abutting property/observation hole within 150 feet of SAS)
► C::`, K,wi with it r^,l PnarH of H-r,-4" -axniain::
F= Checked with local excavatnng in,,t=tilarS- (attach docurrientati)n i
® Accessed USGS database explain:
and Obianit-A rireafr Zea levei daium information
-.:; �• d~:s^ ue how ynU eStqb i shed the high ground water elevation:
Accessed USES aacaoase anc obtained rnean. sea _vei
Town of Barnstable GIS site and referenced the e;evatior: of the.^.ronf rfv
W`.1C IlPlnff(:(5ilf'li if'iw i rlrl i"S Ci i,flit' r- _ ,
t
Commonimeafth
Not for Voluntary Assessment,
961 Pitcher's Wav
t-roperiy Address
Uwners Name
He14.LM-ed-.,-or every —i,Y- NAA I I- IV
SOB is 77 fu-cmnpiezeneass uneCKIISt
Inspectinn. Surnmani: A. BE f , D. or E rheckr-d
InSDection Summary D (System Failure Criteria Applicable to All ,A
�:,tirni+Pri �Jpttj , to hinh nr iindwater
.:..et:.lhl Ir"I Dsposal Systern either drawn on r)aae 15 or attached in separate file
17,
TOWN OF)gA13NSTABLE
LOCATION ��� �I �C`�f RS �1(/ y SEWAGE# 0�,
VILLAGE '4y4*w : ASSESSOR'S MAP&PARCEL _�71 {/</
INSTALLERS NAME&PHONE NO. J�V 1/
SEPTIC TANK CAPACITY D 0 0 �Q d
LEACHING FACILITY.(type) -.f-o® q R.� �/p�e v
,,7 �rr.�.�size)
NO. OF BEDROOMS
OWNER P,
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility). ,
Edge of Wetland and LeachingFeet
Facility(If any wetlands exist
within 300 feet of leaching facility)
FURNISHED BY Feet
C;
. 0
cz�
i
-/ i
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION
Date Time: In L 0 Out /0 S o
Owner W ,( —M4 Tenant V(1 c Z)a/!
Address 3,54 �" H4'"� s7" ���v c.7u �� Address q(Di ' C
Compliance Remarks or
Regulation# Yes NO Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities �-- -------
7. Lighting and Electrical Facilities
8. Ventilation 4"Z-Z
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use r ���� %�f.fin/
12. Exits A-40 v Ep
13. Installation and Maintenance of Structural
Elements a
14. Insects and Rodents No't•td S7n4e, Mace
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
loll
17. Temporary Housing
18. Driveway Width
19. Number of Tenants Observed
PART II 1 Z
37. Placarding of Condemned Dwelling; i�
Removal of Occupants; Demolition vS�f> 2G/!� =/Y
EA
Number of Bedrooms L,2 0(4AS `-yV� Number of Vehicles Allowed (max)
Number of Persons Allowe ( c)
Person(s) Interviewed Inspector
If Public Building such as Store or Hotel/Motel specify here
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
Date , 7i 1 I 0 Time: In 1Z)-'yC- Out
Owner. LA A-k- �C 12.c.��T Tenant 1?$ 6% 1
Address A NO T°V�i tJ K . Address �(P � � �� C sA LAA,
FA \-!�l o y`C 1'1 U' Z S�'r eD Vk,1 A '�S 6✓�/� D ZCoO
Compliance Remarks or
Regulation# Yes NO Recommendations
2. Kitchen Facilities < U aj
3. Bathroom Facilities ti ti
4. Water SupplyIf
�`J 22�5
5. Hot Water Facilities
6. Heating Facilities
7. Lighting and Electrical Facilities ►'? (ice �Up/✓/
8. Ventilation 2 .rC,. C.,S Z- n �
9. Installation and Maintenance of Facilities 'k clk I
10. Curtailment of Service �/,� /9
11. Space and Use
12. Exits
13. Installation and Maintenance of Structural 2o o
C
Elements
S l
14. Insects and Rodents (�
15. Garbage and Rubbish Storage and Disposal f` - CA
16. Sewage Disposal y{�rcj
17. Temporary Housing L
18. Driveway Widths/gam
19. Number of Tenants Observed )2f <"�!o
PART 11
37. Placarding of Condemned Dwelling;
ry G v✓J�
Removal of Occupants; Demolition
Number of Bedrooms Number of Vehicles Allowed (max)
Number of Persons Allo x) R
Person(s) Interviewed J Inspector -�
If Public Building such as Store or Ho el/Motel specify here
. No.- ® Fee ' .pa
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZIpprication for �Digpool 6p6tem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. l �4005,e 96/ Owner's Name,Address,and Tel.No. Z 11V,01A (� ��.Q k
Assessor's Map/Parcel If c/
x 5.7 .e
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
�� 9,L 2P9Ir ea ge?,-SEA.- y yv
d 1 rA 1.4v
Type of Building:
Dwelling No.of Bedrooms 9 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 yy��
Size of Septic Tank L �� Type of S.A.S. - / X 3 e/ 47 Erw'Ola
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) :1�A( S4,e
- LILAI .9
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 o e and not to place the system in operation until a Certificate of
Compliance has been issued by this oard of Health
igned Date l t�� ram►
Application Approved b Date
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued I
{ h
No. O`J `0 Fee
�V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH-DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplica.tion,for �Digo5al *P-stem Construction Permit
Application for a Permit to Construct( ) Repair`( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
"Location Address or Lot No. Owner's Name,Address,and Tel.No. L ","O A
1 , 4 e kea> wA1�
Assessor's Map/Parcel 14{L/
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
. T� 942pq.r f.tri
S'd - 5-6�� — y�i d r'� F� .���'�'1' acs
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 lZ �U Type of S.A.S.Z,- )3 x
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) W 5-co ,9 T/,f W Ph RMb e<S
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 ode and not to place the system in operation until a Certificate of
Compliance has been issued by this oard of Healt
igned Date /_ �— O "
Application App"roved Date j /� g
Application Disapproved by: Date ,
for the following reasons
Permit No., {��� r'Q a Date Issued )Q
-------------------------------------------- -
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS"'' +
Certificate of Compliance
1
THIS IS TO CERTIFY that the On-s'ite Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( )
Abandoned( )b j VV,0
" at ` `5�V Q k 1 -S has been constructed in accordance
with the prov' ions of Title 5 and the for Disposal System Construction Permit No.
