HomeMy WebLinkAbout0225 STRAIGHTWAY - Health 225 Straightway
Hyannis
A=268 -224
a
TOWN OF BARNSTABLE
LOCATION csto� 5� LG14T okAEWAGE# : DO&
VILLAGE ASSESSOR'S MAP
j&PARCEL
INSTALLER'S NAME&PHONE NO. � �% �� S08 40
SEPTIC TANK CAPACITY 2 Qo
LEACHING FACILITY-(type ® �� (size) .
NO.OF BEDROOMS
OWNER
PERMIT DATE: h9 1Z COMPLIANCE DATE: .
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility oe 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
360 feet of leaching facility) Feet
FURNISHED BY
s �
THE COMMONWEALTH OF MASSACHUSETTS FEE
_ BOARD OF HEALTH
O w KI o f ?xpt,r n s 46 1 C'
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct ( ) Repair Upgrade ( ) Abandon ( ) - ❑Complete System Individual Components
aas 51-Rg4C4 4 . 14Y140MIS j?ICH/-i,2D Nic.goc.s
9(8 f a j;Z y Location q7 (3n^JCLv6 5T Owner's Name
Map/Parcel# Address
pi,LCI s. fi,4' 6)0 0541
Lot# Telepho e#
Nolw,es qzn MC.G ry.-��, , I"c
r s Name De' er's Na e
Add
ka /�DYji(I r /�
Telephone#
Type of Building: C[W e, 1 it Lot Size 10 1p m Sq.feet
Dwelling—No.of Bedrooms 3 Garbage Grinder ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.required) 330 gpd Calculated design flow 3_31L gpd Design flow provided 3(oto gpd
Plan: Date �: R'71 2011 Number of sheets oL Revision Date
Title_FPLAIU_ dF MZ010056D SE-PVC SYSTEM UPaRADU
Description of Soil(s) 6-IU" FC L /O� Iq L 1Q-5�8� B Y8-/.70, C sad IXl�t'p In
Soil Evaluator Form No. Name of Soil Evaluator L• C4V*r%L1 tro Date of Evaluation 4./Z 7/Zo 11
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
1
Signed Date
Inspect
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
No. ---THler COMMONWEALTH OF MASSACHUSETTS' 9 FEE
BOARD OF �HE�ALTH
OF 4
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
i
Application for a Permif"to Construct ( ) Repair (X Upgrade ( ) Abandon ( ) - ❑Complete System Individual-Components
� N YA N M i S )�Ic Hxitet> Nlc Notes
/a 9 Location 417 7,4e L sT Owner's Name
i t0 C!
Map/Parcel# Address
Lot# Telephone# •
i P()IV"PS 0.nc� MCCle�th �nC,
I taper's Name De'g er's Na e Oj
/ Addre — Address
So
Telephone#
Type of Building: d w e 1 I it C Lot Size 1,O, ;Z 5�o Sq.feet
Dwelling No.,of Bedrooms Garbage Grinder t
g ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow min.required) 330 gpd Calculated design flow 3 3 g P gpd
Plan: Date ep+• 3-7, a011 Number of sheets a Revision Date
Title PCAN OF Pi20903tD -5 PT/C 3YSTEM UPC-ijZ-AFL
Description of Soil(s) U FIU 1 FLC /y - /9 A4 6- 4,Y' 5
Soil Evaluator Form No. Name of Soil Evaluator L C Q r l r u Date of Evaluation 9'/2 7/ZO I 1
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of/
I� TITLES and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health:
Signed z- l.l �' Date �� "-2
Inspects J/
i
I.
p
Gi
FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 fir,
j NO.iz� T E COMMONWEALTH OF MASSACHUSETTS FEE
BOARD OF HEALTH 1
I
CERTIFICATE OF-COMPLIANCE.
Description of Work: ❑ Individual Component(s) ❑Complete System
The undersigned hereby certify that Sewage Disposal System;Constructed( ),Repaired( Upgraded( ),Abandoned( )
by:
at
has been installed in accordance with the provisions of 310 C 15.00 (Title 5) and the approved design plans/as-built
plans relating to application NA9l1 396dated �O�/I ht< Approved Design Flow �530 (gpd)
r '
InstallernA 1\1V JIq I
Designer: r I Inspector Date
. !d
The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
No. t TtIJE COMMONWEALTH OF MASSACHUSETTS FEE
I
-). t'a 10 BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to Construct ( ) Repair (G--�Upgrade ( ) Abandon ( ) an individual sewage
disposal system at J ? `� r �r��.%�Gri�-�.ir /—/�l �i��i as described
in the application for Disposal System Construction Permit No. �/1 ,dated �U
Provided: Construction shallYbe co )pleted within three years of the date this per it I oca conditions must be met.
Date ! / Board of He th
FORM 2 - DSCP DEP APPROVED FORM 5/96
FORM 1255 (REV 5/96) H&W Homs&WARREN TM PUBLISHERS- BOSTON
Town of Barnstable
o_IWEram, Regulatory Services
ti
�. Thomas F. Geiler,Director
CAB .MASS. Public Health Division
9
�Ar 039" p �
Thomas McKean Director
f0 Mpl
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: */4/ Sewage Permit# 00113g0 Assessor's Map/Parcel a(p8 o?oZy
Installer& Designer Certification Form
Designer: 11olmes Q.. o� AL 61zk,fh. ra Installer:
Address: 36,2 (jz,t t/d Address:
On /0. /1_ // U✓f ( II axu Di n. -e` was issued a permit to install a
(d te) (installer)
/
septic system at z?tr VN/ h ywwms based on a design drawn by
/ ,�/ (a ress)
'1101me5-on �/c&D-Alit lnc dated Selot 077 c?0// & r'evt5ea( 101eill l
(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. Stripout (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations..Plan revision or
certified as-built by designer to follow. Stripout(if.required) was inspected and the soils-
were found satisfactory.