�(� �`�t dated � /�S 17.
Installer e v//V /?)e�(r/•� Designer T� Al I y X � ,y��i+!t`'CIf Al C
#bedrooms J Approved design flow �f y� / gpd
The issuance of this permit shall not be c nstrued as a guarantee that the syste will fun• r, a designed.
Date Inspect,(
———————.————. . —————————————————
———
No. _ �-7 —0 a4 Fee/—
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
xigpogal *pgtem Construction Permit
Permission is hereby granted to Construct ( A— Repair ( ) Upgrade ( ) Abandon ( )
System located at �9' i{� l (r �,2 s /i(i,l./ / •//� Iy /L
r
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.r _
Provided: Construction ust be ompleted withinf three years of the date of this permit.
Date �� i' Approved by
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
aAttersreatXMAM II
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
s�
Date: 149 ��'7 Sewage Permit# �00-7 " 0d I Assessor's Map\Parcel 721 pcezL l Vq
Designer: b.C.,J"V lUI L-5 01 Ppvvu i.y X.Installer:
Address: 1,®(,r, d-SVI 1_114 l`�'A Address: r ' 4) d \f
0a5-lb
On 107 � L� cr�v WA was issued a permit to install a
(date) (installer)
septic system at 9bi 'Pi based on a design drawn by
(address)
�ihn)✓t. Aru, Z l . dated�)� ` I �. 400 3
(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.
P�
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.
N aF
MICHAEL J.
BORSELLI
� o �
(I taller's Signature) Q CIVIL
No 35054
Ago G15'11
n n �ONAIL
signer'sSignature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
JAi -18-2007 15:09 Falmouth Eng. 508 495 3229 P.02
0
}
Notice: -This Form Is To Be Used-For the Repair Of Failed
Septic Systems Only
PERCOLATION TEST AND SOIi.EVA UATION EIMMPTION FORM
,4 M i c h a e l B o r s e l l i, hereby cc*that the engineered plan Biped by me
dated 4/18/0 3 ,concantasthe property located at
Lot 16, Pitchers Way (#961 ) mail 011he
tollowinp oeitedu
•. Two evil evaluadons excavated for detelled ear nfution(po haad M2WkW and two
per6olsdon barb a�hall ber ooa8uotetl. ,
• This felled system is aostaoM to a nddendal dwelling only. There are no oommelcoial or
• bvsinese uses useooiated with the dwellft.
• The aW'is olarsff9ed as CLASS I sad the percolation mte Is less than or equal to S miautes
Per inch, '
• 't'hbre to no hweaee inflow end/or chop in we proposed -
• There an no vsdanow,regwoted or needed.
• The bottam of the propooed laadWag f$oility e"kbe located no lees than five foot above the
mcdmum masted grcnadvrster,table elentLML(AdJM the roundarnter Uhle ums dw
Y tlrgptu metbvd win applicable] '
Plwe ovleb the following:
an the ground instrument survey
A) Tw of 01gaad SMfte Elevedon(win Al
8) O.W.BIev U= g3= + t fQrb*G.W, '** 4 s,(
I OF
DIFFSRBNM BBTWM 18. 0'
o MICHAEL& 4
SIGNBD: DATE: 1�/1_�_/_o 7
Based trpci>a the above infvra�lon,d peadt sill be honed for IM —bodrodm
maximum No additional bedrooms ese autho:ind 14 the Mora without ensloned sepdo sy►etem
PLO' --
* Estimate obtained from Town of Barnstable Engineering Department.
** Conservatively estimated adjustment.
gl8optlelpessexeo�,doo , '
T/T 'A GRGI't1IJ HI-lHgH 40 (INHOR 17RHIgWMHA WHAGI:F )A17 AT•WHI' .:
O jr i v c h e rS 'u 14
LO-CATION SEWA E. PERMIT NO.
.eZ�r►-t-t/1-
9l I L L G E ell
IMSTA Ll 'S WAME i ADDRESS
R. UtLDER OR OWNER
}
DATE PERMIT ISSU E.D
DATE. COMPLIANCE ISSUED
e
r- - -_ _ _ �
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No.. ....._..1 .. "S—au .... ......
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
............ '.........OF........ r --------------- -----------
Appliratiou for Elhgpwial Works C onarurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: 41
f �� ��
/ .. J(/&=-------- -----------------Z� --------------.-------------------.--.---------
--. Loc ion-Add or Lot No.
............ '. .. �� ------------- - mil....-- � , ���. .........------...
w r Ad s
a ................. . .--- - . . _. . _. r�r-...-_ r _.