- v RAUL w
LIZARDI-RIV£RA
ns all Sign ur NO. 46345t
cnnL
�{D/ yola�S
�ION►lfN�
(Designers Signature) (Affix Designers 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:\office forms\designercertification form.doc
10/03/2011 10:49 508-548-9672 HOLMES AND MCGRATH PAGE 02
•i
Town of Barnstable P 1 qA!!,--
Department of RegWatory Services
Public Health Division Date_
ie79 200 Main Street,Hyannis MA 02G01
Date Scheduled ''� F Time 41Feeid.-
Soil Suitability Assessment far Sewase Disposal
Performed By: ! 4 Witnessed By: ' V
LOCAT1ION& GENERAL INFORMATION
Location Address a o?+� St%►(S�T , ��Q n n r S owner's Nerne R t C H R e D N 1C.Ht74 S
J i!— Address 47 6zWkIE S7
MILLIS, N6 OAD 5`''
Assessor's Mapr arcel a L� Engineer's Name
NEW CONSTRUCTION __... REPAIR Telephone# .5'0$ 3S(a '
Land Use re5i t' 6,770-1 slopes(°10) f + a $Itrikce Stones A10
Distances from:.Open Water Body�ft Possible Wet Area_eft Drinking Water-Well =,ft "
Dttinagc Way 8 Property Line ft Other ft.,•
SKETCH:(Stteet name,dimensions oflot,exact locations oftest holes&pem tests,locate wetlands in proximity to twlss)
`fit
C.AULC-WICK LAN
Parent niaterial(geologic) �7►Lt!_lk 0ijt�l/�1'�4� Depth t4 Bedrock
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method uycd;
Depth Obwrved'standing in obs.hole: __. _f/Z_" in. Dept♦,to soil mottles:
„�,,irt_
I>eptb to weeping from,side of obs.hole: in. Groundwatm Adjustrr=t ... ' . ft.
index Weli#H Zl Reading Date: $2011 Index Well level,ALA's—t— Adj.factor 3..6 Adj,Groundwater Leval .Q
PERCOLATION TEST Date z II Time Vv
10/03/2011 10:49 508-548-9672 HOLMES AND MCGRATH PAGE 03
Distances from;.=Open Water Body f Possible Wet Area @ Drinking Water Wed
Drainage Way— _ it Property Line __ L5* ft Other f ,$
SKETCH:(Street name,dimensions of lot,exact locations oftem holes tit pew tegr,locate wetlands in proximity to.holes)
t 4,
r
t
CANDL l (C Y- LAAe r _Zz
•,) -�
Parent Material(geologic) Depth to Bedrock
1
Depth to Groundwater. Standing Water in Bole:_ _'./I'� Weeping from Pit Face _
Fairnated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: ��
Depth Observed standing in ohs.tole: #2 io. Depth to$oil mottles:� m.
Depth to weeping from side of obs•hole: _- in. Groundwater Adjustment __g
Index Well 4011W-29 Riming Date:S r911 Index Well level AZ Ad_f4oter 3,5 +
j Adj,Gmttttdwaret'Level—
PERCOLATION
PERCOLATION TEST Da"'71M 11
Observation
Hole# Time at 9"
Deptb of Pert: Tune at 6"
Start Pre-soak Time Q Time(9"-6")
End Pre-soak 11:4f ��f�
Rate MinJlncb —Y7Rh 2 Mpl
Site Suitability Asseasnzat: Site Passed . Site Failed:—_. Additional Testing Needed(Y/N)
Original: Public Health Division Dbsemdoxt Hole Data To Be Completed on Back••----------
***If perrrnlation test is to be conducted within 100'of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beWasing.
Q;\SEPTIC\PERCFOR.M.DOC
10/03/2011 10:49 508-548-9672 HOLMES AND MCGRATH PAGE 04
DEEP OBSERVATION HOLE LOG Role#_
DepW from Soil Horizon Soil Texture Soil Color Soil Other
Sufte(io,) (USDA) (Munsell) Mottling (Strata tulle,Stems,Bauklerg,
o Gravel
�-- Z.,
f3 L, satw YKGto--
°
of, rt sand
DEEP OBSERVATION HOLE LOG Hole# 2-
Depth from Soil Horizon Sol]Texture Soil Color Soil Other
Surface(ia.) (USDA) (Munsell) Mottling (Structure,Stones,l3Duldem.
� ililL�
Lam, ► ---
Said
Gr jf��r Z� 7.51+1Z �G �r5rk7 �
DEEP OBSERVATION HOLE LOG Hole#_
Depth from Soil Horizon Soil Texture Soil Color .Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,)3<nalderr.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Boil Horizon Soil Texture Soil Color Soil Other
Surface(in,) (USDA) (Munsell) Mottling (Structure,Stories,Boulder,.
Ye1L„—,
Flapd 10mrance Rate Mat):
Above 500 year flood boundary No x Yes '
Within 500 year boundary No ✓ Yes
Within 100 year flood boundary No✓ Yea
10/03/2011 10:49 508-548-9672 HOLLMES AND MCGRATH �,o� PAGE 05
Around 4ey' C? lt2_" `—
]DEEP OBSERVATION HOLE LOG Hole# _ T
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munseil) Mottling (Structure,Stones,33uldeis.
%Grrfel)
DEEP OBSERVATION HOLE L06 Hole#
Depth from soil Horizon Soil Texture Soil Color Sail Other
Surface(in.) (USaA) (Mansell) Mottling (Structure,Stones,Moulders,
Flood Insurance Rate Man:
Above 500 year flood boundary No_ ,. Yes.
Within 500 yearboundary No Yes
Within 100 year flood b=dary No it Yet
Depth of Natontly Osxarrirta Peirvlous Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughaut thie
area proposed for the soil absorption systeto7 y�
If not,what is the depth of naturally oecurriang pervious zzzaterial?
Cextificadon
I certify that on I (date)I have passed the soil evaluator examination approved by the
Department of Enviroarriental Protection and that the above analysis was performed by me consistent with
the required training,expe 'se and jxpenience described in 310 CMR 15,017,
Signature Date
Q:\SFP'l 0PERCF0RM,DOC
10/03/2011 10:49 508-548-9672 HDLMES AND MCGRATH PAGE 06
Permit Number: ___Date. � 1!
Completed by:
HIGH GROUND-WATER LEVEL COMPUTATION
Site Location: 2.49_r. � �f 16 J�� IS Lot Na.. l'
Owner:
.I ti Address:
Contractor: Address:
Notes: '
STEP 1 Measure depth to water table
to nearest 1/10 ft. . ...... 7II� T
.............. ............ ... ......._............., .. Date
mcfnth/d sylyear
STEP 2 Using Water-level Range Zone
and Index Well Map locate
site and determine:
Appropriate Index well................................................. 1'I1W�
Water-level range zone.........................................