Installer Address
Q Type of Building Size ..Sq. feet
U Dwelling—No. of Bedrooms._.......3____________________________•Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures ..................................
a Design Flow................ ...................gallons per person De day. Total daily flow____.__.....33_ _.._...._...�``lops.
W Septic Tank—Liquid capacity_../,06allons Length ------- Width...... r___ Diameter................ Depth_.__7._._..
Disposal Trench—No. ._.. ....p > �__ -___.. Width......,__fir...... Total Length............_ t_____ Total leaching area------ ___ sq. ft.
Seepage Pit No...._,/_____________ Diameter......f�� ... Depth below inlet..._ -......._. Total leaching area._OKEsq. ft.
Z Other Distribution box ( � Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date------------------------------
Test Pit No. 1....<....._..minutes per inch Depth of Test Pit_______ ......
�r Depth to ground water..___. __.
fT4 Test Pit No. 2.....�.9�_minutes per inch Depth of Test Pit....... .... Depth to ground water______-.��---
a' --- .......................................--. ---•-••--••---•-•-----•-•-•..............•...
Description of Soil �, ,� 1 ..'_-a. `..-: _ ...�. . /` 1 f
x -- ------------•-----..•••--
W ............... -----6- .._ ./ rr ---------------------------------------------------------------------------------------------------------------------------
VNature of Repairs or Alteratio s—Answer when appli able------------------------------------------------------------------------------------------------
------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of ii i p of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued y the board Vofhelth
ne77 ""--•-- ---•----� �
Date
Application Approved By. •--•- ...... .. -. .......
Date
Application Disapproved for the following reasons--------------------•-----------------------------------•--------------------------------------•-•--------------
---•.............•--••••-------•---•--•-••••-••-•---...•-•--•---•--------••-------------------•-•-•-••--••----•---------•---•--------------------------------------------------------------------------
Date
PermitNo......................................................... Issued.......................................................
Date
-
No.......... ..._....... Fes$. , (?..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
- ...._......OF..._.....e ,�l ....................................
Appliratilan for Disposal Works Tonstrnr#inn Vrrmit
Application is hereby made for a Permit to Construct X
or Repair ( ) an Individual Sewage Disposal
System at: .f ------•
. Location.Address �^ or Lot No.
flw er Ad ress
w �,1 G? ii/ _ �... .�df/ ........ T--- ✓"_ ' ' s ..
Installer Address '
- 3 _
Type of Building -= Size Lot'____________ _________Sq. feet
U Dwelling—No. of Bedrooms..........,'>.............................Expansion Attic ( ) Garbage Grinder ( )
pa-1 Other—Type of Building ............................ No. of persons-----_______-___..__•__-___. Showers ( ) — Cafeteria ( )
Otherfixtures ----•------ --------_--_----•--•----••-•-•--•--•-•-----••-•-•----• � ...
W Design Flow...............��...g......._����gallons per person per day. Total daily flow..............................................-�.............g�lons.
� Septic Tank—Liquid capacity._;_...._.._gallons Length_____ ______. Width_______-�____ Diameter................ Depth...........
_._.-
Disposal Trench— 0...... '__ _-___ Widths r,: ::... _.._ Total Length........z ..... Total leaching area.......:-__:._,�_sq. ft.
Seepage Pit No.......
/............. >ameter------✓.____........ Depth below inlet-----Z'p.......... Total leaching area..!5'r ``,_..sq. ft.
z Other Distribution box ( �if� Dosing tank ( )
a Percolation Test Results �) Performed bY-----•----------•--•--•-••••-••••••......----•----•-•...7,.•••.•-•••••• Date.........................................
------------------•-----�---•-------
a Test Pit No. I.....____---____minutes per inch Depth of Test.Pit-_____-_-��_.__..,Depth to ground water-__--._ f %
(z, Test Pit No. 2_____ °�_mmutes per inch Depth of Test Pit......... Depth to ground water.-______%'��.......
0 ---------------•--...-------•-----•---
O Description of Soil_...._ ;. �l.-rfJ_______ ___ " c
r3 v�
--------------------------------------- -- - -- - -
U Nature of Repairs or Alterations—Answer when applicable................................................................................................
----------------------------•------••----------------------•------------------------------------•----••-••-•--------------------•••-•--••--•-•-•----------••----••••-•-••••-----•--•-•-•-...........-•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE,
p5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss�-ued by the board of lie Ith f f
,+ Date
Application Approved BY``- Jam- 1� f 4- --••--`--- " •�- 1
Date
Application Disapproved for the following reasons------------------------- -----
•-•••••---.......••--•••-----•--•-•-•-•--------•-•••--------•------•••--------•-•----•-•-•••-•------•=-----•••••-•-••••••-----------------•-•----•----•--------•••-•-•••-•--••••-••---••---•--•...._....
Date
PermitNo..................................---------•------------ Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALT ,
... ..
Tirtifiratr of Tuntpliattrr
THds).kn
IS TO CERTIFY-That the Individual Sewage Disposal System constructed (fi'�or Repaired ( )
by..........
.... '�"��f-a'-1........................•--------•------------------•----•---.......................
/ Instal er
y ------ jlIS-
has been installed in accordance with the provisions a j of;?1he State Sanitary Code as described in the
application for Disposal Works Construction Permit No ................ dated---f. _-_ '__.-.-____----_----•---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION .SATISFACTORY.