STEP 3 Using monthly report"Current
Water Resources Conditions"
determine current depth to
water level for index well ��
monthlyear
STEP 4 Using Table of Water-level Adjustments
for index well (STEP 2A),Current depth
to Water level for index well (STEP 3),
and water-level zone(STEP 2B)
determine water-level adjustment
STEP 5 Estimate depth to high water
by subtracting the water-
level adjustment (STEP 4)
from measured depth to water
level at site(STEP 1) .............
.................. .,...._ ... .�
Figure 13.—Reproftlble computation form.
15
COMMONWEALTH OF MASSACHUSETTS
�Q EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS .
{ t DEPARTMENT OF ENVIRONMENTAL PROTECTION
t
TITLE 5 ..?
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: �a 5 Sit
Owners Name: GLtv��S S2
Owner's Address:
Date of Inspection:- f
Name of Inspector:(please print) W i 11 i am F:_ -Robi nson Sr.
Co:mpanyName: William E. Robinson Septic Service
Mailing Address: P O Box 1 089
Centerville, MA ' .
Telephone Number: t!jti81 775-8776,
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP
approved.system inspector pursuant to S on 15340 of Title 5(310 CMR 15.00%. The system:
asses
Conditionally Passes
Needs Further`E -on by the Local Approving Authority
Fails �
Inspector's Signature: Date: 14 c,A00C7
The system inspector shall'submit a copy of"inspection report to the Approving Authority(Board of Heatth for
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of I0,000
gpd or greater,the inspector and the system owner shall subunit the report to the appropriate regional office of the
DEP.The original should be seat to the system owner and copies-sent to tire-buyer,if applicable,and the approving
:..::.:. authority. z
Notes and Comments
"This report only describes conditions at the time of inspection and under the conditions of use at that
time_This inspection does not address how the system will perform in the'.future under the same or different
conditions of use_
Title 5 Inspection Form 6/15/2000 page I
1
Page 2 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:
Ly"V'\t
Owner. �Q � S
Date or Inspection: ;p
Inspection Summary: Check A,B,C,D or El ALWAYS complete all of Section D
A. Syste asses:
I have not found any information which"indicates that -
an of the
Y failure critcrta d I5.303 or in 310 CMR l estribed us 3I0 C1VIR
5.304 exist_Any[allure criteria not eval'ua red arc mdicated below.
Comments:
B- System Conditionally Passes: / l
One or more system components omponents as des
c ibed in the"Conditional pass"section need to be replaced or
repaired.The system,upon completion of the replacement or r
. epair,as approved by the hoard of Health,will pass.
Answer yes,no or not determined(Y,N,T1D)in il�e
explain. for the following statements.If`not determined"please
� -
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent gym will ass ins
existing tank is replaced with a complying septic tank as approved by the god of Health. P pection if the
•A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box ilue toFb,oken o
obstructed pipes)or due to a broken,settled or unevert distribution box.S r
approval of Board of Health): System will pass inspection if(v tfi
broken pipe(s)are replaced
vbsttuction is rcmgved
distribution box is leveled or replaced
ND explain:
The system required Pumping more than 4 limas a year due to bn)kca or obsutv:trd pis).The system will
Pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction isIMOvod
ND explain:
Page 3 of 11
OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: S{ 2:1•t
. uv t S
Owner-
• ( O5e
Date of Inspection: 1, c7aoo F" ,
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(i)(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 So feet of a bordering vegetated wetland or a salt marsh
' r
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the r '
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
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 I 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 front a
private water supply well" Method used to determine distance'
•'This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other:
E 3
Page 4 of 1 i
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: aDs- S SR C 0C-
Owner: 'JQ.u�Uc M t C7S
Date of Inspection: /J - 4 el
D. System Failure Criteria applicable to all systems:
You must indicate'*ycs"or"no"to each of the following for all inspections:
Yes Now
�' backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
_ Dlschargc or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
'clogged SAS or cesspool
Static liquid level in the distribution box above-outlet invert due to an overloaded or clogged SAS or
✓cesspool
liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow
_/.Required pumping more than 4 times in the last year.NOT due to clogged or obstructed pipe(s)_Number
/of times pumped
_ _✓ Any portion of the SAS.cesspool or privy is below high ground water elevation.
� 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 I 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 f^_et from a private water
supply well with no acceptable water quality analysis.(This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free.from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.l
(YeslNo)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: �!/ V
To be considered a large°syst Ehe system must serve a fac►!iaty with a design flow of 10,000 gpd to 15,000
gpd-
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
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 diuiking water supply
the system is located in a nitrogen sensitive area Interim Wellhead Protection Area—I WPA or a mapped
Zone 11 of a public water supply well
If you have answered"yes"to any question in Section E die system is considered a significant threat,or answered
"yes"in Section D above the large system has fatted.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 oi-vner should contact the appropriate regional office of the Department.
4
Page 5'of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIOMFORM,
- . PART B
CHECKLIST r
r
Property Address. aa5 �,
- O,"�tl�`�
Owner: 3 0 '\.QS
Date of Inspection:
Check if the following have been done.You must indicate`yes`°or"no"as to each of the following:
Yck"No z
—/ — PP mping information was provided by the owner,occupant,or Board of Health
-i/ Were any of the system components pumped out in the revious-two weeks? -
- P ,
'Has the system received normal flows in the previous two week period? h,
Have large volumes of water been introduced to the system recently or as part of this inspection?..
Were as built plans of the system obtained and examined?(If they were not-available note as N/A)
TWas the facility or dwelling inspected for signs of sewage back up?,
— Was the site inspected for signs of break out? h
✓ r 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? t .
_✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Y�es/no
no
to 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)13 10 CMR 15.302(3)(b)]
. ,
i
' t 5
Page 6 of 11
OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:
Owner:
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design)-- -3 Number of bedrooms(actual): .-$
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms), .]-��
Number of current residents:
Does residence have a garbage grinder(yes or no):
Is laundry on a separate sewage system(Y4s or no):.MD [if yes separate inspection required)
Laundry system inspected(yes or no): LV A
Seasonal use:(yes or no): AC
Water meter readings,if available(last 2 years usage(gpd)): �� ��
Sump pump(yes or no):A10
Last date of occupancy. 3 >0
COMMERCIALINDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):_
Non-sanitary waste discharged to the Title 5 system(yes or no):_
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: p+-•.ncr _ei-at ;
Was system pumped as part of the inspection(yes or no):yet`
If yes,volume pumped:4TP gallons—How was quanti- pumped determined? Size .t4
Reason for pumping: 4i.-AA fz cis
TYCOF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
Overflow cesspool
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank Attach a copy of the DEP approval
_Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no): r�.L
6
I i
I'agc 7 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Properly Address: �"
�t✓►'1 n t S � � .
Owner: "`SS 12CS
DAtc of Inspection: f/t3'a�Li
BUILDING SEWER(locate on site plan)
Depth below grade:
rst
Materials of construction:,cast icon —,6 PVC agtcr(explaut):
Distance from private water supply well or suction line:
C ttmcnts(on condition of juutis,venting,evidence of leakage,cic.):
lux
SEPTIC TANK:—(locate on site plan)
Depth below grade: .
Material of construction: Jcoactcic_metal fiberglass Jtolyctltylene
_othcr(cxplain)
If tank is meta)list age: Is age conftnned-by a Certificate of Compliance(yes or no):_(attach a coil),of
certificate)
Dimensions: �e"1z32�
Sludge depth:
Distance from top of sludge to bottom of outlet ice or baffle: —'
Scum thickness:
Distance front top of scum to top of outlet Ice or baffle:
Distance from bottom of scum to bottom of outlet tee or baRle:
I low were dimensions determined:
Comments(on pumping tccontmendatioas,inlet and outlet ice or baffle eondition, structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
G .a di 4 A4.t t
�w 1 F�1.� j CY�rKT S7�PY'� �i► q�i Gc i...i� 4ri '�L--.IBC.Z
Aj !r
GREASE TRAP:_(,Ttocatc on site plan)
Depth below grade:_
Material of construction:_concrete`metal_fiberglass_polycdtf•Ienc other
(explain):
Dimensions:
Scum Iltickrtcss:
Distance from top of scum to top of outlet ice or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
(:ottunents(on pumping recommendations,irtict and outlet tee or baffle cunditiva,structural integrity,liquid levels
as related to outlet invcn,evidence of leakage,etc):
7
: 8of11
OFFICIAL. INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFOIMATION(continued)
perty Address:
n e r: �Ca �—
c of losptctloa: s{ j j_�; •�;
'I IT or I[OLD ING TANK:°�!'(tark trust be pumped at time of inspection)(locate on site plan)
A below grade:
.erial of construction: concrete_nietal fiberglass_polyethylene other(explaul):
tensions:
lacity: -alluns
ign Flow: gallonstday
rm present(yes or no):
rm level: Alarm in working order(ycs or no):
c of last pumping:
iuncros(condition of alarm and float switcltcs,ctc.):
STIUBUTION BOX: '� (if present must be opcocd)(locatc on site plan)
pill of liquid level above outlet invert: 0 it
nunents(note if box is level and distribution to outlets equal,arty evidence of solids carryover,any evidence of
kaS�t^�ntv�}r out of box,ctc.):
11UP CHAMBER: locate on site plan)
nips in working order(yes or no):
arms in working order(yes or no):
munents(note condition of pump cha(liber,cundition of pumps and appurtenances,etc.):
-Page.;9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART•C t
SYSTEM INFORMATION(continued) `
Property Address: aas S +
Owner: Se_
Date of Inspection:
SOIL ABSORPTION SYSTEM(SAS):Zoocate on site plan,excavation not required)
If SAS not located explain why:
T}�leaching pits,number: I 1C1L:.1
teaching chambers,number:
leaching galleries,number.
leaching trenches,number,length:
leaching fields,number,dimensions:
overflow cesspool,number
innovativetaltemative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil.condition of vegetation,
etc.): t
.7 AL'H..' (Jt 4 ke ' 4A,
g, cF its:- by
T
CESSPOOLS:/V1`(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 or no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY:Lizte on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Continents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
9
Page 10 of 11
OFFICIAL INSPECTION FORM`NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
Owner: �1 Cyw-\-e_S M. 1 Q
Date of Inspection: 411 10.1aw.
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building.
l�
n
V�Lu
t �
UP is 174;
f d' 35,,6
A-3�
sus
, --y 3s 'c "
10
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: aaS- sty', "
—
�CLor\t 5
Owner.J Ct/—LQ S O`L .
Date.of Inspection:
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed.-
Observed site(abutting property/observation hole within 150 feel 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:
u:k! wiCf 2`S CF�� �l y� ��i L3GL'�Y� { /���-^�+ Br lr"ItAi bu
PJWJU i.e- cJ C LR 7L1.:r .�irti. tip- LYt, in C'-'Mix
— roe/,.a, �F,
I1
TOWN OF BARNSTABLE
LOCATION �' � S -+�ILZ SEWAGE #
VILLAGE Ia ,n�S ASSESSOR'S MAP & LOT G
INSTALLER'S NAME PHONE NO. A664f-61 6W1Gwa'
SEPTIC TANK CAPACITY 1600
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR P,UB .I . WATER
BUILDER OR OWNER UIM
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: Laz_ /
VARIANCE GRANTED: Yes No C�
-�r
c�`
T
.� ��;
tP , ' \,
t
� �
.__
NO.�........... ..::�
�at�ecv"�0�1 Depar rre t
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
�� TOWN OF BARNSTABLE
igne.d Data
Appliratiou for Di;ipwial Work.6 (nomitrurfinn Vautit
Application is hereby made for a Permit to Construct ( ) or Repair ( �anndividual Sewage Disposal
S st at: `
-•y- ------ -••------------ - •. ------•------------•----•--------•----•-------------------------•--------••-•--•---...------.....
�c: inn-Address i
� ��------ - ------------------------_--------- •... S------- -----.-----------.......
Installer Address
14
VType of Building Size Lot............................Sq. feet
..� Dwelling— No. of Bedrooms_________ _________________________________Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
A' Other fixtures ----------------- ------------ --
W Design Flow................................. .... gallons per person p day. Total aily flow..__� ...........................gallons.
WSeptic Tank—Liquid capaciri t __gallons Length....... ..... Width__ ___...._ Diameter................ Depth................
x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................mmutes per inch Depth of Test Pit.................... Depth to ground water........................
fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Gd
ODescription of Soil........................................................................................................................................................................
x
x •--•--------------------------- -•-----•----._._._..._.....•-------------------------------------•-•-----••-- .......