DATE...........................•----....----•. .. .. .............. j Inspector ----
THE COMMONWEALTH OF MASSACHUSETTS
:. BOARD OF HEALTH _
......... .........OF........,> � �G'� .............._...'.....--...
No.:........ ............ t FEE ...r...m:.
Disposal nrIbi Tondrnrttmrn Pgrutit
Permissioij is hereby granted-------- ..................
t> to Construct ( ) or Repa� ) an Individual Sewage Disposal System
r S e
atNo.................................................... r ... -•---•--......--•.....-/ir --------------_---- •----••-•.-----------------
s+� S reet
as shown on the application for Disposal Works Construction Per t No---____.__ Dated_.�'�ff__=�.�................
•_•____ _......•.•�-� _ _ .w�"_�'_I •__..._....•:...............
_.
card o1 Health
DATE......1-7. 06./..............................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
r
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE I1:MINIMUM STANDARDS FOR HUMAN HABITATION
Date
Owner Xd- � 4' Tenant
Address <C�-d 1�.!'�'y�' ./1�iE ®�ddress 41
Com fiance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities c "ut04"7-
3. Bathroom Facilities
4. Water Supply .
5. Hot Water Facilities "'�G
6. Heating Facilities
7. Lighting and Electrical Facilities
9 9
8. Ventilation
9. Installation and Maintenance of Facilities ,�� Glds1
10. Curtailment of Service
11. Space and Used ' `'
12. Exits � PIE.�
13. Installation and Maintenance of Structural I
Elements
14. Insects and Rodents � �p v
15. Garbage and Rubbish Storage and Disposal .5-.
16. Sewage Disposal ¢ � -
17. Temporary Housing
PART11
37. Plocarding of Condemned Dwelling;
Removal of Occupants; Demolition
t
Person s) Interviewed Inspect
If Public Building such as Store or Hotel/Motel specify here
HOBBS BC WARREN.INC.
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION
Date
Owner .c�"r�Z- Tenant
Address �' Address
Compliance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
. ....T'00,07
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities V ka,
7. Lighting and Electrical Facilities )\6
8. Ventilation A -? ✓9 `
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use
01
12. Exits
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
17. Temporary Housing
PART II
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Person(s) Interviewed I ector
If Public Building such as Store or Hotel/Motel specify here
FAN
%r-I EDMAP
TOWN OF BARNSTABLE 2 8 2003 PARCEL ;,,,�I
BOARD OF HEALTH ; 7to
TOWN OF BA;:i��TABIE
HEALTH DEPT. y'~
ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION
Date
Owner R I�I A-ilk C'io✓ 'A s� Tenant
Address PI%'UbV2 Address
Compliance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities J
3. Bathroom Facilities TI I Al
4. Water Supply" ✓ 01on � 1
5. Hot Water Facilities l�T��
6. Heating Facilities J
7. Lighting and Electrical Facilities
8. Ventilation jj#1e ®V, 40Veo1j& A� :Z�3 'l],
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use
t1.
12. Exits
I
13. (Installation
an aintenance 2 I�9
ments U-1
14. Insects and Rodents ✓ r, rlirAr-+
15. Garbage and Rubbish Storage and Disposal V �� �,-I---
16. Sewage Disposal y/ t-
�d"r
17. Temporary Housing
`�
PART II ixfs)Z4\r5 e 14.6 rt�lGLe ' �IQ`fe?
37. Placarding of Condemned Dwelling; Iyu 's 51 l� n
Removal of Occupants; Demolition
Person(s) Interviewed Inspector
If Public Building such as Store or Hotel/Motel specify here
HOBBS$WARREN.INC. /JA '
X?
L 6�
C"SnNc
/louse E59.5
#975 CATCH
BASIN
LOT 28 59.6
61.8
x 69.2
LOT 17 61.7 EXISTING DRIVEWAY
60.7
60.9
S89'22'15"E HYDRA 1JiT #191
224.12' 60.1
73 6' -1 0.5
`t PP #24
62.1 N PRGinOSED tl2,)LEAQVING AREAS
62.5 iACH_iNTH r'J 500 GALLON o
CHAMBERS KNIT/ 4'OF S76WZ' rn o .r
sit ALL ARGIUNO. h o 00
LOT 29
_ - PUMP ORY AND fILL
�i... •.- i .. �S'.7'Nfr'LEAGh/1/✓�P/T.�'
vVSE BE>Y'CHA/ARK
22,315' #96� / .SYLL Ez.6 4f7 ?�' ; CBBc z
3.0 /
62.8 O a
_ 62.8 h 60.9 .
x ,"" CBBC
2 �
SEP770 j4W 77 RE,NA/N QQ �
62.6 62.8 �/ \
c; NOT, 7NE CONTRACTOR SHALL CONTACT THE 70MV
\ 62.2 �S' N°j o w OF BARNSTABLE AND OTHER 1-177LI7Y COMRAN/ES TO
.ga,4,po �N LOCATE ALL UNDERGROUND UT7L/TIES PR/OR TO
�-4 INSTALLA770N OF TINE PROPOSED SEPTIC SIS)FAI
S7g• Fk/SnNG OR! � �04�. 61.4 IF TINE EX/STING WATER SERl9CE IS LESS THAN
►EW
2 77 07 e A Y �, 10'FROM THE PROPOSED LEACHING SYS)F&,, THEN
7t 62.2 :. 61.7 THE dYATER SERt9CE SHALL BE SLEEIiEO OR
62.3
61.9
61.