U Na e of Re air AJte atio s sw�er a ap licable,� _ -f"�.�----- - ._
t (�
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal'System in accordance with
the provisions of TITLE 5 of the State Environmental Code —T e undersigned further rees not to place the
system in operation until a Certificate of Compliance has be e by the G
Signe ....... ..... . ......-y��--------- --------- . ........ ..............)Q.:::6
Application Approved By ..... .<.........�r,���' -'�G.,-• '-�.--...................... ............................................ .........
Date
Application Disapproved for the following reasons: ...................................... ............................................................ ..................
....... ................ ... ................................... ........................-
Permit No. ....` Issued
Dare
- FEs... .....
THE COMMONWEALTH OF MASSACHUSETTS
S
BOARD OF HEALTH
TOWN OF BARNSTABLE
, pphration for Diripwiat.,lVork.6 Towitrnrtiun Vamit
Application is hereby made for a Permit to Construct' ( ) or Repair ( an Individual Sewage Disposal
System� S�Y�ICl�tG� l rl
Loc,tion• \ddress V t
•••---.m...._..G e - _.-- e2 -•-•-••-••• .....
t�s-ncr -���-
w oh .t l l� 9e r X y Z laud s. 02 C�ya�
a .. _.
------ -••-•--•------ -•-_...
Installer Address !
UType of Building Size Lot............................'jSq. feet '
►-t Dwelling— No. of Bedrooms.......3------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
d Design Flow•Other fixtures,../1----------gallons per person per day. Total aily flow- �30........................__ gallons. 4I
W
WSeptic Tank—Liquid capacitv._10 gallons Length---.--�j...... Width---------------- Diameter................ Depth................
x Disposal Trench--No. .................... Width.................... Total Length...................... Total leaching area. .................sq. ft.
�. Seepage Pit No--------.---_------ Diameter.................... Depth below inlet----------- -____. Total leaching area-,.'-.._.._.._....sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
1.4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water....................
frq Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
a --•------•-----------------•----------------------•--------•------------•-------._....-•---..........._..---._.;.............----...-•••-:_._.....----_..._.
0 Description of Soil....................................................................................................................................-..................................
U
U Nature of Repairs or Alterations—A isw�er w en applicable. ..�a._l.4iC ._.�66.6 � .--� r.....
y ` < =�-7- !_7`---/Z11.... = __IU-.............-...... ------------------------------------------------------- ..............................
Agreement:
. The undersigned agrees to instalLthe aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—the undersigned further al rees not to place the
system in operation until a Certificate of Compliance has beenissued by the boar. _of healt.hi
f
Signed .:.:....... ... .. .�t7
1 ........ .. Dace 1 -
Application Approved B -.-_. . ..� . . ..................
f ✓. .`-� �
f
PPPP Y ...-... -G ..................... ...... .. ..... ..... .......�.
Application Disapproved for the following reasons: ......................................... ...................... .. ......................................................
..._.............................................. . .. . . . .....--...........--................................................... ......... ........................................
.r' ce
Permit No. ._�..* ..." ..-r ......�� ... Issued -...-.._"-.. `�._ _ .�' .
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Cfe>r#tftca#e of Cgootlatiance
THIS IS TO CER' I Y, That the,%ndividual Sewage Disposal System constructed ( ) or Repaired
_ .-.-...... ..._..... P/........
.... . -d� /
by .............. �✓.f L/I -
Instu�lcc
at _..... ��kst
. . .... . ..- .. ... -...---- ------.....has been installed in accordance with the provisionsof TITLE of TIte Environmental Code as described in
the application for Disposal Works Construction Permit No. dated .. .... _ --
t . THE ISSUANCE OF THIS CERTIFICATE SHALL NO B CONSTWU A AS A GUA � "NTEE'THAT TH
d
tSYSTEM WILL FUNCTION SATISFACTORY.
DATE--------------------_....... .. 1........) '.. �- ~CL.�...,7.. ....... _. Inspector ---------------.........?.. ��............ ---------------.-----.--_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF
HEALTH f
TOWN OF BARNSTABLE
No.. FEE.....7
�t��n��t1 nrk� �un�trnrtilan �rrmit
Permission is hereby granted....--------.--- ....f ' � .,/-._.`-._ 1 ���` �
to Construct ( ) or-Repair (�an Individual Sewage Disposal System
atNo.•--•...-••-•--••••-••-••--�= �........ lh✓ �U y--------------- it/7/ ------ ...........................................
street �-
as shown on the application for Disposal Works Construction Pei mit 1 4. :_ G1��Dated...Z�' --_-
�1 ..............................
.....-----•---•............. Board of Health
DATE---- •-%----`�,.,�-t-•---�-------------------
FORM 36506 MOBBS at WARREN.INC.,PUBLISHERS
.� 28
c- F 11. 1 1. I I N/F OV
JOHN J. & MARTHA L. DURCALST
�A< , CONTRACTOR SHALL EXCAVATE 5' ALL AROUND THE 239 STRAIGHTWAY Mq�N m
LEACHING FACILITY AND DOWN TO THE SAND LAYER. •50+49"E ST N
y� REMOVE ALL UNSUITABLE MATERIAL AND REPLACE N53
WITH CLEAN GRANULAR SAND CONFORMING WITH THE 2•6q `� -� ��o rQ 10lk
SPECIFICATIONS SET FORTH IN 310 CMR 15.255. S61 53 51 W
S69.20'17"W S62.57'56"W 42.04'
1 � •
22.34' - 30.29
¢6
G _ �o � � CN RO � MARSTON
w
, I .,3 � � � � � BEA AVE I Z CLEARIN h ° RP\0���
00- of I �o
004v LOCUS
5 T i o. 63 I n� �`' Off` 462 p .........
10' MIN -'' i._ . I•i�v p0 o .... _
- �+ �1= PROPOSED MONITORING PORT. I �� ' m �'
1 I ONE PER EACH BED. SEE DETAIL. i JE�� p
,�tii CENTERVILL�'= :.. :::::::...
HARBOR ::�::
I 11 I PROPOSED SOIL ABSORPTION I p� ! w o -0
1= I r SYSTEM. TWO BEDS OF 12-QUICK4 I
CHAMBERS EACH (26.5'x5.7').