61.9 61.7
. . LOT. 15
62.2 PP #9181 v
PLOT PLAN -- LOT 16
PREPARED FOR
Q r"
B�;SCLLI � � l I LINDA CLARK
f vrt vi
IN
flo,3h1154
GENERAL NOTES: . .g�,� � �f <: HYANNis MA
62.1
►.�, �rJrL ,J. PLAN DATE: APRIL 18, 2003 PLAN SCALE: 1„=20'
1. HOUSE NUMBER: 961
62. CIVIL ENGINEERING �{O WETLANDS PERMITTING
2. ASSESSOR'S NUMBER: MAP 272, PARCEL 144
' WASTEWATER DESIGN COASTAL ENGINEERING
ra
3. ZONING DISTRICT: RC1
°; TITLE 5 PLOT PLANS {�` PIERS AND DOCKS
4. FLOOD HAZARD ZONE: C GINEER
LAND USE PLANNING COMMERCIAL/RESIDENTIAL
5. TOPOGRAPHIC INFORMATION COMPILED ' FROM AN ON THE GROUND SURVEY. spiny Cope Cod and Southeoster» Massochusetts
6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM.
101 TOWN HALL SQUARE - FALMOUTH, MA - 02540 - 508.495.1225 -- 508.495.3229 fax
PROJECT NUMBER: 03010 CAD FILE NAME: 0301OL16 DRAWN BY: L.M.,D.H.M. SHEET 1 OF 2
RN1.91 APADE 9VALL BE 2X M/NU/UM OW?ALL -qPAC S?5" G'GINPGWENTS
TEST HOLE #1 usE 4&A S?0'/FDULE 4O PW OP CASrAtW PIPE
0" 20'M/N/MUM SL'TBAGX'FRW EOGE a--STONE /-0 aVAR NALL
low
SANDY LOAM 1 OYR 30 10'M//V/MUM
SOIL TESL _—' ::=—::: : EL.60.2 sErBAAY
32" : =_ioAMY
,_•_ _:: EL,58.3 REMOVABLE COVERS SET TO WITHIN
Date of soil test: MWOV 25, 200J �'=- - -� �- RE V BLE C GRADE (TOTAL IT 5)
Test taken by. DAND MARAN
Results witnessed by:NA "`'"�.� ,,•?;Y
Percolation rate: Q M/N./IN. - -` }`=»=
Ground water N0TE2VC6VN7FRfD
�-
Y 7/4- ;
3' MAX.
EXISTING ED? 6F ro 1••;-`�'h' .- �v9 /Nl�£RT EZEK - .5B 07 2 L,4
2000 GALLON sETF7Rsr J,104SEPTIC TANK a .012. 00
EL51.0 ;•. h ®®0®®®®®®0®®0®®Cm/ST BOXD/ST. BOX ®®SET ON 6 £i! _ .5607
p LAYER OF
SET SEPTIC TANK AND D/S7R/BU770N BOX ►. q 1j CRUSHED 11
ON 6 LAYER OF CRUSAFD STONE � S70NE INSTALL 9/� 70 1 1/?
Z �' W,49VED,, QPU.SK/ED SrLWEALL 50`
2 Ci t4 AROUNO QVAVM?S ANO OOA N
�\ rO 111E BOrlroW 6F A/E a-14AIBER
SYSTEM. REFER TO LAYWr ac-
SYs"IAW MOW DETAILS
(E0r1W Or 7M-11"EL51.0,�
NOT TO SCALE
jr
2-auTLETs � s/4• � e 1
BASIS FOR DESIGN. OUTLEI - ; , ET
wu
inP2—OWLEM
TYPICAL OF 6 b
ri6•70r4Z DA/L Y R00 /S 6.4S1W OV B BEDrPr1 ..S NO CAR9,44YDISPOSAL
ri'7TAL DA/L Y R01Y- 110 G ,01;V fMW X 8 BE7.yP"S = WO 6PO .
9077i:W APE4 PROPONW 870.4 Sr 'rynA'
j .5�DE AREA PRY.)00.5�'D a .�7.f.4SF. PLAN VIEW '.��al�Ll1YL1
CONSTRUCTION NOTES:
DB-5 DISTRIBUTION BOX (H-10 LOADING)1l7TAL LEAG7�i�/NG AREA PRGPaSI�.D >2f4(8 SF. 1. /NSTALLAAGW Gig' )WE IWOVSEO -Q97770 SY57FA/.ST/AU 6E/N ACCG W"ac'Of/W TITLE 5
APPL/CAAaV R47F- 0.7W 6PD/.SF.
NOT TO SCALE AND THE BOARD LIB"HEAL7HRra144AaYS
3 4,kk of re e ss 2. A LAY Or 711E PLANS-9VN-L BE,4Y41LABL£6W-77F F64 RDITR ar AT ALL AMES DEY6W LE-4 Y INO CAPALYrY= 921 l,JDW > 880 GOD
cy LWAYA49 711E AVSri4LLAAOV 6F THE JQ5P)7C SYSTM..