CB/DISK LOCUS MAP
PUMP ELECTRIC CONDUIT. LOCATION o ' i FOUND w5 Z NOT TO SCALE
1 1 TO BE DETERMINED ON THE SITE. -+
N 1 4h 4 r 24 9'
cn z 46 ' v
'° DEEP BORING HOLE LOG NO. TP-1
� e � APPROXIMATE LOCATION m •„� � �
n v �,; I • =- i i 21 / OF WATER SERVICE. rn 'l7
�p
CID 20 MIN.
�m p C:!
�� SOIL SOIL TEXTURE SOIL COLOR SOIL (STTRUMRRES,
5 STONES, BOULDERS,
a• �► QJ
�"N Ri -f-r':--.- -�- -.•-t LOT DEPTH ELEV. HORIZON (USDA) (Munsell) MOTTLING CONSISTENCY, X GRAVEL
�s ' "F. r-15 TOTAL AREA o r_ �= 0 46.5
1 $, ILA , I �m
o 10,296f S.F. ' n 0"-29" 44.1 FILL
4
. . .:.. 66 8.5 EXISTING HOUSE 01p,bl Z O
ss I to "
N J 29"-42" 43.0 A SANDY LOAM
b I` o G O 42"-57" 41.8 B LOAMY SAND 10 YR 4/6 10% GRAVEL
n N I CO PROPOSED 1,000 �, rn'
o to 12 GALLON PUMP THRESHOLD N O
of I"o _ CHAMBER y - N ELEVATION _ 49.2 W 57"-120" 36.5 C MEDIUM SAND
_ ' 2.5 YR 6/4 LOOSE
'P r NO GROUND WATER TABLE ® 120"
:1 {��
:-.-
�- 34�,
46 I -j . EXISTING SEWER T _
DEEP BORING HOLE LOG NO. TP-2
(... - •. I �'�: APPROXIMATE.LOCATION OF
EXISTING SEPTIC-:TANK. N53.5049"E OTHER
.o�'
CONTRACTOR SHALL PUMP DRY, •8 6 __ _ _. _ v I I X R sTRuc
REMOVE AND RESET AS NEEDED. , 24 i� o� - - SO L SO L TE TU E � LOR. .SOIL
DEPTH ELEV. HORIZON (USDA) w(Munsell) MOTTLING
C) APPROXIMATE LOCATION 'y p AVER OR��
STONES, BOUIDETtS,
w P� CONSISTENCY, X GRAVEL
-. I•' 1 i 1�- OF:EXISTING'D=-BOX. .: 4) - GAS METER 0 46.0
REPLACE WITH NEW.
LO
( 0"-10" 45.2 FILL
N.I 1 I ; == :�\ APPROXIMATE LOCATION OF P,
- EXISTING LEACHING PIT. 10"-19" 44.4 A SANDY LOAM GRAVEL BASE
TP CONTRACTOR SHALL PUMP DRY, ?, " �. YR 4 10% GRAVEL
4�:. ( 1 I •� •� ) :: REMOVE AND DISPOSE OFF-SITE. w 19 -48 42.0 B LOAMY SAND 10 /6
- I wI
�� i I 48"-120" 36.0 C MEDIUM SAND 2.5 YR 6/4 7.5 YR 5�6 LOOSE
.:. I •COI I - '�/ •• •/ #1 � Ni � 7.5YR72
p 1 I 1 "``T�� N I ( < GROUND WATER TABLE ENCOUNTERED ® 112" DEPTH / REDOX ® 92" DEPTH
UNSUITABLE SOILS AROUND EXISTING ��, o CB/DISK o
LEACHING PIT SHALL EXCAVATED AND 4 .9 4 ,% FOUND
t ~ _ REMOVED OFF-SITE. CONTRACTOR SHALL SOIL TEST
10' MI1V. FO. ` REPLACE WITH CLEAN GRANULAR SAND CATCH BASIN
••-��j•Z- �' RIM = 47.54 Date' of soil test: 9/27/2011
.- Iwo CONFORMING TO TITLE 5 ?PECIFICATIONS. v Test taken by. L. CARREIRO
CB/DH 48
o c�F I I CB/BROKEN Results witnessed by. DONNALD DESMARAIS
FOUND •- q'f'ir�G 8438' STOCKADE FENCE FOUND t Percolation rate: < 5 MIN./IN. IN "C" LAYER
.�� Ground water GROUND WATER ELEV.`°36.7
N65'59'48"E �H OF Mqs� ADJUSTED (3.5 FT.) HIGH GROUND WATER ELEV. 40.2
r ' o
PAVED SIDEWALK /o MICHAEL y
:. B.
_ 10/4/11 REVISE SEPTIC DESIGN, ADD PUMP CHAMBER RLR
1 o MCGRATH --q
No.36813 co
49.46 EDGE OF PAVEMENT BERM � , J �o wQ DATE DESCRIPTION Drawn hecked
BENCHMARK: CATCH BASIN R E V I S 1 0 N S
RIM = 47.39
r
TOP OF CONCRETE BOUND
ELEVATION = 50.00 PLAN OF PROPOSED
(DATUM ASSIGNED) CANDLEWICK LANE SEPTIC SYSTEM UPGRADE
co (PUBLIC - 40' WIDE) ' PREPARED FOR
NOTES RICHARD D. & LISA K. NICHOLS
O ES GRAPHIC SCALE FOR LOT 1, #225 STRAIGHTWAY
CATCH BASIN t,
1. HOUSE NUMBER: 225 STRAIGHWAY RIM 47.56 IN
2. ASSESSOR'S NUMBER: MAP 268 PARCEL 224 0 10 5 0 10 30 HYANNIS BARNSTABLE, MA
3. ZONING DISTRICT: RB EDGE OF PAVEMENT - ERM
4. FLOOD HAZARD ZONES: C ( n1 ter ) �, � r
SCALE. 1 = 10 TDA SEPT. 27, 2011
1 inch = 10 ft. e n
5. TOPOGRAPHIC INFORMATION BASED ON AN � .
ON ,THE GROUND INSTRUMENT SURVEY.: CB/DH NOTICE h of m es and m c rath, inc.