MICHAELJ. G�
BORSELLI J NO O/ANMS 70 A/E DESJW S V&L BE PF7PF6l4MED N17716Y/r 771E APPROVAL Or 90711
CIVIL FALMGY/711 ENQNMWNI2 ING; AND 711E BOARD a-HEAL lh:
No 350540 'K THE.WPAC SYS7FM/S SYJB�.lrCr 70/NS7r'ECA6V BY FALMLd%TH D14 NEDWNIQ INC
8' - 31 2" is rt� b`�,�. AND 7hE BOARD Lr HEAL 711
ONAL
5. 111E LY.W7RAC76P",4LL NOAFY FALA1a1;W 9V6;N' E WNa INC AND 711E BOARD 0-HEAL 711
6" AO INSPECT 7HE SEPAC SYSTEM PR16W AO BALYCF/LG /N SWE/NSTAN= 001E 1114N LWE
INS 4WAOV MAYBE NEEDED. r11E LY/N7RAC76W SHALL GWL Y SACOrAZL 711E 1W17aVS OF 711E
`. SYSTEM 711AT HAl2"BEEN/NSPECIF7J AND APPRDIw BYFALMLY/TH ENANEFR/NGj INC AND
34
7H£BOARDO11EALIt,!
J
6. /F T11E CW7RA C7a?"CC VN7ERS AND VAR/AAGS W /N 77£CCW01176 WS SQ AS AV DIFFER/NC
24" ® ® ® ® ® ® ® ® ® � ® ® ® SGYL.S TZF",APHY, OFIZANOS OP 0711ER LYWD/ALWS 711,4T MAY REWIRE RE-EYALUAAGW CF
A/E DEY&Y, 711E LL.W7R.4CM4. .KU /MMED/ATEZ Y C WTiICT F4LA/0Y/7H"afNMWNQ INC
GENERAL NOTES:
8' - r-
1/17/07 REVISE INVERTS
1. HOUSE NUMBER: 961 CROSS-SECTION DATE
REVISION
2. ASSESSOR'S NUMBER: MAP 272, PARCEL 144 8' - s" SEPT
IC DETAILS
3. ZONING DISTRICT: RC1 . . - - „ .. . - - - - . . • .. • ._ - PREPARED FOR
4. FLOOD HAZARD ZONE: C "- s" KNoacouT
LINDA CLARK
5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY.
21" DIAMETER COVER IN
6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. o HYANNIS MA
5" KNOCKOUT - s" KNOCKOUT PLAN DATE: APRIL 18, 2003 PLAN SCALE: AS SHOWN
n CIVIL ENGINEERING j *
S" KNOCKOUT. U J�^ WETLANDS PERMITTING
WASTEWATER DESIGN 1V1 COASTAL ENGINEERING
'
. - TITLE 5 PLOT PLANS ��` �r` PIERS AND DOCKS
. . i. : '. . . - GINEER��
PLAN VIEW LAND USE PLANNING COMMERCIAL/RESIDENTIAL
Sir ng Cone Cod anal Southeastern Mowachusetts
500 GALLON LEACH I N G CHAMBER (H— 0 LOADING) 101 TOWN HALL SQUARE FALMOUTH, MA — 02540 508.495.1225 — 508.495.3229 fax
SCALE: 1' 2' PROJECT NUMBER: 03010 CAD FILE NAME: 0301OL16 DRAWN BY: L.M.,D.H.M. SHEET 2 OF 2
i
=--� TYPICAL SYSTEM PROFILE �
A R E A PLAN FD T FINISH GRADE= ` / _1 I
N 0P - NOT TO SCALE
FINISH
SCALE : I = FINISH GRADE OVER TANK= %7") GRADE OVER PIT= -'i•C'_' {
f
�/ �� 7 _. A / PVC OR O O O
7 67
C. I TEES g733 e • + + + o
Tr—,' Y of -,/�t'�/ .4 7— 7 w�i G B S M T L ` 4750 q. 777710 0 e o t e 0 0
.-�..�.�...,� .:�-,�.•.•.......,�........».....,.,� ...... ; � GAL 4"
,- - FLR
REINFORCED �iST. BOX
CONCRETE 8 TO BE INSTALLED ON
• e t e t • s e 1 c o 1
117
A LEVEL STABLE BASE 1 1 . • • • o + a 1
SEPTIC TANK "
C`* TO BE INSTALLED ON A �� �`=� Sr 15�c , • . • + , ,
LEVEL STABLE BASE , . •
t:
2"-1/8" 1/2 "WASHED PEASTONE ALL ' ' ' ' • ' ` ' ' ..
BRICK a MORTAR COURSES AS • • • ' • . o a a t
N � - AROUND FREE OF IRONS, FINES
_ \ REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE
Z.0/' lti , LEACHING PIT
24 C.I . MANHOLE COVER a 3/4 TO 1-1/2 WASHED CRUSHED
FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE -TO BE LEVEL
$ S IRONS, FINES AND DUST IN
�, _ �.► a , ! PLACE
C -7�� FOR FIN. GRADE \ i
�,_
—
S 2"wof�7! ' SCE SYSTEM PROFILE \
` —# -- s SOIL AND PERCOLATION
L_0 � i ;3 2 I,S7
.~ i I DATA
•�rzF'�s=r.,v 1 1 O �FRE�NT) � I � - - -- -------�---- _ _ �— — —
zo t \
- MI IN,
�5� .aAt . l�tc T ::<�rsc � *. 7 k �,, , I --INV ELEV SEE - - —
� � / 8 _ PERC RATE -; N.
L z 0 4 ` FOR {
INLET I . • - SYSTEM PROFILE F, C. D. SPOHR
c `1 6 TAKEN BY
\ e s LINE 0 0 .iG1�:;
f-X rF`f�^ h _ _ - •tt- 5to 14�I A ; C1 ' _ - =°. j�. WITNESSED B Y
0 OPENINGS W/4-1/8"
9 i w
DATE
f GiiCs1.`3' ::aara.:.te '�'t?. >_ .►,c. eta P�..r _ c ..._,. �i 1 _ /4"� 0
f . 8, 3 OUTER DIA
7 _ . ' e. ` f —
�- o { DIA . TWOMOMM014T A L"wwlwr4R!
TEST PIT GND ELEV. f �'
>�- �6 t ° AREA - e Lis ��
° 0 0 u 3 b Yam: -f- L.OA Al
QTW
.� m �r o - ° o 0 0 0 0 52��
+ it 5 , F . ° °� '44;, r, N� A�c'L157ta
w� s` h00 l'WQ i.t i�l i ° p O v 2�r
"'•'E "'/\/ / 1 0 0 0 0 4'H t G.N T ",p r C1 � ,�l�ti 1H', -
AYES �Ativc i_
6 `- 6 ` DIA. 4
(� ia � �, '� EFFECTIVE DIA. BOT. PERC HOLE
LEACHING PIT - SECTION ( i Fc' jt;t;�.� DOWN
P
No SCALE DESIGN DATA :
NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM
NO. OF BEDROOMS
-- _ DISPOSAL
_ LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT--- GALS .
ELVd- T"fQ/l0 A� +. t.a I . CONC. TO BE 4000 P.S.I o 28 DAYS . SEPTIC TANK i- GAL.
k E .
CE"At/TL-k d..,I MF G� C)7- C- •->,5''_`.-u /k,G< E"L,.50,0' 2 . R E I N F W 6 " x 6 " '*6 G A. W. W. M.
3. 2 AND 4 SECTIONS ARE AVAILABLE FOR
GREATER DEPTH REQUIREMENTS GENERAL NOTES
I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
NOTE • EXCAVATE TO ELEV., 71± OR LOWER AS ACCORDANCE WITH TITLE5 OF THE STATE SANITARY CODE
DATED JULY 111977 & ANY LOCAL RULES APPLICABLE.
REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. IN
MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR.
WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED PRIOR TO BACKFILLING
COMPACTED IN PLACE. NOTIFY THE ENGINEER AND BOAR) OP HEALTH FOR INSP
SIDE AREA = S. F.@ S.F./GAL 940 GALS
BOTTOM AREA=i 6� S.F. '4' � S. F./G�kL I �� GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.ECT ION.
TOTAL AREA = `'L`3 S. F. TOTAL , � / -% GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
APPROVAL BY CHARLES D. SPOHR.
LEGEND 6. FOUNDATION INSPECTION READ. WHEN EXCAVATED.
CWNFkS EU I LD? �S• AF�EA ULAN • + 50.0* EXIST. GROUND ELEV.
FINISH GROUND ELEV 2'UNDERLINED ` �� _,..�,, ►.
V;�-�: � ' ��.:�• k':�sf-� /Q,L --—__ �r-v► �-
_. .. .� ,µ �
C" }c 3 O� C �J T k ��' 1. .-_ �"i j f ,•A',� ' //t/ j-!}-', ,h�,d�,A r„ /L jl�, 4 7 5 0 PIPE i N V E R T. ELEV. R E v. D A T E s D E S C R 1 P T 1 0 N
fl��•�"-�. G2 (a ..��._ t-�='"',�c' C.• y'` a�=, �'3'C.�//..���`���':, .� �; " � TEST PIT LOCATION
01f Al0V 129 /9j;e ,may SEWAGE DISPOSAL SYSTEM
l ! I' /A JFOR
SEPTIC TANK � L— C C
- � E�U ER ..:
❑ DISTRIBUTION BOX
,. c f IE R S V,l`A)
NOW-
4 C. I . PIPE u /- ( -
FF j a cs f 1 i /"".I\`II f i s. N l
1 11 11tt 1 4 BIT. FIBER PIPE -TIGHT JOINTS SPOHR .� .• • .:ram .. ,�: r..r
-t + •to �.: ilG 4• .....
F - `1 '� — -- -- PROPERTY LINE <',r DESIGNED C D SPOHR DATE/9 Lc DRAWING N0.
f )F MIN. CODE DISTANCE / DRAWN: S CA L E'.A S S H� W N
MAP SEC PCL LOT HORSE CHECKED C D S
_-- _ - 52,c TYPICAL SYSTEM PROFILE
AREA _____ PLAN FDN TOP FINISH GRADE= � 1,00
� ---- N O T TO S C A L E
SCALE : I -
�; ,00 ` / FINISH GRADE OVER TANK= - Uc'� FINISH
L O T� 16 }�'I T"i.. �'7 rl
�1"..tom. ,::> V����jr 2 � � l� S. F . , GRADE OVER 1 P I T= ��• 00
/� / c r/{/�sl 48oC PVC OR : . • I . • • • a
M O O/ V L! R I J �l ��/ / / l i�'`3 -o�IC 1/ �4 7, 7 0 O e
C. I . TEES
'7Cl� ��7�� � • . • • 1 • • o
v, TOV', Al ��'�� ,��� AT- TtiF 5frE BSM'T
�I /,�J GJ ,�, -oo 0 0 e o 1 • • • 1 0 0
t FLR �`a.GO' / Q0 GAL. 4 e C�7-7 2-5' � 1 • ► 1 0 • � • 1 0 ° a e
REINFORCED DIST. BOX --- e ► e • • • • o o a a 0
CONCRETE -8 TO BE INSTALLED ON ° ' ' ' • ' ' ° ° ' I
.:
A LEVEL STABLE BASE ° ° • • / 0 1 ° °
• e o • • • • o o • o e
SEPTIC TANK 12f(i"x5,d, x -9, .4" o e ► °
1 TO BE INSTALLED ON A ROTOrJ00 ST 1500
LEVEL STABLE BASE op-, �C�laAl _ c
• e o • • • • 1 • 1 e °
Z 2"-1/8'L 1/2 "WASHED PEASTONE ALL • ' ' ' '
� - BRICK aMORTAR COURSES AS AROUND FREE OF IRONS, FINES
N REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE
LEACHING PIT
24 "C.I . MANHOLE COVER d - 3/4 " TO 1 -112 "WASHED CRUSHED
\ FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL
PLACE, FINES AND DUST IN
?h
FOR FIN. GRADE
kb a J SEE SYSTEM PROFILE SOIL AND PERCOLATION
;z Pry J _ Oil-
of
4,1 - DATA
L _ O - _ --- 8" PERC. RATE ' � r MIN.�IN.