Unless and until such time as the original (red) stamp of the �', �sfl
6. ELEVATIONS SHOWN BASED ON AN ASSIGNED DATUM. FOUND res onsible Profes •a al ine clvll engineers and lan surveyors t
• P
7. THIS PROPERTY IS LOCATED IN A DEP 'APPROVED ZONE 11. appears on this plan: Eng or Professions! Land Sur a or 362 ifford . street 208
08 548-3564(PHONE) �? �� Kr
Y
(A) no person or persons, including any municipal or other folmouth, ma. 02540 548-9672 FAX
8. REFERENCE: PLAN BOOK 240, PAGE 15 public officials, may rely upon the information contained herein, and
PLAN BOOK 331, PAGE 58 (B) this plan remains the property of Holmes & McGrath, Inc. DRAWN: RLR CHECKED: v /"✓
PLAN BOOK 506, PAGE 3
N NICHOLS 211143 211143 .dw JOB NO: 211143 DWG. NO.: 88-1-98 ISHEET 1 OF 2
_ - -
PUMP CALCULATIONS
3" Min. ALL OUTLET PIPES FROM THE 16.5" CONCRETE DESIGN FLOW = 330 GPD
4" aEANOt/T CAP WITHIN DISTRIBUTION BOX SHALL BE 5 - 5" OUTLET COVER DOSE VOLUME: 80 GALLONS
3" OF RNISHED GRADE SET LEVEL FOR AT LEAST 2 FT. KNOCKOUTS " .;• ,.•:-:• ;`; • : 10.7 C.FT.
PROPOSED 1/2" REBAR 4" SOLID O O O O ; 7r
-
OR METALLIC TAPE PVC PIPE ••' �' �1 iINLET TOTAL DYNAMIC HEAD:
TO LOCATE AV FUTURE ' \ 15.5" OUTLET \ J \ _ STATIC HEAD:
o 0
m DBOX INLET INVERT ELEVATION, D inv = 46.12
" �; W PUMP CHAMBER BOTTOM ELEVATION, C bot = 40.55
_ 9 " STATIC HEAD, Hs = (D inv - C bot) = 5.6 FT.
12" O O O O FRICTION LOSSES:
Contractor shall install MINOR LOSSES (FITTINGS) EQUIVALENT PIPE LENGTH:
.. ..
20" a 2" tee horizontally NO. EQ. LENGTH/FITTING EQ. LENGTH
PLAN SECTION at and of force main. CROSS-SECTION TEE 1 11.5 = 11.5 FT.
34" CHECK VALVE 1 14 = 14.0 FT.
ELBOW 7 5.4 = 37.8 FT.
TYPICAL MONITORING PORT INSPECTION PORT 5 HOLE DISTRIBUTION BOX ALARM LIGHT GATE VALVE 1 1.25 = 1.25 FT.
NOT TO SCALE 52" SCALE: 1" = 1" ENLARGEMENT 1 2.4 = 2.4 FT.
EQUIVALENT LENGTH FROM FITTINGS, Lf = 67 FT.
PLAN VIEW LOCATION OF DELIVERY PIPE FORCE MAIN LENGTH, L = 12 FT.
DESIGN CRITERIA CONTROL BOX TO TOTAL EQUIVALENT LENGTH OF PIPE, Lt = L + Lf = 79 FT.
48" Number of bedrooms 3 Equivalent to 330 gal.'s/day BE DETERMINED FRICTION TOTAL HEAD LOSS, Hf = 2.4 FT.
(EFFECTIVE LENGTH) Garbage disposal .unit: NO AT THE SITE. TOTAL DYNAMIC HEAD 8 FT.
Leaching area - capacity required: 330 gal.'s/day* It AL/}RM SRA1LL BE
" Infiltrators leaching area per linear foot: 4.72 sq. ft./linear ft.* I�"/� d PUMP REQUIREMENTS:
12 Proposed length ,of Infiltrators: .104.8 ft.* W1 RED To SEPA'RATE Ipl FLOW GPM 30 GPM
6 _ Total area proposed: 495 sq. ft.* GtRCU1T FRAM FLINT'S.
TDH (FEET) 8 FT.
Proposed leaching capacity. 366 gal.'s/day
CONTROL PANEL
Water supply. TOWN
" _ Precast concrete structures: H-10 loading rate
INSTALL IN READILY PUMP SELECTION:
r� 34 __ _= __ _____=__ *Quick4 Standard Chamber Bed Configuration (4.72 s.f./Lf.) ACCESSIBLE LOCATION MYER DISCHARGE PUMP MODEL SSM33, 1/3 HP. OR APPROVED
EQUAL (1.5" VERTICAL DISCHARGE).
END CAP VIEW SIDE VIEW ►-------- 8__6-_ � CONTRACTOR SHALL SUPPLY ENGINEER WITH PUMP CURVE
INFILTRATOR SYSTEMS INC. -- -- _ AND SPECS. PRIOR TO INSTALLATION FOR APPROVAL.
ALL ACCESS MANHOLE COVERS FOR 2-20" Diameter
TYPICAL QUICK4 STANDARD CHAMBER SEPTIC TANK, DISTRIBUTION BOX, F Access Holes I
FLOATS SHALL BE HUNG AND LEACHING STRUCTURE SET MORE
1k GENERAL NOTES
SCALE: 1" = 1' FROM STAINLESS STEEL THAN 6" BELOW FINISHED GRADE, 0
11
BARS MOUNTED WITHIN SHALL BE RAISED TO WITHIN 6" OF is 1) No change to this system shall be made unless
18" OF THE COVER. FINISHED GRADE. STEEL REINFORCED i approved in writing by holmes and mcgrath, inc.
QUICK4 STANDARD TYP. SLIDE RAILS SHALL BE PRECAST CONCRETE - _� 2) Subject to inspection during construction by the
FINISH GRADE ( ) Board of Health and holmes and mcgrath, inc.
FILTER FABRIC BACKFILL COVER MATERIAL AVAILABLE FOR USE. FRAME & COVER INLET TOU:ii
T 3) Heavy construction equipment shall not travel
N& OVER "T'S" over disposal system during or after construction.
3' MAX BURIAL y�l������� � \��\�� \�\ ��f��%���� % PLAN VIEW FLOATS. SEE 4) Disposal system to be constructed in accordance
with Title 5 of the State Environmental Code.