-•F a 3 15 b p t 4 " FOR INV. ELEV SEE
! s �7kvE�Yr TAKEN BY : C. D. SPOHR
j srok-� d . }1 INLET ° ; SYSTEM PROFILE
CAP i LINE o D6 /�"//c
�,� RP, Q fi fit ! _ ° D OPENINGS W/4 I, D WITNESSED BY:
sc' I OUTER DIA. 8e 1 -3/4 _ o DATE :
PRIcGfSrCo+�C.xE :'� i l✓oo ' y,4 �O L'► 7, DI D °. TEST ,PIT-GND ELEV. + 1, 7-�
' JI s , ° - L e.
' AREA °-u 3 - ;• _ i-0/-1.All
Y ccA . ter ;� �. -- O i • � ` a - o D o D 5 9D _5G 0 -.
FrY / — � - • . ° - ► � _ `:--. — I �..
;�.te�F - _' 7 �,... o o o T r� L►nt�ks o o -+ ° ,f��' o�C' wA r
_ n 1R'jf i o ,
,,,...y...... o =D7�� W L ? _ ;° : _- o o o'fi' ti,c.E; STA o o o C�<12Sj OROW)Q
_.1-- �./ '� t j -- •-, "o ., _ o o D p
6 6 DIA.
��-� ;N f T� .1 p , / BOT. PERC. HOLE
7 N a x ;
�,� / � >==��:-�:_�-••-••�*- f� EFFECT 1 V E DIA.
f - DOWN -1=
LEACHING PIT - SECTION
t
NO SCALE DESIGN DATA : f
NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM
N0. OF BEDROOMS
4<- DISPOSAL !
LEACHING PIT NOTES. EST. TOTAL DAILY EFFLUENT '-' GALS.
•-� I . CONC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANK - �_ `..` GAL.
EJV T""f=�L. ! �!� �°'�F" f._C�T' G ��S'[.1�-b'F�l� �""�, �,,.� � ' �:-. •,�.15���1.r� fc�� ��1"�`,' GF' �►
Bc-k-1 ' 2 7 / 2. R E I N F W' 6 " x 6 " 6 GA. W. W. M.
3. 2 AND 4 SECTIONS ARE AVAILABLE FOR GENERAL NOTES
-- GREATER DEPTH REQUIREMENTS
I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
NOTE . EXCAVATE TO ELEV. OR LOWER AS ACCORDANCE WITH TITLE OF THE STATE SANITARY CODE
- DATED JULY 1,1977 8, ANY LOCAL RULES APPLICABLE.
REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPRD- IN
MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR.
WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILL.ING,
COMPACTED IN PLACE. NOTIFY THE ENGINEER AND BOURJ OF HEALTH FOR INSPECTION.
SIDE AREA = 3" S. F.0 S. F./GAL 910 GALS
4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.
BOTTOM AREA= 1C-'f S. F@ S. F/GAL 1 GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
TOTAL AREA = .5 29 S. F. TOTAL 1 ��-=� GALS APPROVAL BY CHARLES D. SPOHR.
LEGEND 6. FOUNDATION INSPECTION READ. WHEN EXCAVATED.
OWNERS
� BI , I LDERS: AkE-A, PLAN - + 50.0° EXIST. GROUND ELEV.�/ �1 , \ J lJ f� PLAN :
V
_ 50.0' FINISH GROUND ELEV,"UNDERLINED" I ''/�` IFE_h.' 7 REJts>Mt�3 6EG�'�''-,.,t k , �G TO 8 5,R,RESIOr=
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1 ! 4750� PIPE INVERT ELEV. REV DATE DESCRIPTION
0 TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM
� �S'`:� FOR
0 SEPTIC TANK r-
C -ARK FLYNN BUIl_ CLRS
❑ DISTRIBUTION BOX LOTOI ` P I CF IER'S MAY
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,1 .r Arf'� S , MASS .
I i I I H- 4 BIT. FIBER PIPE - TIGHT JOINTS
' JPOI~LLt DRAWING N0
i DESIGNED. C.D.SPOHR DATE:/` '' [)EC, 'tH
�-- ` =. - -- - PROPERTY LINE , �F 40 ./� i
' � � No. 74.68 `� 7
j I .94 /!o �.'s �� ?; tN' /' DRAWN'
SCALE:ASSHOWN ( '
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MAP SEC PCL LOT HOUSE `� =�
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