9" MIN BURIAL
PRECAST CONCRETE Remgvable Cover Cover SCHEDULE TABLE
-� '_w�.:.t.,;..� r,,-: „�.�, -�A::-,.. DEPTH TANK RISER Set 6 fromgrade clearance p on the site
TH VARIES '
a 5) A copy of these plans must be kept
-III z *:-... .. _ "•6 N ;during the time of .construction.
to rode
N _ 6 `'' `•�- I 1 3� 6 A co of these plans must be furnished to the
1 I II M•" ''''� ;.. 11- = 4" GATE VALVE , contractor constructing the disposal system.
BOTTOM ELEVATION=45.20 � INLET ' - 9 p �
N 2 min. inlet „
" _ - - 1 r to outlet 2 PVC FORCE MAIN 7) Before backfillin , the contractor shall notify
r� 5*-8" - BACK ILL WITH NATIVE CAUTION I - o -�l -DISCHARGE PIPE Agent to inspect the system as constructed.
6'-8" SAND TEXTURE MATERIAL. t PUMP ELEVATION �£� � 1 4ys INVERT IN - 44.55 ) y
da 8 If the contractor encounters an variation between
r THIS IS A CONFINED SPACE. E�i Liquid i SCHEDULE of -E-� --ALARM 1/8- BLEEDING HOLE the existing conditions shown on the plan and the
SOIL ABSORPTION SYSTEM CROSS SECTION (BED SYSTEM Do NOT ENTER WITHouT 1 level ACCESS COVER RIM 47.5 I1 - orl S.S. LIFTING CHAINS conditions encountered on the site, or any soil
FOLLOWING OSHA CONFINED ; i 1 INVERT OUT 44.55 �� i OFF BREAKAWAY / LIFT condition different than shown on the soil log, or
NOT TO SCALE SPACE ACCESS REGULATIONS. :r J 1 i ALARM FLOAT 42.80 1 J 1 OUT FITTING any adverse soil, the contractor shall immediately
_+ PUMP ON 42.05 + CHECK VALVE
L PUMP OFF 41.55 1 _J 3 contact holmes and mcgrath, inc. Holmes and
_.
mcgrath, inc. will examine the soil condition
4_4"_ 1 CHAMBER BOTTOM 40.55 1 8'-0' 1 S.S. SLIDE RAIL PIPES P Y 99
PUMP TDH 8 FT. F-�- -� and report to the owner an suggested revisions.
END-SECTION PUMP FLOW 30 gpm CROSS-SECTION
STORAGE ABOVE ALARM 1.4 days
Contractor shall core new outlet on the side of the
existing tank to the some elevation as the existing /► NOTICE
outlet. Use non-shrink mortar to seal the existing TYPICAL 1,000 GALLON SEPTIC TANK (11-10 LOADING) Unless and until such time as the original (red) stamp of the
outlet and around new outlet pipe. Contractor shall responsible Professional Engineer, or Professional Land Surveyor
also install new Zabel filter in new outlet tee. SCALE: 1/4" = 1' appears on this plan:
Finish grade above and adjacent to system shall slope away at a min. of 2X (A) no person or persons, including any municipal or other
public officials, may rely upon the information contained herein; and
ID 20'min. distance (building to edge of leaching system) (B) this plan remains the property of Holmes & McGrath, Inc.
3 10' min. distance (building
In to pump chamber) "
4 diam. cast iron or Schedule 40 PVC pipe (tight joints). INSPECTION PORT TO BE
50 10/3/11 ADD PUMP CHAMBER DESIGN, REVISE ADJUSTED HGW RLR
........... ............................ ..................................
LeBaron Foundry Model LA-266 Contractor shall install a 2". tee WITHIN''C OF FINISH 'GRADE
Frame and Cover or equal. horizontally at end of force main. 47 Of (TYPICAL OF 2) DATE DESCRIPTION Drawn hecked
E isting Ground 47.5t
77
//. /, /. /. \\ go MIN.i/i//i�/i R E V I S I 0 N S
PVG 2' 4"PVC Pipe 3 MAX. Clean Bockfi//
4"PVC f 2Main s /ems/ 8 L.F. s=0.02 min. E/ev.= 4620 CONSTRUCTION DETAILS OF PROPOSED
12 L PWofd =~."_ Y=..
s s=0.01e u =' _
- -- ---- --4- .f/.:. _mil- -�� :l - ....---- .
___u I��L_ x SEPTIC SYSTEM UPGRADE
'- ---------- _
45 _ -
T
C
_ PREPARED FOR
xi tin af
a a
-0
E s 6 /a-
9 r Proposed �•� J '%nsta// End Co %nsto// End Co
Septic Tank crushed
eP 1,000 Gallon �. - _ = RICHARD D. & LISA K. NICHOLS
Q To Remain p compacted
,5,FT: FOR LOT 1, #225 STRAIGHTWAY
Pum Chamber
ra Zabel filter q �� %m �° � ( HIGH IN
W model A1800. u� x I GROUNDWATER
BARNSTABLE MA
1� c\ t 9.2 FT. ELEV. 40.2 HYANNIS
40 -� CONTRACTOR SHALL EXCAVATE 5' ALL AROUND THE
Hold Existing Invert C 3'p LEACHING FACILITY AND DOWN TO THE SAND LAYER. I SCALE: AS SHOWN DATE: SEPT. 27, 2011 �
REMOVE ALL UNSUITABLE MATERIAL AND REPLACE I °<•�
.Z Ss9c
To be verified prior y WITH CLEAN GRANULAR SAND CONFORMING WITH THE
to construction for " SPECIFICATIONS SET FORTH IN 310 CMR 15.255. I holmes and mcgrath, inc. 6 ry cHr-E�
6 layer of crushed compacted stone � e,
positive slope. civil engineers and land surveyors ; o tip. N U
BOTTOM + OF TEST PIT
� ' ' 362 gifford street 508 548-3564(PHONE � 3s 1141
3
Existing Septic Tank 5 Pump Chamber 12 D-Box f0 Soiy Absorption System
...... ................................ ........................ ...... ...... ............ .... ... ........ ............ ............ .. . falmouth, ma. 02540 508 548-9672(FAX)
w 35 NOTE . . ...... .
EXISTING INVERT SHALL BE VERIFIED BY CONTRACTOR PRIOR TO CONSTRUCTION. SEPTIC PROFILE DRAWN•.
RLR CHECKED:
DESIGN ENGINEER SHALL BE NOTIFIED OF ANY DISCREPANCIES.
*EXISTING D-BOX OUTLET INVERT MEASURED AT ELEVATION 44.8t. SCALE: 1/4" = 1' N NICHOLS 211143 211143 .dw JOB NO: 211143 DWG. NO. 88-1-98 SHEET 2 OF 2